Liver Protectants : Evidence-Based Medicine

Liver protectants are therapeutic agents, called hepatoprotectants, that have been promoted for their potential role in the ancillary treatment of liver disease in dogs and cats. Ancillary indicating that alone they do not constitute treatment. These products include both prescription drugs and non-drug dietary supplements.

A drug, by definition, refers to “any substance, food, or nonfood that is used to treat, cure, mitigate, or prevent a disease and any nonfood substance that is intended to affect the structure or function of man or animals.

The 2 most commonly prescribed liver protectants includes denamarin and ursodiol and variations thereof. Unfortunately, there is little to no evidence that exists currently to support their use in the treatment or prevention of liver disease. Furthermore, clients spend hundreds to thousands of dollars on these medications often annually when these funds would be better directed to obtaining a diagnosis.

Veterinarians need to weigh the costs, risks, and potential benefits of nutritional supplements for their patients on an individual basis; however the current literature suggests no benefit and thus the prescription of these nutraceuticals is questionable at best.

Still more , veterinarians should obtain consent from the owners to ensure they understand that little to no evidence exists to support the use of these products for the treatment or prevention of liver disease.

The lack of regulation of nutraceuticals also increases the risk of lack of quality control, labeling inaccuracies, and omission of cautionary statements.

Although some dietary supplements have shown beneficial effects under limited in vitro conditions or for a very specific hepatotoxin, their general use as global hepatoprotectants remains suspect.

---