What is liver disease?
Liver disease refers to any condition that stops the liver from working properly and doing its job in the body. The liver is the second-largest organ in the body and performs more than 1,000 critical biomechanical functions. The liver processes medications, removes toxins from the body, and creates substances essential to life, such as blood clotting factors and the protein called albumin. The liver is essential for adequate nutrition because it is needed to help process protein, carbohydrates, and fat.
Liver disease is one of the most challenging groups of conditions to treat and manage. Conditions that may result in damage to the liver include:
- Inherited portosystemic shunt (an abnormality of blood moving or circulating through the liver)
- Cancer
- Long-term inflammation (also referred to as chronic hepatitis)
- Secondary damage from disease, or drugs, or toxins
The liver can regenerate though, so damage to the liver must be fairly severe before clinical signs are seen. A dog with liver disease may have suffered significant and longstanding metabolic imbalances before a diagnosis is made and a treatment plan created.
Liver disease can obstruct bile flow through the liver, leading to jaundice, which causes a yellow/orange tinge to the skin, mucous membranes, and whites of the eyes. Advanced liver disease may cause gastrointestinal toxins to bypass filtration by the liver, resulting in dulled mental ability. Additionally, advanced liver disease may cause malnutrition if a dog has a decreased appetite and is unable to properly digest, absorb, or metabolize nutrients.
Medical treatment recommendations for dogs with liver disease include targeting the underlying cause (if possible) and treating the clinical symptoms, such as nausea or vomiting. In the short-term, intravenous fluids administered in the hospital may be needed to set the stage for longer-term therapies. Medications are often needed to treat liver disease long-term, often for the remainder of a dog's life.
How can nutrition help manage liver disease?
Nutritional management can be effective in helping manage liver disease when used in combination with appropriate medical treatment (or surgery if required). Nutritional management of liver disease focuses on controlling the clinical signs of disease, as opposed to targeting the underlying cause.
The nutrient profile of a balanced diet for liver disease aims to:
- Maintain normal metabolic function
- Provide an adequate caloric density
- Avoid changes to mental function from toxins in the blood
- Support liver repair and regeneration
- Decrease further damage to the liver
- Maintain appropriate levels of sodium, chloride, potassium, and other biologically active minerals
Water is the single most important nutrient, and good hydration lays the foundation for supporting the health of the liver. Make sure you provide plenty of fresh, clean water each day. Maintain good hygiene habits by washing, rinsing, and drying your pet’s water and food bowls each day.
Your veterinarian will help you choose the most appropriate diet for your dog, based on the complexities of your pet’s liver disease. The total protein content in the recommended food may be lower than most typical dog foods, and your veterinarian will look for a food with lower dietary fiber so it is more readily digestible. Reduced dietary protein that’s readily digestible provides the body with adequate protein to support liver healing, but avoids excessive levels of protein waste that can affect mental function.
It is vital for dogs with liver disease to eat in order to heal, so your veterinarian will want to prevent nausea in order to keep your dog from developing a food aversion. The veterinary healthcare team can help establish a daily calorie goal, based on your dog’s current weight, and offer instructions on what to look for if your dog becomes nauseous.
Will my dog always need to eat special food and take medication?
Managing liver disease in dogs is complex, and regular re-assessments 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 periodically monitor 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 non-veterinary, over-the-counter maintenance food once their liver issue is resolved. That said, it depends on the specific diagnosis; dogs with chronic liver disease might need to eat a veterinary therapeutic diet and take one or more liver-support medications long-term. Your veterinarian will help you make the best decisions on behalf of your dog with liver disease.
