Nutrition for Dogs with Liver Disease

My dog was diagnosed with liver disease. What does this mean?

The liver is the second largest organ in the body and performs about 1500 critical biomechanical functions. The liver metabolizes medications, removes toxins from the body, and creates substances essential to life, such as 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. Conditions that may result in liver disease and damage include:

• Inherited portosystemic shunt (an abnormality of liver circulation)
• Cancer
• 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 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 also cause gastrointestinal toxins to bypass filtration by the liver, resulting in 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 (if 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, often for the remainder of the dog's life.

What role can nutrition play in treating liver disease?

Nutritional management can be an effective strategy 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 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 and 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 choose the most appropriate diet 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 function. 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.

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 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 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.