The liver is a very complicated, hard-working and truly unique organ. It is responsible for protein, fat, and carbohydrate metabolism, vitamin and mineral storage, digestion of food and detoxification of waste.
The liver is unique in the way that, much like a salamander have the ability to grow back its tail, so does the liver have the ability to regenerate if it gets some help. Thus, nutritional support plays an essential role for dogs with liver disease.
The basic goals are to:
- Supply energy and nutrients to prevent malnutrition
- Minimize further damage by copper and free radicals
- Support liver cell regeneration and avoid neurological symptoms
Non-protein calories (fat and carbohydrates) help to prevent the use of protein for energy.
If the food does not contain enough non-protein calories the body will make energy from protein. This process is called gluconeogenesis and takes place in the liver. If the liver is already struggling, this will make the liver work harder.
When feeding a dog with liver disease, it is important not to overload the remaining metabolic capacity of the liver so its diet should contain enough non-protein. Protein requirements for dogs with liver disease are a subject of much discussion.
When protein is broken down, waste is released; this is taken care of by the liver. When the liver is damaged, the waste will get into the system. This can cause neurological problems. Thus, often a low protein diet is recommended. However, proteins are essential for organ health and repairs and too little protein can make liver problems worse.
If the dog is not fed enough protein, it will make its own protein resulting in weight loss and muscle mass loss. When this happens a lot of by products have to be metabolized in the liver – again, extra work load on the liver. Therefore protein restriction should be avoided as much as possible, especially in dogs with acute liver failure.
Moderate protein restriction may be necessary in dogs with clinically evident hepatic encephalopathy. The key is to offer high-quality proteins that leave less waste for the liver to dispose of.
There are several supplements that can be very helpful in supporting the liver during recovery.
Vitamin E and C are both important antioxidants that can help minimize oxidative injury. However, vitamin C should not be given to dogs with copper retention. Vitamin B complex is extremely important for liver health. Supplementation can help regenerate normal liver function. Vitamin K is needed for normal blood clotting and is recommended in cases of chronic liver disease. Zinc might be beneficial as some dogs with liver disease are deficient in zinc and can reduce copper retention. Salmon oil can help with inflammation and organ function. Adenosylmethionine (SAMe) helps to improve liver function. It is also an anti-oxidant and has anti-inflammatory properties.
Milk Thistle is usually the number one recommended natural herb for liver health. It is thought to have antioxidants and helps with free radicals for various types of liver disease. It also helps with toxicity and has been found to help regenerate the liver and remove toxins.