Chronic hepatitis and cirrhosis with hepatic copper accumulation are recognized in a variety of breeds. In this case report, suspected disease in an otherwise-healthy, neutered 1-year-old female Skye terrier was diagnosed by liver biopsy and portal venography, which showed unevenly distributed changes and many unaffected lobules. Treatment and management protocols were implemented for 1 year: colchicine (200 µg orally once daily); elemental zinc (5 mg/kg orally once daily); and nutritional support (Pedigree® Hepatic Support diet with increased zinc and reduced copper-Waltham USA, Vernon CA). Ursodeoxycholic acid (75 mg Q 24 H), believed to have cytoprotective effects on the biliary system, was also administered. As copper concentration was not markedly increased, chelation therapy was not needed and corticosteroids were contraindicated in this case. The dog remained free of clinical signs 2 years later. With timely diagnosis and treatment, copper hepatopathy in Skye terriers is not necessarily terminal. Ursodeoxycholic acid treatment for copper toxicosis may prevent further copper accumulation and subsequent liver damage. More studies are needed to determine the prognostic significance of this protocol.
COMMENTARY: This is a thought-provoking case report. It shows that copper-associated hepatitis can be successfully managed. It also provides a good overview of therapeutic options.
Diagnosis and management of hepatic copper accumulation in a Skye terrier. McGrotty YL, Ramsey IK, Knottenbelt CM. J Small Anim Pract 44:85-89, 2003.