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Liver disease in dogs

Health & Wellbeing

The liver is one of the most important organs in your dog’s body and carries out hundreds of different functions to keep your pooch in good health. For example, a healthy liver will remove toxins from their body, break down drugs, store vitamins, metabolise energy, create bile to aid digestion, and even produces proteins which enable blood clotting.

Liver disease in dogs

However, having so many different functions does mean your dog’s liver can be affected by a lot of different things. This amazing organ can become injured or ill in a number of different ways.

It’s particularly vulnerable to damage caused by toxins, because the liver is responsible for metabolising, storing, or detoxifying chemicals in your dog’s body.

Liver disease is a common condition in dogs, so it’s important to know what symptoms to look out for and what to expect if your dog is diagnosed. We’re going to cover everything you need to know about liver disease in dogs, from what it is, to what it does, and what can affect it.

What is liver disease in dogs?

Liver disease is not a specific disease, but it can be caused by diseases. Instead, liver disease is a bit like kidney disease, because it is actually the gradual loss of function in the organ.

Liver disease means that your dog’s liver isn’t working as well as it should, and some of the tissues of the organ could be degrading or dying.

Liver disease vs liver failure in dogs

The distinction between liver disease and liver failure isn’t a clear one and the terms are sometimes used interchangeably. Typically, liver disease refers to any sort of damage, tissue changes, or inflammatory disease affecting the liver, which often results in loss of function. Liver disease can progress into liver failure.

Meanwhile, liver failure is a significant loss of function or complete failure of the organ. For a dog to be considered to be suffering from liver failure, over 70-80% of the cells in their liver would have died.

Types of liver disease

Acute liver disease

One type of liver disease in dogs is acute liver disease. This is when a pooch suffers from sudden illness and their liver dysfunction happens very quickly, in as little as a few hours or a few days. Many dogs who survive and recover from acute liver disease go on to live a happy, healthy, normal life.

Chronic liver disease

Another type is chronic liver disease, which is where a dog’s liver has been becoming sick and losing its function over a longer period of time, usually a few months. Prognosis for chronic liver disease is trickier because it relies on how well your dog recovers and whether the cause of their liver disease can be treated.

Secondary liver disease

Secondary liver disease is when a dog develops liver disease as a secondary condition. Because the liver is involved in so many bodily functions, particularly the metabolism, it can be affected by other illnesses, especially gastrointestinal conditions.

Secondary liver disease could develop after a dog has suffered from acute pancreatitis, heart failure, infection, trauma, shock, chronic small intestinal disease (e.g. IBD), and more.

What causes liver disease in dogs?

There are a number of different causes of liver disease in dogs which could include physical abnormalities or damage to the organ such as a cyst or cancer, or the liver may be affected by another health problem.

Sometimes, the liver function can simply degrade with old age or a dog is genetically predisposed to the condition.

Some of the causes of liver disease in dogs are:

  • Old age
  • Genetics
  • Poisoning
  • Infections
  • Cysts
  • Adverse reaction to drugs
  • Cancer
  • Trauma
  • Extreme heatstroke
  • Metabolic disorders
  • Sepsis
  • Untreated heartworm
  • Portosystemic shunts
  • Endocrine diseases such as diabetes, hyperthyroidism, and Cushing’s disease

Causes of acute liver disease in dogs

An acute case of liver disease appears very suddenly and is often caused by a single traumatic illness or damage to the dog’s body which directly affects the liver. These include:

Poisoning

Poisoning is the most common cause of acute liver disease, and the most common toxins are found in household items you probably have in your home and garden.

Some of the most common causes for toxicity and acute liver disease or liver failure in dogs includes eating paracetamol, xylitol, blue-green algae[2] , various wild mushrooms, tulips, lilies, as well as a number of other toxic house and garden plants.

Infections

There are a number of infections that your pooch can catch with the potential to damage their liver and cause liver disease. These infections could be viral, bacterial, or fungal.

Some of the infections that can lead to liver disease include hepatitis, leptospirosis, heartworm, and histoplasmosis.

These conditions can also cause acute liver failure and acute kidney failure, so it is important to vaccinate your pooch and provide regular worming treatment to protect them from these nasty diseases and the damage they can cause.

Heatstroke

Extreme heatstroke can cause multi-organ cellular necrosis in dogs. In other words, it can cause the organ tissue to break down and “die” and the organ loses its functionality.

