Hi scrappymomma, I'm so sorry that your little girl is so sick...She's dehydrated because RC Hepatic LS 14 is a dry food, and liver compromised dogs *need* water added to their food. That food is excellent for them, but dry foods do not provide nearly enough moisture even if they drink lots of water on the side.
I'm not sure if you free feed or have her on a schedule, but liver compromised dogs should eat on a schedule because they are only allowed to take in certain amounts of protein at a time. She should be fed, at the very least, 4 small meals of RC Hepatic per day with equal parts added to the water. The several small meals help lighten the load on the liver so that it's not processing too much at one time.
How much food would you say she eats in one day? At 4 lbs and the fact that she is symptomatic means that she should be taking in around 3.6 to 4 grams of protein per day until you get her symptoms under control. 1/4 cup of RC Hepatic contains 4 grams of protein, so this would be the max. amt. of protein that she could take for now, but you can add cooked carrots and/or green beans specifically to add some substance to it if you want and if she's hungry for it. A couple of other options include adding seedless watermelon or peeled pieces of apple. Do not add oats, rice, beans, or anything like that. Oats and beans are high in purines and rice is high in manganese.
How many times a day do you give her lactulose? If her dose is 6 ml per day, then it needs to be split up into 2 ml 3x per day instead of 1 or 2 larger doses. This is very important so that she doesn't get stopped up and then have diarrhea and then get stopped up and then get diarrhea again.
Is she having at least 2 bowel movements per day? What is the consistency of her stool? Is it soft or firm?? Her stool should be soft and difficult to pick up , but not diarrhea and not firm. The dosage of lactulose should be adjusted to make the stool this consistency.
Although many people have success with Marin, I do not like to recommend this to dogs who have a history of seizures and hepatic encephalopathy because it does contain liver and yeast which are two high purine foods that should not be given to very sensitive liver compromised dogs, in my opinion. You may find that plain dried herb milk thistle or Hepatosupport are better options for her.
PediaSure or DogSure is recommended for dogs who won't willingly eat so that they get some nutrients and caloric requirements. You might try this.
I have found that when Miko has seizures, it is helpful to hold an ice pack on his mid to lower back area. For some reason this seems to help him a great deal and slow down the seizures to a stop. Some people think it works, some people don't. It has worked for us.
I am not a vet, and I am only providing information that has successfully worked for my yorkie and several other dogs that I have helped.
If you have any questions, please ask.
So sorry for the long post!!
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