Chronic Liver Failure
Why Should I Bring my Pet to Willows for Chronic Liver Failure?
Willows is one of Europe’s leading small animal referral centres. Our state-of-the-art hospital is led by internationally renowned Specialists, committed to providing the highest standards of veterinary care. Our Specialist Multi-disciplinary team, provide gold standard management and treatment of chronic liver disease patients.
The liver is a vital organ and its dysfunction has an effect on the entire body, as such this must be evaluated and accounted for during diagnostic investigations. Our Specialist Diagnostic Imaging service enables evaluation of the size, texture and blood vessels of a patient’s liver before any biopsies are taken, enabling as much information to be obtained in a non-invasive way. Our Specialist Anaesthesia team has the unique training to manage your pet under anaesthesia with altered liver function.
At Willows our Intensive Care Unit is often used for the recovery of patients with liver failure following biopsies or other procedures that require anaesthesia. At Willows your pet will receive safe and thorough investigations, with Specialist interpretation of results and design of a tailored treatment plan.
The liver is a vital organ performing many complex functions essential to daily life and good health. Its main functions are:
- Absorption and digestion of food into; glucose, proteins and fats
- Maintaining vital bodily functions i.e. normal blood clotting and immunity
- Production of bile, to assist with the absorption of fat and certain vitamins
- Storing of the body’s primary sugar (glucose) as glycogen releasing it into the bloodstream when needed
- Neutralising and breaking down toxic substances i.e. chemicals and some medications, for later elimination in bile or through the kidneys in urine.
What is Chronic Liver Failure?
Chronic liver failure occurs due to long-term damage to the liver, resulting in a liver that fails to work. It can be caused by chronic exposure to toxins, heavy metals (copper, iron and zinc), chronic infections, chronic inflammation/irritation, cancer, blood vessel abnormalities, immune disease and fatty liver syndrome in cats.
The liver is very good at regenerating itself (unlike other organs such as the kidneys), however serious ongoing damage can cause long-term failure of the liver’s function, known as chronic liver failure. Over 75% of the liver is usually damaged before liver failure occurs. As the liver is responsible for eliminating many toxins, including those that have an effect on mental ability, a failing liver can present as a neurological problem (falling over, stupor, fits etc.).
How is Chronic Liver Failure Diagnosed?
Liver failure is diagnosed by blood tests. Further investigations, such as ultrasound scans, CT, urine cultures, blood cultures, may be required in individual cases. Samples of the liver are often required to diagnose the cause of liver failure, these may be obtained through a needle placed into the liver under guidance on an ultrasound scan; alternatively the liver may be visualised by using keyhole surgery (laparoscopy) or by a full surgical procedure.
The technique that is chosen will depend on a number of factors, which will be discussed in the event that biopsies are required. For some patients the initial cause of the problem may no longer be present at the time of investigation, however the disease itself may still cause symptoms, and the damage to the liver may also continue.
What are the Most Common Signs of Chronic Liver Failure?
- Reduced appetite
- Lethargy
- Increased thirst
- Strange behaviours
- Vomiting
- Diarrhoea, occasionally blood in the stools, or dark, tarry stools
- Bloated tummy due to fluid accumulation
- Yellow skin, urine, gums (jaundice)
- Weight loss
Fig 1: Symptoms of acute liver failure include yellow gums and eyes (jaundice)
What Treatments are Available for Chronic Liver Failure?
Chronic liver failure requires a multimodal approach, including the adjustment of diet, prescription of medications and activity levels. During diagnostics an underlying cause is sometimes detected, allowing directed therapy to eliminate the initiating cause (e.g. toxins, infections, cancer etc.). In some instances this is not possible and therapy is focused on supporting the liver in its remaining function. Liver disease is a non-painful condition, however dogs and cats can be nauseous, neurological or accumulate fluid in the abdomen, all of which require medication to control.
Treatments which may be required in chronic liver failure include:
- Dietary modification to provide calories, lower protein and reduce minerals or toxins normally digested by the liver. In some cases, particular with concurrent medical problems, our Specialist Nutritionist will prescribe and design a bespoke diet for the patient.
- The liver produces proteins, if these become very low, fluid can accumulate in the abdomen and must be drained to maintain comfort
- Supportive therapy for the gastrointestinal signs include antacids to reduce gastrointestinal ulceration, anti-nausea medications and therapy for diarrhoea
- In dogs with neurological signs secondary to hepatic encephalopathy, specific medications are used to reduce the amount of neurotoxins in the blood
- General supportive therapy of the liver is provided to all cases of liver failure including oxidants and other natural supplements to support liver functions
- Specific therapies are necessary for some patients that have an underlying issue, such as copper binding drugs for dogs with copper associated hepatitis.
What Can I Expect if my Pet is Treated for Chronic Liver Failure?
Chronic Liver Failure can be a challenging condition to treat. Early intervention and aggressive treatment can be successful in where the extent of damage is not too severe. At the present time, liver transplants are not available in Veterinary medicine.
If your pet develops chronic liver failure, treatment options will be discussed in detail and advice given to support when making decisions about what treatment you wish for your pet. In the long term care of patients with chronic liver disease our Specialists rely heavily on an owner’s account of a pet’s progress at home, i.e. appetite, weight and overall form. Providing an acceptable quality of life is the most important aim of therapy in these cases.
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Internal Medicine
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To assist owners in understanding more about Internal Medicine we have put together a range of information sheets to talk you through the some of the more common Medicine conditions seen and treated by our Specialists.
