Copper Hepatopathy in Dogs: Causes, Symptoms & Treatment
There’s nothing that would make us happier than knowing our dogs would remain healthy. We love them, and we don’t want them to get harmed. Unfortunately, there are different diseases and conditions that can affect our dogs, and sometimes, we can’t do anything to prevent them from getting them. One of those conditions is copper hepatopathy. If you’re worried about your dog’s health and you suspect they might have liver issues, here are a few things you should know about copper hepatopathy in dogs.
Copper is a trace element that is also an essential micronutrient. Adequate amounts are needed as cofactors for various enzymes, electron transport proteins, and antioxidant molecules, all of which are essential for normal cellular function. Copper is transported into the portal venous circulation by the enterocyte via ATPase7A after being absorbed by the stomach and small intestines. The liver, the primary organ involved in copper homeostasis, rapidly absorbs copper from the portal venous circulation.
Copper travels through one of several metabolic pathways within the hepatocytes. It can be incorporated into enzymes for use within hepatocytes, or it can be incorporated into ceruloplasmin, which is then returned to the circulation for transport to extrahepatic tissues. Copper may also be stored in hepatocyte lysosomes as copper metallothionein or excreted into bile by the hepatocyte. The primary route by which unused or excess copper leaves the body is via biliary excretion.
Copper storage hepatopathy is a condition caused by an abnormal accumulation of copper in the liver of an animal, which results in progressive liver damage and scarring (cirrhosis). This condition could be caused by a secondary disease or a genetically based abnormal copper metabolism.
Primary copper liver diseases (medically known as hepatopathies) are classified into three types:
1. Subclinical disease is a condition in which the disease exists in an organ or body but is not detectable by abnormal signs or changes in the dog.
2. Acute (sudden) disease that primarily affects young dogs; associated with the condition that causes liver tissue to die (hepatic necrosis)
3. A chronic progressive disease characterized by liver damage and scarring in middle-aged and older dogs with chronic hepatitis (cirrhosis)
Secondary copper hepatopathies are characterized by symptoms of progressive liver disease caused by chronic hepatitis or progressive cirrhosis. Cholestatic liver disease occurs when bile flow is slowed or stopped; the abnormal flow of bile results in secondary copper retention.
Copper hepatopathy symptoms include any or all of the following and are rarely seen before liver damage has occurred:
- Pain in the abdomen
- Bleeding from the gums
- Dark urine
- Abdomen swollen
- Liver enlargement
- Excessive thirst and urination
- Appetite loss
- Nose bleeds
- Pale gums
- Inadequate coat condition
- Loss of weight
It is important to note that copper storage hepatopathy can affect dogs of any age. The leading cause of this liver disease in Bedlington Terriers and possibly other breeds is genetics. Here's what we know about the genetic factors that play a role:
- The absence of a specific gene (COMMD1) coding for a liver protein involved in the excretion of copper in the bile has been confirmed as an autosomal recessive trait in Bedlington Terriers.
- Previously, up to two-thirds of Bedlington Terriers were either carriers of the gene or affected by the disease; however, with recent genetic screening, the incidence is now much lower.
- In breeds other than Bedlington Terriers, a genetic cause is suspected but unconfirmed. It is unknown what mode of inheritance is used.
- The prevalence appears to be high in certain lines of West Highland White Terriers. Still, the incidence is low in the breed as a whole.
- A reported 4% to 6% of Doberman Pinschers have chronic hepatitis, which can cause copper storage hepatopathy.
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Unfortunately, any dog breed with a liver can develop copper hepatopathy, which means any dog breed can get it. However, based on the copper hepatopathy cases they have studied thus far, veterinarians and dog owners have drawn some conclusions. The following dog breeds are responsible for the majority of copper hepatopathy cases:
- Bedlington Terrier
- Doberman Pinscher
- Labrador Retriever
- Skye Terrier
- West Highland White Terrier
Although symptoms of acute copper hepatopathy should indicate that the liver is likely to be involved, many of the symptoms of chronic hepatitis are somewhat ambiguous. They could indicate various conditions, particularly the disorder's earlier symptoms. Your veterinarian will examine your dog physically, and if the liver is swollen, she may be able to feel it when she palpates the abdomen. In severe cases of chronic injury, the liver may instead shrink, making it difficult to feel anything at all. Even before symptoms appear, standard blood tests such as a biochemistry profile and complete blood count may reveal elevated liver enzymes, regenerative anemia, or coagulation disorders.
Ultrasound imaging can help determine the size and shape of the liver and may reveal abnormalities such as nodules on the liver or abdominal swelling. A liver biopsy is required for a definitive diagnosis of copper hepatopathy. The biopsy can be performed using an ultrasound-guided needle biopsy, a laparoscopic biopsy, or a wedge biopsy. Fine needle aspiration samples are usually insufficient for proper testing.
Dogs with signs of liver failure require inpatient evaluation and treatment. The type of disease and whether it is acute or chronic will determine the course of treatment.
In most cases, modifying the dog's diet and feeding it copper-free foods has proven effective. Most commercially available diets contain high levels of copper, so follow your veterinarian's recommendations for feeding a diet tailored specifically for your dog. You should also avoid giving your dog copper-containing mineral supplements. Your veterinarian may also prescribe medications (e.g., penicillamine) and/or nutritional supplements (e.g., zinc) to help your body eliminate copper.
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Blood tests will be performed every four to six months to monitor the dog's liver enzyme levels as well as zinc levels if the patient is taking a zinc supplement. The veterinarian may also request that you keep track of your dog's body weight. A liver biopsy may need to be repeated in rare cases to monitor the effectiveness of treatment.
The prognosis for this condition is guarded to poor. It is dependent on several factors, including the amount of damage done by the time the disease is diagnosed, as well as the breed and age of the dog. Dogs with acute onset copper hepatopathy are more likely to succumb to the disorder than dogs with chronic or progressive hepatopathy. To prevent future copper buildup, a change in diet to a high-quality, low copper diet is usually recommended. Some dogs may require supplemental zinc or additional chelation treatments to maintain liver health for as long as possible.
World Dog Finder team