Canine Liver Failure

" Canine liver failure relates to different aspects of liver function , malfunction including hepatic tissue death and complete or partial collapse. A canine liver can fail to function as the primary issue or cause secondary problems such as canine hepatic encephalopathy (unconsciousness), ascites (fluid accumulation n the abdomen), coagulation abnormalities, infections, fibrosis and cancers. Liver problems may be acute (severe symptoms over a short period of time), but are most probably chronic in nature and cause the loss of appetite, jaundice, increased thirst, urination, fever, coagulation problems, weakness, and many other symptoms, depending upon a dog's particular condition. Diagnosis requires a detailed clinical examination and advanced laboratory procedures to confirm the type, degree and possible outcome of the dog liver issue. Treatment is specific  to each cause, while supportive therapy and management of nutrition are effective for many types of hepatic disease associated with liver failure. "


Pathology of Canine Liver Failure:

There are many pathological possibilities which end with hepatic (liver_ malfunctions. Bacterial and viral infections, parasites, nutritional disorders, abdominal ascites (accumulation of fluid), and tumors are some examples. There are many other direct or indirect pathological conditions which can lead to canine liver failure. Liver failure can be primary or secondary, it means that either  a pathological condition that doesn't originate in the liver results in the death of hepatic (liver) tissues, or chronic complications of the canine liver makes it non-functional.

Canine chronic hepatitis and cancers can gradually decrease the capacity of the hepatic tissues. Secondary dog liver failure can be the result of conditions such as hepatic encephalopathy (unconsciousness, coma), ascites (abdominal fluid accumulation) or due to coagulation disorders in the liver.

Clinical Symptoms of Canine Liver Failure:

In the earlier stages of a dog liver problem it is hard to make an assessment of the condition since the failure of hepatic tissues tend to happen in isolated episodes. Thus symptoms exhibited by affected dogs are initially mild and negligible with the severity increasing over time or only if the number of hepatic tissues involved result in a pathological development.

Anorexia, weakness, fever, jaundice, increased thirst and urination are some typical signs of a canine liver problem. Some other signs such as aimless wandering, abdominal pain and ascites, ataxia (failure of muscle coordination), visual problems, aggression and coma may be noted as different causative conditions associated with canine liver failure.

The severity of clinical symptoms are very helpful in making an assessment of the different stages of hepatic failure or pathology. Though not recommended, but in most cases, a clinical prognosis is made upon the basis of the severity of symptoms alone.

Diagnosis of Canine Liver Failure:

Clinical symptoms, history and laboratory procedures will reveal the cause and degree of pathological condition that resulted in the dog liver failure. As symptoms associated with liver failure ascends or increases with time, even though negligible in the early stages, it is highly recommended that screening tests be carried out regularly in order to estimate possible pathological developments in the liver.

Liver Enzyme Activity, is the most efficient approach to asses the liver status in canines. ALT, AST, AP, GGT and Bilirubin etc are usually assessed for canine liver status. Detailed biochemical profiling is considered a must for this purpose and should not be delayed.

Other effective techniques to assess liver function is to fast and then take the blood ammonia level detection test and ammonia tolerance tests. With the help of these procedures, differentiation between hepatic and biliary diseases (gallbladder) is possible. Due to constraints in sample handling and possible harsh side effects of testing, these procedures are not practiced by every veterinary practitioner.

Radiography can help in assessing anatomical disturbances, size, appearance and involvement of adjacent organs.

Treatment of Canine Liver Failure:


As canine liver failure relates to partial or complete malfunction and sometimes the death of hepatic tissues,  treatment is of no use in severe cases. Specific and timely treatment plans for different pathological conditions are essential to maintain liver health. Conditions such as hepatic encephalopathy, ascites, coagulation abnormalities, infections and tumors should be carefully and specifically treated, as these are major reasons for hepatic tissue death and the permanent malfunctioning of the canine liver.

Nutrition:

Dietary change is highly recommended in dogs with the possibility of liver failure.  Diets containing a large percentage of carbohydrates, usually 20-40% of the whole diet is needed. Restricting fats is not effective, but a dog's cholesterol level should be closely monitored and kept within acceptable limits. Meat proteins should be restricted in order to control ammonia production, which is highly lethal for diseased hepatic tissues. Vegetable and dairy proteins are alternatives for meat proteins and should be part of the provided dog food.

Minerals and especially zinc (for controlling Fibrosis) should be included in the selected dog food after performing tolerance tests to make sure they do not cause any kind of reaction. Vitamins should also be added in abundance.

Controversies in Treatment:

There are various controversies about using anti–inflammatory drugs and corticosteroids in the treatment of canine liver disease. These drugs are commonly used in practice, but some researchers and professionals do not recommend them due to the reason that these drugs, while effective in reducing inflammation, infections or any other conditions, but on other hand they cause severe side effects and complications.

For example, Corticosteroids are effective in the management of liver conditions, but causes such as GI ulcers, pancreatitis, ascites leaves a dog with secondary bacterial infection when the drug is stopped. Similarly, some anti inflammatory drugs are effective in one breed, but they can cause severe complications in another breed. This effect has been reported to be highly variable in different dogs of similar breeds as well.

A liver that has been partially damaged can regenerate itself with proper care. Natural supplements can help accelerate and support this process. Immunity & Liver Support Formula is a good choice if the initial damage was caused by a fungal or bacterial infection. Liver-Aid Formula is a  general care supplement for other causes of dog liver failure. Check with your veterinarian regarding this approach for your dog.

References:

Merck Veterinary Manual (Merck & Co. 2008)

Dobson, J.M, Text Book of Small Animal Medicine (W.B Saunders London. 2001)

F. Cheville, “Introduction to Veterinary Pathology” (Wiley-Blackwell, 2000) Revised Ed.






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