J Vet Sci.  2016 Sep;17(3):431-433. 10.4142/jvs.2016.17.3.431.

Hyperammonemic hepatic encephalopathy management through L-ornithin-L-aspartate administration in dogs

Affiliations
  • 1Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea. hyyoun@snu.ac.kr
  • 2Department of Veterinary Internal Medicine and Institute of Veterinary Science, College of Veterinary Medicine, Kangwon National University, Chuncheon 24341, Korea. chungjinyoung@kangwon.ac.kr

Abstract

Seventeen dogs were treated with L-ornithin-L-aspartate (LOLA; experimental group). Three dogs were treated with lactulose recognized therapy (control group). Following LOLA administration, 15 dogs experienced a significant decrease in ammonia level (p < 0.05) and showed clinical signs of improvement. However, there were no clinical signs of improvement in two dogs, even though the ammonia level decreased. Conversely, the clinical signs of the control group also improved and the ammonia level decreased, although these changes were not significant (p > 0.05). These results suggest that LOLA is an effective drug to treat hyperammonemia in veterinary medicine.

Keyword

L-ornithin-L-aspartate; dogs; hepatic encephalopathy; hyperammonemia

MeSH Terms

Ammonia/metabolism
Animals
Dipeptides/*therapeutic use
Dog Diseases/*drug therapy
Dogs
Female
Hepatic Encephalopathy/drug therapy/*veterinary
Hyperammonemia/drug therapy/*veterinary
Male
Dipeptides
Ammonia

Figure

  • Fig. 1 Changes in ammonemia level before and after L-ornithine-L-aspartate (LOLA) intravenous administration in dogs with severe HE and mild HE (*p < 0.05, **p < 0.01).


Reference

1. Ahmad I, Khan AA, Alam A, Dilshad A, Butt AK, Shafqat F, Malik K, Sarwar S. L-ornithine-L-aspartate infusion efficacy in hepatic encephalopathy. J Coll Physicians Surg Pak. 2008; 18:684–687.
2. Blei AT. Diagnosis and treatment of hepatic encephalopathy. Baillieres Best Pract Res Clin Gastroenterol. 2000; 14:959–974.
Article
3. Czarnecki GL, Baker DH. Urea cycle function in the dog with emphasis on the role of arginine. J Nutr. 1984; 114:581–590.
Article
4. Gerber T, Schomerus H. Hepatic encephalopathy in liver cirrhosis: pathogenesis, diagnosis and management. Drugs. 2000; 60:1353–1370.
5. Häussinger D. Nitrogen metabolism in liver: structural and functional organization and physiological relevance. Biochem J. 1990; 267:281–290.
Article
6. Häussinger D, Kircheis G, Fischer R, Schliess F, vom Dahl S. Hepatic encephalopathy in chronic liver disease: a clinical manifestation of astrocyte swelling and low-grade cerebral edema? J Hepatol. 2000; 32:1035–1038.
Article
7. Jiang Q, Jiang XH, Zheng MH, Chen YP. L-Ornithine-L-aspartate in the management of hepatic encephalopathy: a meta-analysis. J Gastroenterol Hepatol. 2009; 24:9–14.
Article
8. Laflamme DP, Allen SW, Huber TL. Apparent dietary protein requirement of dogs with portosystemic shunt. Am J Vet Res. 1993; 54:719–723.
9. Meyer HP, Legemate DA, van den Brom W, Rothuizen J. Improvement of chronic hepatic encephalopathy in dogs by the benzodiazepine-receptor partial inverse agonist sarmazenil, but not by the antagonist flumazenil. Metab Brain Dis. 1998; 13:241–251.
10. Nusrat S, Khan MS, Fazili J, Madhoun MF. Cirrhosis and its complications: evidence based treatment. World J Gastroenterol. 2014; 20:5442–5460.
Article
11. Poo JL, Góngora J, Sánchez-Avila F, Aguilar-Castillo S, García-Ramos G, Fernández-Zertuche M, Rodríguez-Fragoso L, Uribe M. Efficacy of oral L-ornithine-L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy. Results of a randomized, lactulose-controlled study. Ann Hepatol. 2006; 5:281–288.
Article
12. Reagan-Shaw S, Nihal M, Ahmad N. Dose translation from animal to human studies revisited. FASEB J. 2008; 22:659–661.
Article
13. Sharma K, Pant S, Misra S, Dwivedi M, Misra A, Narang S, Tewari R, Bhadoria AS. Effect of rifaximin, probiotics, and l-ornithine l-aspartate on minimal hepatic encephalopathy: a randomized controlled trial. Saudi J Gastroenterol. 2014; 20:225–232.
Article
14. van Straten G, van Steenbeek FG, Grinwis GCM, Favier RP, Kummeling A, van Gils IH, Fieten H, Groot Koerkamp MJA, Holstege FCP, Rothuizen J, Spee B. Aberrant expression and distribution of enzymes of the urea cycle and other ammonia metabolizing pathways in dogs with congenital portosystemic shunts. PLoS One. 2014; 9:e100077.
Article
15. Wright G, Jalan R. Management of hepatic encephalopathy in patients with cirrhosis. Best Pract Res Clin Gastroenterol. 2007; 21:95–110.
Article
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