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What is Liver Disease (Copper Storage)?

Copper is an important trace element for dogs. It is vital to the production of enzymes and other important cellular processes. Copper taken in through food is metabolized and stored in the liver. Any excess copper is excreted in bile and flushed out of the body via the stool and urine. If too much copper accumulates in the liver, it can cause copper-associated hepatopathy which leads to liver dysfunction and eventually failure. This problem is most commonly caused by a genetic abnormality. A specific gene that reduces bile excretion and causes copper to accumulate in the liver has been identified in some Bedlington terriers. Other breeds can have a similar problem, although the condition is usually not as severe and the exact genetic mechanisms have not been fully studied. Dogs with copper-associated hepatopathy can show varying symptoms. Some dogs have bloodwork that indicates a degree of liver dysfunction, but little or no sign of illness. Other dogs may have slowly developing symptoms of chronic hepatitis. Acute liver failure may develop suddenly with little warning. Sometimes the liver releases large amounts of the stored copper, killing red blood cells and causing copper related anemia. Over time, even mild conditions can cause scarring of the liver and eventually cirrhosis and end-stage liver disease. Some medications and diet change can help to stop the accumulation of copper in the liver.

Excessive copper storage in the liver is caused by a genetic abnormality. In dogs, veterinarians define this as copper-associated hepatopathy. It is more common in some breeds. Untreated, it can lead to cirrhosis and acute liver failure.

Liver Disease (Copper Storage) Average Cost

From 367 quotes ranging from $1,000 - $6,000

Average Cost

$2,500

Symptoms of Liver Disease (Copper Storage) in Dogs

Any of the following symptoms should be evaluated by a veterinarian. Acute, life-threatening symptoms should be treated as an emergency.

  • Vomiting
  • Decreased appetite
  • Weight loss
  • Excessive thirst
  • Frequent urination
  • Bloody diarrhea
  • Jaundice
  • Anemia
  • Ascites (fluid in the abdomen)
  • Gastrointestinal bleeding
  • Ulcers
  • Hepatic encephalopathy (disorientation, circling, aggression, seizures coma)

Types

Three different manifestations of the disease have been noted.

  • Sub-clinical disease – blood tests show signs of liver disease and high copper levels can be detected with a biopsy of the liver, but dogs don’t show symptoms of illness
  • Chronic hepatitis – traditional symptoms of liver dysfunction; symptoms may progress slowly, but lead eventually to acute liver failure; sometimes copper accumulation can occur secondary to chronic hepatitis from another source
  • Acute hepatic necrosis – dogs will develop the traditional symptoms of acute liver failure along with copper induced hemolytic anemia; death normally takes place within 2-3 days; survivors may experience bouts of intermittent illness
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Causes of Liver Disease (Copper Storage) in Dogs

Three factors can affect copper storage in the liver.

  • Failure to excrete copper in the bile – this is known to be a problem in Bedlington terriers
  • Excessive copper storage – the liver can sometimes store too much copper, particularly if hepatic inflammation or chronic hepatic disease is present; it’s believed that this condition may be responsible for copper accumulation in other breeds
  • Excessive copper ingestion – copper is found in trace elements in the diet; too much copper at one time can overwhelm the liver’s storage capacity and cause liver damage; this isn’t normally a problem, but dogs with a genetic tendency to excessive copper storage can be affected by a high copper diet; changes in dog food in the late 90’s made dietary copper in most brands more accessible to dogs and have led to higher levels of copper accumulation, even in dogs that don’t show symptoms 

Breed and family heritage is a big factor, although it’s possible for any dog to have this problem. Some breeds tend to manifest the disease differently.

  • Bedlington Terriers – most dogs with the gene will develop acute liver necrosis before they are 6; breeding management has helped to decrease the number of cases
  • Doberman Pinschers – blood work can be abnormal as early as 1 year old, but liver disease doesn’t usually manifest until dogs are about 7
  • West Highland White Terriers – disease can occur at any time, copper accumulation is apparent as early as 1 year old
  • Skye Terriers – disease can occur at any time
  • Dalmatians – middle aged dogs are often diagnosed with chronic hepatitis
  • Labrador Retrievers – middle aged dogs are often diagnosed with chronic hepatitis
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Diagnosis of Liver Disease (Copper Storage) in Dogs

Blood and urine tests will usually show signs of liver failure, especially if your dog has significant symptoms. Some blood tests may require fasting. X-ray’s and ultrasound may be taken to check for enlarged liver as well as eliminate some other causes of liver failure.  A definitive diagnosis of copper-associated hepatopathy is made with a biopsy of the liver. This is an invasive procedure that will not be possible with dogs experiencing symptoms of acute liver failure.

The veterinarian will want to know your dog’s breed and family history to help determine how likely it is that your dog has this condition. Your dog’s age could also be relevant. Past and present medications can help determine if drug poisoning or toxicity could have contributed to the liver failure, and the veterinarian may also want to know the dates of your dog’s last vaccinations to eliminate some infectious causes.

