Monday, February 23, 2009

Nutrition and diet for a dog with liver disease

God knows I googled this again and again, hoping I would find some answers. My internist told me to limit her protein, but I have found that not always to be true. I found a great book, "Hope for healing liver disease in your dog," which is a must have if you have a dog stricken by this disease. Generally, your vet will put your dog on vitamin K, denamarin or denosyl and antibiotics. Initially, the antibiotics are helpful for inflammation and infection, but I would ween your dog off it as soon as possible. Here is a rough time capsule of Macy's illness. Jan 15th, 2009: My sister told me Macy had been refusing to eat and seeming despondent. She thought she was missing me, at the time Macy was staying with her until I could find a dog friendly apartment. I took her that night and she hardly seemed glad to see me. Needless to say she didn't eat. I took her to the vet the following morning who discovered she was jaundiced. I admit I am embarrassed I didn't notice, but it was late and I was tired from refinishing floors all day. He took blood tests and x-rays and suggested we go to the specialty clinic here in the upstate. They gave her an ultrasound and determined that based on her blood tests and ultrasound results, it could be Leptospirosis. They kept her for a day and a half to keep her quarantined and give her IV's of antibiotics and fluids. She was released with prescriptions of Denamarin and Ampicillan. In the meantime, she was still showing little to no interest in food, although she seemed hungry. The Lepto tests came back negative, so the hospital recommended a biopsy. The results of the biopsy came back a week later with canine hepatitis as the result. In the meantime, Macy barely ate and when she tried, she would drop her food and open her mouth as if she was gagging. It had been close to 4 weeks and she was terribly gaunt. I told the doctor this and was written a prescription for Prednisone (appetite enhancer with multiple side effects), Metoclopram (anti nausial ) and Tramodol for pain. I only gave her the Prednisone and the Metoclopram once. I was home cooking for her and the ampicillan had cleared up some of her distress so she started to eat like a house on fire. As long as she was eating, I refused to give her the Metocloram and the Prednisone. I continued with the Ampicillan. Macy started to gain some weight. In the meantime, I wanted to make sure I was giving her a balanced diet and the right food. I called the internist, who gave me a protein to fat to carb ratio, but I still felt I was missing something. I continued to search on the computer until I found this book. Would strongly recommend buying this book but here is what i am doing. Macy is on a home cooked diet. The rough percentage ratio is a third protein, a third vegetable and a third carbohydrate. Macy is normally a 70lb dog, although she lost close to 20 lbs with all this. Here is her diet for the next two or three weeks: Protein: Tofu, non fat yogurt or non fat cottage cheese Vegetables: Spinach, green beans, carrots, broccoli, squash, celery, peas, beets or kelp Seeds/Oil: Flax or pumpkin seeds, fish or extra virgin olive oil. Carbs: Potatoes or yams, brown rice, kidney beans, barley, oatmeal or brown rice Fruits: Banana, berries and pineapple (in small amounts because of the citric acid) If your dog is experiencing severe signs, bloating, jaundice, white stools, spasms etc, consider distilled water for the first few weeks as drinking water Macy's meal: (this she just loves and does really well with) Tofu: three thin slices cubed and sauteed in a tablespoon of olive oil and a bit of garlic powder until browned Veggies: Pick two to three of the list and steam gently Carbs: Prepare as directed. If you are using potato, keep the skin on and bake in the microwave. Combine the three and shake some flax seeds on the top. Mix in a tablespoon or two of nonfat yogurt. you can add a bit of fruit if you like or save that for treats. Prunes and figs are good too and great pill hiders. Meds: Denosyl/Denamarin and Vitamin K (50 mg): In the morning 1 hour before breakfast. Mix with a food salt peanut butter or cream cheese. Milk thistle extra with dandelion, fennel and licorice (240mg) 2 to 3 times a day. I put it in her food. B complex with C (make sure it includes the daily recommended supply of B12) and a 200 IU vitamin E softgel. Mix in food. Try this for the first two weeks. Also, if your dog is not eating, try some salt free beef or chicken broth, a bit of white fish (cod, whitefish, flounder poached) or a small bit of skinless chicken boiled with no seasoning. Break meals down in to small portions fed 2 to 3 times a day. Finally, keep an eye on their behavior. If they are lethargic, stool eating or ravenous, the dog may need a bit more protein and more frequent, smaller meals. If the dog seems nauseous or depressed, lower the amount of protein and also break the meal portions into multiple times during the day with less food. Also keep an eye on the stools. Are they brown and well formed, runny, white? Your probably feeling terribly overwhelmed at this point. I know I was, but don't. Your dog will tell you how they feel. The recipe above has Macy looking and feeling good. You may have to play around with it a bit to find the right mix for your dog. But it's not that hard. I bulk cook and freeze what I don't need for three days or so. Get frozen veggies and frozen fish which saves time and waste. The other good news is in the week that Macy has been on this diet, the jaundice is almost completely gone. Haven't taken her in for her blood retest, but the physical signs leave me no doubt her panels will be much better. By the way, my internist told me the jaundice would likely be permanent....HA! Stay upbeat, stay positive and stay in touch.


