Liver Disease in Dogs
Written by Small Door's medical experts
Liver disease is an umbrella term for conditions affecting the liver that typically cause damage and/or inflammation. This can be a primary liver problem or secondary to other underlying conditions. Left untreated, liver disease can have serious health consequences for your dog. Along with the guidance of your veterinarian, there are several preventative measures and treatment options available for liver disease that can allow your dog to live a long and healthy life.
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The liver performs multiple functions. It helps your dog metabolize fats, carbohydrates, and proteins. It stores and processes vitamins, minerals, triglycerides (a type of fat), and glycogen (a form of glucose, or sugar). It aids in blood clotting and takes part in your dog’s immune system. The liver also removes toxins from your dog’s body and helps metabolize medications. In addition, the liver is special in the way that it can repair itself and regrow after injury or disease.
Liver disease in dogs can emerge in different scenarios, with a variety of different signs and symptoms. It can be mild to severe, and oftentimes you may not notice symptoms in your dog. Blood tests may show signs of primary liver disease or injury, or elevated markers in your dog’s blood might arise from an entirely different disease that does not start in the liver, such as diabetes, pancreatitis, or Cushing’s disease (an overactive adrenal gland).
Types of canine liver disease
Hepatitis: Hepatitis is inflammation of the liver, which can be short-term (acute) or long-term (chronic). There are many causes of hepatitis, including exposure to poisons or toxins, certain medications (such as NSAIDs, which refers to non-steroidal anti-inflammatory drugs), bacterial infections, viruses, or fungal infection. Hepatitis is usually a clinical symptom that occurs secondary to another issue or disease. Some of the viral causes can include Leptospirosis, which is spread through the urine of other animals, and infectious canine hepatitis (ICH), which is caused by the canine adenovirus 1 and is spread through the saliva, urine, and feces of dogs. Most dogs are vaccinated against both viruses as part of their Distemper/Leptospirosis vaccine series.
Cirrhosis: Cirrhosis is a very advanced stage of liver disease in which normal, functioning tissue gets replaced by scar tissue, usually caused by chronic hepatitis.
Portosystemic shunt (PSS): A PSS, or liver shunt, is when a dog’s venous blood from the stomach, pancreas, spleen, and intestines bypasses the liver. This causes a buildup of toxins within the body due to the liver being unable to filter blood. This condition can be present from birth (congenital) or acquired later in life due to other issues (such as cirrhosis and hypertension). Untreated shunts can lead to acute liver failure or hepatic encephalopathy. Hepatic encephalopathy, which occurs secondary to liver disease, happens when toxins build up in the bloodstream and then travel to a dog’s central nervous system, causing neurological problems. However, this condition is reversible once the toxins are removed from the bloodstream.
Copper storage disease: This is a disease when excessive amounts of copper accumulate within the liver because the liver is unable to remove enough of it from the body (either due to a genetic abnormality or from a diet too high in copper). Bedlington Terriers have a genetic predisposition to this condition.
Hepatic lipidosis: Also known as fatty liver disease, this is when a buildup of lipids (fat cells) collect within the liver, which prevents the liver from working properly. (This condition is more common in cats than it is in dogs.)
Hepatic neoplasia: Hepatic neoplasia (cancer) can originate in the liver or be metastatic, which is when a neoplasm originates from another location within the body and then spreads to the liver. There are several types of liver cancer that may occur in dogs, with hepatocellular carcinoma as the most common.
Fulminant hepatic liver failure: Fulminant hepatic liver failure is a syndrome characterized by a sudden loss of liver function. Hospital treatment based on the cause is needed to allow the liver time to heal.
If your dog is showing any of the following symptoms, consult your veterinarian immediately:
Weight loss
Fever
Decreased appetite
Neurologic signs (seizures, disorientation, staring into space, circling)
Lethargy
Temporary blindness
Increased thirst and urination
Jaundice (yellowing of the skin, gums, eyes)
Ascites (a visible swelling or distention of the abdomen due to an accumulation of fluid)
Pale-colored bowel movements/feces
Liver disease can have many different causes, including bacterial infections, toxin exposure, viruses, or congenital defects from birth.