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Treatment of Liver Disease (Copper Storage) in Dogs

Acute liver failure will need to be treated supportively. Fluids and electrolytes will be given to help flush toxins out of the body. Blood transfusions may be necessary for dogs with high levels of red blood cell destruction and copper induced anemia. Severe acute attacks can end up being fatal even with treatment.

Several medications are given to help reduce copper accumulation. Copper chelators bind to the copper in the liver so that it can be excreted in the urine. Over time, this can reduce high copper levels and reverse liver dysfunction. These medications do have significant side effects, however, and they must be taken over a period of 4-6 months to have an effect. Copper deficiency can also be a problem. 

Zinc can reduce copper absorption in the intestine. This medication is sometimes used in milder cases. It should not be with combined with chelators as the two medications can negate each other. Zinc can also have significant side effects in some dogs, and blood tests will be necessary to avoid toxic levels. The veterinarian may need to try several medications to see what works best for your dog. Vitamin E and other antioxidants are often given along with both medications to reduce liver damage.

Diet change may be prescribed in many cases. Some veterinarians may recommend dog food designed especially for dogs with liver disease. This type of food is lower in copper and protein. Others may recommend a homemade diet. Avoid feeding your dog any supplements that contain copper as well as organ meats that are high in protein and minerals. Small carbohydrate based meals put less stress on the liver.

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Recovery of Liver Disease (Copper Storage) in Dogs

Full recovery from copper-induced hepatopathy is rare. At the very least your dog will need to follow a strict diet, probably for the remainder of his life. This is the best way of treating young dogs to avoid the accumulation of copper before it becomes problematic. Dogs with severe cases will need long term medication. Discuss the best medication with your veterinarian and monitor the side effects closely. You should return often for testing so the veterinarian can keep track of your dog’s progress.

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Liver Disease (Copper Storage) Average Cost

From 367 quotes ranging from $1,000 - $6,000

Average Cost

$2,500

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Liver Disease (Copper Storage) Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Ask a Vet

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Yorkie

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Four Years

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Unknown severity

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0 found helpful

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Unknown severity

Has Symptoms

None

Are copper dog tags toxic to dogs?

July 19, 2020

Owner

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Dr. Michele K. DVM

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0 Recommendations

Thank you for your question. It would depend on the material that the copper dog tag is actually made of, if it has a copper coating or a metal inside with a copper outside. I would worry more about a GI upset or blockage if the dog ate the copper tag, actually. If your dog is showing any signs of vomiting, diarrhea, lethargy, or loss of appetite, then it would be best to have them seen by a veterinarian. I hope that all goes well for your dog.

July 19, 2020

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Chloe

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Goldendoodle

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7 Months

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Fair severity

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Fair severity

Has Symptoms

No Symptoms That Anything Is Wrong,

We have a 7 month old goldendoodle, we had preop blood work done that showed her ALT was elvated. The pre op blood work was to have her spayed. We got the results, they said they were slightly elevated and to repeat the blood the AlT to see if she got into something or if something else is going on. We repeated the alt again with 5 to 7 days and found out the number had now doubled from what it was before. They immediately thought she needed a shunt for her liver, and ordered a sonogram. Sonogram we were told it looks like her liver is not allowing the blood to pass through the liver and it is going around the liver. The vet then asked to send results to a specialist to get another opionion to be told no shunt, blood vessels are enlarged, recommended a bile acid test and another blood test to check her blood count. BUT, when I asked what they think is wrong with her they said hypertension, parasites, or cooper storage disease. I am looking for another persons input, as it feel if it is hypertension or parasites why do they need a bile test? and if it is cooper storage dont they need a biopsy of the liver to give diagnosis? she has NO signs at all of being ill! she is 100 percent playful, obedient pup still learning but picking things up very quickly.

July 17, 2018

Chloe's Owner

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3320 Recommendations

It is possible that they are looking at doing a bile acid test just to rule things out, however their interpretation of the the possible differential diagnoses would be based on existing test results, any clinical symptoms observed (if any) among other factors; if you’re not sure why a test is being done or isn’t being done you should ask your Veterinarian for the rationale for the tests being offered. For copper storage disease, a biopsy would be the diagnostic method of choice to visualise the copper. Regards Dr Callum Turner DVM

July 17, 2018

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Enya Rose

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Papillon

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2 Years

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Moderate severity

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Moderate severity

Has Symptoms

Extremely High Alt Levels/Anorexia

Hello! I have an 11 pound papillion mix who is 2.5 years old. She has been experiencing severe anorexia. Her blood work came back with ALT levels in the 1200's. Our vet put her on two forms of broad spectrum antibiotics which she was on for over a month along with an appetite stimulant (which did little to help until the antibiotics started taking effect). I also have her on milk thistle. She eats a freeze dried raw diet mainly from Stella and Chewy and Open Farm. Her ALT levels dropped down to 108 after only about 3 weeks on the antibiotics. Her appetite completely returned during this time. However, 3 weeks after completing her medications, her appetite starting diminishing again and I took her in for a blood work follow up where her ATL levels had already increased back to 350. Our vet put her back on the same antibiotics and did a CBC and bile acid test all of which came back all within normal levels. She is now sending us to an internal specialist for a consult and most likely a liver biopsy. They want her to be off of all antibiotics and supplements for 10 days prior to the consult/biopsy to help determine the cause without a "tainted" result. I feel so confused and lost as to what this could be. Getting her to eat is like pulling teeth and quite frustrating. At one point I was trying everything from various brands, to treats, to human food, to raw food, to canned food! She lost 4 pounds within a month and barely ate a bite for 3 weeks. I guess at this point I'm just looking for a second vet opinion as to next steps to help me sweet girl.

