{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:13:43Z","timestamp":1776132823021,"version":"3.50.1"},"reference-count":46,"publisher":"American Veterinary Medical Association (AVMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2015,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective<\/jats:bold>\n                    \u2014To elucidate the relationship between plasma ammonia concentration and severity of hepatic encephalopathy and determine whether factors that precipitate hepatic encephalopathy in humans are associated with the presence of clinical signs of hepatic encephalopathy in dogs previously treated for the disease.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design<\/jats:bold>\n                    \u2014Retrospective case series.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Animals<\/jats:bold>\n                    \u2014118 dogs with hepatic encephalopathy.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Procedures<\/jats:bold>\n                    \u2014The medical records database of a veterinary teaching hospital was searched for records of dogs in which hepatic encephalopathy was diagnosed between October 1, 1991, and September 1, 2014. Hepatic encephalopathy severity was graded on a 5-point scale, and the correlation between disease severity and plasma ammonia concentration was determined. Respective associations between hepatic encephalopathy and systemic inflammatory response syndrome, gastrointestinal hemorrhage, dietary indiscretion, constipation, furosemide treatment, azotemia, hypokalemia, hyponatremia, alkalosis, and hyperammonemia were assessed by Fisher exact tests followed by multivariable logistic regression.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    \u2014Severity of hepatic encephalopathy at hospital admission was not significantly correlated with plasma ammonia concentration. Dogs treated for hepatic encephalopathy prior to hospital admission were significantly less likely to have clinical signs of the disease at hospital admission, compared with dogs that were not treated for the disease (OR, 0.36; 95% confidence interval, 0.17 to 0.78). None of the putative precipitating factors for hepatic encephalopathy were significantly associated with the presence of clinical signs of the disease at hospital admission.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions and Clinical Relevance<\/jats:bold>\n                    \u2014Results indicated that hepatic encephalopathy treatment alleviated clinical signs of the disease. Further investigation is necessary to identify precipitating factors for hepatic encephalopathy in dogs. (\n                    <jats:italic>J Am Vet Med Assoc<\/jats:italic>\n                    2015;247:176\u2013183)\n                  <\/jats:p>","DOI":"10.2460\/javma.247.2.176","type":"journal-article","created":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T10:26:11Z","timestamp":1435832771000},"page":"176-183","source":"Crossref","is-referenced-by-count":17,"title":["Putative precipitating factors for hepatic encephalopathy in dogs: 118 cases (1991\u20132014)"],"prefix":"10.2460","volume":"247","author":[{"given":"Jonathan A.","family":"Lidbury","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata","family":"Ivanek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan S.","family":"Suchodolski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg M.","family":"Steiner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"key":"ref1","series-title":"Hepatology","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1053\/jhep.2002.31250","article-title":"Hepatic encephalopathy\u2014definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998","volume":"35","author":"Ferenci","year":"2002"},{"key":"ref2","series-title":"Aliment Pharmacol Ther","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1111\/j.1365-2036.2011.04590.x","article-title":"Review article: the design of clinical trials in hepatic encephalopathy\u2014an International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) consensus statement","volume":"33","author":"Bajaj","year":"2011"},{"key":"ref3","series-title":"Am J Med","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/S0002-9343(02)01477-8","article-title":"Correlation between ammonia levels and the severity of hepatic encephalopathy","volume":"114","author":"Ong","year":"2003"},{"key":"ref4","series-title":"Res Vet Sci","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/S0034-5288(18)32352-X","article-title":"Arterial and venous ammonia concentrations in the diagnosis of canine hepato-encephalopathy","volume":"33","author":"Rothuizen","year":"1982"},{"key":"ref5","series-title":"Nat Rev Gastroenterol Hepatol","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1038\/nrgastro.2010.116","article-title":"Mechanisms, diagnosis and management of hepatic encephalopathy","volume":"7","author":"Prakash","year":"2010"},{"key":"ref6","series-title":"J Coll Physicians Surg Pak","first-page":"514","article-title":"Precipitating factors and the outcome of hepatic encephalopathy in liver cirrhosis","volume":"20","author":"Mumtaz","year":"2010"},{"key":"ref7","series-title":"J Ayub Med Coll Abbottabad","first-page":"58","article-title":"Precipitating factors of hepatic encephalopathy: experience at Pakistan Institute of Medical Sciences Islamabad","volume":"18","author":"Maqsood","year":"2006"},{"key":"ref8","series-title":"N Y State J Med","first-page":"2891","article-title":"Precipitating factors in genesis of hepatic