I've not seen any proof at all that triclabendazole doesn't work just as well when the liver is damaged. Heard it said a lot, but not seen any actual evidence.
Well, horse's mouth, then.
Which said, we have certainly had a batch in which the fluke was not cleared up by dosing with Combinex - and I'm sure we don't underdose, quite the reverse.
This year we've fluked all summer and wormed through the first half of the winter - the weather simply didn't change enough for either parasite group to get inactive, and we had lab reports showing fluke damage in lambs sluaghtered in August

Wow to the 600 and only 2 in lamb. Did he have fluke? It can be one of the causes of low scanning rates.
We have assumed it's fluke, having heard of other very poor scans where it has been fluke.