June 27, 2018

Enya Rose's Owner

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3320 Recommendations

Increased ALT may be caused by a variety of different causes including infections, poisoning, metabolic diseases, cancer among other causes; I know it can be hard to get a dog to eat especially under these conditions and Enya Rose may lose some weight but you need to think of the value of the testing in the long term when it comes to making a diagnosis and narrowing in on a specific underlying treatment, three weeks is a short period of time. Regards Dr Callum Turner DVM

June 28, 2018

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Blaze

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Miniature Pinscher

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10 Years

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Serious severity

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1 found helpful

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Serious severity

Has Symptoms

Vomiting

My dog had a Cholecystoduodenostomy hes recovering well but he does have copper in liver and is taking denamarin and was just prescribed penicillamine which with this vet wants me to give 40mg of vitamin e from a capsule how do i figure out how much is 40mg?

April 30, 2018

Blaze's Owner

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3320 Recommendations

Most vitamin supplements give doses in IU (international units) which makes things unnecessarily complicated; but we know that: 1 IU of the natural form is equivalent to 0.67 mg of alpha-tocopherol and 1 IU of the synthetic form is equivalent to 0.45 mg of alpha-tocopherol so depending on which type of vitamin E you have you need either around 60 IU of vitamin E in its natural form or around 90 IU of vitamin E in its synthetic form. So from here you take the bottle or capsule and divide accordingly, if you are having difficulty you should speak with your Veterinarian for help. Regards Dr Callum Turner DVM https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/

April 30, 2018

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Rumi

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German Shepherd

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6 Years

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Mild severity

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Mild severity

Has Symptoms

Weight Loss
Hair Loss
Skin Irritation

My dog was diagnosed recently and has been on penicillamine for three months now. Her ALT levels have lowered significantly but our vet wants us to do one more month for good measure. My dog has started having skin reactions (darkened, scaly spots), hair loss around the dried out skin, and weight loss. Our vet is encountering this disease for the first time so more opinions are optimal. I am worried about the severity and possible underlying causes of these reactions. I have found studies where humans show skin reactions, but might this be similar?

March 29, 2018

Rumi's Owner

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3320 Recommendations

Metal toxicity may lead to the symptoms you are describing of dry flaky skin with darkened spots; they are not consistent with the side effects of penicillamine which doesn’t have hair loss but may have some skin issues in rare cases. You should continue on the course of treatment prescribed by your Veterinarian for another month if they believe it is required (it is down to their discretion as they have examined Rumi). Regards Dr Callum Turner DVM

March 29, 2018

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Barley

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Labrador Retriever

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11 Years

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Mild severity

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Mild severity

Has Symptoms

None

We rescued Barley, a yellow lab, about three years ago - guessing he was about 8 at the time. From the start his ALT levels were borderline and for the first year we just kept an eye on them. At year two, now with ALT levels slightly elevated, the vet recommended he go on Denosyl, which he did, but it did nothing to lower his levels. At a follow-up he was now in the ~250 range. Vet did a bile acid (normal) and continued on the Denosyl. In the next blood work before a dental, about 3 months later, his levels were now in the low 500s. Did an ultrasound and when nothing was found, started making some changes to diet and supplements. The ultrasound vet did put him on antibiotics for a month and also put him on the Hills L/D diet and we started giving him filtered water. We live in the mountains and are on a well and we know there is at least some copper in the water due to the blue rings in sinks/tubs that are seldom used. Also took him off the Denosyl and put him on the Marin Plus (the milk thistle supplement). After two months, his levels were down to mid 300s. After another two months he's down to 200. Vet has said it's OK to take him off the L/D food (he's actually put on a bit of weight on this food, I think due to the high fat content). Currently looking for an alternative dry food with low copper levels (why isn't this info published on most labels???). I can't help but wonder if the copper in our water is the biggest problem for my boy. Seems to me that could explain the slow build for high liver values when he came to live with us. Maybe the filtered water has been the change making the difference! Thoughts?

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Jack

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Goldendoodle

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10 Years

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Moderate severity

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0 found helpful

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Moderate severity

Has Symptoms

Weight Loss
Loose Bowel Movements
High Alt

My 10 year old golden doodle has ALT his vet says is 10 times normal. His ALP and other CBC bloodwork was all normal. He has lost about 9 pounds in the last year. I thought this was due to age and loss of muscle mass. He wasn't eating as much for a while and his stools were loose. He is doing fine with eating now and his stools have improved. He is active and his coat is shiny. Could this be cooper storage disease or is it more likely a tumor or cancer? He is scheduled for xray and ultrasound tomorrow.

Liver Disease (Copper Storage) Average Cost

From 367 quotes ranging from $1,000 - $6,000

Average Cost

$2,500

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