Author TB Thompson DVM has been a licensed, practicing veterinarian since 2000.
In my 20+ years as a vet, I’ve seen more and more dogs with too much copper in their liver.
The resulting condition is called copper storage disease (CSD). Excessive copper damages liver cells and leads to symptoms like poor appetite, vomiting and weight loss. This type of hepatitis may even end in organ failure.
But there is hope for affected dogs when they get the proper treatment. This comprehensive guide gives you practical advice on how to use a combination of medical treatment and careful nutrition to help your dog stay healthy.
KEY POINTS
- CSD occurs when too much copper accumulates in a dog’s liver, leading to cell damage.
- Symptoms of CSD include vomiting, diarrhea, weight loss and yellowing skin due to liver cell toxicity. Some dogs show no symptoms at all.
- Treatment focuses on reducing the amount of copper in the liver, feeding a low copper diet and decreasing copper absorption.
Archie’s Illness from Copper
Last spring, Archie, a Labrador mix, suddenly started vomiting and lost his appetite while on vacation with his owners. They rushed him to our clinic for help.
Tests revealed extremely high liver enzymes. Our next step was to collect a liver biopsy. Testing confirmed a diagnosis of chronic active hepatitis and high copper levels, indicating copper storage disease (CSD).
We quickly began treatment with prednisolone, D-penicillamine, ursodiol, and a low-copper diet. Thanks to his owners’ diligent care, Archie’s health significantly improved over the next few months. Soon his test results were normal and he was back to being his lively self.
Archie’s case underscores the effectiveness of prompt treatment for CSD.
Now, let’s examine the specifics of CSD. What exactly is this condition, and how can it be effectively managed? We’ll explore its impact and the various treatment strategies available for this challenging condition.
OVERVIEW
Copper is a key mineral for dogs. They get it mostly from their food and a little from water. It helps with many body processes.
Here’s how it works: Dogs absorb copper from food in their small intestine. Then, it goes to the liver through the blood. The liver holds onto copper until the body needs it. Any copper that’s not needed gets removed through bile and leaves the body in your dog’s poop.
Normally, the body balances how much copper the liver holds. But, if this balance fails, too much copper can build up. This is copper storage disease (CSD).
High levels of stored copper are toxic to liver cells. If enough cells die, the liver can’t function well.
Risk Factors
CSD can affect any breed, age or sex of dog. A few breeds have a known genetic predisposition
- Bedlington Terrier
- Corgi
- Dalmatian
- Doberman Pinscher
- Labrador Retriever
- Skye Terrier
- West Highland White Terrier
Females and middle-aged to older adult dogs are more likely to get the disease.
Dogs with other liver diseases such as chronic hepatitis or portosystemic shunts are more likely to develop copper storage problems in their liver.
CAUSES
Copper storage problems are often multifactorial, but one or more of the following factors is responsible. Three ways dogs collect excessive amounts of copper in their liver
- Excessive copper in the diet
- Genetic errors that affect copper transport in the liver
- Liver disease that interferes with normal copper elimination
SYMPTOMS
Not all dogs with excessive liver copper have symptoms even when very high levels of the mineral are present. Other dogs show symptoms which can include
- Poor appetite and weight loss
- Vomiting and/or diarrhea
- Increased thirst and urination
- Abdominal discomfort, swelling, pain
- Fever, weakness, lethargy
- Pale gums, excessive bleeding
- Jaundice and yellowing of the eyes
- Seizures, disorientation, walking in circles
DIAGNOSIS
Your vet will start with a health history review and a physical exam. Here’s a breakdown of the diagnostic tests:
| Type of Test | Purpose |
|---|---|
| Basic Blood Tests | Checks for low red blood cell count, high liver enzymes (ALT, AST, ALP), and bilirubin build-up. |
| Liver Function Tests | Measures bile acid levels before and after a meal to assess liver function. |
| Radiography and Ultrasound | Evaluates liver size, shape, and internal structure. |
| Blood Clotting Tests | Blood tests to see if liver disease has changed how your dog’s blood clots. |
| Liver Biopsy | A small liver sample is examined for abnormalities and copper levels. See details below. |
| Genetic Testing | Identifies gene mutations that affect copper transport. |
To diagnose this disease, vets need to take a small sample of the liver, called a biopsy. This sample can be used to measure liver copper levels. The following guidelines have been established:
- Normal: Up to 400 micrograms of copper per gram of liver.
