Liver Failure (Acute) in Dogs

Acute liver failure is a very serious condition. It can occur suddenly, or as the end-stage of a chronic liver disease. The liver cleans and detoxifies the blood; it stores reserves of many nutrients and produces hormones that regulate digestion, metabolism and blood coagulation. Failure in the liver can cause multiple systemic problems, including fluid in the abdomen (ascites), digestive ulcers, lack of blood coagulation, susceptibility to infection, and hepatic encephalopathy, a liver-related brain disease. Many different conditions can lead to acute liver failure in dogs. Poisoning and infection are some of the most common issues that will trigger a sudden illness. Many endocrine imbalances affect the liver, and cancer or chronic inflammation can slowly destroy tissue. Some liver diseases are the result of a congenital abnormality that is present at birth. 

Depending on the cause, liver failure can occur at any time in a dog’s life. Some cases are reversible once the issue causing the problem is resolved. The liver is capable of regenerating itself and building new, healthy cells, but too much dead tissue causes scarring and cirrhosis. Many symptoms can be treated supportively with medications that support liver function. Diet change can also put less stress on the liver. If the condition cannot be treated, acute liver failure will lead to death.

In dogs, severe liver failure can cause dysfunction in many different systems and may even affect important organs like the brain. Veterinarians call this condition acute liver failure. It needs immediate treatment. Long-term recovery will depend on the cause.

Vomiting, poor appetite, and weight loss are often the first signs of chronic liver failure. A dog with these symptoms should be evaluated by a veterinarian before acute liver failure develops. Severe symptoms should be treated as an emergency.

• Vomiting

• Excessive thirst

• Frequent urination

• Bloody diarrhea

• Jaundice (yellow mucous membranes)

• Gastrointestinal bleeding

• Ulcers

• Ascites (fluid in the abdomen)

• Disorientation or aimless wandering

• Aggression

• Excessive drooling

• Poor coordination

• Blindness

• Seizures

• Coma

Types

Symptoms of acute liver failure can appear with any condition affecting the liver. Conditions can be very sudden, or chronic and slow developing.

Sudden – poisoning can cause immediate liver failure if there are more toxins in the system than the liver can handle. Infection can also severely limit liver function quite suddenly. Occasionally necrosis, or the death of liver cells, can generate sudden, acute, symptoms.

Chronic – long term liver disease may begin slowly, but it will eventually manifest acute symptoms.

These are some of the most common causes of liver failure

Many types of poisoning

• Alcohol

• Drugs

• Antifreeze

• Herbicides, fungicides or insecticides

• Some types of mold, amanita mushrooms or blue-green algae

Infectious diseases

• Infectious canine hepatitis

• Leptospirosis

• Fungal infections

• Toxoplasmosis

Chronic hepatitis – long-term inflammation of the liver, due to copper accumulation and other causes. This condition is more common among some breeds.

• Bedlington, Skye and West Highland White Terriers

• Cocker Spaniels

• Doberman Pinschers

• Standard Poodles

Endocrine disease – these may cause or contribute to liver failure.

• Diabetes

• Cushing’s Disease

• Hyperthyroidism

Liver cysts – more common in Cairn and West Highland White Terriers

Cancer – cancer that originates in or spreads to the liver can cause liver failure

Congenital abnormalities

• Hepatic amyloidosis – an abnormal protein accumulation, more common among Chinese Shar-Peis

• Glycogen storage disease – caused by a genetic enzyme deficiency

• Tendency to liver fibroses – scar tissue replaces normal liver cells

• Vascular abnormality in the liver i.e. liver shunt

Your dog’s symptoms will probably indicate severe liver failure. Bloodwork and urine samples can show the level of dysfunction and help to determine the cause of the problem. The veterinarian will check for infectious diseases, signs of poisoning, and hormone or enzyme imbalance. X-rays and ultrasound will often show an enlarged liver and may help to diagnose cancer, cysts, or vascular abnormalities.

The veterinarian will need your dog’s medical history, including any known conditions such as diabetes, and any medications, past or present. Family history may also be important, since breed is a factor. Any potential exposure to poisoning will be extremely relevant. An exact description of your dog’s symptoms may help to indicate the source of the problem. The veterinarian will need to know the dates of your dog’s last vaccinations and any potential exposure to infections.

The veterinarian will start by treating the symptoms of acute liver failure. Severely affected dogs are often comatose and will need to be given intravenous fluids and electrolytes to decrease blood toxicity. Diuretics or enemas could be given to clean out the system. If too much fluid in the abdomen is causing respiratory difficulty, a long needle may be inserted to siphon off some of the fluid. If the blood is not clotting properly, transfusion may be necessary as well as medications that assist coagulation, such as heparin or vitamin K. Antibiotics may be given to treat and/or prevent infection since the immune system becomes less functional with liver failure.

After stabilizing the symptoms, the veterinarian will try to treat the underlying cause of the liver disease.  If poisoning was the issue, the condition may reverse itself once the toxins are flushed out of the body. Liver failure that is caused by an endocrine problem can often be rectified by treating this condition medically. Antibiotics or antifungal medication may be prescribed for bacterial or fungal infections. With viral infections, supportive management of the symptoms may be the only treatment possible until the immune system has fought the virus.

Surgery may be necessary to treat some causes of liver failure, such as cancer, cysts or vascular anomalies. This will depend on your dog’s overall health. Surgery will not be possible unless the symptoms of acute liver failure can be stabilized. Some conditions are inoperable, and there is always a certain amount of risk with surgery. Chemotherapy may be prescribed for some types of cancer.

Dogs that have chronic hepatitis as the result of a congenital abnormality may need long term medication. Drugs that bind to copper can help to reduce copper storage problems. Congenital enzyme and protein abnormalities usually result in a shorter life, although the condition may be manageable for a time with diet and medication.

Your dog’s outlook for recovery will be based on the diagnosis made by a veterinarian. Complete recovery depends on identifying and eliminating the cause of acute liver failure. Some conditions are treatable. Others will need to be managed with long-term medication that may cause significant side effects.

For most chronic liver problems with an unknown or untreatable cause, a low protein, low sodium diet is recommended. Frequent, small, carbohydrate-based meals can help to put less stress on the liver and prevent the recurrence of acute liver failure. Some veterinarians may prescribe food designed specifically for dogs with liver problems, while others will recommend a homemade diet. Antioxidants, vitamin E, milk thistle and other supplements can also be given to support liver function.

Acute liver failure can be expensive to treat. If you suspect your dog has acute liver failure or is at risk, start searching for pet insurance today. Brought to you by Pet Insurer, Wag! Wellness lets pet parents compare insurance plans from leading companies like PetPlan and Trupanion. Find the “pawfect” plan for your pet in just a few clicks!