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Avatar universal


Have a 12.5 year old springer with liver failure. We're managing quite well apart from the obvious problems with food i.e. low fat, low easily digestible protein. Until recently tho would eat for a couple of days then be "unwell" for a day or so and vomit bile then start eating again.  Vet said that this was due to bile salts. Since last visit to vets approx 11 days ago, we changed diet to pasta and fish and no vomiting until today, and even then not a lot. Have looked up bile salts on i/net but unsure whether it is a LACK of bile salts or EXCESS bile salts causing the vomiting?  Not due back at vets for 10 days or so. Dog on Vit E, Milkthistle compound and Biostrath from us and antiobiotics and liver supplment from vets. Generally quite happy in himself apart from his "off" days when he vomits and is very sorry for himself!.  Any ideas from anybody would be appreciated!  I've looked up so much stuff on i/net I'm googled out!   Thanks to anybody who has any suggestions.
11 Responses
82861 tn?1333457511
I think your vet was talking about the dog vomiting actual bile.  When there is no food on the stomach, an animal (or human!) will often vomit bile because it's the only thing there to come back up.  That in itself is not something to worry about other than being a symptom of something else going on.  

Bile is produced in the liver and aids in digesting fats.  Normally, it travels down the bile duct and some of it gets stored in the gallbladder to be ready to dispense in the sudden presence of a fatty meal.  If too much bile gets dumped into the small intestine - as in people or dogs who have had their gallbladders removed - explosive diarrhea can result.

Bile is also what gives feces its brown color.  If a dog's stool is light tan, that means bile is not getting into the small intestine.  Same thing goes for humans.  In the case of liver failure, I imagine there is a lack of bile available to aid in digestion; hence the nausea and vomiting.

Has your vet prescribed a specific nausea medication to help keep your dog more comfortable?  The cheapest one available is reglan (metoclopromadine) and it works by increasing peristalsis to move food and digestive enzymes through the tract faster.  If the dog can't keep it down long enough to do any good, you can inject it at home.  We had much better results with injections last year with our dog who was dying of kidney failure.  Sometimes bypassing the GI tract altogether produces a better result with things.

I take phenergan every day for my own medical issues, and learned from my vet that dogs can also take phenergan.  When nothing else works, one 25 mg phenergan gets rid of my dog's occasional nausea, extreme bowel noises and vomiting.  He's just got one of those touchy tummys and gets the barfs if he manages to sneak something he shouldn't have.  You could even try plain Tums tablets - the ones that are calcium only with no other additives.  Dramamine (the OTC motion sickness med) is another over-the-counter anti-emetic that dogs can take.  Of course, check with your vet on any of these meds first so they don't interact with his other meds, and also for correct dosing amounts.

Dealing with any kind of organ failure finally becomes a matter of treating the symptoms to keep your pet comfortable until the end.  Keep after your vet for these kinds of palliative measures.  And never be afraid to ask him ANY kind of question.  If you aren't getting an understandable explanation of what is happening to your dog, keep asking questions until it's clear.  Those kinds of conversations can be invaluable and lead to "What if we do XYZ?" questions that might trigger your vet into trying something he wouldn't have thought of otherwise.
660872 tn?1238644845
When my dog had liver failure (resolved spontaneously), she turned bright yellow because of the high bile level.  The vet kept her in hospital for a long time on a drip to help excrete the bile through the urine.  When she came home, I almost forced her to drink a lot so that she still had the high urine output and hence the increased bile excretion via the kidneys. I gave her any fluid she wanted including lactose free milk, goats milk as well as her usual water. I was lucky (??) because she also had a disease that required giving her a lot of salt as well.  This increased her thirst and made it easier to get her to drink.  I don't know if that is an option for you.  You would need to ask a vet before giving extra salt because sometimes in liver failure it's better to have low salt due to retaining fluid in the abdomen and tissues.  

I hope things go well for you.  I had a miracle in my house and my dogs liver tumour disappeared. My vet doesn't know how the tumour went away because we didn't give her any anti cancer treatment.