Bella said...

Great post! You said in your newest post that you were gonna write another entry indicating why you choose not to use grains in a liver diet...I'd be interested to read that :)

I called the internist, who gave me a protein to fat to carb ratio, but I still felt I was missing something.

May I ask what the ratios were that the internist gave you?

Margot Hackett said...

It was 1/3 each evenly. But every dog is different and their attitude and stool color will tell you a lot! You have to supplement carbs because they have to be on a lower protein diet than most dogs and the carbs give them energy. But if they are stool eating or terribly ravenous on the diet, you may want to up the ante on protein slowly.

Stool patrol is crucial, if you don't walk the dog. If the stool in the yard is fresh and whitish in color, you need to contact your vet and have some blood tests done. I normally take Macy in every three months for a complete blood work up and urinalysis, to make sure she is doing well with her diet too.

One thing I have noticed is I have to feed her more these days to keep weight on her bones. Amazing how much the liver has effect on other organs of the body!

architeria said...

hi there.
my 11-year old schnauzer has gone thru the blood count,x-ray and ultra-sound and found the adnormal in her liver and spreen...
my vet said that her situation is kinda invasive if doing the biopsy test.. .

and it was like a death sentence and the vet asked me to prepare for her sudden death in few months time.. or one.
i am so upsad.. and iam till thinking and trying to find the way out to heal her disease.

after searching thru the internet, came across with this book" Hope For Healing Liver Disease in Your Dog" ... is it too late for my dog's case? or should i give it a try?

so far, the vet only gave me the anti-biotics and sylmpy as the liver supplement...

I am trying to seek help from all over the globe. and see if anyone got the similar situation ..

coz' i don't want to give up for my dog.. i love her so much and i want to save her life..

Margot Hackett said...

I know how you feel! When the vet gave Macy three to six months, I cried for two hours. I'll warn you it is a lot of work, but I don't think your dog is a lost cause! Get her on distilled water pronto. Give the book a whirl. Vastly cheaper than medication.

In about a month and a half, Macy's blood levels were completely normal. Keep her on antibiotics and denosyl or denamarin, but ditch the rest.

Try to feed her a completely vegetarian diet for at lest three weeks. If she balks, try adding some whitefish or beef/chicken broth to her diet...salt free of course.

Supplements I would recommend. Antibiotics until she gets some pep in her step, denamarin or denosyl night or 1 hour before food, Vitamin K 50 ml once a day either late at night or morning 1 hr before her food, milk thistle plus with both feedings, multi B with C once a day,vitamin E gel cap once a day.

Feel free to email me if you run into problems, but the book I recommended is a godsend and it can't hurt to try it. One month later, Macy was back to her old self!

I will be keeping you and your girl in my thoughts!

Denise said...

Hi Margot,
Thank you for posting this blog!
I have ordered the book :)
My dog was diagnosed with liver disease via blood tests and xrays. He was also tested for Leptospirosis and it was negative. We did not go though the biopsy as it is dangerous to his fragile health and cost prohibitive as well.
I recently started him on Denamarin at the suggestion of the vet ... but now he has diarrhea as a side effect.
I have tried making his food, but unless is it chicken & broth only, he won't eat it. He won't eat the prescription food either. I recently purchased a bag of California Natural (21% protein, 11% fat, 300 IU/kg vitamin E) which he is happily eating!
My dog, like yours, has lost nearly 20 lbs though all of this (75 down to 55 lbs). He is now up to 59 lbs, but it is a slow process.
At this point, my biggest concern is the diarrhea. I don't want to loose ground. Do you know which compound in the Denamarin could be causing this? Have you heard of a mix that does not cause this side effect?
Thank you again!!!!!

Margot said...

So he is loosing weight rapidly. You have to find something you can cook that he can eat, But prepared food isn't it. If he isn't eating it is because he can't. Food tastes like crap. I say this because i have gone through this. If you have seen your dog gag, or open his mouth like he is going to vomit. Know it is frustrating but you need to find what tweaks your dogs appetite, yes you need to retrain their eating habits. Please not country time stuffing!