homemade diet for dog with liver shunt

By Isabella Storyclaire

last updated November 19, 2024

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Feeding Pets with Liver Shunts

Congenital portosystemic shunts (AKA liver shunts) are relatively common birth defects in pets where the blood vessels in the abdomen develop abnormally and instead of funneling blood from the intestines through the liver, the blood is able to bypass the liver and enters the systemic circulation. This abnormal blood flow prevents the liver from doing its job of processing the blood eliminating medications, waste products, and toxins, breaking down nutrients from food, and regulating the bodys energy balance. Shunts are most common in small breeds of dogs, especially Yorkshire terriers, Maltese, and Cairn terriers. However, they can also be seen in larger dogs (such as Irish wolfhounds and retrievers) and less commonly in cats.

Pets with liver shunts can look and act completely normal and may only be diagnosed when bloodwork is done for another reason (shunts often cause changes in blood values that can be seen on routine blood panels) or may be the runts of their litters and may be quieter than normal for a young animal. In severe cases, pets may stare at walls, act like they are drunk, or even have seizures (especially after meals) and experience urinary issues due to kidney or bladder stones caused by the buildup of compounds that would normally be removed by the liver.

Some shunts can be repaired with surgery or non-surgical interventional procedures but others either cannot be fixed or the treatment is too expensive for the pet owner. Typically, pets that are waiting to have their shunts fixed or those whose shunts cannot or will not be fixed are treated with a combination of medications and diet. Diet and medications do not fix the blood vessels in the liver, they simply reduce the symptoms so the pet can have a more normal life. Some pets can be well maintained with a good quality of life for years with diet and medications while others can develop uncontrollable symptoms and rarely liver failure.

Pets with shunts can have trouble with protein metabolism they cant get rid of the waste products after breaking down protein from the diet and it causes neurological signs, called hepatic encephalopathy, which including dullness, disorientation, difficulty walking, behavioral changes, and possibly even seizures. Not all pets with shunts develop obvious neurological signs, but those that do need to be treated with medications to increase protein tolerance. They are also typically fed diets that are lower in protein than typical commercial diets, but still have enough protein to meet their needs as too little protein could make them sicker. The amount of protein that is appropriate/tolerated will be different for each pet. Carefully considering the diet is especially important in a puppy or kitten because not all of the diets typically used to treat portosystemic shunts meet the nutritional needs of growing animals so alternatives or even nutrient supplementation may be necessary. Similarly, many therapeutic diets used to treat pets with shunts may not be good choices for healthy pets in the household.

Both the amount and the type of protein can be important. Egg, dairy, and soy protein are less likely to cause hepatic encephalopathy or shunt-associated bladder stones compared to muscle and organ meats. Therefore, carefully designed, good quality therapeutic diets typically use these proteins instead of meats, organ meats, or fish. Medications can help increase the amount of protein that pets with shunts will tolerate, so it is important to combine nutrition and medical treatments to maximize the pets nutrition while minimizing symptoms. Depending on how severe the symptoms are and whether the shunt can be surgically corrected, it may be possible to slowly increase the amount of protein over time, even to the levels in normal diets.

Your vet is likely to recommend one of several veterinary therapeutic diets for dogs with liver shunts that need lower protein diets. Lower protein home-cooked diets can also be designed for adult dogs but it is important that they be designed by a board-certified veterinary nutritionist with experience in managing dogs with shunts. Unfortunately, there are fewer commercial options available for puppies (even commercial therapeutic diet options are unlikely to meet the needs for large breed dogs with shunts) and home-cooked diet recipes carry high risk for growing animals. There are no therapeutic diets specifically designed for cats with liver shunts, so typically lower protein diets designed for other health conditions (such as kidney disease) are used in cats with shunts but they may need adjustment of other nutrients. Be sure to talk to your veterinarian about the most appropriate diet if your pet has a shunt and consider a consultation with a board-certified veterinary nutritionist if you need additional options or your pet is not doing well on the commercially available choices.

What about treats? Luckily, pets with shunts do not have to go entirely without treats. However, pets who have had hepatic encephalopathy should not be fed meats or high protein foods or treats (e.g. many biscuits, jerky, rawhides, bully sticks, pig ears) on top of the commercial diet or home-cooked diet recipe or they may develop signs again. Better treat options for dogs with shunts include meat-free dog biscuits, human snacks such as animal crackers and breakfast cereal, or non-toxic fruits and vegetables.

In summary, dietary changes can be very important to help manage pets with liver shunts. If your pet is diagnosed with a shunt, put together a thorough diet history of what you have been feeding your pet and talk to your veterinarian about what diet would be best suited to your pet.

Posts authored by the Clinical Nutrition Service team are by Dr. Lisa M. Freeman, DVM, PhD, DACVN, Dr. Deborah E. Linder, DVM, MS, DACVN, and Dr. Cailin R. Heinze, VMD, MS, DACVN

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How To Support My Dogs Liver Shunt

In most cases, a liver shunt is caused by a birth defect. This is known as a congenital portosystemic shunt. But acquired shunts can also occur this is usually linked to primary liver disease, or a disease involving the normal blood vessels into the liver.

We describe the liver as the powerhouse of the body, quite simply because it carries out so many functions, so, is there anything we can do to support it when its function isnt quite up to par?

Lets take a look at whether we can support a dog with a liver shunt.

What Does The Liver Do?