Heatstroke can also cause complete organ failure and affects several of your dog’s internal organs including their liver as well as their heart and kidneys.

Metabolic disorders

Dogs can develop acute liver disease as a result of suffering from an acute metabolic disorder such as acute pancreatitis or acute haemolytic anaemia. Obesity can also increase a dog’s risk of liver disease. This is because the liver is vital in the metabolism process, so these disorders have a gradual effect on the liver.

Trauma

Acute liver disease can also be caused by sudden trauma to the body or shock, such as an abdominal injury which damages the liver.

Other causes are rarer but can include hernia, liver lobe entrapment, liver lobe torsion, or hypoxia, which is a lack of oxygen in the tissues.

Causes of chronic liver disease

Chronic liver disease is developed much more gradually and is usually the result of another long-term illness or a physical abnormality with the liver.

A dog might develop these illnesses or defects, or they could be born with them. Some of the causes of chronic liver failure are:

Physical abnormalities

Your dog might have a congenital defect with their liver that they were born with. They could also develop a physical abnormality in their liver later in life such as portosystemic shunts or cysts in their liver.

Other illness

A dog can develop liver disease as a secondary condition. For example, dogs with diabetes are at higher risk of developing hepatic lipidosis (“fatty liver disease”) because fat is more likely to collect in their liver.

Obesity may also be linked with the development of chronic liver disease. Some dogs might have a chronic disease affecting the liver directly, such as hepatitis, which is a specific liver disease.

Are some dogs more at risk of liver disease?

Dogs of any age, gender, or breed can be affected by liver disease and other liver problems.

However, chronic liver disease is more common in middle-aged or older dogs as the damage to the liver tissue and gradual loss of function has built up over time, and old age can cause loss of function in the liver.

There are also certain breeds of dog that are more likely to develop specific conditions that affect the liver and could cause liver disease.

For example, “Hepatic copper toxicosis” which is excessive copper build up in the liver can cause liver disease. Labradors, Dalmatians, Bedlington Terriers, and West Highland White Terriers are more prone to this copper build up compared to other breeds of dog.

Meanwhile, the above breeds and Dobermans, Cocker Spaniels, English Springer Spaniels, Standard Poodles, Chihuahuas, Maltese, and Skye Terriers are more likely to develop chronic hepatitis which is the most common liver disease in dogs.

It’s unclear whether gender can impact liver disease. One study found that male Cocker Spaniels and Springer Spaniels were more commonly affected, whereas female Labradors were more at risk.

How to prevent liver disease

There is no way to prevent liver disease in itself, however, there are a number of things you can do to prevent some of the causes of liver disease. By protecting your dog against these, you can lower their risk of developing liver disease.

For example, vaccinating your dog against diseases such as hepatitis or leptospirosis will help to prevent liver disease in your dog because these infections can cause damage and disease in the liver.

One of the best methods of preventing liver disease and liver failure in dogs is to simply stop your pup from eating anything that could be toxic. This includes keeping all human medicines out of reach of your dog, and never feeding your dog anything that could contain a harmful ingredient like chocolate, grapes, raisins, or anything containing the sweetener xylitol.

You can also make sure any toxic plants in your garden are fenced off or houseplants are kept out of reach of your dog. Otherwise, you could use dog-friendly plants in your house and garden.

Keeping your dog on a lead and making sure they’re supervised and under control when outside or in new environments will also help to prevent them having any mishaps and eating something they shouldn’t.

For example, don’t let your dog roam freely in a forest as they might find and eat something like a wild mushroom or a conker and make themselves ill. In the case of mushroom toxicity, this could lead to liver disease, so making sure you always keep an eye on your pup will help to protect their health.

If your pup has a habit of munching things they shouldn’t, you can try muzzle training them. Muzzles are completely harmless and dogs do get used to wearing them the same way they would a halti, harness, or collar.

With a muzzle on, you could let your pup off lead without worrying about them being able to eat anything they shouldn’t, whether that’s conkers, acorns, mushrooms, or even poop.

Signs and symptoms of liver disease in dogs

It can be hard to spot the signs of liver disease in dogs at first because a dog’s liver has a large functional reserve, which means it can still work even when a lot of it has been damaged. Dog’s livers can also regenerate. It means that livers can compensate for lost function remarkably well for some time.

Sadly, that also means that liver disease is usually advanced before a dog shows any signs of illness. In fact, obvious symptoms of liver dysfunction don’t appear until a dog has lost about 70-80% of their liver function.

