Copper-associated hepatitis, hepatopathy, and storage disease in dogs all involve abnormal copper metabolism but differ primarily in their underlying causes and specific manifestations. Copper-associated hepatitis is often genetic and breed-specific, hepatopathy is a broader term that can include various causes, and storage disease typically involves significant genetic defects affecting copper metabolism.

How Copper is Processed in Your Dog's Body

Copper is essential for many bodily functions. It's a crucial part of several necessary enzymes that help with energy production, antioxidant defense, and connective tissue formation. These enzymes need copper to work correctly.

Copper from your dog's food is absorbed in the small intestine, which converts it into a form that can be absorbed by the intestinal cells. Particular proteins help transport the copper from the intestine into the bloodstream.

Once in the bloodstream, copper binds to proteins and is carried to the liver. The liver is the main organ for processing copper in your dog's body. In the liver, copper gets attached to a protein called ceruloplasmin, which helps distribute copper to other body parts.

The liver also stores excess copper, binding it to proteins that keep it safe and non-toxic. Stored copper can be released into the bloodstream as needed. Excess copper is mainly excreted from the liver into the bile, then passed into the intestines and out of the body in the feces. A small amount is also lost through urine, sweat, and shedding hair and skin cells.

Your dog's body regulates copper levels carefully to avoid both deficiency and toxicity. Unique proteins in the liver help control how much copper is stored and excreted. If there's a problem with these proteins, it can lead to copper buildup and liver damage.

Some dogs have genetic mutations that affect how their bodies handle copper, making them more prone to copper-associated liver diseases. Breeds like Bedlington Terriers, Labrador Retrievers, and West Highland White Terriers are known to have these issues. Diet also plays a significant role—foods high in copper can contribute to problems if your dog's body cannot process copper efficiently.

Several common liver disorders in dogs interfere with the utilization and storage of copper, including copper-associated hepatitis, copper-associated hepatopathy, and copper storage disease.

The Different Terms for Copper-Associated Disorders in Dogs

Copper-associated hepatitis, copper-associated hepatopathy, and copper storage disease are conditions that dog owners should be aware of, mainly if their pets belong to breeds that are prone to these issues. These conditions all involve the abnormal accumulation of copper in the liver, which can lead to significant liver damage. An accumulation of copper in the liver is often due to genetic defects in how copper is processed in the body or excessive copper in the diet.

Breeds such as Bedlington Terriers, Labrador Retrievers, and Dalmatians are particularly susceptible to these conditions because of their genetic predispositions. Clinical signs that dog parents might notice in affected dogs include loss of appetite, vomiting, lethargy, and weight loss. Blood tests in these dogs often show elevated levels of liver enzymes, indicating liver damage.

While these conditions share similar signs and involve copper buildup, they differ in crucial ways. Copper-associated hepatitis (CAH) is mainly caused by genetic defects that affect copper metabolism and is commonly seen in breeds like Labrador Retrievers. Copper-associated hepatopathy is a broader term that can include various causes of copper accumulation in the liver, including other liver diseases. Copper storage disease refers specifically to inherited conditions, such as those seen in Bedlington Terriers, where an apparent genetic defect leads to excessive copper storage.

The progression of these diseases also varies. In CAH, copper buildup leads to chronic liver damage and, if untreated, can progress to cirrhosis. Copper-associated hepatopathy may present differently depending on whether the copper accumulation is a primary issue or secondary to another liver disease. Copper storage disease typically results in rapid and severe liver damage if not managed.

Diagnosing these conditions often involves liver biopsies to measure copper levels and assess liver damage. Genetic testing can also help identify specific mutations responsible for these conditions.

Understanding these conditions is crucial for early detection and management. Regular veterinary check-ups, including liver function tests, can help catch these diseases early. Managing copper intake through diet and, in some cases, medications can significantly improve affected dogs' health and quality of life.

If you own a breed prone to these conditions, talk to your veterinarian about screening and preventative measures. Being informed and proactive can make a significant difference in managing your dog's health.

Increasing Prevalence of Copper-Associated Diseases in Dogs

Copper-associated hepatopathy is increasingly recognized as a significant cause of liver disease in dogs, particularly in certain breeds. Studies have documented the prevalence and implications of this condition across different breeds and time periods.

In a study examining 546 archived liver specimens from dogs over 34 years, the incidence of abnormally high hepatic copper concentrations was found to have increased significantly over time. The proportion of dogs with hepatic copper concentrations greater than 300 μg/g increased from 28% to 49% in non-predisposed breeds and from 48% to 71% in predisposed breeds such as Doberman Pinschers and Labrador Retrievers.

It has been speculated that the increased incidence of copper-associated hepatitis in dogs coincided with the Association of American Feed Control Officials  (AAFCO) 's recommendation to stop using copper oxide as a source of supplemental copper in dog diets due to its extremely low bioavailability. This change has raised questions about the bioavailability of copper from various dietary ingredients and supplements, as well as how other nutrients and different physiological states influence these factors.

