Overview of Canine Hepatic (Liver) Failure
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 of Hepatic Failure in Dogs
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
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)
What to Watch For
Diagnostic Tests for Hepatic Failure
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 for Hepatic Failure in Dogs
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 of Hepatic Failure in Dogs
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.
Information In-depth on Liver 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).
There are several diseases/disorders that have similar symptoms and/or cause hepatic failure. These include: 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. 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.