In the early stages of liver disease symptoms can be vague such as weight loss, vomiting, diarrhoea, or loss of appetite. These early symptoms of liver disease in dogs typically affect the gastrointestinal system.

Additionally, there are other conditions which could affect the liver and cause similar symptoms.

Another reason the symptoms of liver disease in dogs can be tricky to recognise is because they can be very varied. Since the liver carries out so many different functions within the body, dogs with liver disease can show entirely different sets of symptoms based on what functions their liver can no longer carry out.

The fact that the liver is so multi-purpose also means that there’s often a knock-on effect on other organs once the liver packs up.

The signs and symptoms of liver disease in dogs are:

  • Weight loss
  • Loss of appetite
  • Vomiting
  • Diarrhoea
  • Increased thirst
  • Increased urination
  • Changes to the colour of their urine or poo (especially if it’s darker than normal)
  • Bloody faeces or urine
  • Lethargy
  • Depression
  • Weakness
  • Ascites (fluid in the abdomen)
  • Jaundice (yellowish skin, gums, tongue, and whites of the eyes)
  • Neurological symptoms
  • Coagulopathy (bleeding disorders)
  • Seizures

In some cases a dog with liver dysfunction can develop a condition called hepatic encephalopathy. This affects the central nervous system and causes a series of neurological symptoms.

Symptoms of hepatic encephalopathy include:

  • Circling or compulsive pacing
  • Aimless wandering
  • Walking into walls and furniture
  • Head pressing
  • Vocalisation
  • Difficulty training and learning
  • Sudden aggression
  • Depression
  • Lethargy
  • Confusion
  • Ataxia (unsteady walk)
  • Personality and behavioural changes
  • Blindness
  • Seizures
  • Coma

There are other physical signs of hepatic encephalopathy which can also be signs of liver disease in dogs, such as changes to urine colour, increased thirst and urination, weight loss, etc.

Diagnosis

First of all your vet will discuss your dog's symptoms with you and perform a full physical examination of your dog. If they suspect they might have liver disease, they will carry out further tests which will help to rule out other conditions that could be affecting your dog’s liver and to determine what exactly is wrong with your pup.

These tests will include blood tests to assess your dog’s liver function. Blood testing will also be used to test for anemia which is a symptom of liver disease. They will also measure the levels of ammonia in your dog’s blood because elevated ammonia levels indicate a dysfunctional liver. They might also look for increased levels of liver enzymes in your pup’s blood and test your pooch’s platelets, as decreased red blood cell platelets can indicate liver disease.

Your vet will also conduct urine analysis and look for a compound called bilirubin in your dog’s wee. Bilirubin is usually found in bile, and having too much in your dog’s urine means their body isn’t reabsorbing bile properly, another sign of liver disease. They will also look for urine crystals because urine crystals and stones can also be caused by liver disease.

In addition to testing your dog’s blood and urine, your vet might x-ray or ultrasound your dog’s abdomen to take a look at what their liver looks like inside. Livers affected by liver disease are often smaller than normal.

Finally, your vet might perform a biopsy to remove a small sample of liver tissue to test. This will confirm the presence of liver disease and scarred tissue, and it can help to determine the type of disease your dog is suffering from.

Your pooch might need to be put under anaesthetic so the vet can open their abdomen and examine their liver and remove a small sample.

However, it is now more common for vets to use a small needle guided by an ultrasound to go under a dog's skin and remove a tiny tissue sample. Using a needle is far less invasive and it means your dog doesn’t need to go under anaesthetic.

Treatment for liver disease in dogs

Treatment for liver disease in dogs will vary according to how advanced your dog’s liver disease is and what symptoms they are showing. The main aim is to treat and remove the cause of the liver disease where possible, to reduce inflammation of the liver, reduce scarring, manage symptoms, and to provide the ideal conditions to encourage the liver to regenerate.

Because the liver is the only organ able to regenerate, treatment is all about making a dog more comfortable and making sure the liver has the opportunity to repair itself. However, advanced cases of liver disease can cause cirrhosis and scarring of the liver tissue which is irreversible.

How is liver disease in dogs treated?

The initial treatment your dog receives will probably include intravenous fluids and electrolytes to combat dehydration, and they may need oxygen. Some dogs require blood transfusion or blood plasma if they are suffering from a blood clotting disorder.

Once a dog is stable, your vet will prescribe medicine to help treat their symptoms and manage the condition so their liver has a chance to recover. They’ll usually discharge your pooch so their treatment and recovery can take place at home.

