How do you treat HPN in cats? - briefly
Treating hepatic portal venous obstruction (HPN) in cats typically involves a combination of medical management and supportive care. This may include anticoagulant therapy to prevent further clot formation and manage any existing blood clots, as well as providing a low-protein diet to reduce the workload on the liver.
How do you treat HPN in cats? - in detail
Hepatic portosystemic shunts (HPN) in cats are abnormal connections between the portal and systemic circulations, bypassing the liver. This condition can lead to various clinical signs, including neurological abnormalities, gastrointestinal issues, and stunted growth. Treatment of HPN in cats typically involves a combination of medical management and surgical intervention.
Medical management is often the first line of treatment for HPN in cats. This approach aims to reduce ammonia levels in the blood and manage clinical signs. Medications such as lactulose, which acts as a prebiotic to promote beneficial gut bacteria, can help lower ammonia production. Additionally, antibiotics like neomycin or metronidazole may be prescribed to alter the gut microbiome and reduce ammonia levels. A low-protein diet is also crucial in managing HPN, as it helps minimize the production of ammonia from protein breakdown.
While medical management can alleviate symptoms and improve quality of life, surgical intervention is often necessary for long-term resolution. The most common surgical procedure for HPN in cats is attenuation or ligation of the shunt. This involves reducing the size of the shunting blood vessel to restore normal blood flow through the liver. Surgical success rates are generally high, with many cats showing significant improvement after surgery. However, post-operative care is essential, including monitoring for signs of recurrence and maintaining a low-protein diet as advised by the veterinarian.
In some cases, endovascular coil embolization may be an alternative to surgical ligation. This minimally invasive procedure involves placing coils into the shunt through a catheter, which promotes clot formation and reduces blood flow through the shunt. While this technique can be effective, it is not always available in all veterinary facilities.
In conclusion, treating HPN in cats requires a multifaceted approach that includes medical management to control symptoms and surgical intervention for long-term resolution. Close collaboration with a veterinarian experienced in feline hepatic disorders is crucial for achieving the best possible outcomes.