Dr. Mark is a veterinarian. He has been working with dogs for more than 40 years.
Finding Out What Is Wrong With Your Dog
If you have noticed that the whites of your dog's eyes have turned yellow, this is something to be concerned about and something that needs to be taken care of immediately. Yellow skin and/or mucosa means your dog has jaundice, also known as icterus, and it is a sign that they may have a serious medical problem.
Jaundice in your dog is a symptom, not a disease, and may have several causes, including liver disease, liver obstruction, or a blood disease. Before you can try to manage the symptoms of jaundice at home, you will need to find out what is wrong with your dog. Below, you will find a guide to common questions and advice for helping a dog with jaundice.
A Guide to Jaundice (Icterus) in Dogs
- 1. Symptoms of Jaundice in Dogs
- 2. Dog Breeds That Are Most Likely to Develop Jaundice
- 3. Diseases That Can Cause Jaundice in Dogs
- 4. How a Veterinarian Tests When Your Dog Has Jaundice
- 5. Veterinary Treatments for Jaundice in Dogs
- 6. What You Can Do at Home
- 7. Best Foods for a Dog With Jaundice
- 8. Can My Dog Live With Jaundice?
- 9. What You Can Do If No Vet Is Available
1. Symptoms of Jaundice in Dogs
When it comes to symptoms, you may notice that the whites of your dog's eyes are yellow and that their mucous membranes (in the mouth) may also be yellow in color, depending on their original gum color. Most dogs with jaundice that is caused by liver disease and obstruction also have the symptoms listed below.
Symptoms Caused by Liver Disease and Obstruction
- Loss of appetite and weight loss
- Swollen and painful abdomen
- Increased urine output with an orange color
- In cases of obstruction, the stool is pale
- Bleeding (since the liver cannot make some clotting factors)
- Fluid-filled abdomen
- Neurological signs (since the liver cannot remove toxins from the blood)
Symptoms Caused by Red Blood Cell Destruction
- Loss of appetite
- Pale gums (which may be masked by jaundice)
- Rapid and shallow breathing
- Exercise intolerance
- Orange urine
- Pica (e.g. eating sand)
2. Dog Breeds That Are Most Likely to Develop Jaundice
Although any breed of dog can develop jaundice secondary to some infections or some cancers, these dog breeds also have inherited conditions that make them more prone to developing the condition:
- Alaskan Malamute (stomatocytosis)
- Basenji (pyruvate kinase deficiency)
- Beagle (pyruvate kinase deficiency)
- Bedlington Terrier (copper-associated chronic hepatitis)
- Bichon Frisé (immune-mediated hemolytic anemia or IMHA; portosystemic shunt)
- Chihuahua (copper-associated chronic hepatitis)
- Cocker Spaniels (copper-associated chronic hepatitis, IMHA)
- Dalmatian (copper-associated chronic hepatitis)
- Dobermans (copper-associated chronic hepatitis)
- Finnish Spitz (IMHA)
- Irish Setter (IMHA)
- Labrador Retrievers (copper-associated chronic hepatitis)
- Miniature Pinscher (IMHA)
- Old English sheepdog (IMHA)
- Poodle (IMHA)
- Scottish Terrier (vacuolar hepatopathy)
- Shar-Pei (hepatic amyloidosis)
- Shetland Sheepdog (gallbladder mucocele)
- Skye Terriers (copper-associated hepatitis)
- Springer Spaniel (phosphofructokinase deficiency)
- West Highland White Terrier (copper-associated hepatitis)
3. Diseases That Can Cause Jaundice in Dogs
Jaundice caused by liver disease and liver obstruction:
- Cancer of the liver
- Leptospirosis and other infections (bacterial, viral, and fungal)
- Poisoning (including drugs given intentionally, like phenobarbital for epilepsy, acetaminophen, and many others)
- Inherited conditions (e.g. copper-associated)
- Idiopathic hepatitis (no known cause)
- Severe trauma (like being hit by a car)
Jaundice caused by red blood cell destruction:
- Immune-mediated hemolytic anemia (IMHA), either inherited or from systemic lupus
- IMHA secondary to cancer, vaccinations, drugs, and some infections
- Hypophosphatemia (low blood-phosphorus)
- Microangiopathic hemolysis (e.g. heartworm, DIC)
- Onion, zinc, lead, and other toxicities
- Infection (leptospirosis, Ehrlichia, babesiosis, and others)
- Cancer (lymphoma and some other cancers that affect the blood)
- Inherited blood deficiencies (prominent in Basenjis, Beagles, English Springer Spaniels, and Alaskan Malamutes)
- Incompatible blood transfusion
4. How a Veterinarian Tests If Your Dog Has Jaundice
Clinical signs and symptoms may help a veterinarian reach a diagnosis, but the causes of jaundice can never be decided without testing. The following tests are commonly used for diagnosis:
- Complete Blood Count (CBC): This test is often the first step in the diagnosis. When the vet draws blood, he or she can see how bad the icterus is, and the CBC will tell them immediately if the jaundice is due to liver disease or blood cell destruction.
