Pathophysiology

• Chronic hepatitis Liver: chronic hepatitis , hereditary portosystemic shunts Congenital portosystemic shunt (CPSS) , and tumors (eg lymphoma, also primary liver tumors Liver: neoplasia and metastatic spread) comprise much of primary of canine liver disease Liver: chronic disease - overview.
• The liver is also affected secondarily by many other diseases, eg pancreatitis Pancreatitis: chronic , inflammatory bowel disease Inflammatory bowel disease: overview , anemia - termed reactive hepatitis, which makes up about a fourth of canine liver disease.
• Some dog breeds (eg Bedlington terriers, West Highland White Terriers, Skye terriers, Dalmatians, Doberman pinschers and Labradors) may have a metabolic defect causing excess copper associated hepatotoxicosis Liver: copper accumulation - West Highland White and Skye Terriers.
• Other patients with hepatitis may also accumulate copper in the liver.
• The liver has over 1000 functions in metabolism and digestion which can be compromised with disease.
• Impaired hepatic function Liver function assessment and storage may result in malnutrition and vitamin and mineral deficiencies.
• The goals of nutritional therapy are to help maintain the functions, decrease signs of hepatic encephalopathy Hepatic encephalopathy (HE), provide substrates (energy and protein) for hepatic repair, decrease oxidative damage and correct electrolyte disturbances.
• Ammonia is converted to urea in the normal liver; where this is compromised in hepatopathies, ammonia increase, contributing to HE.

Dietary requirements

Special considerations

Diets

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Bauer J E & Shenk P A (1989) Nutritional management of hepatic disease. Vet Clin North Am Small Anim Pract 19 (3), 513-526 PubMed.

Other sources of information

• Marks S L (2012) Nutritional management of hepatobiliary disease. In: Applied Veterinary Clinical Nutrition.Editors Fascetti AJ and Delaney SJ. Wiley Blackwell, West Sussex, U.K. pp 235-250.
• Meyer H, Twedt D C, Roudebush P, Dill-Macky E (2010) Hepatobiliary Disease. In: Small Animal Clinical Nutrition 5th Edition. Editors Hand MS, Thatcher CD, Remillard RL, Roudebush P, Novotny BJ. Mark Morris Institute, Topeka, Kansas. pp 1155-1194.