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Copper Associated Hepatitis, Copper Toxicosis Signs and Treatment
Copper-associated diseases are increasingly being reported in both man and animals. Wilson's disease is an autosomal recessive disorder that results from pathological accumulation of copper mainly in the liver and brain. Copper also has a role in fatal, non-Wilson's liver diseases affecting young children with a genetic abnormality of copper metabolism. Excess accumulation of copper also occurs as a consequence of chronic liver diseases such as primary biliary cirrhosis, and chronic hepatitis in both humans and animals.
Copper Associated Hepatitis (CAH) is a disease which results in the excessive accumulation of copper in the liver cells. CAH is actually a group of hepatic diseases with similar characteristics but different causes. It most often affects certain breeds of dogs, and has been well studied in Bedlington Terriers, West Highland White Terriers, and Doberman Pinschers.
Copper toxicosis can be classified as primary when it results from an inherited metabolic defect, and as secondary when it is the consequence of an abnormally high intake, increased absorption, or reduced excretion of copper due to underlying pathologic processes.
In Bedlington terriers and Westies there is an inherited defect of copper metabolism that allows toxic concentrations of copper to accumulate in the liver. Recently, a mutated MURR1 gene was discovered in Bedlington terriers affected with the disease. In Doberman, copper concentration increases in most but not all affected dogs. It is unclear in the Doberman (and the Skye terrier) whether high copper levels are the cause of the hepatitis or the result. Copper can concentrated in the liver as a consequence of hepatitis alone. As a rule, the higher the copper concentration, the more likely it is that the copper is the cause. Genetic testing for copper toxicosis is available.
SIGNS Both sexes can be equally affected. At the early stage of the disease, affected dogs may have no signs, or show progressive liver failure (failure to thrive, jaundice, and ascites). About half of the animals die within a week of the onset of jaundice. Biochemical test reveal liver copper increased 5 to 50 times the normal levels (normal less than 300 &milli;g/g dry weight; up to 12 000 &milli;g/g recorded in the affected dogs.) In Bedlington terriers older than 1 year of age, there is a progressive increase in the accumulation of tissue copper until 8 years of age.
TREATMENT Blood tests, ultrasounds, and CT scans provide useful information, but the only definitive test is biopsy of the liver. The prognosis for recovery depends on how long the dog has been ill, the extent of liver damage, and whether the disease can be surgically cured or controlled with medications. Treatment of Copper Associated Hepatitis varies with the affected breed. Medications can be given to move copper out of the liver into the circulation, where it can be excreted in the urine. The absorption of copper can be decreased by giving oral zinc and copper chelator products that bind copper in the gut. Early diagnosis and intervention are key to the successful treatment of dogs with hepatitis.
Recently, the disease has been increasingly reported in Labrador Retrievers. Clinical signs included loss of appetite, vomiting, lethargy, and weight loss. Certain copper-associated disorders, such as chronic active hepatitis in Doberman pinschers and Skye terrier hepatitis are characterized by copper retention secondary to the underlying disease, thus resembling primary biliary cirrhosis in humans. Copper-associated liver disease has increasingly being recognized in Dalmatians. Excess copper accumulation occurs as a consequence of chronic liver disease in other canine breeds dogs, particularly Cocker Spaniels and Poodles
A linkage-based test is available for screening fir this disease. Dogs with inherited defects in copper metabolism should not be used for breeding.
Copper Associated Hepatitis has been reported in the following breeds:
Go Pets America recommends seeking the advice of your local veterinarian for the most appropriate vaccination program and for the diagnosis and treatment of your pet's health problems. For vaccination requirements please contact your state and local licensing authorities.
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