Dietary therapy plays an important role in managing copper associated liver disease. The ideal food is low in copper, high in zinc, high in B-vitamins (which are often deficient with liver disease), and contains adequate but not excessive amounts of high quality protein since eating too much protein can adversely affect brain function in dogs with liver disease. The diets should be tasty enough to encourage dogs to eat and nutrient dense so that pets with marginal appetites don’t have to take in large volumes. Feeding multiple meals throughout the day is often necessary to maintain a dog’s body condition.
The Bureau of Human Resources is responsible for the employment and personnel matters of each of the Bureaus. Such matters include all aspects of human core capital processing, recruitment, retention, benefits, worker’s compensation, job performance monitoring, and discipline. The Bureau is responsible for workforce development which is inclusive of managing the on-line learning system, organizing training opportunities for employees and assisting with the documentation of employee training credits. The Bureau also oversees the Contract Management of the agency’s contract workers and independent contractors assuring compliance with state rules and regulations.
Glucocorticoid therapy is associated with an appreciable risk of bone loss, which is most pronounced in the first few months of use. In addition, glucocorticoids increase fracture risk, and fractures occur at higher bone mineral density (BMD) values than occur in postmenopausal osteoporosis. The increased risk of fracture has been reported with doses of prednisone or its equivalent as low as to mg daily [ 1 ]. Thus, glucocorticoid-induced bone loss should be treated aggressively, particularly in those already at high risk for fracture (older age, prior fragility fracture). In other individuals, clinical risk factor and bone density assessment may help guide therapy. The prevention and treatment of glucocorticoid-induced bone loss will be reviewed here. The clinical features are reviewed separately. (See "Clinical features and evaluation of glucocorticoid-induced osteoporosis" .)