Hepatic Encephalopathy in Cats
Is a severe liver disease that has some very chilling effects

Hepatic encephalopathy in cats, also known as HE, is a degenerative disease that affects your cats brain as the result of severe hepatic insufficiency associated with advanced liver disease.

It is best known as a condition that causes abnormal mental disturbances in your cat, as well as altered states of consciousness.

It can also cause neurological functions to become impaired.

This condition also occurs in humans, but in cats it is slightly different.


With cats, this condition is usually associated with advanced liver disease.

However, it is most often seen when the blood in your cat has become diverted or shunted around their liver.

This is referred to as portosystemic shunting, as blood is diverted around the liver as the result of a congenital shunt that is present.

However, this is not always the case, as the shunt can also be acquired.

If this is the case, it is than considered secondary and the result of a long term liver disease.

As a result of either of these causes, your cat’s liver cannot detoxify the blood properly, and because of this, the toxins reach their brain.

Once the toxins are in the brain, it can rapidly alter their personality.

Other types of severe liver disease can also lead to Hepatic encephalopathy in cats, but it is widely held that portosystemic shunts are the actual cause.

In fact, it is estimated that over 90 percent of all cats with portosystemic shunts will develop this condition and begin to show the very chilling signs.


Green eyes in catsYour cats diet must be changed if you are to win the battle

Hepatic encephalopathy in cats will show you several symptoms; both neurological as well as what are referred to as clinical manifestations.

There are numerous theories as to what causes the neurological signs, but most all experts agree on one major cause; ammonia.

The liver in your cat converts ammonia into urea, and when the liver is unable to complete this task properly or if the blood contains high levels of ammonia, it bypasses the liver because of the shunt.

It than circulates in very high levels in the blood stream, affects the brain, which in turn causes the symptoms.

The first set of symptoms that you will begin to see will be depression that is very quickly followed by a drastic change in your cat’s personality.

Once this occurs, your cat may also start to drool, which is always a real warning sign. From here, the symptoms become much more severe.

Your cat may begin to pace and circle continuously which will soon develop into staggering and rapid weakness.

Their head and muscles may start to tremble, but this is not just shaking. The only way you can properly describe trembling, is to actually witness it.

But it still gets worse, as your cat may also fall into a stupor, have seizures, go partially deaf and blind, and then go both totally blind and deaf.

Because Hepatic encephalopathy in cats can become so devastating, it has been assigned a grading system.

The grading system is similar to that in humans, but it has been modified specially for cats.


The grading system for Hepatic encephalopathy in cats has been modified and is graded on a scale of one to four.

Understanding this grading system and then seeking medical attention as quickly as possible may save your cats life as this condition can be revered.

Grade one is where your cat starts to show listlessness as well as depression.

You will also begin to see their personality changing slightly and they will begin to appear mentally dull almost like they are in another zone.

However, the sign that you may notice first in this stage is your cats suddenly urinating excessively.

In stage two, things start to become much worse, as your cat is now becoming uncoordinated, disorientated, and they will begin to pace and circle in a compulsive manner.

They will also begin to show signs of blindness, run into objects, and start to salivate and drool excessively.

In stage three, they may fall in and out of stupors as well as experience seizures. Stage four has only one real symptom; a coma.


Hepatic encephalopathy in cats has several very effective treatments, but the backbone of any of the forms of treatment will be your cat’s diet.

Cats with HE will need to have their diets modified immediately, and the biggest change will come with the protein intake.

Reducing the amount of protein is critical with this condition. If you are feeding your cat a raw diet, you will have to reduce the protein levels.

If you feed commercially, there are diets specially formulated with lower protein levels. One example is Hill’s Science Diet Prescription Diet L/D.

Removing the actual cause of Hepatic encephalopathy in cats is also critical.

However you will need to discuss this in depth with your veterinarian and seek a second opinion if you do not like the answer.

There are several drugs that require metabolism by the liver, and in this situation, they should be totally avoided.

They can have severe effects on your cat so it is very important to ask the right questions concerning treatment.

Infections will also need to be addressed, usually by antibiotics.

Bacterial infections in your cats intestinal tract help to generate the ammonia build up as well as the toxins that generate this condition.

The most effective way to combat bacteria is with antibiotics.

Lactulose, which is a synthetic sugar, is also extremely effective.

It helps to acidify the colon when given orally, and then traps the ammonia and other forms of toxins in the colon.

By doing this, it prevents them from entering into your cat’s bloodstream and naturally releases the toxins in your cat’s feces, where they are excreted.

This form of treatment, if not recommend, should be requested.

However, most all veterinarians will use this as part of the treatment process. Surgery is also an option, and it is extremely effective in completely eliminating the believed cause; the shunts.


Hepatic encephalopathy in cats is an extremely dangerous condition, but it is also one that can be treated and reversed.

If you see any of the symptoms, the quicker you react, the better chance your cat will have of surviving this attack on their life.    

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