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Copper-Storage Hepatopathy/Hepatotoxicosis in Dogs
By: Tippy & Turbo


Copper-Storage Hepatopathy or Hepatotoxicosis in canines is
caused by an abnormally high amount of copper in the dog's
liver due to an inability to pass excess naturally occurring
copper from the dog's food. This leads to hepatitis, more
damage to the liver and scarring of the liver (also called
cirrhosis) over a long period. It is believed that this
condition is the result of an inherited abnormal copper
metabolism.

The condition occurs more often in certain dog breeds.
Bedlington Terriers, West Highland White Terriers, Skye
Terriers, Doberman Pinschers, Labrador Retrievers,
Spaniels, and Keeshonds are all canine breeds that are known
to be often susceptible to Copper Storage Hepatopathy. As
many as two thirds of the Bedlington Terriers in the United
States have this disease. West Highland White Terriers often
do not show the clinical signs of the disease even though
they may have high levels of copper. When it comes to
Doberman Pinschers, gender is also involved in whether or
not the dog may develop the condition.


Cases of Copper Storage Hepatopathy usually fall into one of
three categories:

The Subclinical disease: This is when the disease is
affecting the dog and is in the organ or body of the dog,
but there are no symptoms or changes in the dog's behavior.

Sudden Acute disease: This form more often than not will
affect young canines. It is associated with hepatic necrosis
that causes the death of the liver and eventually the dog.

Chronic Progressive disease: The symptoms of this are most
often seen in middle-aged dogs with severe hepatitis. The
dog may also have cirrhosis.

Secondary copper Hepatopathy will only be shown with
progressive signs of liver damage usually because of chronic
hepatitis or worsening cirrhosis.

When flow of bile from the liver is slowed or stops
altogether it is known as cholestatic liver disease. The
abnormal flow of bile results in secondary copper retention.

When they are in their acute or chronic forms, either
disease may result in the following symptoms:

Acute symptoms:

- Anorexia
- Dark urine due to the presence of bilirubin (bilirubinuria)
- Depression
- Hemoglobin in the urine (hemoglobinuria)
- Lethargy
- Moist tissues of the body (mucous membranes) are pale
due to low red blood cell count; simply referred to as anemia
- Vomiting
- Yellowish discoloration of skin and mucus membranes

Chronic symptoms:

- Abdominal distention due to fluid buildup in the abdomen (ascites)
- Anorexia
- Depression
- Diarrhea
- Excessive thirst and urination (polydipsia and polyuria)
- Lethargy
- Nervous system dysfunction due to the liver being unable
to break down ammonia in the body (hepatic encephalopathy)
- Spontaneous bleeding, black or tarry stools (melena)
- Vomiting
- Weight loss
- Yellowish discoloration of skin and mucus membranes

Methods of diagnosis include blood tests, ultrasound of the
liver, X-rays and liver biopsy. Treatment may include
chemicals that bind to copper, zinc acetate before meals,
and vitamin supplementation to help reduce the absorption of
copper.



Prevention, Avoidance and Treatment of Copper Storage
Hepatopathy


When a dog has sign of liver failure inpatient evaluation by
a veterinarian is need to determine the right treatment for
the disease. Treatment of the dog will be determined by what
type of disease the dog has, from acute to chronic hepatitis
or liver damage and cirrhosis.

The dog will be put on IV fluids and electrolytes supplements.

In many cases modifying your dog's diet and providing it
with dog food that is low in copper is an effective
treatment. Most commercial dog foods contain excessive
amounts of copper. You will need to follow your
veterinarian's advice as far as your dog's diet is
concerned. Also avoid giving your dog any supplement that
has copper in it. Your veterinarian can prescribe water-
soluble vitamins for your dog if needed.

In rare cases a surgical liver biopsy will be needed to
screen your dog for Copper Storage Hepatopathy. This also
will make it possible for your veterinarian to monitor the
response of your dog to treatment. Dog that have liver
failure are at a higher risk of complication when put under
anesthesia or surgery.


Living with and Managing Copper Storage Hepatopathy
in your Dog

After therapy your dog will probably be biopsied again after
six months to see if the therapy was effective. More blood
tests may be needed to be done every four to six months in
order to monitor the liver enzyme levels.

Your dog may also need to have its diet monitored to be sure
that it is not gaining excessive weight, or it may need to
be put on a diet to remove excess weight.


Preventing Copper Storage Hepatopathy

When considering the purchase of any of the breeds most
vulnerable to Copper Storage Hepatopathy, have the dog
tested for the gene that causes this disease.

In the case of Bedlington Terriers, if its liver copper
concentration is less than 400 µ g/g DW at one year of age,
it is unaffected by the disease.

There are also "clean" lineage liver registries available
for these breeds of dog. This will diminish your chances of
getting a dog with this particular genetic defect.



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