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.

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

Three different manifestations of the disease have been noted.

Three factors can affect copper storage in the liver.

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.

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.

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.

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.