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Care continues at home...

"Liver disease often persists for some time. Once your pet has left hospital it is important you maintain the correct management of a patient with liver disease. This useful article spells out the essentials you must know."

Liver disease: Home care notes

The following notes have been prepared to help you cope with the nursing of your pet at home.
Liver disease has many causes. The following notes apply generally. Your veterinarian will discuss any case specific requirements for pet.

General

The liver has many functions within the body. It detoxifies the blood, removes old and damaged red blood cells, helps in supplying energy to the body, plays a role in digestion, provides clotting factors for the blood, manufactures blood proteins, acts as a store for vitamins and minerals etc. As a result liver disease can manifest itself through a diverse range of clinical signs.

Exercise

By minimising the bodies demand for energy you can help reduce the demands upon the liver. What functional liver remains can then work more efficiently, keeping blood toxin levels to a minimum.
Dogs suffering from liver disease usually feel weak and lethargic, so keeping them rested is not difficult. Let them rest all they want. Out only to toilet then back indoors. Do note force them on a significant walk until they are fully recovered.

Diet

    Is a major consideration. Liver disease often results in poor appetite and vomiting so keeping them eating is important. We advise:

  1. Feed a low fat diet with protein of high quality. At Seaforth Veterinary Hospital we sell Hill's L/D dry diet. This diet has all the modifications required for optimal nutrition in the liver disease patient. Hill's I/D diet is also low fat and is a reasonable alternative. It also comes in a canned formulation.
  2. Feed white meats as a supplement: Chicken and fish will be useful for tempting your pet to eat. White meats provide proteins of high quality and are therefore more highly utilised by the body, reducing the need for the liver to burn up none required proteins (which in turn can elevate blood waste / toxin levels). Once eating try to aim for a fully balanced liver diet as above.
  3. Other goodies you can feed: "Nice" biscuits are a good treat. They are high in energy and palatability. Cottage cheese is also said to be a useful adjunct.
  4. Refusing to eat anything! In this case we advocate anything is better than nothing! Starving a liver patient simply because they won't eat what you offer them is not a good idea! Once you have them eating, try stage 2 then 1 above.
  5. Vitamins: Liver patients have problems mobilising and storing vitamins. Try offering / crumbling a multivitamin tablet into their diet once they are eating. Your vet may discuss the specific use of vitamin K in cases of clotting defects.
  6. Water: Ad lib access to water is important to maintain hydration. If your pet continues to vomit at home it is important to resort hydration with intravenous fluids, as this is the only sure way of maintaining this essential function.

Medicines

Just as the causes of liver disease are quite varied so are the medications required. Your veterinarian will discuss the specific treatments most suited to pet's case.  

Major things to watch for:

You must ensure your veterinarian is aware of any:
1. Bleeding: either in urine, faeces, vomit, from the gums etc. This may reflect a defect in blood clotting. Resting a patient is important also bleeding can occur into joints and cause lameness.
2. Vomiting
3. Diarrhoea
4. Swelling in limbs or abdomen due to low albumin levels or a swollen liver.

Further blood testing?

Follow up blood sampling is the best way we can monitor the success of treatment and how soon you can get your pet to a normal life style. Liver enzymes, bilirubin (jaundice factor), albumin levels and haematology are all important in monitoring progress.