Читать книгу Canine and Feline Epilepsy - Luisa De Risio - Страница 88

Renal-associated encephalopathy can occur in animals with acute or end-stage chronic renal failure (uraemic encephalopathy), following haemodialysis (dialysis disequilibrium syndrome) or renal transplantation (post-renal transplantation encephalopathy). As for hepatic encephalopathy the pathogenesis of renal-associated encephalopathy is complex and incompletely understood. Neurological signs may result from accumulation of uraemic toxins, altered balance between excitatory and inhibitory neurotransmitters, as well as acid-base, fluid and electrolyte abnormalities. Parathyroid hormone (PTH) disturbance may also play a role in the pathogenesis of uraemic encephalopathy. In addition, hypertension secondary to renal disease may lead to intracranial cerebrovascular accidents (O’Brien, 1998). Dialysis disequilibrium syndrome is thought to be caused by an osmotic gradient between the brain cells and the extracellular fluid due to excessively rapid haemodialysis, which results in cellular swelling and cerebral oedema. Post-renal transplantation encephalopathy (resulting in seizures, stupor, ataxia and central blindness) has been reported in cats and it is most likely associated with uncontrolled hypertension (Kyles et al., 1999). Uraemic encephalopathy has been infrequently reported in dogs with renal failure (Wolf, 1980; Fenner, 1995).