What is Liver Cancer (Hepatocellular Carcinoma)?
Primary liver cancer accounts for less than 1.5% of all tumors in dogs. The most common type of cancer to originate in the liver is hepatocellular carcinoma. This cancer is believed to form on stem cells in the liver and it can grow to be quite large. It is responsible for about 50% of the liver tumors found in dogs. In some cases, the tumor can be identified as a palpable mass in a dog’s stomach. Often dogs present the typical symptoms of liver disease, but some tumors can be non-symptomatic for quite some time. Eventually, the tumor will cause serious abdominal hemorrhage. This type of cancer is slow growing; however, left untreated, it will cause cell death and cirrhosis of the liver and eventually lead to end-stage liver disease. It can metastasize to other areas of the body, most commonly to other organs in the abdomen, but this is less likely than with more aggressive forms of cancer. Surgery is possible with many tumors, and dogs have a good chance of recovery as long as the entire mass is removed. More diffuse tumors, including several lobes or even the entire liver, are much harder to treat. Cancers on the left lobe usually have a better chance of being successfully removed. This type of cancer is more common in older dogs, around 10-12 years of age.
Cancers often spread to the liver with metastasis, but primary liver cancer is rare in dogs. The most common tumor to originate in the liver is hepatocellular carcinoma. This is a slowly developing cancer. Many cases are treatable with surgery, but it will depend on the type and location of the tumor.
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Symptoms of Liver Cancer (Hepatocellular Carcinoma) in Dogs
Hepatocellular carcinoma is much easier to treat in the early stages. Take your dog to see a veterinarian if you notice any of the following symptoms.
- Decreased appetite
- Weight loss
- Lethargy
- Abdominal distention
- Mass can be felt in the stomach
- Vomiting
- Excessive thirst
- Frequent urination
- Bloody diarrhea
- Jaundice
- Ascites (fluid in the abdomen)
- Gastrointestinal bleeding
- Ulcers
- Hepatic encephalopathy (disorientation, circling, aggression, seizures coma)
Types
Hepatocellular carcinomas are defined by the type of tumor they form.
- Massive – the cancer forms as a single, discrete mass; as the name implies, it can grow to be very large; sometimes there is one large mass and several smaller ones in a different part of the liver; these tumors are easier to remove since they form a distinct growth
- Nodular – the cancer forms several nodes or smaller masses; nodes may be located on one or more lobes of the liver; these tumors still form a discrete mass, but they are more likely to metastasize and spread than massive tumors
- Diffuse – the cancer may involve the most of the liver; cancerous cells are not well differentiated from healthy cells, so they can be difficult to remove
- Hepatocellular adenoma – this is a non-cancerous tumor that is the benign form of hepatocellular carcinoma; large tumors can still be a problem if they rupture and bleed, or if they put pressure on other abdominal organs
Causes of Liver Cancer (Hepatocellular Carcinoma) in Dogs
It’s not known what causes liver cancer to form. It is less common in dogs under 9 years old, so age is a factor. Some studies have noted a higher rate of incidence in Miniature Schnauzers, and others have found more tendency to liver cancer among male dogs, but this hasn’t been widely confirmed.
Diagnosis of Liver Cancer (Hepatocellular Carcinoma) in Dogs
The veterinarian will examine your dog physically. If a mass is felt on the liver, this will be a good indication of a hepatocellular tumor. If your dog has symptoms of liver dysfunction, cancer may be suspected as the cause, based on age and the elimination of other factors. Blood and urine tests will indicate the degree of liver failure that is present and help to determine whether your dog is healthy enough for surgery. Some bloodwork may require fasting. Abnormal liver enzymes may suggest the presence of a tumor or even show the type of cancer, but bloodwork isn’t often conclusive.
A definitive diagnosis will be based on magnetic imaging. Massive tumors are visible on an abdominal X-ray. Ultrasound can identify smaller more diffuse tumors and help to show metastasis. Ultrasound guided biopsies and aspirates may be needed to determine if the tissue is cancerous or benign. The veterinarian may need to evaluate the coagulation level in your dog’s blood before these tests, since tumors may hemorrhage during biopsy. Additional x-rays, ultrasound, or other magnetic imaging tests could be ordered to check for metastasis in other parts of the body.
