Retrospective Report of Improvement Following Treatment With Intravenous Lipid Emulsion Therapy in Two Puppies With Hyperammonemia and Signs of Hepatic Encephalopathy Refractory to Conventional Therapy

OBJECTIVE: To describe the adjunctive use of IV lipid emulsion (ILE) therapy in the medical management of two dogs with hepatic encephalopathy (HE). Clinical signs in both cases and plasma ammonia concentration in one case were documented to have improved immediately after ILE therapy. SERIES SUMMARY: Two dogs were presented with signs consistent with HE and were initially treated with conventional therapy including lactulose, antimicrobials, anticonvulsants, and IV fluids. Clinical signs and ammonia concentrations initially showed no or minimal improvement. The patients were then administered ILE therapy, after which clinical signs improved and, in one case, hyperammonemia improved. NEW OR UNIQUE INFORMATION PROVIDED: To the authors' knowledge, this case series is the first report of improvement of clinical signs and ammonia concentration in dogs intentionally treated with ILE therapy for refractory signs of HE despite conventional therapy.