Nutritional management of inherited copper-associated hepatitis in the Labrador retriever |
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| Authors: | Hille Fieten Vincent C Biourge Adrian L Watson Peter AJ Leegwater Ted SGAM van den Ingh Jan Rothuizen |
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| Institution: | 1. Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands;2. Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands;3. Department of Biochemistry and Cell Biology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands;1. Institute of Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64?7TE, UK;2. National Consortium for Zoonosis Research, Leahurst Campus, Chester High Road, Neston, Cheshire CH64?7TE, UK;3. University of Liverpool School of Veterinary Science, Leahurst Campus, Chester High Road, Neston, Cheshire CH64?7TE, UK;1. Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, 4474 TAMU, Texas A&M University, College Station, TX 77843, USA;2. Veterinary Specialty Hospital, 10435 Sorrento Valley Rd, San Diego, CA 92121, USA;3. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, IN 47907, USA;4. Department of Pathobiology, College of Veterinary Medicine and Biomedical Sciences, 4474 TAMU, Texas A&M University, College Station, TX 77843, USA;5. Clinical Pathology Laboratory – DCPAH, Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, A 215 Veterinary Medical Center, 736 Wilson Rd, East Lansing, MI 48824-1314, USA;1. Genética y Mejora Animal, Cordoba University, Edificio C5 Gregor Mendel 1st Floor, Campus Universitario Rabanales, 14071 Córdoba, Spain;2. Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;3. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark |
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| Abstract: | Canine hereditary copper-associated hepatitis is characterized by gradual hepatic copper accumulation eventually leading to liver cirrhosis. Therapy is aimed at creating a negative copper balance with metal chelators, of which d-penicillamine is the most commonly used. d-penicillamine often causes gastro-intestinal side effects and life-long continuous therapy may lead to a deficiency of copper and zinc. The aim of the current study was to investigate the effect of a low-copper, high-zinc diet as an alternative to continuous d-penicillamine treatment for the long-term management of canine copper-associated hepatitis.Sixteen affected Labrador retrievers were followed for a median time period of 19.1 months (range, 5.9–39 months) after being effectively treated with d-penicillamine. The dogs were maintained on a diet containing 1.3 ± 0.3 mg copper/1000 kcal and 64.3 ± 5.9 mg zinc/1000 kcal. Liver biopsies were taken every 6 months for histological evaluation and copper determination. Plasma alanine aminotransferase (ALT) and alkaline phosphatase, as well as serum albumin were determined.Dietary treatment alone was sufficient to maintain hepatic copper concentration below 800 mg/kg dry weight liver in 12 dogs during the study period. Four dogs needed re-treatment with d-penicillamine. ALT activity and albumin concentration were not associated with hepatic copper concentration, but showed a significant association with the stage and grade of hepatitis respectively. In conclusion, a low-copper, high-zinc diet can be a valuable alternative to continuous d-penicillamine administration for long-term management of dogs with copper-associated hepatitis. The copper re-accumulation rate of an individual dog should be considered in the design of a long-term management protocol and in determining re-biopsy intervals. |
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| Keywords: | Copper Diet Hepatitis Liver Zinc Canine |
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