Your vet will prescribe your pooch with any medication they need to treat their symptoms, such as antiemetics to prevent vomiting and nausea. This will hopefully restore your pooch’s appetite because eating plenty is vital in their recovery.

Your pup might be given gastric protectors to prevent and treat any damage or ulcers in their gut. Your vet might also give your dog a low dose of lactulose to reduce the levels of ammonia in their blood, and choleretics to increase bile production. Some dogs may also be given corticosteroids to moderate the inflammation and fibrosis in their liver, or diuretics to combat fluid retention.

However, your vet will be cautious about what medicines they prescribe your pooch because the liver is where drugs are metabolised, and certain drugs or too many might do more harm than good.

If your dog’s liver disease has come as a result of an infection, your vet will prescribe them with antibiotics or antifungal medication to try and clear it. Some dogs receive this medication anyway to ward off secondary infections during recovery.

Many dogs suffering from liver disease require dietary changes and supplements as part of their treatment plan. In terms of diet, you might be advised to follow a high carb, low protein diet (we’ll talk about this in more detail below). The aim of supplements and diet isn’t to treat the cause of liver disease, but instead to prevent further damage to the liver and to provide the nutrition required for regeneration.

Supplements

Supplements are a crucial part of treating liver disease. Antioxidants like vitamin E prevent oxidative damage to the cells and can help to reduce inflammation caused by liver disease. Meanwhile, your vet may offer vitamin K1 therapy to your dog if they are suffering from a bleeding disorder, as vitamin K is responsible for promoting healthy blood clotting.

Feeding these vitamin supplements will also help to prevent vitamin deficiencies caused by your dog being unable to absorb some nutrients because of their lowered bile production.

Your vet might suggest you give your dog milk thistle, which is a safe herbal remedy with powerful anti-inflammatory and antioxidant properties. It’s been used to effectively manage liver disease in both humans and hounds for some time.

Other supplements your vet might use include S-adenosylmethionine (SAM-e) and silibinin, which protect the liver. SAM-e is important because it’s made up of a compound called glutathione which the liver uses in detoxification, it helps to regulate cell membranes, and it’s used to produce and regulate hormones. Meanwhile, silibinin is the extracted active ingredient from milk thistle seeds, so it does a very similar job to milk thistle.

Surgery for liver disease

Some dogs might have to have an operation as part of their treatment for liver disease. This is usually to fix a physical defect in their liver that is causing their condition, such as portosystemic shunts or torsion. Surgery may also be required to remove cysts or cancerous tumours that could be causing their condition.

If your dog is suffering from fluid retention they might need abdominocentesis, which is when a vet removes excess fluid from their abdomen using a needle.

If your dog is suffering from secondary liver disease caused by another condition, they will need the appropriate treatment for the primary illness. For example, if their liver disease is caused by cancer they might need chemotherapy, if they have diabetes they will need regular insulin injections.

Further treatment and managing liver disease

Finally, you should make sure your pup has adequate crate rest and limited exercise. This is to ensure that your dog receives plenty of rest to aid their recovery. It’s just like bed rest for a human.

Your vet will want to see your dog for regular check-ups and tests to check how well they are recovering. This also means they can spot any troubling signs early, and make any adjustments to your pooch’s treatment should they need it.

Many dogs recover well from liver disease with early diagnosis and treatment. And once your vet is happy with your dog’s condition, they might take them off some or all of their medication. This is because the liver might regenerate well enough to become healthy and functional again so medication is no longer required to support it or to manage symptoms.

Home remedies for liver disease in dogs

There are no effective home remedies for liver disease in dogs, and many “home treatments” are the same dietary and supplementation advice that your vet will give you.

However, much of the traditional treatment for liver disease in dogs is carried out at home. This includes making sure your pup is hydrated, eating an appropriate diet, and receiving any medication or supplements advised by your vet.

The best dog food for liver disease

Giving your dog tasty and nutritious food is key in helping them to recover from liver disease. The best dog food for liver disease will have adequate nutrients and calories to support their recovery.

It should also be tempting enough to encourage your dog to eat even if they have previously lost their appetite or suffered from nausea. However the specific dietary needs of your pooch can vary depending on the type of liver disease they have and what’s causing it.

