Copper Hepatopathy in a Labrador Retriever

A 5-year-old neutered male Labrador retriever is presented for evaluation of decreased appetite, lethargy, and intermittent vomiting.

The patient has a 3-year history of seizures occurring every 6 months; however, the frequency of his seizures has recently increased, with 3 seizures occurring in the past 2 months. An investigation into the cause of the seizures has not been performed. The patient also has bilateral hip osteoarthritis. Serum chemistry profile reveals increased liver enzymes (ALP, 437 U/L; reference range, 10-130 U/L and ALT, 885 U/L; reference range, 10-120 U/L), mild hyperbilirubinemia (1.8 mg/dL; reference range, <0.3 mg/dL), and hypoalbuminemia (2.2 g/dL; reference range, 2.6-4.0 g/dL). Abdominal ultrasonography reveals a coarse echotexture in the liver but no other abnormalities. Prothrombin time and activated partial thromboplastin time were both within the control ranges. A liver biopsy shows chronic hepatitis with moderate lymphoplasmacytic and neutrophilic infiltrates, as well as moderate bridging fibrosis. There is increased staining for copper, and liver copper concentration is 2143 ppm on a dry-matter basis (normal, <400 ppm; toxic, >1500 ppm). Aerobic and anaerobic cultures reveal no growth.