- Chemistry Panel: If the CBC is normal, then the blood chemistry is checked to evaluate liver enzymes. The ratio of the enzymes can sometimes provide a diagnosis of whether the liver is inflamed or blocked.
- X-Rays of the Abdomen and Chest: If your dog has cancer, the tumors will sometimes be visible on a radiograph.
- Ultrasound: Information from ultrasound varies a lot depending on the skill of the person doing the test, but this type of imaging will allow a vet to see the pancreas and gall bladder to find out if they are affected. If there is any fluid in the abdomen, the vet can use ultrasound to help tap the abdomen for a fluid sample and examine it.
- Biopsy: A needle is sometimes put into the liver so that the cells that are collected can be looked at under a microscope. If no information is obtained, then the vet might suggest a surgical biopsy under anesthesia. This procedure will gather useful information to help diagnose your dog but can be risky, so not all dogs have this done. Your vet may also recommend a follow-up liver biopsy to see how your dog is responding to therapy. This may seem traumatic, but it is the best way to find out if what you are doing is effective.
- Miscellaneous Tests: Sometimes, the most common types of tests do not provide enough information to treat your dog. Your vet may suggest testing clotting times, performing blood culture tests to look for an infection, or testing serum titers to find out if an infection is causing your dog to be sick.
5. Veterinary Treatments for Jaundice in Dogs
Red Blood Cell Destruction
When your dog has jaundice secondary to red blood cell destruction, the first treatment your vet will do will be against the primary disease. If your dog has ehrlichiosis, for example, your vet will treat your dog with an antibiotic that is effective against this tick-borne disease. Your dog will also be given any additional treatments based on his or her clinical condition.
Chronic Liver Disease
With chronic liver disease caused by cancer, the main disease will need to be taken care of before your dog will have any chance of surviving. Dogs with an obstructive liver disease will need to be diagnosed and their problem treated.
With chronic liver disease, your vet will treat the main problem and may give some other treatments that will reduce zinc levels, reduce fiber buildup, stop further inflammation, and make your dog feel better. Your dog will also be treated with the antioxidants listed in the section on home-care, as well as some others that can only be given as an injectable solution (e.g. antibiotics for sepsis, diuretics for fluid buildup, prednisone to control inflammation, and others).
Your veterinarian may also treat copper buildup. The metal may be put into a form so that it can be removed (chelated) from the body, or a medication like zinc may be given to decrease the copper's toxic effects.
6. What You Can Do at Home
As well as treating the primary disease that has been diagnosed by your veterinarian, you can give antioxidants to protect the liver. Free radicals (from excess copper, drug injury—e.g. phenobarbital, and similar) have been shown to cause serious injuries in dogs with liver disease. Antioxidants prevent injury from free radicals and are something you can provide for your dog at home. Antioxidants like milk thistle have mostly been used in alternative medicine but are now used by conventional veterinarians.
This plant contains about 60–80% silymarin, a powerful antioxidant and anti-inflammatory that improves liver function, so holistic veterinarians have been using it for a long time. It has been used by humans with liver disease for over 2000 years, but experiments proving its effectiveness have only been done with the injectable solution. The exact dose is still debatable, but responses have been reported using doses from 20 to 50 mg per kilogram. (In the chart below, I am recommending 50 mg for each pound, but if your dog's condition is severe, your vet may want to try a higher dose.) A toxic dose has never been accurately reported, but if your dog is very sick, a smaller dose might be a good idea.
