Liver Diseases Flashcards
function of the liver, and what can happen if damaged
- Essential role in protein, carbohydrate and fat metabolism as well as micronutrient metabolism
>Damage can affect metabolism and utilization of nutrients - Tremendous storage capacity, functional reserve and regenerative capacity
liver disease presentations
- elevations in liver enzymes without clinical signs
- to severe cirrhosis with hepatic encephalopathy and ascites
Goals for Nutritional Management of liver disease
Directed at clinical manifestation rather than specific cause
- Maintain normal metabolic processes and homeostasis without overwhelming the
damaged liver
> Energy metabolism
> Oxidative damage
> Electrolyte balance - Provide sufficient nutrients for hepatocellular repair and regeneration
- Avoid or manage hepatic encephalopathy
key nutritional factors for dogs and cats with liver disease
Most patients with liver disease can continue to eat a complete and balance diet for their life stage
-if signs of hepatic encephalopathy, DM protein levels should be limited to 10-15% for dogs and 25-30% for cats until signs resolve
dietary fat considerations in cases of liver disease
Beneficial
* Energy source > protein-sparing effect
* Essential fatty acids
* Fat soluble vitamin absorption
* Enhance palatability
- No need for restriction unless steatorrhea
- Cholestatic disease (biliary duct obstruction, gall bladder removal)
- Concurrent diseases causing fat malassimilation
- Avoid high fat in dogs predisposed to pancreatitis or hyperlipidemia
dietary protein considerations in cases of liver disease
- NOT restricted unless signs of hepatic encephalopathy (increased ammonium)
- Minimum set by AAFCO should be met and exceeded provided patient tolerance
- Protein intake relative to current intakeDiet history!!
- Meet essential amino acid requirements
- Especially taurine and arginine in cats
- Taurine supplementation may be needed in dogs
- Plant-based and dairy protein reduce signs of HE
what is hepatic encephalopathy
is a reversible syndrome observed in patients with advanced liver dysfunction
- accumulation of neurotoxic substances in the bloodstream (and ultimately in the brain)
diet for HE dog considerations
-want to reduce protein to reduce ammonia…but also minimum protein requirements must be met
what can help reduce ammonia absorption from the gut
soluble fibre
avoid copper at what levels in diet to stop copper-associated hepatotoxicosis, in certain breeds
- Copper restriction < 5.0 mg/kg DM
key nutritional factor for hepatic lipidosis
high protein