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Treatment of Liver Disease in Dogs
Veterinary & Aquatic Services Department, Drs. Foster & Smith
Liver and Pancreas
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In many cases of liver disease, specific treatment is unavailable. Treatment is mainly supportive and symptomatic, such as administering subcutaneous (SQ) or intravenous (IV) fluids to prevent dehydration, providing adequate nutrition, and giving medications to control vomiting.

Medications

The type of medications given depend on the cause and extent of the liver damage. The liver is one of the main organs that breaks down medications. If the liver is not functioning correctly, medications often need to be given at lower doses since they remain in the body for a longer period of time. This includes those medications the pet may have been taking prior to the liver disease.

Corticosteroids are used in certain cases of liver disease, such as chronic hepatitis, to decrease inflammation and scarring. They also stimulate the appetite and promote an overall feeling of well-being. High doses of corticosteroids can actually cause liver disease; do not give corticosteroids to a pet with liver disease except under the direct supervision of your veterinarian.

Antibiotics are used in cases of infection or if the patient is at risk of a secondary infection.

Penicillamine and zinc acetate are used in the treatment of copper storage disease to reduce the amount of copper in the liver.

Medications may be indicated to help decrease nausea or vomiting caused by the liver disease, or to prevent ulcers in the stomach or small intestine. Examples of these medications include sucralfate and cimetidine.

Ascites is treated with a diuretic such as furosemide (Lasix). Left untreated, ascites will cause difficulty breathing as it puts pressure on the diaphragm.

Dehydration and changes in electrolytes need to be prevented with the use of IV or SQ fluids and electrolyte supplements such as potassium.

Diet and supplements

For many liver diseases, diets may need to be altered to maintain proper nutrition and caloric intake. Specific diets may be recommended depending on the diagnosis. Some animals may have reduced appetites or refuse to eat. In these cases, the pet may need to be force-fed with a syringe or a feeding tube will need to be placed.

Dogs with copper storage disease need to be placed on a special diet low in copper.

A daily vitamin and mineral supplement is often advised for pets with liver disease to help prevent deficiencies. If copper storage disease is diagnosed, this supplement should not contain any copper.

Supplemental vitamin K may be necessary to help control bleeding disorders, since a diseased liver produces and stores less of this vitamin which is necessary for the liver to produce clotting factors.

Vitamin E is given as an anti-oxidant to remove free radicals and prevent further oxidative injury to the liver. A water-soluble form of vitamin E is preferable, since the absorption of fat-soluble vitamins may be decreased in some forms of liver disease.

A newer therapy for the treatment of liver disease is S-adenosylmethionine (SAMe). Normally produced by the liver, SAMe is necessary for many functions of liver cells. It is available as a dietary supplement.

Summary

Some types of liver disease are not curable, but with supportive care, the patient may still be able to live a comfortable, though shortened, life.

 
References and Further Reading

Ettinger, SJ; Feldman, EC. Textbook of Veterinary Internal Medicine. 5th Ed. W.B. Saunders Company. Philadelphia; 2000.

Leveille-Webster, CR; Center, SA. Chronic Hepatitis: Therapeutic Considerations. Kirk's Current Veterinary Therapy XII Small Animal Practice. W.B. Saunders Company. Philadelphia; 1995.

LaFlamme, DP. Nutritional Management of Liver Disease. Kirk's Current Veterinary Therapy XIII. W.B. Saunders Company. Philadelphia; 2000.

Weiss, DJ; Armstrong, PJ; Gagne, JM. Feline Cholangiohepatitis. Kirk's Current Veterinary Therapy XIII Small Animal Practice. W.B. Saunders Company. Philadelphia; 2000.

Center, S (moderator). New approach to managing hepatic dysfunction. Veterinary Forum. 2000 (December); 44-49. 

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