Copper Hepatopathy: an unusual diagnosis especially in a “healthy” dog.
At Hawthorne Hills Veterinary Hospital there is a reason we require pre-anesthetic examinations and laboratory testing. We understand there are always risks to putting a pet under anesthesia and we want to make it as safe as possible. Our anesthetic protocols are specifically tailored to each individual patient and, although we have the best monitoring equipment, we do not blindly trust the machines but have a trained staff member observing your pet during the entire anesthetic process.
Sometimes animals can seem completely healthy and even have a perfect physical exam but their body is expertly hiding disease.
Laboratory tests such as bloodwork and urinalysis can help veterinarians determine whether a pet’s liver, kidneys, and endocrine systems are functioning appropriately to handle anesthesia.
River is the sweetest border-collie mix who will be 3 years old this month! Her owners originally started bringing her to Hawthorne Hills Veterinary Hospital after they adopted her at 5 months old. Throughout the years she had some mild allergy symptoms but otherwise seemed like a healthy, active young girl. Last September she came in for her biannual preventative exam. Dr. Robin Riedinger noticed that she had a broken canine tooth. Broken teeth can lead to pain and infection so a root canal was recommended.
River returned to see Dr. Brandi Eskesen in December for another well pet exam and some laboratory testing before her oral surgery. Although she had very normal bloodwork results one year before we decided to repeat them to be on the safe side. Her physical exam was completely normal at that time and Dr. Eskesen was expecting the bloodwork results to be the same. She was surprised to see very elevated liver enzyme values. Because these values do not tell us anything about what is actually wrong with the liver, there was a little more detective work to be done. The dentistry was postponed due to the increased risk of anesthesia that results from liver disease.
After other tests showed that River’s liver was not functioning well, Dr. Eskesen recommended that River start a special liver diet and a liver protectant while awaiting an internal medicine specialist consult. After an abdominal ultrasound and a liver biopsy River was diagnosed with liver inflammation associated with Copper Hepatopathy.
Copper Hepatopathy is a disease where the liver collects and stores too much copper leading to inflammation. Inflammation of the liver (hepatitis) can lead to severe illness and a decrease in the ability to metabolize drugs, especially drugs used in anesthesia.
River’s treatment included a steroid to decrease the inflammation, Vitamin E and ursodeoxycholic acid to protect the liver, and a medication to bind and eliminate the copper. Once River was started on treatment the owners noticed a difference. They stated she had “all sorts of energy they didn’t know she had”! This shows that River was physically effected by her liver disease but we just couldn’t tell because the change in energy level was too slow to observe.
River is now feeling great, her liver values have improved and she had her root canal surgery in April! What a difference some pre-anesthetic lab work makes!