- Secondary CSD: 400-1000 micrograms/gram.
- Primary/Genetic CSD: Over 1000 micrograms/gram.
TREATMENT
The main goal of treating copper storage disease in dogs is to reduce the amount of copper in the liver. This is done by decreasing copper consumption, decreasing copper absorption and helping the body get rid of copper stored in the liver. (5)
Medicines for Treating CSD in Dogs
Treating Copper Storage Disease (CSD) in dogs usually involves several drugs and supplements. The main goals of these treatments are:
- Binding Copper: D-penicillamine (Cupramine) is a medicine that attaches to copper in the liver so it can be removed more easily.
- Improving Bile Flow: Ursodiol (Actigall) is given to increase bile flow. This helps move copper out of the liver.
- Protecting the Liver: Supplements like Vitamin E and silybin are used to shield liver cells from the harmful effects of too much copper.
- Reducing Copper Absorption: Dogs may take oral zinc supplements. These help lower the amount of copper absorbed from their intestines.
Feed a Low-Copper Diet
Since most of the copper a dog stores comes from their diet, feeding a low copper diet is helpful.
Non-prescription dog food is not low enough in copper for dogs with CSD. Prescription diets with low copper levels include Hill’s Prescription Diet Liver Care l/d® and Royal Canin Veterinary Diets Hepatic®.
You may also consider working with a veterinary nutritionist to create a low-copper homemade food recipe for your pup (try Balance.it).
Avoid High-Copper Food
Some foods are naturally higher in copper. Avoid giving these as supplements or treats to dogs with CSD:
- Beef liver
- Oysters
- Mushrooms
- Tofu
- Potatoes
PREVENTIVE CARE
Most dogs don’t need special steps to prevent copper storage disease (CSD).
If your dog has a higher risk of developing CSD, you can take extra steps:
- Early Detection: Use genetic testing, regular blood tests, and ultrasound checks. These can spot CSD early.
- Diet Tips: Keep your dog on a low-copper prescription diet. Don’t give foods high in copper to dogs at risk. Check their vitamins and supplements for copper.
- Increased Vet Checkups: Dogs with a chronic disease need to see a vet more often for optimal monitoring. Every 3-6 months is a commonly recommended interval.
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PROGNOSIS/LIFE EXPECTANCY
Dogs with mild CSD often have a good prognosis and can live well for years with proper treatment. However, the outlook varies by breed; Bedlington Terriers usually have a more severe form and often pass away between 2 and 6 years old. (1) Labradors typically survive around 17 months. (3)
Dogs with liver cirrhosis have a less favorable prognosis, with survival ranging from a few days to several months.
While genetic CSD can’t be cured, secondary CSD is manageable with controlled primary liver disease.
All dogs with CSD should follow a lifelong low-copper diet.
HOME CARE & MAINTENANCE
It’s important to follow your veterinarian’s instructions for medication, diet and follow-up visits. Keep these things in mind…
- Monitor your dog daily for changes in appetite, weight, and energy level and call your vet if you notice anything unusual.
- Follow the recommended diet and avoid foods high in copper.
- Stick to your recommended veterinary check-ups with blood and liver function tests.
When to See a Veterinarian
See your vet if your dog shows any of the symptoms discussed earlier. Watch for changes in their appetite, thirst, urination or bowel habits. Also, consult your vet if you have trouble giving medication or getting your dog to eat the prescribed diet.
Frequently Asked Questions (FAQs)
Additional Resources
It’s often helpful to talk to other dog owners dealing with the same challenges. There are several Facebook groups dedicated to the topic of CSD in dogs including this one:
Genetic testing is available for some at-risk breeds. Work with your vet to submit your samples:
- Bedlington Terrier: PawPrint Genetics
- Labradors, Doberman Pinscher and Black Russian Terrier: UC Davis Veterinary Genetics Laboratory
- Labradors, Labradoodle and Doberman Pinscher: DDC Veterinary
Share Your Dog’s Story
Has your dog been diagnosed with excessive liver copper? Help other worried dog lovers by sharing your story in the comment section below. What symptoms did you notice? Do you have any tips to help dogs with this problem feel better?
