Successful management of clinical signs associated with hepatic encephalopathy with manual therapeutic plasma exchange in a dog.

Objective: To describe the use of manual therapeutic plasma exchange (TPE) to manage hepatic encephalopathy (HE) in a dog.

Case Summary: A 9-year-old neutered female Dachshund presented for HE secondary to a previously diagnosed portosystemic shunt. The hyperammonemia and severe clinical signs of HE persisted despite extensive medical management.