INTERNAL MEDICINE
need for protein for growth.
In these patients my approach is to maintain the highest protein diet I can get away with without getting
any neurological signs (a puppy diet or an adult gastrointestinal /maintenance diet), whilst adding the
other medications to reduce the ammonia such as
lactulose and metronidazole/neomycin.
If surgery is not an option for whatever reason, then
once the patient is adult, decisions can be made on
switching from controlling clinical signs of HE with
medical supplements to rather controlling them with
dietary protein reduction. Once again, unless HE is
present, dietary pro Z[