Successful use of haemoperfusion therapy in an adult horse with hepatic encephalopathy and cholangiohepatitis

Summary A 4‐year‐old, 520 kg, American Quarter Horse broodmare, approximately 90 days in foal, was presented to Texas A&M University Teaching Hospital for suspected liver disease. Based on clinicopathological values and hepatic abnormalities noted ultrasonographically, the mare was presumptively diagnosed with cholangiohepatitis. The mare developed hepatic encephalopathy while hospitalised. Due to the rapid progression of disease, therapy with haemoperfusion using a polymer‐based column was implemented. The mare tolerated the treatment well, showing immediate improvement in mental status and marked improvements in bilirubin and ammonia concentrations, liver enzyme values, continued fetal viability and ultrasonographic findings prior to discharge. To the authors' knowledge at the time of submission, this is the first clinical report of haemoperfusion for hepatic encephalopathy in large animal medicine. This modality should be considered a potential adjunct therapy in the management of equids with severe hepatic compromise.