Dog breeds prone to liver diseases
There are several breeds of dogs that are predisposed to developing chronic hepatitis, portosystemic shunts, and liver disease. These breeds are:
Australian Shepherd
Australian Cattle Dog
Bedlington Terrier
Bichon Frise
Chihuahua
Cocker Spaniel
Dandie Dinmont Terrier
Doberman Pinscher
German Shepherd
Havanese
Irish Setter
Irish Wolfhound
Keeshond
Labrador Retriever
Maltese
Old English Sheepdog
Samoyed
Skye Terrier
Springer Spaniel
Standard Poodle
West Highland Terrier
Yorkshire Terrier
How your veterinarian will diagnose liver disease may depend on your dog’s symptoms and how sick they are. Typically, the first step will be blood work, and it is likely that your veterinarian will recommend additional diagnostics as well.
If there is a concern about the presence of liver disease, your veterinarian may recommend performing one or more of these tests:
Blood chemistry test: A blood chemistry test will check the function of your dog’s organs. Your veterinarian will specifically be looking for abnormalities within your dog’s liver enzymes, such as alanine aminotransferase (ALT) and alkaline phosphatase (ALP), as well as other enzymes that can also indicate a liver issue, such as albumin, bilirubin, blood urea nitrogen (BUN), creatinine, glucose, and cholesterol.
Complete blood count (CBC): A CBC will measure your dog’s red and white blood cells and platelets. For example, anemia (low red blood cells) found in this test can be a sign of chronic liver disease.
Coagulation profile: Prothrombin time (PT) and activated partial thromboplastin time (APTT) will show your dog’s ability to form blood clots and detect bleeding risk.
Urinalysis: A urinalysis will check your dog’s urine for protein, blood, infection, crystals, and pH levels.
Radiographs: Abdominal radiographs, or x-rays, may be taken to view your dog’s liver and surrounding organs. Radiographs can help your veterinarian determine whether the border of the liver appears irregular, if it is enlarged, or if there are any masses present.
Ultrasonography: An abdominal ultrasound can be used to view the liver and biliary system (the bile ducts and gallbladder). Ultrasonography offers a different perspective from radiographs and allows your veterinarian to obtain more information. Some things an ultrasound can show include: Measurements of the thickness and dimensions of an organ; An accumulation of mucus (also known as a mucocele) within the liver or gallbladder; Lymph node enlargement; An accumulation of free fluid (effusion) in the abdomen; Abnormalities within the veins and arteries attached to the liver; Architecture and composition of the liver.
Computed tomography: A computed tomography (CT) scan can be a useful tool in identifying mass lesions or abnormalities of the veins and arteries attached to the liver.
Bile acid stimulation test: A blood test that helps determine liver function. This involves taking blood samples to measure the amount of bile acids present before and after feeding your pet.
Liver biopsy in dogs
A liver biopsy is when a small collection of tissue and cells are obtained and then studied under a microscope, also known as histopathology. A biopsy can help your veterinarian to identify the presence of any cellular abnormalities and diseases, such as cancer. Biopsy samples may also be tested for copper levels or cultured to check for bacterial infection.
Your veterinarian can extract the biopsy sample through different methods, including:
Wedge biopsy: Performed under anesthesia, a small wedge is taken from the liver during either an open abdominal or laparoscopic surgery.
Ultrasound-guided needle biopsy: Performed with or without sedation/anesthesia, your veterinarian will use an ultrasound probe to locate the liver and then aspirate (take) a small portion of cells using a syringe and needle. This method does not involve any surgical incisions.
Treatment of liver disease can vary depending on the underlying cause and severity of symptoms. You’ll work closely with your veterinarian to come up with a treatment plan.
