Brain Disorder Due to Liver Disease Average Cost

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What is Brain Disorder Due to Liver Disease?

Just like our bodies, our dog’s body produces ammonia when it metabolizes (breaks down) the food we eat. Your dog’s liver is supposed to detoxify the ammonia and other waste in the body and send it to the kidneys to be excreted from the body. Other essential functions the liver is responsible for are producing albumin (a protein in the blood) and creating bile to digest fats. If your dog has liver disease or liver failure, the ammonia cannot be filtered and excreted so it builds up in the body. When the ammonia reaches the brain it is able to cross the blood-brain barrier and causes degeneration of the brain and mental functions (hepatic encephalopathy). If you notice that your dog is acting strangely or confused, walking in circles, acting as if he cannot see, and acting intoxicated, you need to call your veterinarian immediately. These symptoms are usually more prevalent right after eating or during times of stress.

Brain disorder due to liver disease (hepatic encephalopathy) is a metabolic disorder caused by liver disease that affects the brain. This disorder has three types: Type A, Type B, and Type C, but they are all related to a buildup of ammonia from other waste materials in the dog’s body and they all have the same symptoms. There are four stages of hepatic encephalopathy as well, graded on the severity of the brain damage. The liver is supposed to break down the ammonia to make it less toxic, but in hepatic encephalopathy, the liver is compromised and cannot perform this task. This causes the ammonia and other toxins to build up in the brain, which causes confusion and mental deterioration.

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Symptoms of Brain Disorder Due to Liver Disease in Dogs

The symptoms of hepatic encephalopathy are the same for all types, but they are different depending on the stage of the disorder:

Stage I

  • Confusion and walking aimlessly after eating
  • Appetite loss
  • Barking excessively
  • Dull behavior
  • Unable to train
  • Whining
  • Diarrhea
  • Vomiting
  • Frequent urination
  • Dark urine (could be dark orange or brown)
  • Males may be unable to urinate
  • Walking like intoxicated

 Stage II

  • Stunted growth rate
  • Behavioral changes
  • Excessive sleepiness or dizziness
  • Disoriented
  • Exhaustion
  • Shaking
  • Lethargic
  • Pressing their head against the wall or other objects
  • Inability to see

 Stage III

  • Pacing back and forth
  • Increased thirst
  • Confusion
  • Acting out of it
  • Drooling
  • Incoordination
  • Laziness
  • Occasionally aggressive
  • “Daydreaming” or staring at nothing
  • Hiding under tables or beds

 Stage IV

  • Unable to rouse
  • Seizures
  • Coma
  • Collapse


Type A occurs with acute liver failure that is abrupt and unexpected from a rapidly moving liver disease, infection, or injury.

Type B is a gradual disorder related to a portal bypass of the liver with no underlying disease or infection.

Type C occurs gradually with chronic liver failure (cirrhosis) and is rare in dogs. It causes the toxic waste to bypass the liver into your dog’s bloodstream.

Causes of Brain Disorder Due to Liver Disease in Dogs

Finding out the cause of the hepatic encephalopathy is essential to determine the best treatment for the health of your dog. There are some precipitating factors for hepatic encephalopathy, which are too much protein in the diet, overmedicating, infections, kidney failure, and dehydration. However, each type of HE has its own causes. Some of these causes are:

Type A

  • Toxicity from ingested poisons
  • Encephalitis
  • Brain abscess
  • Infections
  • Interruption of blood flow
  • Some metabolic diseases
  • Uremia (kidney failure)
  • Hypoxia (low blood oxygen)
  • Hypoglycemia (low blood sugar)
  • Ketoacidosis (high blood sugar)
  • Thyroid dysfunctions

Type B

  • Portosystemic shunts (vascular abnormality that causes blood to bypass the liver)
  • Portal vein hypoplasia w/o hypertension
  • Urea cycle disorder (genetic enzyme deficiency)

Type C

  • Cirrhosis
  • Fistula
  • Chronic hepatitis
  • Portal vein hypoplasia with hypertension

Diagnosis of Brain Disorder Due to Liver Disease in Dogs

While the veterinarian is doing a complete physical examination of your dog he will need to know your dog’s complete medical history (e.g. recent illnesses), what symptoms you have noticed, when the symptoms started, how fast the symptoms have progressed, changes in eating habits, personality, or activity. Some tests that will need to be done are:

  • Complete blood count (CBC)
  • Blood chemistry panel
  • Blood clot profile
  • Blood ammonia level
  • Urinalysis
  • Bile acid test
  • Digital radiographs (x-rays) of the abdomen
  • Ultrasound of the abdomen
  • Portal scintigraphy
  • Biopsy of the liver

Treatment of Brain Disorder Due to Liver Disease in Dogs

Treatment depends on the cause and stage of the hepatic encephalopathy but the first thing your veterinarian will do is to stop the cause of the hepatic encephalopathy. The veterinarian will most likely hospitalize your dog and administer IV fluids, oxygen therapy, enema, electrolytes, and antibiotics. Food will be withheld until your dog’s condition is improving. Anti-epileptic medications will be given if your dog is having seizures.