Fat isn’t the enemy

Often dogs with liver disease are advised to try a diet with a higher fat content than usual because this is more palatable and can encourage them to eat, however, fresh food and real meat is often enticing enough to get a dog to eat (whereas kibble is often sprayed with fat to make it more palatable for dogs).

The right balance of fat is more important than just tempting your pooch to eat though. Dogs with liver disease need to eat plenty of calories to enable their recovery, but they’re often unable to eat large quantities of food.

Higher fat content helps to bump up their caloric intake without increasing the volume of food, and it helps to prevent your pooch from becoming malnourished. Balance is important though, because too much fat can put additional strain on the pancreas and liver and make matters worse.

Less protein but higher quality

Dogs with liver disease need to eat plenty of protein to allow the liver to regenerate. The problem is, they usually need to eat a lower amount of protein compared to healthy dogs. The best dog food for liver disease will have a lower volume of protein, but the protein source in the food must be highly digestible and higher quality.

The increased digestibility and quality mean your dog canabsorb more of the protein, so they still get the nourishment they need despite the lower volume. This is because many so-called high protein foods use a low-quality protein source, and although the dog eats more protein by volume, most of this protein goes to waste because it cannot be absorbed by the body.

Protein waste can impact the mental function of a dog, so avoiding this waste is especially important for dogs who are vulnerable to hepatic encephalopathy as a complication of their liver disease.

Low protein waste also helps to reduce the amount of urea in the blood, because urea is leftover amino acids from broken down proteins. A dysfunctional liver can’t filter urea out of the blood properly.

So, you can do the liver’s work for it and reduce the amount of urea in your dog’s body by simply reducing the amount of protein they eat, and making sure the protein they have is digestible and high-quality so more of it is absorbed and used rather than becoming a waste product.

Higher quality, digestible food also means less strain on the gastrointestinal system to try and break down and filter out the waste from the nutrients.

The right balance of nutrients is crucial too, and your dog’s food should have the right amount of potassium, sodium, and other minerals needed to keep the body healthy. However, some dogs are advised to eat low sodium food to prevent fluid retention.

Don’t forget the antioxidants

Your pooch might be given antioxidants as a supplement by the vet, however, they can also get plenty from their diet. Many fruits and veggies are packed full of antioxidants as well as vitamins A and E which are vital for dogs with liver disease.

Changes to their meals and eating habits

Some dogs will need the number of meals they eat each day adjusted, in addition to changing their actual food. This is because most pups with liver disease need to eat smaller but more frequent meals.

Where possible, you should maintain your dog's normal dinner routine. But if your pup isn’t eating, your priority is to get them to eat anytime rather than maintaining routine. Some dogs might need to be hand fed for a while until their appetite returns. Otherwise, warm food or changes to the food’s consistency can also help to encourage them to eat. Mixing food like Pure with warm water can work wonders at encouraging your pooch to eat more.

You might be advised to try assisted feeding, which could involve hand-feeding your dog, or using a syringe to feed them. Food like Pure which can be mixed with water into different consistencies is great for this purpose, since you can try using hot or cold water or mix it with more liquid to make a soupier dinner that can be syringed into their mouth.

Keeping your pup hydrated is also an important part of managing liver disease, so being able to mix water in with their dinner can help them to stay hydrated.

Your vet can advise you on the best dog food for liver disease in dogs, and our canine nutritionists can help you find the perfect food to meet your pup’s specific nutritional needs.

Outlook and life expectancy for dogs with liver disease

The prognosis for liver disease in dogs can vary depending on the severity and stage of their condition, how well they respond to treatment, and whether or not the underlying cause can be treated.

Because the liver is actually able to regenerate, it can recover amazingly in the right environment. If your vet can identify and successfully treat the cause of your dog’s liver disease, it will give the organ a chance to repair itself.

However, severe or highly advanced cases of liver disease have a much more guarded prognosis. In these cases, your vet might be able to treat their liver disease well enough to manage the condition and ease their symptoms to improve the wellbeing and comfort of your dog and allow them to live a normal life with a good life expectancy. Even dogs with chronic liver disease or conditions affecting the liver such as chronic hepatitis can live happily and comfortably for several years with treatment.

Dogs with cirrhosis and heavily scarred liver tissue that cannot regenerate have a worse prognosis than others, and their life expectancy can be limited.

Sources
  1. Breed, sex and age distribution in dogs with chronic liver disease: a demographic study Journal of Small Animal Practice, 32, (1), Jan 1991, 1-5, doi.org/10.1111/j.1748-5827.1991.tb00844.x