coma","volume":"70","author":"Faloon","year":"1970"},{"key":"ref9","series-title":"J Hepatol","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1016\/S0168-8278(99)80144-5","article-title":"Prognostic significance of hepatic encephalopathy in patients with cirrhosis","volume":"30","author":"Bustamante","year":"1999"},{"key":"ref10","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"717","DOI":"10.2460\/javma.2004.224.717","article-title":"Ultrasonographic findings in dogs with hyperammonemia: 90 cases (2000\u20132002)","volume":"224","author":"Szatm\u00e1ri","year":"2004"},{"key":"ref11","series-title":"Vet Clin North Am Small Anim Pract","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/S0195-5616(95)50030-0","article-title":"Hepatic encephalopathy: clinical signs, pathogenesis, and treatment","volume":"25","author":"Taboada","year":"1995"},{"key":"ref12","series-title":"PLoS ONE","doi-asserted-by":"publisher","first-page":"e82303","DOI":"10.1371\/journal.pone.0082303","article-title":"Hyperammonemia and systemic inflammatory response syndrome predicts presence of hepatic encephalopathy in dogs with congenital portosystemic shunts","volume":"9","author":"Tivers","year":"2014"},{"key":"ref13","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1111\/j.1939-1676.2009.0327.x","article-title":"Soy protein isolate versus meat-based low-protein diet for dogs with congenital portosystemic shunts","volume":"23","author":"Proot","year":"2009"},{"key":"ref14","series-title":"Vet Rec","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1136\/vr.150.8.245","article-title":"Usefulness of systemic inflammatory response syndrome criteria as an index for prognosis judgement","volume":"150","author":"Okano","year":"2002"},{"key":"ref15","series-title":"Hepatology","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1002\/hep.510310107","article-title":"Partial pressure of ammonia versus ammonia in hepatic encephalopathy","volume":"31","author":"Kramer","year":"2000"},{"key":"ref16","series-title":"Ann Intern Med","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7326\/0003-4819-58-1-1","article-title":"Studies of the blood ammonia in liver disease. Its diagnostic, prognostic, and therapeutic significance","volume":"58","author":"Stahl","year":"1963"},{"key":"ref17","series-title":"Metab Brain Dis","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s11011-012-9278-x","article-title":"Dogs with congenital porto-systemic shunting (cPSS) and hepatic encephalopathy have higher serum concentrations of C-reactive protein than asymptomatic dogs with cPSS","volume":"27","author":"Gow","year":"2012"},{"key":"ref18","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1111\/j.1939-1676.2009.0408.x","article-title":"Whole blood manganese concentrations in dogs with congenital portosystemic shunts","volume":"24","author":"Gow","year":"2010"},{"key":"ref19","series-title":"J Small Anim Pract","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1111\/jsap.12196","article-title":"Whole blood manganese concentrations in dogs with primary hepatitis","volume":"55","author":"Kilpatrick","year":"2014"},{"key":"ref20","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1111\/j.1532-950X.1997.tb01699.x","article-title":"Evaluation of the sensitivity and specificity of diagnostic criteria for sepsis in dogs","volume":"26","author":"Hauptman","year":"1997"},{"key":"ref21","series-title":"Hepatology","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1002\/hep.23367","article-title":"Ammonia and the neutrophil in the pathogenesis of hepatic encephalopathy in cirrhosis","volume":"51","author":"Shawcross","year":"2010"},{"key":"ref22","series-title":"Vet J","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.tvjl.2014.01.007","article-title":"Plasma cytokine concentrations in dogs with a congenital portosystemic shunt","volume":"200","author":"Kilpatrick","year":"2014"},{"key":"ref23","series-title":"Am J Gastroenterol","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1038\/ajg.2009.293","article-title":"Hyponatremia is a risk factor of hepatic encephalopathy in patients with cirrhosis: a prospective study with time-dependent analysis","volume":"104","author":"Guevara","year":"2009"},{"key":"ref1","series-title":"Hepatology","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1053\/jhep.2002.31250","article-title":"Hepatic encephalopathy\u2014definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998","volume":"35","author":"Ferenci","year":"2002"},{"key":"ref2","series-title":"Aliment Pharmacol Ther","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1111\/j.1365-2036.2011.04590.x","article-title":"Review article: the design of clinical trials in hepatic encephalopathy\u2014an International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) consensus statement","volume":"33","author":"Bajaj","year":"2011"},{"key":"ref3","series-title":"Am J Med","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/S0002-9343(02)01477-8","article-title":"Correlation between ammonia levels and the severity of hepatic encephalopathy","volume":"114","author":"Ong","year":"2003"},{"key":"ref4","series-title":"Res Vet Sci","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/S0034-5288(18)32352-X","article-title":"Arterial and venous ammonia concentrations in the diagnosis of canine hepato-encephalopathy","volume":"33","author":"Rothuizen","year":"1982"},{"key":"ref5","series-title":"Nat Rev Gastroenterol Hepatol","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1038\/nrgastro.2010.116","article-title":"Mechanisms, diagnosis