From the Research
For a dog with a liver shunt, a low-protein diet is recommended, typically containing 18-22% protein on a dry matter basis from high-quality, easily digestible sources, along with lactulose treatment, as this combination has been shown to be effective in controlling clinical signs and improving quality of life 1. The diet should be specifically formulated for liver disease, with commercial prescription diets like Hill's l/d, Royal Canin Hepatic, or Purina EN Gastroenteric being suitable options.
- Key considerations for the diet include:
- Protein content: 18-22% on a dry matter basis
- Protein source: high-quality, easily digestible sources
- Dietary restrictions: limited protein to reduce ammonia production
- Treatment usually includes medications such as:
- Lactulose (0.5-1 ml per 10 pounds of body weight, 2-3 times daily) to reduce ammonia absorption from the intestines
- Antibiotics like metronidazole (7.5 mg per kg twice daily) or amoxicillin to decrease bacteria that produce toxins
- Supplements often include:
- Milk thistle (20-50 mg per kg daily)
- SAMe (20 mg per kg daily)
- Vitamin E for antioxidant support
- Surgical correction of the shunt is the definitive treatment when possible, with success rates of 60-85% 2. The specialized diet and medications work by reducing the workload on the compromised liver, preventing the buildup of toxins like ammonia that can cause neurological symptoms, and supporting liver function until surgery can be performed or as long-term management for inoperable cases.
- A study published in 2022 found that combined treatment with a hepatic supportive diet and lactulose was effective in controlling clinical signs in dogs with congenital extrahepatic portosystemic shunts 1.
- Another study published in 2020 found that non-surgical treatment with an adjusted diet and lactulose improved quality of life and clinical performance in dogs with congenital portosystemic shunts 2.