Liver disease in dogs

Tucked neatly under your pup’s ribcage, the liver is a busy little powerhouse. It helps process nutrients from food, makes bile to help digest fats, stores energy, processes medicines and other substances, and helps maintain healthy blood by making important proteins and processing old red blood cells.

It also has an impressive ability to repair and regenerate itself, which means a liver problem doesn’t always mean permanent damage or liver failure. But what can go wrong with your dog’s liver, what signs should you look out for, and how is liver disease treated?

What is liver disease in dogs?

Liver disease is a broad term for anything that damages or affects the liver or stops it working as it should. It doesn’t necessarily mean that the liver itself is the original source of the problem. Conditions elsewhere in the body can also put extra pressure on the liver or cause changes in how it works.

One important thing to know about liver disease is that raised liver enzymes such as ALT and ALP don’t automatically mean your dog is in liver failure. Liver enzymes can increase when the liver is irritated, inflamed or affected by something elsewhere in the body, and some medicines and hormonal conditions can raise them too. They’re a useful clue for your vet, but they’re not a measure of how well the liver is doing all of its jobs. Your vet will look at your pup’s blood results alongside their symptoms, medical history and, if needed, further tests to work out what’s really going on.

Types of liver disease 

There are lots of conditions that can affect the liver; some develop slowly, while others can cause problems much more quickly.

Hepatobiliary disease 

The liver makes bile, which helps your dog digest and absorb fats. Bile flows through the bile ducts within the liver and is stored in the gallbladder before being released into the intestines after a meal. Because they are all connected, a problem in one part of this system, such as inflammation or obstruction, can affect the others. 

Toxic liver damage

Some plants, chemicals, medicines and foods can damage a dog’s liver. Even certain human medicines and foods can be dangerous to dogs, such as food sweetened with xylitol. Toxins can cause a wide range of symptoms which can progress fast, including vomiting, diarrhoea, weakness, tremors, seizures or changes in behaviour. If you think your pup has eaten something they shouldn’t, contact your vet straight away for advice.

Endocrine 

Hormonal conditions can affect the liver too. Diabetes and Cushing’s disease (hyperadrenocorticism), for example, can cause changes in the liver even when the liver isn’t the original source of the problem.

Liver cancer 

Like other organs, the liver can develop tumours. These may start in the liver itself or spread there from another part of the body. 

Congenital conditions

Dogs can be born with conditions that affect how their liver develops or functions. Some breeds are more prone to certain conditions. For example, Bedlington Terriers can be prone to copper storage disease, while portosystemic shunts are seen more often in small or toy breeds like the Maltese. A shunt is an abnormal blood vessel that allows some blood to bypass the liver, which can affect normal liver development and function. 

Infectious 

The liver can also be the target of various infections. Vaccination helps protect dogs against important diseases such as leptospirosis and canine infectious hepatitis. Other bacterial, fungal and parasitic infections can also affect the liver, although these are less common.

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Symptoms of liver disease in dogs

One of the tricky things about liver disease is that the early signs can be surprisingly vague. Your pup might simply seem a little quieter than usual. This is partly because the liver has a remarkable ability to keep doing its job even when it is irritated or damaged.

So liver damage doesn't necessarily mean liver dysfunction or liver failure, and doesn’t always cause obvious symptoms. 

Early signs of liver disease or liver damage

These signs aren't specific to the liver and can have many other causes, but they can be an early clue that something isn't quite right:

• Being more tired or less interested in walks and play
• Reduced or changing appetite
• Vomiting or diarrhoea
• Weight loss or difficulty maintaining weight
• Drinking or peeing more than usual
• Changes in behaviour or energy levels
• Poor growth in puppies
• Changes to the skin or coat
  

Signs of more advanced liver dysfunction

When the liver is no longer able to perform some of its essential jobs properly, the signs can become more distinctive. These can include:

• Jaundice – a yellow tinge to the whites of the eyes, gums or skin caused by a build-up of bilirubin
• A swollen or “pot-bellied” tummy – which can sometimes be caused by fluid building up in the abdomen
• Unusual bruising or bleeding – because the liver makes many of the proteins involved in blood clotting
• Pale or unusually greasy-looking poops – particularly when bile flow or fat digestion is affected
• Neurological signs – including confusion, staring, wandering, changes in behaviour, head pressing, poor coordination or seizures. These can occur when substances normally processed by the liver, particularly ammonia, affect the brain
  

These more serious signs can also occur in other conditions, but if you notice them, regardless of the possible cause, contact your vet right away. 

Diagnosing liver disease in dogs

Blood tests are often one of the first steps when your vet is investigating liver health, and liver enzymes such as ALT and ALP are commonly included in many blood tests. But an elevated liver enzyme result doesn't, by itself, mean your dog has liver failure.

They can rise for many reasons and aren’t a direct test of how well the liver is functioning. Your vet will need to look at the whole picture, including your pup's symptoms, history and further tests that might include: 

• Additional blood tests and/or liver function: bilirubin, albumin, glucose, cholesterol, blood clotting, bile acide stimulation etc.
• An ultrasound scan to look at the liver, gallbladder and surrounding organs
• Other advanced imaging, depending on what your vet suspects
• In some cases, a liver biopsy to examine liver tissue and establish a more specific diagnosis
  

A raised liver enzyme result can understandably sound worrying, but it is a reason to investigate, not a diagnosis of liver failure.

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Treating liver disease in dogs

There isn’t one treatment protocol for liver disease because causes and severity vary. Treatment may be targeted at the underlying cause or simply provide supportive care and may include:

• Hospitalisation for fluid therapy
• Antibiotics, antiparasite or antifungal treatment
• Surgery
• Vitamins and other supplements such as SAMe
• Support for poor blood clotting
• Medicines to reduce the circulation of bile acids, where appropriate
• Medicines to reduce inflammation or, in some conditions, fibrosis or scarring
• Lactulose for dogs with hepatic encephalopathy to reduce the production and absorption of ammonia and other gut-derived toxins. 
  

Prognosis for dogs with liver disease

The good news is that the liver has a remarkable ability to regenerate, so some dogs can do very well with the right treatment. However, the outlook depends on what has caused the liver disease, how much damage has occurred and whether the underlying cause can be treated. 

What to feed a dog with liver disease

Some dogs may benefit from a specially formulated diet with carefully adjusted levels of protein, fat, copper or other nutrients, depending on their condition. If your dog has hepatic encephalopathy, for example, your vet may recommend modifying their protein intake.

What to remember about liver disease in dogs 

A raised liver enzyme result can sound scary, but on their own, they rarely mean liver failure. They’re a hint your pup’s liver is a bit unhappy, but your vet will need more than a blood test to get to the root of the problem.

The good news is that the liver is a remarkably resilient organ. It can keep performing its essential jobs despite quite a bit of damage and has an impressive ability to repair itself. With the right treatment, many dogs with liver disease can recover or have their condition managed with tail-wagging results.