By Teresa Garden, DVM
In our last article we discussed various supplements used to treat or support liver disease. In this article we will focus on a specific and common liver disease in dogs and how supplements are incorporated into their treatment plan.
Canine hepatitis is an inflammatory disease of the liver characterized by fibrosis, hepatocellular necrosis and predominantly nonsuppurative inflammation. Cirrhosis may be the end result in chronic cases. In most dogs the underlying causative agent is never identified. An adenovirus may be involved. Some cases may be caused by the bacterium Leptosporosis or the long-term use of drugs such as phenobarbital, primidone, phenytoin, or carprofen. The pathophysiology of hepatitis involves an immunological response producing antibodies directed at liver-specific antigens. Liver injury ensues.
Breeds commonly affected by hepatitis include Dobermans, Labs, Cocker Spaniels, and German Shepherds. Symptoms of hepatitis are lethargy, anorexia, vomiting, weight loss, diarrhea, and increases in drinking and urination. In severe cases ascites (fluid accumulation in the abdominal cavity), jaundice, and neurological symptoms may occur.
Your veterinarian can diagnose liver disease by performing blood tests. Liver enzymes and bilirubin will be elevated. Albumin may be decreased. Radiographs and ultrasound of the abdomen can further evaluate liver disease. Definitive diagnosis of hepatitis requires aspiration or biopsy of the liver.
The goals of treatment are to control inflammation, slow or arrest fibrosis, resolve any infection, decrease toxins, improve bile flow, and support hepatic regeneration. Treatment protocols can be comprised of western drugs, holistic therapies or a combination of the two based on the individual patient’s needs and the client’s wishes.
Drug therapy may employ the medicine colchicine to combat fibrosis. Ursodiol will improve bile flow and decrease toxic bile acids. Antibiotics will be instituted if infection is confirmed. Metronidazole may be employed for its possible immunomodulatory and antioxidant effects. Prednisone may be used to decrease inflammation. Ascites may be helped with diurectic therapy.
A holistic approach may incorporate diet, antioxidants, eastern or western herbs, acupuncture, and nutritional supplements. A good diet for liver disease should be easily digestible, highly palatable, calorically dense, and easy to prepare and feed. Highly digestible protein should comprise 25-35% of the diet. Vegetable or dairy protein may be preferred over meat sources for some liver disorders. There are good homemade diets available that are tasty and can help the liver to detoxify. Homemade diets must be balanced by adding vitamins, minerals, and bonemeal. Feed your dog frequent small meals for optimal food digestion and nutrient assimilation.
Denamarin is a wonderful supplement for liver disease employed by both conventional and holistic veterinarians. It is made by the Nutramax company and contains both silymarin (derived from Milk Thistle) and s-adenosylmethionine (SAM-e). Silymarin or the herb Milk Thistle functions as an antioxidant that reduces inflammation and stabilizes hepatic cell membranes. It has anti-fibrotic effects, promotes protein synthesis, and reduces damage from toxic insults. SAM-e is a potent antioxidant that detoxifies free radicals and has broad metabolic benefits.
Vitamin E is often prescribed in the treatment of canine hepatitis. It reduces the toxicity of bile acids to hepatocytes. Vitamin E modulates the cellular response to oxidative stress and provides anti-inflammatory and antifibrotic effects. Tumeric or curcumin may be utilized to treat hepatitis as well. It is a powerful antioxidant, inhibits hepatocellular carcinogenesis, and reduces toxin-induced damage to the liver.
We often advise adding fresh liver to the diet. Liver is a concentrated source of vitamins, minerals, aminoacids, and other nutrients that may benefit your own pet’s ailing liver. As an alternative, we may employ a liver glandular product such as Canine Hepatic Support by Standard Process. This liver supplement provides nutrients to help liver cells repair and regenerate.
Your veterinarian will monitor your dog’s response to treatment by performing periodic physical exams and blood tests. The prognosis is guarded with advanced chronic hepatitis and cirrhosis. Fortunately, most cases are diagnosed earlier and the prognosis is fair to good. At Animal Health & Healing, we believe our canine hepatitis patients achieve the best responses with integrative treatment protocols that maximize optimum outcomes.
Dr. Teresa Garden is chief veterinarian /owner of Animal Health & Healing, a full-service holistic and conventional veterinary practice in the Maplewood/Richmond Heights area. AnimalHealthandHealing.com; phone: 314-781-1738.