Nutritional Management of Canine Liver Disease

There are many misconceptions on the nutritional management of the dog with liver disease.

Different liver disease processes can all lead to progressive damage and destruction of liver cells and can ultimately lead to what is called liver failure. The initial damage usually results in leakage of certain enzymes from the liver cells into the bloodstream and the elevation of these liver enzymes on a blood test indicates that a patient may have a hepatopathy (liver disease) but does not indicate whether that patient is in liver failure.

Some patients with liver failure lose the ability to remove the normal by-products from digested and absorbed food from the circulation. Therefore, these by-products remain in the circulation and lead to metabolic and clinical abnormalities. These adverse effects are frequently manifested as neurologic signs, referred to as hepatic encephalopathy (HE). HE can be manifested as lethargy, star gazing, head-pressing, or even seizures.

A lot of owners and veterinarians want to change the diet if they see any signs that something is wrong with the liver however changes in liver enzyme values does not necessarily mean that a dietary change is appropriate. Protein restriction should be instituted only if signs of HE exist. Reducing dietary protein in all patients with liver disease is not appropriate as it may lead to protein malnutrition.

A significant number of patients that I evaluate for liver disease are presented for evaluation on a prescription liver diet that they do not need.