For a dog with hepatitis, your veterinarian may recommend supportive care to help reduce liver inflammation and scarring (cirrhosis), which can include intravenous (IV) or subcutaneous (SQ) fluids, antibiotics, antioxidants, steroids, and supplements. Sometimes immunosuppressive drugs or dietary changes are also needed.
Portosystemic shunts can be surgically repaired in the majority of cases.
Copper storage disease can be treated through copper-restricted diets and medications called chelating agents that bind to the excess copper and support the excretion of copper through your dog’s urine.
In cases of liver cancer, treatment can include surgical excision of any mass and chemotherapy.
Is there a cure for canine liver disease?
Whether or not liver disease can be cured really depends on the underlying cause of disease. For instance, in most cases a portosystemic shunt can be surgically repaired, which can be curative. Acute hepatitis can be cured if there has not been too much liver damage prior to the beginning of treatment. With liver cancer, surgery and chemotherapy can help reduce your dog’s symptoms, but they may not provide long-term survival. However, certain types of tumors in the liver that are caught early can be surgically removed and your dog can be cured.
Is liver disease in dogs contagious for humans or other pets?
Most causes of liver disease in dogs are not contagious or transmissible to humans. Infectious canine hepatitis is not transmissible to humans, but it can be transmitted to other dogs via feces, saliva, and urine. Leptospirosis can be transmitted to both animals and humans through contact with the urine of an infected animal.
However, most dogs are vaccinated against both viruses as part of the Distemper/Leptospirosis vaccine.
What is the cost of treating liver disease in dogs?
The cost of treating liver disease can vary depending on the severity of symptoms and what treatment is needed. It may cost about $150 for a basic examination and medications to upward of hundreds to thousands of dollars more if further testing and supportive care is needed.
Liver disease can be managed in dogs, and if caught in the early stages, most dogs will recover without permanent damage to their liver.
Liver disease in dogs prognosis
Your dog’s prognosis is dependent on the underlying cause of their liver disease. For example, acute hepatitis often has a better prognosis than chronic hepatitis, depending on how much liver damage has occurred. Chronic hepatitis cases can have an average survival rate of 2 to 3 years, depending on the severity of symptoms and how well the liver responds to treatment. With liver cancer, your veterinarian will be able to give you an idea of prognosis based on whether the tumor can be removed and whether cancer has spread. Dogs with certain liver cancer types may recover fully after surgery and the liver regenerates.
Diet for liver disease in dogs
Dogs with liver disease may need to adjust their diets as part of their treatment. Depending on the underlying cause of their disease, they may need a diet with a reduction in copper or a restriction of protein. Your veterinarian may prescribe Ursodiol, a medication that decreases both the amount of cholesterol made by the liver and absorbed by the intestines. Certain supplements, such as Denamarin (a tablet that combines the ingredients SAMe and silybin), can also be added into your dog’s food to help reduce copper levels. Your veterinarian can help determine if a special diet is required and help tailor that diet to your dog’s specific needs.
Liver disease in dogs can be prevented through:
Vaccinations
Avoidance of exposure to toxins or chemicals
Following any recommendations your veterinarian has for annual preventative wellness bloodwork to monitor the effects of medications that your pet may be on (such as NSAIDs like Rimadyl or carprofen)
Is there a vaccine for canine liver disease?
Yes, there are vaccines your veterinarian will recommend that could help prevent liver disease. While vaccines may not prevent the infections that lead to liver damage, they will minimize the severity of symptoms should your dog contract infectious canine hepatitis (canine adenovirus 1) or Leptospirosis.
As a dog parent, being familiar with the signs and symptoms of liver disease can help you know when to seek medical care from your veterinarian right away. Though some cases of liver disease can be fatal, there are therapeutic and preventative measures that can be taken to help protect and treat your dog. Some dog breeds are more prone to liver disease than others. Talk with your veterinarian about what you can do to protect your dog.
