Cirrhosis and Fibrosis of the Liver in Dogs

Fibrosis and cirrhosis of the liver are serious conditions affecting the functionality of the liver. Toxins, chronic illnesses and physical trauma to the liver can all contribute to the formation of fibrosis and cirrhosis. Scar tissue from damage to the liver can build up and prevent the liver from operating properly. Indications that liver functions are reduced in your canine are an urgent situation and your veterinarian should be contacted as soon as possible to prevent further irreversible damage.

Fibrosis and Cirrhosis are terms relating to the formation of scar tissue in the liver. This is a serious condition, and should be evaluated by a veterinarian in a timely manner.

• Abdominal pain
• Black, tarry stools (due to the presence of digested blood)
• Constipation
• Diarrhea
• Fluid build-up in the abdomen
• Increased thirst
• Increased urination
• Jaundice
• Lack of energy
• Loss of appetite (anorexia)
• Orange urine
• Pale or orangish stools
• Poor body condition
• Seizures
• Skin lesions
• Skin ulcers
• Unexplained or prolonged bleeding
• Vomiting, sometimes with blood

Types

• Fibrosis- Fibrosis is the formation of fibrous scar tissue within the liver. Fibrosis can sometimes be reversed or reduced by proper treatment. If the fibrosis or it’s underlying cause remains untreated then it may lead to cirrhosis.
• Cirrhosis- An irreversible liver disease that is marked by inflammation of the liver, thickening of tissue, and the breakdown in the cellular structures within the liver. If normal function of the liver reaches below 20% the disease is considered terminal. Cirrhosis can be caused by several diseases and disorders, as well as trauma to the liver via physical damage or toxins.

There are multiple triggers for fibrosis or cirrhosis to develop in your pet. These could include:

• Acetaminophen
• Bacterial infection
• Chemotherapy drugs
• Chronic gum disease
• Chronic hepatitis
• Chronic infections (anywhere in the body) 
• Congestive heart failure
• Fungal infection
• Genetic predisposition (Bedlington Terriers, Chihuahuas, Cocker Spaniels, Doberman Pinschers, Labrador Retrievers, Maltese, Skye Terriers, Springer Spaniels, Standard Poodles, West Highland White Terriers)
• Heartworm infection
• Liver cancer
• Pancreatitis
• Physical trauma to the liver
• Prolonged use of NSAIDs or steroids
• Viral infection

In order to make an accurate diagnosis your veterinarian will start by asking for a full history of your pet (recent illnesses, medications, behavioral changes), as well as a general physical exam, taking particular note of any abdominal swelling or pain. A complete blood count, biochemistry profile, and urinalysis are likely to be ordered to discover the underlying cause of the symptoms, and a fecal sample may also be required to test for blood or parasites. Special attention will be paid to readings of anemia, indications of infection, and the liver enzymes. An ultrasound or radiograph will allow the veterinarian to visually inspect for any growths or scar tissue that may be present as well as to get an accurate measurement of the liver’s size and density. Finally, a biopsy of the affected tissue will be taken and examined at the lab to determine the condition of the liver cells themselves and to determine the proper course of treatment.

Treatment will vary somewhat depending on the underlying cause and the extent of the damage to the liver. Initially, supportive care will be given depending on the situation. In advanced circumstances, this could involve the hospitalization of your companion and the patient may be connected to an IV drip to maintain hydration and electrolyte balances. 

In the case of fibrosis there are some medications that can reverse the damage to the liver, but in the case of cirrhosis, the focus is on slowing or halting the damage as reversing damage is not possible at this time. Any toxins that are causing damage to the liver should be discontinued immediately and medications to address any bacterial, viral or fungal infections will be prescribed. Your veterinarian may also recommend a change in diet, either to a prescription dog food meant for dogs with liver function issues or to a diet with high-quality, low-ammonia producing proteins.

It is important to be vigilant with your pet’s diet after a diagnosis of liver disease. Most damage to the liver is irreversible and once the liver functionality drops below twenty percent the damage is considered terminal. High levels of top-quality protein are recommended, although it does need to be a low ammonia producing food. A vitamin and mineral supplement may be recommended, however in order to prevent further damage, extreme caution should be taken when giving your dog supplements and a veterinarian should be consulted before making any changes to your dog’s diet when liver impairment is involved.