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.

ILE therapy improved clinical signs and ammonia in dogs with HE refractory to conventional therapy.

This case series describes the use of intravenous lipid emulsion (ILE) therapy as an adjunctive treatment in two puppies with hepatic encephalopathy (HE) that were refractory to conventional management. Both cases presented with clinical signs consistent with HE and were initially treated with standard therapies including lactulose, antimicrobials, anticonvulsants, and IV fluid support. Despite these conventional interventions, clinical improvement was minimal or absent. Following administration of ILE therapy, both patients demonstrated rapid clinical improvement. Additionally, plasma ammonia concentration improved in one of the cases. This case series represents the first documented intentional use of ILE therapy for managing refractory HE signs in dogs, demonstrating potential benefit as an adjunctive therapeutic option when conventional therapies fail to control clinical signs and hyperammonemia. The mechanism of ILE's benefit in HE management warrants further investigation.

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