Chronic liver disease in dogs encompasses a spectrum of conditions from portosystemic shunts to hepatitis, causing nausea, neurological signs, and significant welfare compromise.
Chronic liver disease causes a fluctuating welfare burden including nausea, anorexia, and in advanced cases, episodic hepatic encephalopathy that causes significant neurological distress. Dogs with HE may appear blind, confused, head-press (pressing head against walls), or have seizures — all distressing and indicating substantial welfare compromise. Welfare management involves dietary protein modulation (enough to prevent muscle wasting, insufficient to generate excess ammonia), lactulose to acidify colonic environment and reduce ammonia absorption, and treatment of underlying causes where possible. Quality-of-life monitoring must account for both the burden of disease and treatment side effects. End-of-life decisions require careful assessment of good-day versus bad-day frequency.