This just doesn't add up. MVD can be controlled by diet. As for the medication, I'm not sure he needs all of those. I would discontinue the Mirtazapine. If he has MVD, then the Mirtazapine is not going to help his appetite. Dogs with MVD have a poor appetite because when they eat, they flood their body with toxins and become sick. Controlling his diet and using the lactulose should help with that. I also question the metronidazole. It is known to cause liver damage as well and makes existing liver conditions worse. Why in the world would it be prescribed for a dog with liver problems?
You may need to hand feed him as well. I used the L/d at first for Lily but I had to bake it before she would eat it. Now I use the Royal Canine Hepatic LS 14 and combine it with steamed potatoes, green beans, baby carrots, and yogurt. As for the medication, I mix her lactulose with the yogurt and grind up the milk thistle and mix that with yogurt as well.
Please get some more information from your vet and get a second opinion if you don't feel comfortable. It just doesn't sound right for your vet to put a liver compromised dog on some of those medications and for her to say that he only has a year to live with MVD. Like I said, it just doesn't add up
