Particularly bizarre behavioral signs or loss of intellectual function, unpredictable bouts of aggression, staggering, pacing, circling, head pressing, blindness, deafness, tremors, seizures and coma may be seen. The cause of hepatic encephalopathy is now known, but probably is a result of toxins effecting the brain. Tobias reports, that ammonium crystals are seen in as much as 74 percent of reported cases. A routine urine sediment examination will reveal the crystals and the presence of the crystals is specifically distinctive or characteristic of the disease. It could be speculated that prior to onset of clinical signs, the majority of portal blood passed through the liver rather than the shunt.
Therapy can be medical or surgical.
Medical therapy helps to maintain a quality of life, but the disease will continue to progress and the animal will succumb to the disease. Successful surgeries can result in complete reversal of symptoms. Surgery is used to ligate the shunt flow that will redirect the blood through the liver. When blood is re-routed though the liver the pressure on the liver must be stable. Death from hypertensive shock will occur within 12-24 hours if the pressure is too high.