Once your dog is stable, the veterinarian will concentrate on preventing it from getting any worse. Although most times it is a progressive disease and cannot be stopped, it can be slowed if the right measures are taken. A diet low in protein is essential to your dog’s health because protein induces ammonia in the body, which causes the hepatic encephalopathy. Lactulose is a medication that is actually just sugar that changes the pH in your dog’s intestines to decrease the absorption of ammonia. Vitamins will also be added to your dog’s diet.

If your dog has a portosystemic shunt, your veterinarian will probably suggest surgery to fix the condition. Surgery is the most favorable choice for a successful recovery and the success rate is more than 95%. Most dogs are completely cured following surgery.

Recovery of Brain Disorder Due to Liver Disease in Dogs

Since hepatic encephalopathy is not usually found until the damage to the liver is significant, the chances of a cure are not good. However, depending on the cause, if the veterinarian can treat the underlying illness or remove the cause before your dog reaches stage III of hepatic encephalopathy, the chances of recovery are good. It is important to give any prescriptions as directed, maintain a high quality and low protein diet for your dog, and keep all follow-up appointments with the veterinarian.

Brain Disorder Due to Liver Disease Questions and Advice from Veterinary Professionals

2 Years
Mild condition
0 found helpful
Mild condition

Has Symptoms


About 8 months ago our dog unfortunately ingested some cycad seeds. We rushed him to the Vet and he received treatment immediately. He stayed at the Vet for treatment for about 5 days, after which the Dr declared him healthy, with no permanent damage. He struggled to eat for a while after that, we had to feed him with a syringe, but surely after a couple of weeks he started to regain his strength and get his energy back.

Last week we noticed our dog shivering, we thought it might be the cold and made sure he keeps warm. This went on for about 3 days. We also noticed some diarrhea but no vomiting. On the 4th day he got a fit/seizure. We rushed him to the Vet, luckily he started to regain consciousness and the Dr started treating him (not sure for what). Treatment included: D.Ringers Lactate 200ml, D Lignocaine 2%/ml, D.Clamoxyl Rtu/ml and IV fluids

The blood tests revealed that he had increased sugar levels (it was 15 and should be between 4 and 6). No other abnormalities was noted with the blood results and the Dr explained that the increased sugar levels might be due to stress.

He's been home for about 2 days now and he's back to his happy energetic self. However he still gets the shivers, but everything else seems to be normal.

They also did IDEXX Bio Serum Bile Acids testing: 1st sample while Fasting and 2nd sample Post Prandiol. They received the test results back today and we were informed that these test results seem to indicate Liver dysfunction. We now have to do Liver scans in order to determine what the damage is and how bad the damage is.

Can this liver damage be due to the cycad poisoning? And why did the Dr not give us any preventative treatment after the cycad poisoning?

Does his symptoms sound like Brain disorder due to liver disease? - as he only has the shivers.

We are scheduled to do the scan in a week or so and I really do hope that there is not any severe damage.

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Labrador Retriever
8 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Pale Pink Gums

Labrador started having seizures, high blood ammonia (112 mg/l) was detected along with high bilirubin total (0.6 mg/l) and bilirubin direct (.3mg/l). CBC showed low haemoglobin, low neutrophils and high lymphocytes. was on Lornit and Mucyst through IV while admitted to a hospital. A week hence symptoms improved and brought back home. Is still on same medicine administered orally along with liver supplement (Venttura LivoPlus). But looking pale again and having mini seizures. Ultrasound

Dr. Michele King, DVM
Dr. Michele King, DVM
1611 Recommendations
I'm sorry that Chill is having these problems. It sounds like your veterinarian is doing everything that they can to manage her disease. I hope that she is okay.

