Our seizure pups are warriors. 🧠 And one of the most important things we can do for them—besides managing their seizure activity—is supporting their liver health. Today I want to talk about why liver care matters so much for dogs on phenobarbital and other anti-seizure medications metabolized by the liver, and the steps I take to protect Forrest’s little liver every single day. ❤️🩹
Why Liver Support Matters
Phenobarbital (and several other AEDs) are incredibly effective at controlling seizures, but they are also very demanding on the liver. Over time, they can cause elevated liver enzymes, inflammation, strain and irreversible damage—especially in dogs on long-term therapy. This is why routine monitoring and proactive liver support isn’t optional… it’s essential.
Why I Use Denamarin Advanced
Let me say this loud and clear:
Milk thistle and Denamarin are NOT the same thing.
And Denamarin Advanced is NOT the same as basic Denamarin.
Yes, Denamarin contains milk thistle (silybin), but it also contains SAMe and uses a specific formulation that makes it FAR more bioavailable and effective. Denamarin Advanced is considered the gold standard in liver support in veterinary medicine. When it comes to protection from a strong medication such as phenobarbital, second best just isn’t good enough.
Here’s why I love it for Forrest:
- It protects liver cells
- It helps the liver regenerate
- It helps reduce inflammation
- It supports healthy enzyme levels
But—and this is big—it must be given on an empty stomach.
If it isn’t, the body can’t absorb it properly.
How I Time It
Forrest gets his Denamarin Advanced around midnight.
That’s a few hours after his frozen bedtime treat and several hours before breakfast. Because I break his meals into smaller portions throughout the day so he never feels hungry and gets to “snack” often, this is the only time in our schedule when I can guarantee his stomach is truly empty. Phenobarbital makes them feel hungry and want to eat, so feeding smaller meals throughout the day is a great way to help them not feel hungry or deprived.
If you struggle to find the right window, you are NOT alone. It takes some adjusting.
That’s why I’m sharing what works. best for us. You may find it to be a great option for you as well.
One more thing:
You can’t buy Denamarin Advanced on Amazon.
It’s a veterinarian-only product. Forrest’s vet offers autoship, which makes life so much easier.
If you ever want a breakdown of the differences between milk thistle, Denamarin, and Denamarin Advanced—just ask ChatGPT. It will spell it all out for you.
Lab Work Matters—Don’t Skip It
If your dog is on phenobarbital, you must stay on top of their lab work.
✅ Drug monitoring panel every 6 months
This checks:
- phenobarbital levels (to make sure the dose is safe & therapeutic)
- liver enzymes
- full CBC/Chemistry
Other AEDs also require monitoring, but the timing varies. (Your vet can give you the exact schedule for potassium bromide, zonisamide, etc.)
Why I Do Yearly Abdominal Ultrasounds
Call me an extra dog Mom—I know I am and I don’t mind one bit!
When it comes to Forrest’s health, I refuse to be reactive. I want to catch issues early. He’s my furchild and I want to stay on top of his health in every way possible.
So, in addition to routine labs, Forrest gets an abdominal ultrasound every year.
This helps check:
- the size and structure of his liver
- any thickening, nodules, or abnormalities
- early signs of disease
This isn’t just for AED monitoring.
It’s also a proactive measure for spotting hemangiosarcoma, especially since Australian Shepherds are among the breeds at higher risk.
(Important reminder: cancer is never breed-specific. Any dog can get it.)
Other Things That Can Harm the Liver
Even if your dog isn’t on anti-seizure drugs, their liver can still be affected by:
- certain antibiotics
- environmental toxins
- leptospirosis
- chronic inflammation
- diet issues
- genetic conditions
- long-term medications
Liver protection isn’t just for epi dogs. Check with your dogs veterinarian if you have any concerns about your pups liver health.
A Reminder From Me to You
Being proactive is the best gift you can give your dog.
Bloodwork, monitoring, supplements, and knowledge WILL make a difference.
And if you’re ever unsure about something?
Ask. Learn. Research. Advocate.
Nobody knows your dog like you do.
Let’s Talk
If you have an epi dog, what are your biggest health concerns for him or her?
And how do you stay on top of their liver health?
Leave a comment—I’d love to hear from you!
Closing Thoughts
Thank you for being here.
Thank you for caring about your dogs the way you do.
And thank you for helping this blog grow—
Please share this post on your social media to help spread awareness about canine epilepsy and support other dog parents walking this road. You never know who might need it.
From our lavender world of grace, we’re holding onto hope, walking by faith.
💜
“The righteous care for the needs of their animals.” — Proverbs 12:10
⚠️ Important Disclaimer
I am not a veterinarian.
Everything I share is based on my experience as Forrest’s mom, research, and advice from his veterinary team. Always talk to your dog’s vet before making changes to their medications or supplements.
The Epi Dog Mom Blog 
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