Dog Fluid Retention May Indicate Liver Failure

Q. My 9-year-old female mixed breed had a life threatening liver disease last year. She has since recovered, but is retaining fluid. She has been drained by our vet around five times now.

The vet put her on a daily dose of 160 mg of frusemide, 11 mg of spironolactone and 5 mg of prednisolone. At first, a month or two would pass before she swelled up after being drained, but she was last drained only one week ago and is once again huge. My vet is at a loss at what to do. He says it’s not healthy to keep draining her, but he can't see any other solution.

A. I’m sorry to hear about your dog’s liver problems. Because of the repeated appearance of abdominal fluid, your dog, by definition, has liver failure. The severe scarring of the liver causes a back up of fluid that normally would pass through the liver. The presence of abdominal fluid due to liver failure is called ascites.
 
Unfortunately, there’s no reversing the progression of liver failure. In humans, you would be looking at a liver transplant. It sounds as if your dog is on all of the appropriate medications to help drain fluid, mainly diuretics, which draw fluid out of the body into the urinary tract.
 
Some nutritional supplements can help support to the liver, but these are usually only helpful in cases of liver inflammation, not liver failure.
 
Ideally, you want to get a specific diagnosis for the liver disease, which can only be done with a liver biopsy. An ultrasound must be used to help get the sample. It’s not inexpensive. With a biopsy, you vet may see something that requires additional medications, such as an antibiotic.
 
You also should make sure your dog's heart has been evaluated, because congestive heart failure can also cause ascites. Specific medications can help relieve ascites due to heart failure.
 
Realistically, you may be looking at a very short window for a reasonable quality of life for your dog. Once that quality of life falls below an acceptable level, it’s time to consider euthanasia. This is a decision only you can make, but your veterinarian can assist you. We look at euthanasia as a privilege that allows us to end untreatable suffering after all reasonable options have been exhausted.