Another antioxidant that you might consider for your dog is alpha-tocopherol. Its antioxidant properties will protect cell membranes and may also potentially protect the liver. The maximum dose I have seen used is 400 IU, but some literature recommends more when some diseases are diagnosed. (The natural form, d-alpha-tocopherol, is better than the artificial from since it is more bioactive.) I do not know of any research into higher doses for larger dogs.
S-Adenosyl Methionine (SAM-e)
This antioxidant is naturally present in your dog but will help a dog with liver disease since it breaks down to form glutathione, a product that aids metabolism, prevents liver injury (stress oxidation), and even protects red blood cells; it is especially helpful for dogs with inflammatory, toxic, and metabolic diseases. It can be tricky to treat tiny dogs since the capsules are coated and not meant to be split or crushed. If you need to give your dog SAM-e, try to find pills as close to his or her recommended daily dose as possible.
These drugs have only recently been accepted by conventional veterinarians but have been used by holistic practitioners for a long time. Some veterinarians will still not accept them. Keep this in mind but discuss your options with your overseeing veterinarian before introducing a new supplement or remedy into your dog's diet. Some doses mentioned below are still controversial.
|Weight||Milk Thistle||Vitamin E||SAM-e|
If your dog has been diagnosed with a liver disease associated with copper buildup, zinc is one of the best methods of treatment. Although zinc also protects the liver in some other ways and is available in many combination drugs (like with milk thistle), I do not think it should be used unless your dog has been diagnosed by a veterinarian. It often causes vomiting as a side effect and the dose must be weaned down when it becomes effective to prevent the dog from being poisoned by the zinc.
Other Possible Home Remedies
- B-Complex Vitamins: Dogs may be deficient in the B vitamins (like B6 and B12). It is a good idea to give this supplement with the antioxidants.
- Turmeric: This is an Ayurvedic treatment and has been shown in studies to work as an antioxidant and anti-inflammatory. Unfortunately, some studies have shown that this compound can make liver issues worse. The dose recommendations vary a lot, but about a teaspoon for a large dog is the average recommendation.
- Artichoke: Leaves from this plant may help with liver metabolism. It is available in some “liver cure” pills when mixed with milk thistle and zinc.
- Dandelion: Another herb that may help liver function, dandelion leaf is known to suppress fat accumulation in the liver.
- Miscellaneous: Carnitine, methionine, and natrium sulphate have also been recommended by some practitioners.
7. Best Foods for a Dog With Jaundice
Dietary changes are not going to heal your dog but will allow them to recover in some cases. The “liver diet” is meant to keep your dog strong through his or her illness while providing as little stress to the liver as possible. At home you can provide small meals about five times a day and make up their diet according to these suggestions:
- Protein: When it comes to a protein source, lean chicken is fine since it is low in copper. Eggs are great, and you can also give your dog fish. Cottage cheese and yogurt are also good protein sources as long as they do not have added salt. Do not give fatty meat, organs (beef liver, kidneys, etc.), pork, duck, or salmon.
- Fiber: Soluble fiber sources like oatmeal help remove ammonia from your dog's system so that their liver will have to work a little less hard. My dogs also like pumpkin, another good fiber source. To encourage them to eat it, you can blend it together with the protein source.
- Fish Oil: Add a dose of fish oil or salmon oil to your dog’s meals. These oils are rich in omega-3 fatty acids and they can help reduce inflammation within the liver.
- Coconut Oil: This oil provides fat in the form of medium-chain triglycerides and can spare the liver some work in processing. Coconut oil may also offer antibacterial and antiviral effects that can help your dog. For best results, I always recommend virgin cold-pressed coconut oil. (Offer about 1 tablespoon of virgin coconut oil each day for a medium-sized dog.)
- Fruit: Papaya is palatable and provides additional calories without stressing the liver. If your dog has not eaten this fruit before, however, you should make sure to hand-feed them and that they like the taste.
