The liver is responsible for producing many of the proteins involved in the normal blood clotting process. A severely diseased liver doesn’t produce these proteins in normal amounts, and spontaneous bleeding may occur. For liver function to be affected enough that the production of these proteins is diminished, the underlying liver disease must be serious. Diseases of the liver cause widespread damage, including inflammation, cancer, and terminal scarring or cirrhosis.
An underlying liver disease may cause decreased appetite, fever, weight loss, lethargy, vomiting, or diarrhea. Some patients with significant liver dysfunction become jaundiced, with yellow discoloration of the skin, the gums, and the white parts of the eye. The patient may show bruising, and urine may be a dark, yellow-orange color.
In patients with liver disease, liver blood tests are usually elevated, and other blood tests may also be abnormal. Your veterinarian may recommend additional liver function tests, such as bile acids or blood ammonia levels. If they suspect a bleeding disorder, vets often perform a coagulation panel of several different clotting tests. An ultrasound of the liver can also evaluate any structural changes. A liver biopsy can determine the underlying cause of the disease.
Treatments aim to correct the underlying cause of the liver disease whenever possible. Such treatment may include antibiotics, steroids, intravenous fluids, nutritional support, plasma transfusions, or chemotherapy, depending on the cause. Liver supplements may also be prescribed, such as vitamin B, vitamin K, SAM-e, milk thistle, and various amino acids. Periodic lab monitoring and repeated ultrasounds may be needed long-term to evaluate liver function.
Advanced liver disease has a guarded to poor prognosis. In some cases, however, the disease may be reversed with aggressive and intensive therapy. Reversibility depends largely on the underlying cause and the extent of liver damage present at the time of diagnosis.
Dr. Karsten Fostvedt is a veterinarian at St. Francis Pet Clinic in Ketchum.