Veterinary Guide to Canine Liver Failure 2025 🩺🐶

By Dr. Duncan Houston BVSc

🧬 What Is Liver Failure?

Liver failure occurs when over ~70% of hepatic function is lost, either acutely or chronically. The liver’s critical roles—detoxification, bile production, nutrient storage, protein and clotting factor synthesis—become compromised, leading to systemic illness.

⚠️ Clinical Signs: When Liver Disease Becomes Failure

Symptoms emerge when liver function declines sharply or over time:

• Jaundice (icterus): yellow gums, eyes, and skin due to bilirubin buildup.
• Ascites: fluid accumulation giving a “pot‑bellied” appearance, due to low albumin.
• Hepatic encephalopathy: neurologic signs like seizures, head-pressing, confusion from toxin buildup.
• GI signs: vomiting, diarrhea (possibly grey), anorexia, weight loss.
• PU/PD: increased drinking & urination from impaired metabolism.
• Lethargy, fever, abdominal discomfort: often present.
• Coagulopathies: bleeding issues, bruising from poor clotting-factor production.

🔍 Diagnosing Liver Failure

1. History & Exam: note toxin ingestion, infections, breed risk (e.g., shunts).
2. Bloodwork: CBC, chemistries (ALT, ALP, bilirubin, albumin), clotting panels, bile acids, ammonia.
3. Urinalysis: assess concentrating ability, toxins.
4. Imaging: ultrasound/X-ray to identify shunts, masses, ascites.
5. Special Tests: bile acids, ammonia, especially for shunts.
6. Sampling: FNA/biopsy to identify neoplasia, copper storage, chronic hepatitis.

🛠️ Treatment Strategies

1. Treat the Underlying Cause

• Toxins: remove via decontamination, antidotes, supportive care (e.g., NSAID, xylitol, mushroom poisoning).
• Infections: use targeted antibiotics (e.g., leptospirosis) or antifungals..
• Shunts: surgical attenuation with ameroid band or cellophane for congenital shunts—excellent outcomes for extrahepatic cases; intrahepatic shunts are harder to manage.
• Metabolic/endocrine: address underlying conditions (Cushing’s, diabetes)..

2. Supportive Care

• IV fluids, electrolytes, antiemetics, pain control.
• Lactulose + antibiotics (neomycin/metronidazole) to reduce ammonia absorption.
• Vitamin supplements: SAMe, silybin, vitamin K.

3. Nutritional Management

• Low-to-moderate protein, high-quality carbohydrates, low-fat diet.
• Prescription hepatic diets and supplement protocols.

4. Cancer or Masses

• Surgical removal for cysts or focal tumors; medical or palliative care for diffuse disease.

5. Chronic Monitoring

• Reassess labwork, imaging, and clinical signs every 3–6 months or as needed.
• Manage ongoing hepatic encephalopathy and coagulopathies.
• Track body condition, activity, appetite, neurologic health.

📈 Prognosis

• Acute or mild toxin/infection: good – liver can regenerate if treated early.
• Congenital shunts: excellent for extrahepatic; guarded for intrahepatic shunts.
• Chronic hepatitis, copper storage: fair; requires lifelong management.
• End-stage failure or cirrhosis: poor – quality of life may dictate palliative care or euthanasia.

📱 Ask A Vet Telehealth Support

• 📸 Share lab results, imaging for remote specialist review.
• 🔔 Medication, diet, ammonia-control, and recheck reminders.
• 🩺 Video assessments of neurologic status, abdominal distension, jaundice.

🎓 Case Spotlight: “Milo” the Maltese

Milo, a 2‑year‑old Maltese, showed vomiting, slow growth, and ataxia. Labs revealed elevated bile acids and ammonia; ultrasound confirmed microvascular dysplasia. With lactulose, a low-protein diet, supplements, and antibiotics, Milo stabilized in weeks. Ask A Vet provided lab tracking, dietary plans, and telehealth monitoring—now thriving at 4 🐾.

🔚 Key Takeaways

1. Liver failure occurs when >70% hepatic function is lost—an emergency, whether acute or chronic.
2. Watch for advanced signs: jaundice, ascites, neurologic changes, bleeding, and GI upsets.
3. Diagnosis requires labwork, imaging, and sometimes biopsy or shunt testing.
4. Treat by addressing cause, providing supportive care, and managing diet and supplements.
5. Prognosis varies: excellent for acute or treatable causes, fair with shunts, poor in end-stage/cirrhosis.
6. Ask A Vet telehealth provides critical support—diagnostics review, remote monitoring, medication coordination, and peace of mind 📲🐾

Dr Duncan Houston BVSc, founder of Ask A Vet. Download the Ask A Vet app to guide your dog through liver failure—from early signs to diagnostics, diet plans, telehealth check-ins, and informed care decisions at every stage 🐶📲