The liver processes blood and the substances found within it. In a healthy animal, blood draining from the intestines passes immediately through the liver for nutrients to be processed and for toxic compounds to be removed. The blood then re-enters main circulation.

What is a Liver Shunt?

In an animal with a portosystemic shunt (liver shunt), a significant volume of blood bypasses the liver, enters main circulation and heads to the heart where it can be pumped around the body.

As the blood being pumped around the body is technically unfiltered, toxic compounds can build up. In addition, the liver is unable to break down nutrients or regulate the bodys energy balance.

Signs and Symptoms of a Liver Shunt:

Stunted growth
Poor muscle development
Abnormal neurological behaviour disorientation, staring into space, circling or head pressing, seizures
Drinking/urinating too much
Vomiting
Diarrhoea
Lethargy

In both cases of congenital and acquired, reduced blood flow to the liver also results in atrophy which subsequently affects function.But the liver is a rather unique organ, it is the only one that can regenerate, therefore appropriate intervention and management is essential.

Considerations to make for the dog with a liver shunt:

Diet

The conventional concern with many liver issues is protein intake. When protein is broken down in the body, left behind is ammonia. The liver plays a key role in metabolising ammonia ready for it to be excreted by the kidneys into urine, but when blood flow bypasses the liver, ammonia builds up in the blood and enters systemic circulation this is what leads to many neurological issues alongside poor liver function.

Traditionally, dietary management has included protein restriction to reduce ammonia absorption from the colon, but more recently it is considered that colonic absorption is only significant in those fed poor-quality diets that contain poorly digestible protein.

In addition, it has been established that those with chronic liver disease may develop muscle wasting from being in a long-term catabolic state with low protein diets leading to increased muscle protein catabolism.

Findings Here

We would advocate a fresh-food diet, with highly digestible protein sources. The general school of thought is 2g of protein per kg of body weight.

Beneficial proteins to feed in liver disease include eggs for the most bioavailable protein and choline content, poultry and a little fish such as sardines, salmon and cod.

Fats such as omega-6 and omega-3 in 4:1 ratio are important in liver conditions. Moderate amounts of hemp oil, phytoplankton (offering DHA and EPA) and fish, both whole and in pure oil source may help to protect the liver and reduce systemic inflammation and inflammation in the liver.

Detoxification

The liver neutralises a range of toxic chemicals, both those produced internally (waste from used hormones or neurotransmitters for example) and those from the environment, like air pollution, pesticides and food additives.

It does this by filtering the blood to remove large toxins, synthesising, and secreting bile and lastly enzymatically disassembling unwanted chemicals found in the body. If its function isnt up to par, toxins can start to build up.

Gut Guardian

Enzymatic Detoxification

This enzymatical detoxification occurs in three phases.

Phase I directly neutralises chemicals and changes them into new metabolites. These are then processed by phase II enzymes. This is known as the conjugation phase, which in short, liver enzymes attach small chemicals to the toxin. There are many ways in which this is done, it all depends on the type of chemical the liver is trying to manage.

Phase I results in high levels of reactive oxygen species so antioxidant levels are key in modulating potential damage.

Does My Dog Need Antioxidants?

Beneficial Additions:

Broccoli contains glucobrassicin, the glucosinolate precursor of indole-3-carbinol (I3C) and subsequently Diindolylmethane (DIM) which is attributed to supporting phase one of the liver detoxification.

Berries and cranberries whole and in extract contain anthocyanins that demonstrate hepato-protective abilities. An experiment found that antioxidants commonly found in berries slowed the development of lesions and fibrosis, the development of scar tissue, in the livers of rats.

Phase II is nutrient demanding and sufficient levels of key vitamins and minerals like vitamin A, C, E, B1, B2, B3 and iron are essential. There has also been data to suggest dandelion amongst others can support the enzymatic detoxification pathway too.

Phase III is the elimination phase. For optimal excretion of toxins through the digestive system, gut health is vitally important. Maintaining the mucosal barrier is key for gut health along with supporting motility. Its important to include a range of functional ingredients in your dogs diet that can lubricate the digestive tract, promote regular motility, aid elimination and support the microbiome. Prevention of absorption through trapping of potential toxins is also an effective way of mitigating toxin exposure and this is a key feature of many clay products.

7 Reasons to Use Clay

In addition, some fibre helps to speed up colonic transit and prevent constipation. This reduces the amount of toxins absorbed from the colon and circulated into the system for the liver to deal with.

7 Foods To Add Fibre To Your Dogs Diet

The most important thing to do to support detoxification is to avoid exposure in the first place, so consider how much you and your dog are exposed to:

Pesticides
Heavy smoke
Phthalates
Mould
Medications like steroids, antibiotics, and painkillers
Heavy metals
Cleaning products
Air fresheners
Eating foods cooked at high temperatures

Does My Pet Need to Detox?Is Your Toxic Home Affecting Your Pet?

Water

Always filter or provide fresh bottled water for your pet. Tap water contains flouride, pesticides, fungicides and many more toxins that the liver must process during detoxification.

To keep things more interesting a broth could be a great alternative to water. However, be careful the broth doesnt contain high levels of sodium. Even a little liquid chlorophyll in water can be helpful for electrolytes and has shown to help with high levels of ammonia in the body.

The Importance of Water

There are many other nutrients that are particularly important when supporting a dog with a liver shunt, along with hepato-protective herbs and supplements. If you are looking for a bespoke diet plan to support your dog and their liver health, then please check out our services to see how we can help.

Thanks for reading,

MPN Team