Liver Disease

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There are no specific signs of liver disease. Early general signs of liver disease include:

  • loss of appetite
  • loss of weight
  • increased drinking and urinating
  • lethargy
  • vomiting
  • diarrhea
  • prolonged recovery time after an anaesthetic

Diarrhea is less common than vomiting. In later stages more clinical signs appear. Over 80 percent of liver function has been lost by the time these signs are visible.

  • yellow staining to body tissue (jaundice)
  • dark tea-coloured urine (bile)
  • grey-white, fat-loaded faeces containing no bile colouring
  • fluid in the abdomen (ascites)
  • behaviour changes such as disorientation, loss of coordination, twitching or even seizures caused by ammonia-induced brain inflammation (hepatic encephalopathy)
  • swelling of the legs (dependent edema)
  • blood in the urine or stool, bruising on the skin

While jaundice may appear to be a specific clinical sign of liver disease, it also occurs when red blood cells are destroyed, as in hemolytic anemia. Ascites results from severe liver damage but is more likely to occur as a result of heart failure.

Because so many causes of liver disease occur outside the liver it is very important that we make an accurate diagnosis and treat the primary condition. A variety of blood tests are used, including enzymes, bilirubin and bile acids. X-rays including contrast x-rays with dyes are used. So too is ultrasound, CT and MRI imaging. The most accurate diagnosis comes from a needle biopsy, or a fine-needle aspiration, carried out under ultrasound guidance although most conditions can be diagnosed quite accurately without need for biopsy. Aggressive fluid therapy is vital for a number of liver diseases. Nutritional support eases the work of the liver while the primary condition is treated.

Liver Shunt - Liver Bypass - Portosystemic Shunt - Hepatic Encephalopathy - Dogs

This condition in its congenital form occurs when a newborn pup's communication between the (portal) vein bringing blood from the gastrointestinal tract to the liver, and the posterior vena cava carrying blood back to the heart, does not shut. If this fails to close properly, not all the blood from the intestines filters through the liver and gets purified of substances such as ammonia. The unpurified blood is pumped to the brain where these substances cause brain inflammation (hepatic encephalopathy). Breeds with a genetic predisposition include:

  • Miniature Schnauzer
  • Yorkshire Terrier
  • Maltese
  • Cairn Terrier

Affected dogs show signs associated with brain inflammation, including staggering, twitchiness, lethargy and seizures. Dogs can also acquired liver shunts as a consequence of traumatic liver damage affecting the portal vein.

Diagnosis is based on blood samples, bile acid measurement, x-rays and ultrasound. The shunt is corrected surgically. Lactulose acidifies the colon and traps ammonia. Antibiotics such as metronidazole and neomycin reduce bacteria populations, the source of ammonia.

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