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
Husky mix
Kisa
13 Years
1 found this helpful
1 found this helpful
My pet has the following symptoms:
Pain
Lethargy
Less Appetite
Loose Bowel Movements
One week ago my dog presented with vomiting with red blood, solid bowel movements with red blood, and crying in pain every few hours. We took her to the vet and the vet thought it may be ulcers or cancer that were agitated from antibiotics she was on due to a dental abscess. We stopped the antibiotics and gave her aluminium phosphate and a white meat diet. The vet had told us if it was ulcers we would see marked improvement within days. If not better the next option would be an endoscopy but she was reluctant to do it because of my dog's age.
She had stopped vomiting and her stool had no blood but it is now soft, not diarrhea more like mud, and she is lethargic and clearly in discomfort. I called the vet and she said give it a couple more days. After a couple more days she said give it a couple more but to come in for another injection for the pain.
When we went, a different vet was there and she suggested an ultrasound and x-ray. The appointment was today and she found a single large mass in the liver and an enlarged gallbladder. She would not give me a prognosis. She said that the liver is not causing the pain, lethargy, and loose stool, that the gallbladder is and to treat the gallbladder for 30 days with ursulvan, prednisolone, and aluminium phosphate and follow up with another US and bloodwork (bloodwork was fine this time around except low WBC and high-end of normal kidney values, liver was fine). If this doesn't work she recommends excision of the tumor.
This makes no sense to me. If they were concerned about her risk during an endoscopy, which is pretty non-invasive, wouldn't removal of the liver be even riskier? Plus I am under the impression that liver tumors have a guarded to poor prognosis (though she refused to tell me). I don't want to put my 13 year old dog through all that for maybe another year of what will probably be an uncomfortable life. And isn't the liver what's causing the gallbladder to act up? What good is only treating the gallbladder for if it's just going to get worse again? I told her that at this point I'm more interested in giving her quality of life, not quantity of life, and would prefer to euthanize her instead of put her through that but she kind of ignored that comment and diverted the conversation.
Does this make sense to you? Is there something I'm missing in the explanation of things? It's possible because she really rushed through the explanation because the same time I arrived an emergency walk-in came as well. Should I be seeking a second opinion? Am I jumping the gun with euthanasia? I just really don't want her last chunk of life to be a miserable one.
March 23, 2018
Answered by Dr. Michele K. DVM
1 Recommendations
I'm sorry that is happening to Kisa. I think it makes sense to give the medications for the gallbladder, as gall bladder disease can cause liver disease, and vice versa. The tumor may be a benign mass, or a malignant mass, and unfortunately without removing it, there isn't any way to know. If you are not interested in pursuing surgery, the medications make sense, and she may recover enough to be comfortable without surgery. If you were not comfortable with your veterinarian's explanation of things, it is absolutely within your right to ask for a more thorough explanation of options and treatments. I hope that she does well.
March 23, 2018
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Border Collie
Alex
14 Years
2 found this helpful
2 found this helpful
My pet has the following symptoms:
Lethargy
Frequent Urination
Weakness
Alex is a 14yr old border collie diagnosed with a tumor on his liver a couple of weeks ago, after blood work showed liver enzymes elevated, x-ray showed "rounded" liver. We had an ultrasound done, which confirmed a 7cm x 5cm x 3cm tumor on the right, near the stomach and gall bladder. We don't know what kind of tumor, but blood work was fine about 5 months ago, so our guess is it has grown quickly. The internal med vet who did the ultrasound indicated it could rupture in a day or a year. We were not considering surgery because of his age and it's position. The following day, I came home and found he had vomited and had a soft bulge about 2-3" wide on his right side that hadn't been there, and he seemed very weak. Emergency vet said he had a fever, aspirated the bulge and it was blood, did a quick ultrasound and found some fluid, but limited to the area right around the liver/stomach only. We were told to take him home and watch for a bloated tummy and pale gums (his gums were still pink), probably a week or less. He's been on gabapentin and Clavamox and is not himself but much better 5 days later. No vomiting, eating small meals well, sleeping a lot but little bursts of energy. I also started giving him the Chinese herb Yunnan Baiyao, which seems fairly well-known for help with bleeding. In any case, is it common for a tumor to start to rupture and then stop? I feel like we're just waiting on pins and needles, not knowing if the end could be today or next month?
March 19, 2018
2 Recommendations
Unfortunately some tumours do rupture and we have no advanced warning, it is just recommended to not allow a dog to do anything which would elevate blood pressure like exercise, excitement, stress etc… Yunnan Baiyao is becoming more commonly used in western medicine in both humans and animals, whilst there are some promising articles and its history of use there is not much been done on efficacy in these types of cases (more nosebleeds and wounds); but it is worth trying and I have recommended it many times. Tumours don’t typically stop when they have ruptured, but the blood may have been caused by a capillary or other small blood vessel which may stop bleeding due to normal clotting. Regards Dr Callum Turner DVM
March 19, 2018
Hi my name is Cheryl and my boy is going through something very similar. Were do I go to get some Yunnan Baiyao?
June 1, 2018
Cheryl W.
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Labrador
Luna
13 Years
5 found this helpful
5 found this helpful
My pet has the following symptoms:
Liver Tumor
In November of last year (2017), we took Luna to the vet clinic because she suddenly became limp and she was completely pale. She was admitted, placed with dextrose and was diagnosed with a big tumor on her liver. A surgery was recommended but she was only given 20% chances of surviving the surgery. We felt we were sending Luna to her own grave at that time so we decided to take her home and not perform any surgery. The following medication were prescribed to her; hemolitan, furosemida, prednisolona, silimarina, gastrum, omega 3, clindamin and vitamin C. A couple of weeks ago her tummy started to bloat, she was double her weight and she couldn't stand up on her own. Her muscles began to disapper specially on her legs and head. She was suffering a lot. I didn't want her to leave so soon but the veterinarian suggested to perform euthanasia which I permitted because I didn't want to see her to continue suffering. My question is, if I had the liquid removed from her body instead of performing euthanasia, could it have changed her condition and prolong her life? How long? I know that the liquid would come back and was willing to have this process performed whenever needed. How long do you think would she continue holding on to survive? Did I make the right decision to perform euthanasia on her? She was still in her complete senses when she was given the injection, you could see the pain in her eyes but you could also see that she wanted to live. I miss her so much and life will never be the same without her. This is absolutely driving me crazy.
March 5, 2018
Answered by Dr. Michele K. DVM
5 Recommendations
Thank you for your email. I'm sorry for the loss of your Luna. I know that is a hard decision to make. if she had a tumor on her liver, the chances that she would have recovered from an acute bleed would be slim. Your veterinarian would have had her best interest in mind when they recommended euthanasia.
March 6, 2018
I understand what it feels like to second guess yourself like that, because here I am, over a year later, still wondering if I could have saved my dog. He had diffuse tumours all over one side of his liver and was bleeding internally. I was told there was nothing to be done. He was suffering and it still hurts so much knowing he had to go much too soon.
I'm sorry if this isn't helpful--but know you're not alone. You did all you could and your Luna was suffering. Finding peace with that is a struggle. I wish you all the best and much healing.
March 5, 2018
Jennifer S.
Thanks Dr. Michele King & Jennifer S. for your messages.
March 7, 2018
Luna's Owner
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Liver Cancer (Hepatocellular Carcinoma) Average Cost
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Average Cost
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