and management of hepatic encephalopathy","volume":"7","author":"Prakash","year":"2010"},{"key":"ref6","series-title":"J Coll Physicians Surg Pak","first-page":"514","article-title":"Precipitating factors and the outcome of hepatic encephalopathy in liver cirrhosis","volume":"20","author":"Mumtaz","year":"2010"},{"key":"ref7","series-title":"J Ayub Med Coll Abbottabad","first-page":"58","article-title":"Precipitating factors of hepatic encephalopathy: experience at Pakistan Institute of Medical Sciences Islamabad","volume":"18","author":"Maqsood","year":"2006"},{"key":"ref8","series-title":"N Y State J Med","first-page":"2891","article-title":"Precipitating factors in genesis of hepatic coma","volume":"70","author":"Faloon","year":"1970"},{"key":"ref9","series-title":"J Hepatol","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1016\/S0168-8278(99)80144-5","article-title":"Prognostic significance of hepatic encephalopathy in patients with cirrhosis","volume":"30","author":"Bustamante","year":"1999"},{"key":"ref10","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"717","DOI":"10.2460\/javma.2004.224.717","article-title":"Ultrasonographic findings in dogs with hyperammonemia: 90 cases (2000\u20132002)","volume":"224","author":"Szatm\u00e1ri","year":"2004"},{"key":"ref11","series-title":"Vet Clin North Am Small Anim Pract","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/S0195-5616(95)50030-0","article-title":"Hepatic encephalopathy: clinical signs, pathogenesis, and treatment","volume":"25","author":"Taboada","year":"1995"},{"key":"ref12","series-title":"PLoS ONE","doi-asserted-by":"publisher","first-page":"e82303","DOI":"10.1371\/journal.pone.0082303","article-title":"Hyperammonemia and systemic inflammatory response syndrome predicts presence of hepatic encephalopathy in dogs with congenital portosystemic shunts","volume":"9","author":"Tivers","year":"2014"},{"key":"ref13","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1111\/j.1939-1676.2009.0327.x","article-title":"Soy protein isolate versus meat-based low-protein diet for dogs with congenital portosystemic shunts","volume":"23","author":"Proot","year":"2009"},{"key":"ref14","series-title":"Vet Rec","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1136\/vr.150.8.245","article-title":"Usefulness of systemic inflammatory response syndrome criteria as an index for prognosis judgement","volume":"150","author":"Okano","year":"2002"},{"key":"ref15","series-title":"Hepatology","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1002\/hep.510310107","article-title":"Partial pressure of ammonia versus ammonia in hepatic encephalopathy","volume":"31","author":"Kramer","year":"2000"},{"key":"ref16","series-title":"Ann Intern Med","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7326\/0003-4819-58-1-1","article-title":"Studies of the blood ammonia in liver disease. Its diagnostic, prognostic, and therapeutic significance","volume":"58","author":"Stahl","year":"1963"},{"key":"ref17","series-title":"Metab Brain Dis","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s11011-012-9278-x","article-title":"Dogs with congenital porto-systemic shunting (cPSS) and hepatic encephalopathy have higher serum concentrations of C-reactive protein than asymptomatic dogs with cPSS","volume":"27","author":"Gow","year":"2012"},{"key":"ref18","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1111\/j.1939-1676.2009.0408.x","article-title":"Whole blood manganese concentrations in dogs with congenital portosystemic shunts","volume":"24","author":"Gow","year":"2010"},{"key":"ref19","series-title":"J Small Anim Pract","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1111\/jsap.12196","article-title":"Whole blood manganese concentrations in dogs with primary hepatitis","volume":"55","author":"Kilpatrick","year":"2014"},{"key":"ref20","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1111\/j.1532-950X.1997.tb01699.x","article-title":"Evaluation of the sensitivity and specificity of diagnostic criteria for sepsis in dogs","volume":"26","author":"Hauptman","year":"1997"},{"key":"ref21","series-title":"Hepatology","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1002\/hep.23367","article-title":"Ammonia and the neutrophil in the pathogenesis of hepatic encephalopathy in cirrhosis","volume":"51","author":"Shawcross","year":"2010"},{"key":"ref22","series-title":"Vet J","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.tvjl.2014.01.007","article-title":"Plasma cytokine concentrations in dogs with a congenital portosystemic shunt","volume":"200","author":"Kilpatrick","year":"2014"},{"key":"ref23","series-title":"Am J Gastroenterol","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1038\/ajg.2009.293","article-title":"Hyponatremia is a risk factor of hepatic encephalopathy in patients with cirrhosis: a prospective study with time-dependent analysis","volume":"104","author":"Guevara","year":"2009"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/247\/2\/javma.247.2.176.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/247\/2\/javma.247.2.176.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/247\/2\/javma.247.2.176.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T20:08:59Z","timestamp":1775765339000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/247\/2\/javma.247.2.176.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,15]]},"references-count":46,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.2460\/javma.247.2.176","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2015,7,15]]}}}