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Miniature Schnauzer
12 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Frequent Urination

Medication Used


My 12 1/2 year old miniature schnauzer was diagnosed with liver disease. I first started noticing his dark orange-ish colored urine and took him in to see if he had urine or bladder infection. The vet did bloodwork and his liver enzymes were astronomical.
In about two weeks, he is urinating very frequently and he ocasionally has an accident which is not typical. He seems to sleep more and shakes frequently as though he was cold. I make his homemade food and it is all that is required for a dog with liver disease. I have been doing this for about two years since we got another puppy schnauzer. Currently he is on witch hazel and did a course of antibiotics. I’m just wondering what I can expect next?

Dr. Michele King, DVM
Dr. Michele King, DVM
1611 Recommendations
Thank you for your email. Without knowing what the cause of his liver disease might be, it is hard for me to comment on what to expect for him. Some types of liver disease resolve with IV fluids, antibiotics, and Denamarin. Some types of liver disease do not resolve. Your veterinarian may need to have an ultrasound performed to determine what Zackary's prognosis is. I hope that he is able to remain comfortable.

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Yorkshire Terrier
7 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms


Medication Used


My yorkie was diagnosed with liver shunts and hepatic encephalopathy about 5 years ago. Within the last month, he has started barking and whining at all hours of the night. My husband and I have tried everything, but nothing seems to help. He'll settle temporarily, then start up again. I have noticed that he will also sit and stare at me and whine.. it's almost like it comes out with is breath. Uncontrollable. He experiences many other symptoms, but those are "normal" for him.

Is there anything we can do for him, or is he coming up at the end stage??

Thank you,

Exhausted Yorkie Mom

Dr. Michele King, DVM
Dr. Michele King, DVM
1611 Recommendations
Thank you for your email. Lucky may be having further signs of hepatic encephalopathy, but he may also be having unrelated anxiety. Since I cannot examine him, it would be a good idea to have him seen by your veterinarian, as they can assess him neurologic status, determine what the cause of this behavior might be, and get him any appropriate medications. I hope that everything goes well for him.

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Miniature Schnauzer
Serious condition
1 found helpful
Serious condition

Has Symptoms


My pup has been diagnosed with hepatic encephalopathy and the symptoms come and go throughout the day. There does not appear to be a shunt causing the liver disease and her liver is smaller than it should be. I have asked this question several times and I know there is not a definitive answer but what are the things I should look for that tell me she is in pain and the quality of life is not good. She seems happy and loves being at home as far as I can tell, with periods where she is comfy...

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3320 Recommendations

Hepatic Encephalopathy occurs due to the accumulation of toxins (ammonia) in the blood due to inefficiencies in the liver to process them leading to central nervous system signs. Usually the condition is congenital but may be acquired in the following cases: infection, liver failure, high blood pressure and poisoning among others. The signs are incoordination, circling, lethargy, seizures, vomiting, diarrhoea, lack of appetite and behavioural changes. Determining quality of life is never an easy task to think about, fundamentally I believe that if an animal can still enjoy their life without pain or loss of body function then they should enjoy their life; however, if their life becomes difficult (pain and loss of bodily functions), you see severe behavioural changes or a general decrease in health then you need to decide on your choices for Fantasia. Regards Dr Callum Turner DVM

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Jack Russell Terrier
7 Years
Critical condition
0 found helpful
Critical condition

I'm struggling with the decision I made to have my dog pot down. He was disoriented, could not see drooling 2 times in 3 days, taking him to the emergency room. His ammonia level was 400 , I just couldn't stand to see him suffer he was so scared. Could I have done something?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3320 Recommendations
In cases where brain and body function is compromised by liver disease, it depends on the severity and the underlying cause; if the underlying cause is determined and can be treated or managed then there may be an option otherwise euthanasia is the best option. Without having examined Comet or seen a full blood panel, I cannot say what options you would have had. Regards Dr Callum Turner DVM

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4 Months
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Head Pressing

Medication Used

Duphalac syrup


I have a small puppy of 4 months she is suffering from all these symptoms mental dullness
head pressing
After checking they have concluded that she is having more percentage in ammonia 142.0 μ.mol/L
< 54..

Presently we are using Duphalac syrup 5ml thrice a day to decrease the level of ammonia in blood..
Please let me know is there any other treatment to overcome these problem

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3320 Recommendations

The most important step is to determine the cause of the hepatic encephalopathy, usually the cause is due to a portosystemic shunt which may be congenital in origin (most likely in a puppy); if the cause is a portsystemic shunt, a ligation surgery may be performed before symptoms worsen; but the outcome is variable. Dietary management will reduce the stress of the liver and administration of lactulose will reduce the absorption of ammonia from the colon, also hydration therapy will reduce the relative concentration of ammonia in the blood stream. Usually if treated early and regular checks are made with management the prognosis is fair. Regards Dr Callum Turner DVM

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