The veterinarian will want to know your dog’s age and medical history, including any prior problems with the liver. A detailed description of the symptoms will also be helpful.
Treatment of Liver Cancer (Hepatocellular Carcinoma) in Dogs
Treatment will depend on a veterinarian’s diagnoses. Surgery is the best option, but in some cases it may not be possible. Nodular or diffuse tumors can be difficult to operate on, and tumors with a high degree of hemorrhage may pose too big a risk. If your dog has symptoms of acute liver failure, he will not be healthy enough for surgery unless this condition can be stabilized.
The veterinarian will discuss the amount of risk involved with surgery. Your dog may need to stay in a veterinary hospital for a number of days after surgery for monitoring. The liver can regrow itself, so dogs can recover even if a large amount of the liver has to be removed, but the veterinarian will need to ensure the liver is functioning adequately before sending your dog home. Biopsies will be taken during surgery to check for metastasis in other parts of the liver. It’s likely the veterinarian will put your dog on a low protein, low sodium diet to avoid unnecessary stress on the liver.
Chemotherapy may be ordered for tumors that are inoperable or if metastasis was noted at the time of surgery. Chemotherapy drugs are administered by injection for approximately 3 or 4 weeks, or as long as the veterinarian thinks necessary. Each chemotherapy appointment will last at least 1 ½ hours for adequate testing and administration. Dogs don’t usually experience hair loss, but they can have quite severe gastrointestinal side effects.
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Recovery of Liver Cancer (Hepatocellular Carcinoma) in Dogs
Massive or benign tumors that are fully removed with surgery have a good prognosis. Many dogs don’t have recurrence and may live for a number of years after the operation. The veterinarian may recommend a long-term diet change.
Dogs with inoperable tumors have a low chance of recovery. Chemotherapy can sometimes slow the progression of the cancer, but only for a matter of months. Symptoms may progress gradually since this is not an aggressive cancer, but they will eventually become severe. The chance of your dog’s recovery will be evaluated by a veterinarian upon diagnosis.
Liver Cancer (Hepatocellular Carcinoma) Average Cost
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Liver Cancer (Hepatocellular Carcinoma) Questions and Advice from Veterinary Professionals
European
WINNIE
14 Years
1 found this helpful
1 found this helpful
Good morning,
My name is Cristina Sararoiu, I am living in Bucharest - Romania.
My friend's dog Winnie experienced loss of weight since October 2017 until now from 25 Kg to 19 Kg, so doctors started to fully investigated her thinking also to neoplastic process. Below is a summary of analysis and investigations, I only pointed out what seems to be of interest.
03.02.2018: alkaline phosphatase = 91 U/I (range 0-200), GOT/AST = 118 U/I (range 10-50).
11.04.2018 : alkaline phosphatase = 266 U/I (range 0-200), GOT/AST = 27 U/I, GGT = 13,5 U/I (range 1-10).
03.05.2018 : alkaline phosphatase = 593 U/I (range 0-200), GOT/AST = 10 U/I, GGT = 8,4 U/I.
03.05.2018 : serum albumin = 3,24 g/dl (range 3,4 – 4,2), Canine Pancreatic Lipase/Snap CPL = normal.
03.05.2018 : trypsin-like immunoreactivity = 16,1 ng/mL (range = 5 – 35).
Coprology/17.04.2018 revealed Yersinia and Coprology/16.05.2018 revealed a strain of E.Coli – for both she has received specific treatment.
Ultrasound examination/ 06.03.2018
Spleen: slightly irregular contour, normal size - 2.09 cm in hilum. Normal homogeneous background echogenicity; normal homogeneous background echotexture; there are several discreet hypoechogenic formations with dimensions up to 1.02 / 0.66 cm, spread throughout the spleen. Capsular invaginations present. Non-ectasia vascular system. Without ultrasound detectable splenic lymphadenopathy.
Liver: irregular contour in the area of anatomical projection of the papillary process of the caudal lobe, normal dimensions, normal homogeneous echogenicity, homogeneous normal echotexture; In the hepatic mass there are several hypoechogenic homogeneous formations, the largest being of 3.18 cm ø with localization in the left lobe. Non-ectasia vascular system. Non-expanded biliary ducts. Porta hepatis looks normal. VP = 0.96 cm ø, laminar flow, normal ultrasound. Hepatic lymph nodes are ultrasonically undetectable.
