Methods to prevent/ avoid malnutrition include:

• Tube feeding
• Balanced and concentrated diet
• Good quality protein
• Hand feeding/ warming/ encouraging
• Good nursing care
• Appetite stimulant
  

Effects of malnutrition on the liver include:

• Negative energy and negative protein = harmful effect on heptatocytes
• Clotting problems
• Malabsorption
• Increased requirements
• Cholestasis enteropathy

• Energy provided primarily from moderate fat and complex carbohydrates. Care must be taken with fat levels in cats with hepatic lipidosis
• Restriction of dietary protein to minimum requirements. This should be derived from a high quality single source protein to minimise ammonium production. Care must be taken in cats to ensure that all the required amino acids are supplied
• Maintenance of fibre content to prevent constipation, and to encourage enteric bacterial growth and so inhibit ammonia absorption into the blood stream
• Supplementation of vitamins and mineral as required, although copper intake should be kept to the minimum required
• Antioxidants - liver disease results in an increase production in free radicals. Supplementing with antioxidants (vitamin E, C, taurine, SAMe) will help minimise any oxidative injury of the tissue
• Vitamin deficiency common in chronic liver disease, especially B vitamins and fat soluble vitamins
• Mineral deficiencies - potassium, especially in cats. Supplementation of the diet may be necessary in some cases
• Certain dog breeds are prone to copper accumulation in the liver and so a low or restricted copper diet is recommended for these dogs

NOTE: SaMe - S-Adenosylmethionine - a product produced by the liver from the break down of the amino acid methionine. SAMe is further converted to an anti oxidant by the liver cells and is important in the production and movement of bile in the gall bladder and bile duct. As an antioxidant it also prevents or minimises any inflammatory reaction of the bile duct

Dogs:

• Infectious hepatitis (canine infectious hepatitis/ leptospirosis)
• Chronic hepatitis
• Cirrhosis
• Drug induced
• Portosystemic shunts (congenital)
• Cholestasis
• Choleangitis

Natural products used in the treatment of liver disease: Milk thistle is used in many of the commercially produced products sold at veterinary practices indicated for the treatment of liver disease in dogs and cats. Owners can also purchase milk thistle in homeopathic shops