The National Research Council (NRC) recommends six parts per million (ppm) of copper in the total diet for adult dogs at maintenance, based on a dietary energy concentration of 4,000 kcal per kilogram of dry matter. The NRC recommends 11 ppm for puppies after weaning, and the recommendation for females during late gestation and lactation is 12.4 ppm.

AAFCO's 2023 guidelines recommend a minimum copper concentration of 7.3 ppm in the total diet for adult dogs at maintenance and 12.4 ppm for growth and reproduction periods or all life stages. It's important to note that these recommendations are for the total copper content in the diet, including dietary ingredients and any supplemental contributions, not just the supplemental amounts. However, neither organization has established upper tolerable limits for copper in dog diets.

Studies have shown that the frequency of copper-associated hepatitis and other copper-related liver conditions in dogs may be linked to changes in dietary copper intake, influenced by AAFCO recommendations made in 1997. High dietary copper levels, often found in commercial dog foods, are associated with increased liver copper concentrations in dogs, especially in breeds predisposed to copper storage disorders like Labrador Retrievers. This suggests that dietary management and the copper content in dog foods play a significant role in developing and exacerbating these conditions.

In 1997, AAFCO approved using chelated copper in dog food as part of its broader nutrient guidelines for pet foods without imposing an upper limit on copper content. Recently, AAFCO reaffirmed its guidelines for copper concentrations in dog foods following a comprehensive review by an expert panel. The panel, convened in response to concerns about increasing liver copper levels in dogs, concluded that there is currently insufficient scientific evidence to establish a safe upper limit for copper in dog foods. Therefore, AAFCO decided not to implement additional restrictions on copper sources beyond those already specified in their definitions.

Bioavailability of Natural versus Synthetic Copper

When it comes to providing copper in your dog's diet, it's essential to understand the differences between natural and chelated copper. Bioavailability, or how well a substance is absorbed and utilized by the body, varies significantly between these two forms.

Natural copper, often found in forms like copper sulfate, has a 30-40% bioavailability, whereas chelated copper is 80-90% bioavailable. Chelated copper is bound to organic molecules, significantly improving its digestive tract absorption. These organic molecules help transport copper across the intestinal lining more effectively, allowing for better uptake into the bloodstream. 

However, the increased bioavailability of the chelated copper is the problem with AAFCO not imposing an upper limit for copper in dog food. If there is excessive copper in the food, it will accumulate in the liver, leading to liver diseases. 

When feeding your dog whole foods as a natural source of copper, there is little chance of copper toxicity due to its lower bioavailability and because the excess natural copper can be excreted in your dog's feces.

Fresh Food Diets to Prevent Copper-Associated Disorders in Dogs

All dogs benefit from a species-appropriate fresh diet that provides all essential nutrients from real foods. Breeds predisposed to copper-associated liver diseases should be fed a diet that contains natural copper only. Knowing the nutrient profile of the components of a fresh diet is instrumental in preventing and managing disorders like CAH or copper storage disease.

The Real Ancestral (6X) DietTM contains raw meaty bones, muscle meat, liver, another secreting organ, seafood, and fur or fiber. Chicken and turkey muscle meat, raw meaty bones, and organs have the lowest copper levels. Lean beef is also low in copper, but beef liver is high in copper and should be avoided in the meals of dogs in breeds predisposed to copper-associated diseases. Goose and lamb liver are also high in copper. Shellfish should also be avoided due to high levels of copper.

Remember to include the treats when monitoring your dog's copper levels. Many dog parents use beef liver treats for training. Again, these should be avoided in dogs that require limited copper levels. 

There are three types of copper-associated diseases seen in dogs: copper-associated hepatitis, copper-associated hepatopathy, and copper storage disease.

The prevalence of copper-associated diseases has increased since 1997 when AAFCO approved using chelated copper in dog food.

There is no upper limit of copper in dog food despite increased copper-associated disease in predisposed and non-predisposed dog breeds.

Copper metabolism and its implications for canine nutrition - PMC  

Chronic hepatitis in Labrador Retrievers: clinical presentation and prognostic factors  

Copper-associated liver disease in Dalmatians: a review of 10 dogs (1998-2001)  

Possible nutritionally induced copper-associated chronic hepatitis in two dogs  

Canine copper-associated hepatitis: A retrospective study of 17 clinical cases - PMC  

Copper-associated hepatitis in a young Dalmatian dog in Japan - PMC  

Copper metabolism and oxidative stress in chronic inflammatory and cholestatic liver diseases in dogs  

Pathology of the liver in copper overload  

Is it time to reconsider current guidelines for copper content in commercial dog foods?   

Copper-Associated Liver Diseases in Dogs: Causes, Clinical Signs, and Treatment

Feed Real Institute

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