I took my dog to the veterinarian because her behavior had changed - she seemed “dull.” She was diagnosed with liver disease. What does this mean?
The liver is the second largest organ in the body and provides about 1500 critical biomechanical functions. The liver metabolizes medications, removes toxins from the body, and creates substances essential to life like the protein albumin and blood clotting factors. The liver is actively involved in nutrition as an intermediary to protein, carbohydrate, and fat digestion. Liver disease is one of the most challenging groups of conditions to treat and manage. The various conditions that can result in liver disease and damage include:
- Inherited portosystemic shunt (an abnormality of circulation through the liver)
- Chronic hepatitis
- Secondary damage from disease, drugs, or toxins
Because the liver can regenerate and has a large functional reserve, damage to the liver must be fairly severe and advanced before any clinical signs are seen. This means that a dog with liver disease may have suffered significant and longstanding metabolic imbalances before a diagnosis is made and a treatment plan created.
Obstruction of bile flow through the liver can lead to jaundice causing a yellow/orange tinge to the skin, mucous membranes, and whites of the eyes. Advanced liver disease can cause gastrointestinal toxins to bypass filtration by the liver resulting in that dulled mental ability. Advanced liver disease can also cause malnutrition through decreased appetite and abnormal nutrient digestion, absorption, and metabolism.
General medical treatment recommendations for dogs with liver disease include targeting the underlying cause whenever possible, and treating the symptoms. Intravenous fluids in the hospital may be needed short-term to set the stage for longer term therapies. Medications used to treat liver disease are often needed long term, possibly for life.
What role can nutrition play in treating her?
Nutritional management can be an effective strategy when used in combination with appropriate medical treatment (or surgery if required). The goals of nutritional management of liver disease focus on controlling the clinical signs as opposed to targeting the underlying cause. The nutrient profile should: maintain normal metabolic function; provide an adequate and highly digestible caloric density; avoid changes to mental function from toxins in the blood; support liver repair/regeneration; decrease further damage to the liver; and maintain appropriate levels of sodium, chloride, potassium, and the other biologically active minerals.
Your veterinarian will help you to choose the most appropriate nutrient profile for your dog based on the complexities of her liver disease. You will notice that the total protein content will be lower than regular dog food, but the digestibility and quality will be higher. This provides the body with adequate protein to support liver healing, but avoids excessive levels of protein waste that can affect mental processing. Because it is so important for these dogs to eat in order to heal, it will be important to prevent nausea in order to keep the dog from developing an aversion to the very food she needs to eat.
This seems quite complicated. Will my dog always have to eat a special food and take medication?
Managing liver disease in dogs is a complex process, and regular reassessments will ensure that your dog’s healing is moving in the right direction. You will monitor appetite, activity level, weight, and body condition. In addition, your veterinarian will need periodic updates of liver-related blood tests to evaluate the effectiveness of the treatment plan and the course of healing. Many dogs with liver disease can discontinue medications and eat regular life-stage maintenance food once their liver issue is resolved. That said, it all depends on the specific diagnosis. Dogs with chronic liver disease must generally eat a therapeutic diet and take some liver-support medication long-term. Your veterinarian will work with you to help you make the best decisions on behalf of your dog with liver disease.
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