Liver Failure in Dogs

What Is Liver Failure in Dogs?

The liver is a very important organ that removes waste products from a dog’s body, absorbs and produces proteins and clotting factors, eliminates toxins, and aids in metabolism and digestion.

Because it has so many functions it’s more susceptible to damage, and inflammation (swelling) can occur, known as hepatitis. This leads to death of liver cells, loss of function, and eventual liver failure.

The liver has the unique ability to regrow after damage, but if the damage is excessive, this makes it difficult to regenerate. Many diseases can result in liver failure when more than 70% of the liver becomes damaged.

Liver failure in dogs is a medical emergency. This condition is painful and can result in death.

Dogs with end-stage liver failure (cirrhosis) often die within one week of diagnosis. Dogs with accompanying ascites, or fluid buildup in the abdomen, have a poorer prognosis overall.  

Fortunately, some causes of liver failure can be healed if diagnosed and treated early enough by a veterinarian.

Symptoms of Liver Failure in Dogs

Several symptoms of liver disease in dogs are nondescript and can be seen with almost any type of disease. They include:

• Weakness

• Decreased appetite

• Increased thirst and urination

• Weight loss

• Abdominal pain

• Vomiting with or without blood

• Diarrhea with or without blood

However, if a progressive loss of liver function leads to liver failure, the following symptoms may occur:

• Jaundice

• Bruising on the skin, nose, and eyes

• Bleeding from the nose, mouth, rectum, and bladder

• Black, tarry stools

• Ascites

• Swelling of the limbs (edema)

• Collapse

• Hepatic encephalopathy

  • Hepatic encephalopathy causes neurologic signs such as head pressing, seizures, circling, behavioral changes, lack of coordination, blindness, or coma

Causes of Liver Failure in Dogs

There are many causes of liver failure in dogs, and it’s often frustrating for veterinarians to diagnose. Sometimes the initial cause may never be found.

However, there are several known causes of liver failure. These include:

• Medications such as Tylenol® (acetaminophen)

• Heavy metals like copper

• Toxins such as blue-green algae, mycotoxins (usually through eating moldy or spoiled food), xylitol, sago palm, rodenticides

  • If you suspect your pet has consumed a toxin, call the Pet Poison Hotline (855-764-7661) for advice.

• Infectious organisms such as infectious canine hepatitis, leptospirosis, histoplasmosis, or heartworm disease (specifically end-stage caval syndrome)

• Cancer

• Inherited conditions such as copper storage disease, often seen in Bedlington Terriers and West Highland White Terriers; amyloidosis, seen in breeds like Shar-Pei

• Portosystemic shunts, usually a congenital issue

How Veterinarians Diagnose Liver Failure in Dogs

Since symptoms of liver failure in dogs can be vague, vets rely on diagnostics such as bloodwork and urinalysis as well as a physical exam.

Your vet may recommend additional blood tests, as well as X-rays, ultrasound, and abdominocentesis. In this procedure, a needle is inserted to collect fluid to look for evidence of infection or cancer in dogs.

Additionally, your vet may need a sample of your dog’s liver to make an accurate diagnosis. This sample can be taken either through surgery or through a biopsy, where a needle is put directly into the liver.

Liver biopsies have risks, and they are usually done once the patient has been stabilized.

Treatment of Liver Failure in Dogs

Treatment of liver failure in dogs is most effective if started early. This is very important for dogs with acute liver failure  because they often come to the vet in critical condition.

The goal of treatment is to slow the disease and allow time for the liver to regrow. Supportive care to relieve the symptoms alongside treatment of the underlying cause may involve several medications, including:

• SAMe and milk thistle derivatives (silymarin)

• N-acetylcysteine

• Vitamin K1

• IV fluids (blood transfusions or plasma transfusions may also be needed) with electrolyte and glucose supplementation

• Pain medications

• Antacids, anti-nausea medications (famotidine, ranitidine), and gastroprotectants like sucralfate

Because the liver helps with digestion and metabolism of nutrients, a diet that requires less work for the liver can be helpful.

Prescription diets such as Hill’s® l/d, Royal Canin® Hepatic or Purina® HP Hepatic are formulated to have more digestible protein, contain more antioxidants, and have lower amounts of certain minerals like copper that can be harmful to the liver.

At first, feeding tubes may be needed to deliver nutrients to a dog. Speak with your vet for advice on the best diet for your individual pup.

Protein restriction is important in dogs diagnosed with hepatic encephalopathy or at risk of developing it.

Dogs with hepatic encephalopathy may also be helped by enemas, lactulose, and antibiotics like neomycin or metronidazole. Periodic abdominocentesis may be needed to help ease symptoms and improve comfort and breathing.

In cases of cirrhosis, symptomatic care is directed at slowing its progression, managing complications, and keeping a good quality of life for as long as possible.

For some dogs with advanced disease or poor outlook of recovery, humane euthanasia may be recommended by your vet.

Recovery and Management of Liver Failure in Dogs

Because the liver has a unique ability to regrow, dogs can have a good prognosis and go on to live a normal life with some diseases that are caught early and treated aggressively.

However, chronic liver disease may occur secondarily. That can lead to frequent rechecks and lifelong medical and dietary management, but dogs may still have a decent quality of life. This typically occurs in cases of leptospirosis and if your dog has eaten certain toxins.

Prevention of Liver Failure in Dogs

Not all causes of liver failure in dogs can be prevented. However, there are some ways to decrease risks, such as:

• Keep garbage securely put away and out of your dog’s reach

• Keep all medications locked up

• Remove any toxic plants from the yard and inside the home

• Block access to chemicals and toxins, like rodenticide

• Vaccinate your dog against leptospirosis and infectious canine hepatitis.

• Take steps to avoid sources of possible bacterial contamination by restricting access to standing water, avoiding contact with wildlife, and using pest control as needed.

• Speak with your veterinarian about the risks and benefits of certain medications for your dog.