Avatar universal
Thanks for responding so quickly.  Interesting comments - but he only seems to vomit bile after he has been eating for a couple of days. Not a vast amount either - we can usually tell that he's going to be sick as he has a good long drink of water and then whoops! there you go!   He doesn't have diarhhea and his stools seem relatively normal, if only slightly looser and lighter than usual.  As we've got him on a (hopefully) easily digestible diet of either white fish/rice/pasta or turkey mince(recommended by Vet) and also (hopefully) fairly low in protein and fats, he seems to be managing - as I said we've just done 11 days with an enormous appetite, back to bouncy self and only punctuated by one barfing up bile episode!  He's starting to eat again now (usually does after a day or so) and encouragingly this started only a few hours after he vomited.  We're just trying to control it all by diet, hence the do we need to give him more stuff for bile salts or less!  You've suggested in your post that it might be lack of bile salts due to gall bladder etc. - I think you've hit the nail on the head - he also started off with pancreatis and gall bladder problems so your explanation fits the scenario.    Don't want to give too many tablets too soon - apart from odd days when he is obviously off colour, when we just pamper & comfort him, he really isn't that bad - we're not hiding our heads in the sand, but are trying to the best of our ability and limited knowledge to provide comfort and palliative care to him.  Do you have any ideas re diet?  We know that everything probably tastes of cardboard due to the jaundice associated with liver failure (which last time at vets we were told was receding!) but we're not sure whether he's trying it on sometimes with food i.e. holding out for something better and tastier!  Never previously a fussy eater, but now is extremely fussy - will eat something one day and refuse it the next! and we do know what they say about "they'll eat it when they're hungry". Well he won't and in his current state of health, I'm not willing to risk waiting anyway!    Thanks again for your post - it was very positive and informative!  
Avatar universal
Thanks for your post.  It's nice to find a site where there are people willing to give their advice/experience!   He doesn't seem to have encountered any problems drinking (as yet) but sometimes we try and limit it as he'll try and gorge a whole bowl at once and then sicks up bile!  His eyes show his jaundice but last time at vets we were told it wasn't as bad as before.   Have you any tips on diet?  We know low protein, low fat, and very easily digestible.  He can't digest chicken, but can digest turkey mince (recommended by Vet). Fish he's OK on and pasta but at present time he is refusing to eat rice. Occasionally when he's off food (generally after having an "off" day) we can get him to eat either porridge or weetabix with a little skimmed milk. He eats these best if we are eating them as well!!  I've just been given an article from newspaper stating that probiotic yoghurts are good for treating liver failure in humans so we'll try him on some of that tomorrow as he likes yoghurt (and as long as it doesn't make him worse, may even help to alleviate some of his tummy problems).Vet recommended Marmite for B vitamins which is quite salty, but he's flatly refused that, even mixed with food/spread on toast or smeared on gums.I can't stand it either, so would probably do the same!   Any recommendations for foods that you gave your dog during his/her illness gratefully received.   I'm so glad your dog recovered!  We know ours isn't going to, but that doesn't mean that you just have to sit and watch them die, does it?  Anything that helps maintain their quality of life is better than just giving up, even if you know their quantity isn't going to be that long.  Again, thanks for responding, as I said to Jaybay its reassuring to know that people have other ideas and recommendations which they are willing to share/pass on in order to help.  
390388 tn?1279639813
Hi my dog also has liver failure.  I was pulling my hair out as I watched our 17 year old border collie drop 21 pounds.  Thank goodness she was really fat before this started.  lol.  
Anyhow being serious here, she would go maybe 3 days and eat fine and then be sick or totally refuse to eat.  The vet specialist phoned in a Rx. for Lactulose for her to regulate her stool and help to move things along and also Reglan for any upset stomach issues as needed.  I was happy and it seemed to help a lot.  

This has been going on since ~ July with her diet but her it goes concerning diet.  
She flatly refused the Rx food (l/d) after a few weeks.
So next we done chicken, mashed potatoes, rice, children's single grain rice for baby's and that worked great for a while.  
Then she changed again.  For the last two weeks we have been buying baby food for kids #3 stage, example turkey dinner, chicken dinner, etc. as a last resort where she gets a (lg. size jar) different jar 3 times a day and nutra-cal once every other day.  So far so good.  

I hope that helps you a little with diet ideas.  I would talk to your vet. or specialist though before you change her diet.  For us it was starting to be a question and quality vs. quantity.  As of now she loves the baby food as long as she doesn't get the same kind twice in a row and is back to running around out in the yard again.  Best of wishes to you.  I hope this might help you and your vet a little in diet ideas.

O forgot to add she stopped getting zinc daily.  The specialist we take her to say's that the SAMe and Zinc sometimes will mess with them.

Take care and best of wishes for your fur baby.  
82861 tn?1333457511
I think you're doing everything you possibly can do regarding diet.  At some point, the weight loss and malnutrition get to the point that ANYTHING you can get your dog to eat is a victory - even if it's on the "do not eat" list.  That's what happened to our dog in kidney failure.  Even with vitamin supplements, she was so malnourished in the last 2 weeks that her hair fell out by the handful.  

We lost our first dog to pancreatitis and associated liver failure.  He was an inpatient the last 2.5 weeks of his life with TPN nutrition and hydration given through a port in his neck.  His pancreas got so hugely swollen that the pressure on the bile duct caused the bile to back up into his gallbladder and liver.  There was just nothing else to be done so we had to put him to sleep.  I completely embarrassed myself at that time, my husband, the vet, the vet tech and likely scared the cr*p out of everyone in ear shot.  It seemed to come out of nowhere, but there it is.

It doesn't sound like your dog has anything for nausea, so ask your vet about something to cover that angle.  It really can make a big difference in getting a sick dog to eat more.  And get your pilling technique refined so you can just pop that pill down his throat before he even notices.  If you get it past where the back of the tongue rises against the roof of the mouth, it won't come back up.  I can pill my dogs in less than one second by now.  They never know exactly what just happened.  LOL!

You're doing a great job.  No matter what happens, never forget that.  :-)
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