Gallbladder: Smooth contour, normal size, thin wall, anechogenic content with echogenic medium “sludge” and sedimentary hyperechogenic component that creates a slight acoustic shadow (cholelithiasis). Common bile duct undetectable by ultrasound.
Pancreas: right lobe homogeneous hyperechogenic, thickness of 1,48 cm, without pathological alterations ultrasound detectable on the anatomical area of the body and left lobe. Peripancreatic fat has a normal appearance.
Ultrasound examination/14.04.2018
Spleen: smooth contour, normal size-2,10cm in hilum. Normal homogeneous echogenicity, fine granular characteristic echotexture, non-ectasia vascularization. Capsular invaginations and hemangiomas (benign aspects) are present. Splenic lymph nodes are not ultrasound detectable.
Liver: smooth contour, normal size. Normal homogeneous echogenicity, homogeneous normal echotexture; in the right lobe there are discreet hypoechogenic areas with dimensions up to 1.83 / 0.69 cm in the sagittal plane. Non-expanded vascular system. Non-expanded bile ducts. Porta hepatis looks normal. VP = 0.91cm ø. Aorta = 0.90cm ø. VP / Ao ratio = 1.01 (normal). No detectable periportal lymphadenopathy.
Gallbladder: smooth contour, increased dimensions (preprandial aspect), thickened wall -0.49 cm. Anechogenic content with isoechogenic “sludge” with hepatic parenchyma. Undetectable common bile duct.
Pancreas: no pathological alterations ultrasound detectable on the anatomical projection area.
Kidneys: two cortical cysts on left kidney and one cortical cyst on right kidney.
Rest of organs appeared normal at both ultrasound examinations, including all segments of the bowels.
We don't know what to consider anymore, doctors first suspected "fat liver".
Also, doctors recommended a biopsy from intestines through endoscopy but we are very afraid that she might not cross through the general anesthesia as she is 14 years old!
Winnie continues to have extremely "watery" stools/watery diarrhea (3-4 times a day) of YELLOW color - in jet !, sometimes vomiting but rarely, she has perfusion with NaCl and glucose on daily basis as she gets dehydrated because of the watery stools and she has also got treatment with i.v. Metronidazole.
We started to give her Enterogelan (from Virbac): starting with today (22.06.2018), is it Ok to give her also pre/probiotics and liver protection medication as well as antiseptic medication such as Furazolidone ?
Many, many thanks for your time !
Yours sincerely,
Cristina
June 22, 2018
Answered by Dr. Michele K. DVM
1 Recommendations
I'm sorry that Winnie is having these problems, as dogs age it can be very difficult! Given the lab results that you have shown, starting her on Probiotics and liver supplements like Milk Thistle should not do any harm. Ursodiol is another medication that can help move gall through the gall bladder, and your friend can discuss with her veterinarian if that is an appropriate medication for her. I hope that she recovers from this well.
June 22, 2018
Thank you very much, we started giving Winnie Enterogelan and probiotics and she is much better in the way that stool is more solid and not water-like anymore, also we will start with Milk Thistle and we will check with vet about Ursodiol - this is a very good hint. I really appreciate your answer, many-many thanks, kind regards, Cristina
June 26, 2018
WINNIE's Owner
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Jack Russell Terrier
Bruno
10 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Pale Gums, Weak On Legs Out Of Blue
How can a dog show no symptoms of anything wrong....Running wild just hours before then suddenly something within a few hours the dog is acting strangely with pale gums and internal bleeding? Rushed to er and was diagnosed with Hemangiosarcomas only no tumors were visible. Liver felt abnormal but no visible tumor. Spleen looked fine and nothing seen in kidney. Was told the internal bleeding was most likely in liver since it felt abnormal or kidney but not seen on sonogram or radiology. Dog was bleeding out severely anemic and diagnosed with Hemangiosarcomas of liver 99.9 percentage sure? How is it possible to have no symptoms until the rupture? Transferred to surgery hospital immediately only to be told he didn’t have a chance. How is this possible to blink & it all happen in a few hours time.,we are talking about a highly active wild small breed dog. Both vets hospitals gave same diagnosis Is it possible they were wrong? How long could he have had this when always got yearly exams??but yet not 1 sign. Inside dog so no chance of an injury. Just trying to understand how?
