Hepatic Failure in Dogs
Hepatic failure is a condition that occurs when the liver is affected by poor blood flow, decreased oxygen delivery, hepatotoxic drugs or chemicals, heat excess or infectious agents. Hepatic failure is seen in all ages and breeds and affects both dogs and cats. This condition may affect several organ systems, including the liver and gall bladder (hepatobiliary tract), nervous system, gastrointestinal tract, and hematologic (blood) system. Affected individuals may show any number of signs, including anorexia, lethargy, depression, vomiting, diarrhea, seizures, ascities (fluid in the abdominal cavity), bleeding and jaundice (yellow color to the skin). Hepatotoxins. These are agents or drugs harmful to the liver and include heavy metals, anti-inflammatory agents, certain antibiotics, anticonvulsants, and certain chemical dips and sprays.
There are several diseases/disorders that have similar symptoms and/or cause hepatic failure. These include:
Infectious agents. Leptospirosis (a bacterial infection) or canine infectious hepatitis (a viral infection) may be associated with hepatic failure.
Massive, overwhelming multi-system events including heatstroke, thromboembolic disease (blood clots), shock and disseminated intravascular hemolysis (DIC) can also be associated with liver failure.
Hepatic neoplasia (cancer of the liver), most commonly lymphosarcoma, can cause changes and clinical signs similar to hepatic failure.
Bile duct obstruction can occur due to tumors, inflammation or infection. This bile duct blockage can cause signs similar to liver failure.
Pancreatitis, an inflammation of the pancreas, often presents for some combination of vomiting, lethargy, and loss of appetite, and can be associated with liver failure, or it can initially mistaken for liver failure.
Pancreatic cancer can block the biliary tract, causing symptoms similar to liver failure.
Intestinal inflammation, tumors, or foreign bodies need to be considered.
Disorders associated with fluid accumulation in the abdominal cavity can also be mistaken for liver failure. Some of these disorders are associated with protein loss and others are caused by abnormal functioning organs.
Protein losing enteropathies. These intestinal disorders cause profound protein loss and include inflammatory bowel disease, lymphangiectasia and intestinal cancer. When protein is lost, fluid can accumulate.
Protein losing nephropathies. These are kidney disorders that allow protein loss. The most common is inflammation of a part of the kidney (glomerulonephritis) or the deposition or collection of a type of protein in organs and tissues that compromise their normal function (amyloidosis).
Right heart failure can cause a fluid build-up in the chest and/or abdominal cavity.
Carcinomatosis is widespread cancer throughout the abdominal cavity.
A variety of disorders are associated with jaundice, including liver failure.
Autoimmune hemolytic anemia, which is destruction of red blood cells by the immune system.
Infectious diseases, such as Babesiosis, Leishmaniasis, liver flukes.
Other Causes of Illness
Inflammatory liver diseases (chronic active hepatitis, cholangiohepatitis), and other disorders such as cirrhosis (severe, end-stage liver disease), copper toxicity of the liver, and portosystemic shunt.
Primary gallbladder diseases (stones, cancer, inflammation, infection) may need to be differentiated.
Coagulopathies (bleeding disorders) including thrombocytopenia (decreased platelets), warfarin ingestion and disseminated vascular coagulation (DIC).
Disorders that cause cerebral edema (brain swelling) need to be ruled out.
Diseases associated with hypoglycemia (low blood sugar) including insulinoma, hepatomas, sepsis and others need to be considered as well.