Example Diet for a Dog With Jaundice
I usually recommend that the client make up food at least twice a week. Figure out approximately how much you will need based on your dog's weight. Make the diet a little different every time so that your dog will stay interested. An example of a typical diet mixed up in a blender might be:
- 2 eggs
- 2 chicken breasts
- Cottage cheese to fill up the blender to about halfway (if the blender is 1.8 liters, fill it up to almost 900 milliliters)
- Oatmeal (fill the blender to about 1.4 liters)
- Papaya (about 1/2 of a small fruit)
- Pumpkin, cooked (fill the blender up to 1.8 liters)
- Add the correct amount of salmon oil based on how many days your dog will be eating this diet (based on his/her weight)
- Blend this mixture up and feed your dog the correct amount about five times per day. Do NOT add salt.
How Much to Feed Your Dog
Dogs need to eat at least 2% of their body weight each day to stay healthy. The amount you feed each day is based on his or her healthy weight. So, if your dog was 20 pounds before getting sick, give them about 6 or 7 ounces. (You can weigh out the correct number of tablespoons on your kitchen scale and from then on you will know to give that number of tablespoons per days of feeding.)
Monitor your dog's weight as often as possible, and if your dog is not maintaining or gaining weight, or if they are hungry even after being fed, you need to increase the serving size a little. Try giving a few ounces more and then see how your dog responds.
What About Consulting a Veterinary Nutritionist?
If someone tells you that you are not a veterinary nutritionist and you cannot make up your dog's meal at home, they are wrong. You are not trying to make up a diet that meets AAFCO standards and provides 100% of your dog's daily requirements in every meal. You can provide your sick dog with a much better and healthier meal than he or she can get in any canned food.
8. Can My Dog Live With Jaundice?
If your dog has jaundice secondary to red blood cell destruction, the prognosis is usually good as long as the primary disease can be handled. With a problem like IMHA, however, about one-third of dogs do succumb to the disease. When your dog lasts past the first few weeks, there are a lot of long-term therapies that can be tried and their chance of survival is much better.
With a liver problem, the prognosis varies even more. Some diseases are treatable, but when a dog has liver cancer or severe chronic hepatitis, all you can do is make them feel more comfortable. Also, with any disease, the stage to which the damage has progressed is significant. By the time many people take their dogs to the vet, there may be severe signs of chronic liver failure and the chances of pulling through are poor. Dogs may only live a few months, and with most treatments, the most you should hope for is several years.
In humans, chronic hepatitis would be treated with a liver transplant. Without a functioning liver, treatment can make your dog feel better, but he or she may not live long.
9. What You Can Do If No Vet Is Available
Some dog owners have access to the internet but not a vet. These people might be in remote locations with satellite hookups and have no way to take their dog to a vet in the nearest urban area. If you are not in an isolated area and just want to save money on an exam and lab tests, I will tell you that it will not usually work. Most dogs that are treated without a diagnosis are going to die.
If you cannot take your dog to the vet, however, the only way to treat them is “shotgun” style. Go through the clinical symptoms above and see if your dog is showing any specific disease. If not, treat them with an anti-inflammatory, an antibiotic that is usually effective against tick-borne diseases, the antioxidants listed above, and a diet that limits stress on the liver.
Anti-inflammatories and antibiotics are available at feed stores in some countries. The antioxidants you use should be milk thistle (dose recommendations vary, but 100 mg/kg seems like a common recommendation), vitamin E (which can be given at up to 15 IU for each kilogram of the dog's weight every day), and S-adenosylmethionine or SAM-e (about 20mg/kg per day).
If your dog has been poisoned, has a ruptured gall bladder, or has cancer, these treatments will not be effective.
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- Kern, Zachary. Immune-mediated hemolytic anemia: Treating cats and dogs with a complex disease. 2019.
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- Webster CRL. History, clinical signs, and physical findings in hepatobiliary disease. Ettinger SJ, Feldman EC, editors: Textbook of veterinary internal medicine, 7th edition, St Louis, 2010, Saunders Elsevier, pp 1612–1626.
This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.