i
June 20, 2018
Answered by Dr. Michele K. DVM
0 Recommendations
Hemangiosarcomas are quiet tumors until they rupture, sadly. They can be there for months or years, sometimes, and if an x-ray isn't taken (which we don't usually do unless there is a reason), we don't detect these tumors until it is too late. When they rupture, there is typically dramatic blood loss, and they are often fatal. The signs do come on very quickly, and it is very shocking when they do. I am very sorry for the loss of your Bruno.
June 20, 2018
Thank you! With imaging can you see inside the liver itself? Because in this case he was bleeding from 2 quadrants, liver enlarged, but no visible tumor. Vet said it only leaves bladder or liver. Spleen looked good! She suspected liver because of enlargement. Red blood cell count was less than 1/2 of the low end of normal. Totally himself until just last few hours of getting to the vet. So a tumor could have been there that long without a single symptom or feeling anything upon exam yet still act full of life for months to years upon it appearing.?
Literally playing in the morning as normal and dying by afternoon.
Is this common and is it common in small pure breeds. He had recently had a tooth extracted & no complications with that either.
I’m lost without him.Will vets do an X-ray if I request one for peace of mind if I get a future dog? Or would they want a reason other than my peace of mind?
Thank you! I have read a lot on this since this happened jumping from site to site searching for the answers, the signs, that I clearly never saw. Two different er rooms saw Him both took there own images. Both same diagnosis so why was the tumor not seen & only the internal bleeding & liver abnormality?
June 21, 2018
Kendall T.
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Mixed
Tessa
11 Years
3 found this helpful
3 found this helpful
My pet has the following symptoms:
Increased Thirst
Increased Urination
Abdominal Mass
I appreciate any help I can get as I can not seem to get a straight answer. My Dog Tessa, turns 11 in October 2018, is a 40LB mixed. upon our annuals the bloodwork came back off in the liver. I had x-rays done and then ultrasound with needle biopsy. results came back that the left liver has either a adenoma or adenoma carcinoma. They could not tell. I believe we caught it early as the only symptoms are increased thirst and urinating and abdominal swelling, but no vomiting or lethargy. The surgery is expensive and just want to make sure it is the way to go and if it would give her a healthy life and what the life expectancy would be? My research showed that if a carcinoma, that they would only live a few months more and do not want to spend the money if it is not going to help. How can they tell if it is malignant or not? Please help.
June 4, 2018
3 Recommendations
The only real sure way to determine whether the mass is malignant or benign is to get a good biopsy sample (more than a needle biopsy), this would involve anaesthesia and a laparotomy; if a biopsy by laparotomy is going to be performed, you may as well have the tumour removed as the same time. There are no shortcuts to this answer unfortunately. Regards Dr Callum Turner DVM
June 5, 2018
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Goldendoodle
Zeke
9 Years
1 found this helpful
1 found this helpful
My pet has the following symptoms:
Weight Loss
My dog has a tumor in his liver that is taking up 1/3 of his abdomen. They said it's on the right and had blood vessels running through it (especially a major one). We have ruled out surgery and it's a high risk for minimal chance of reward. I've moved him to a raw dies (Primal) and give him Milk Thistle and Liver Detox (Hampl). He eats like a champ and would eat continually if I let him. He's not losing anymore weight, but he's not putting any on either. Should I increase his intake? Should I add rice, potates or other starches to his diet?
June 1, 2018
1 Recommendations
It seems that surgery would be a bad idea given the size of the tumour and the risk of damaging blood vessels and not being able to take an adequate margin when removing the tumour. Dietary management is important but should be low quantity but high quality protein with some vegetables; however I don’t know the specific Primal diet Zeke is eating so I cannot comment on whether a dietary change would be suitable. You should keep an eye on him for the time being if he isn’t losing any weight and check in with your Veterinarian at his next checkup. Regards Dr Callum Turner DVM
June 2, 2018
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Liver Cancer (Hepatocellular Carcinoma) Average Cost
From 367 quotes ranging from $3,000 - $15,000
Average Cost
$8,500
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