Sam-E does help a lot. My yorkie has intrahepatic liver shunt and it is managed through diet and medicine. He eats Royal Canin Veterinary Hepatic LS 14. It is low in protein and the protein comes from vegetables/soy (animal protein is too difficult for their liver to process). He takes lactulose and SAM-E everyday. For under 10 lbs, they recommend about 90mg. per day.
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