Section: Overview
Hepatic (liver) failure is the loss of greater than 75 percent of the function of the liver, occurring secondary to severe, massive liver necrosis (death). This is a syndrome seen more commonly in dogs than in cats, and there are no age, breed, or sex predilections.
General Causes
Drugs
Antimicrobials (antibiotics)
Chemotherapy agents
Anthelmintics (anti-parasite medication)
Analgesics (pain medication)
Anesthetics
Biologic Toxins
Amanita phylloides mushrooms
Aflatoxins (toxin produced by a mold or fungus)
Infectious Agents
Canine infectious hepatitis
Leptospirosis
Other
Heat stroke
Post-whole body hyperthermia treatment for cancer
Thromboembolic (blood clot) disease
Shock
Disseminated intravascular coagulation (DIC)
Acute circulatory failure from any cause
What to Watch For
Vomiting
Jaundice (yellow color to the skin and mucus membranes)
Diarrhea (with or without blood)
Depression
Seizures
Stupor
Coma
Bleeding
Abdominal enlargement
Ascities (fluid in the abdominal cavity)
Diagnostic Tests
Your veterinarian will recommend the following diagnostics:
A complete blood count (CBC)
Biochemical profile
Urinalysis
Serum bile acids
Ammonia levels
A coagulogram (clotting profile) to rule out a clotting disorder.
Abdominal radiographs (X-rays)
Abdominal ultrasound
Liver biopsy and culture/sensitivity
Ultrasound
Exploratory laparotomy (abdominal surgery)
Laparoscopy, which is a procedure that allows visualization and sampling of abdominal structures by an instrument introduced through a tiny incision
Treatment
Specific treatment is needed for any underlying or associated disorders. Hospitalization and support generally includes fluid and electrolyte therapy as well as dextrose (sugar) as needed for dehydration, metabolic imbalances and hypoglycemia (low blood sugar). Some more specific treatments include:
Nutritional support and dietary management
Colloids, such as plasma or hetastarch
Antibiotic therapy
Antiemetics, which are medications that stop or control excessive vomiting
Diuretics, which are drugs that help the body eliminate excess fluid
Lactulose, which is a drug that slows the absorption of ammonia from the GI tract
Mannitol, which is a drug that has several actions, including alleviation of cerebral edema or brain swelling
Enemas (saline, neomycin, lactulose)
Antiulcer therapy
Vitamin K
Home Care and Prevention
Administer all medication and recommended diet as directed by your veterinarian. Your pet will need to have follow up examinations and biochemical evaluations to monitor progress.
The prognosis of the liver failure depends on the quantity of liver mass destroyed and the ability to control underlying disorder and complicating factors.
Preventing liver failure can be difficult, if not impossible. To reduce the risk, vaccinate dogs against infectious canine hepatitis and leptospirosis and try to avoid drugs and toxins associated with liver toxicity.
