Copper Storage Hepatopathy in Cats

Copper storage hepatopathy is a condition caused by an abnormal accumulation of copper in the liver, which can lead to hepatitis and cirrhosis of the liver over the long term. This condition is believed to be secondary to a primary disease, usually the result of a genetically-based abnormal copper metabolism.

This disease has been found in cats, but these cases are considered rare and isolated.

Symptoms and Types

Primary copper liver diseases (medically referred to as hepatopathies) generally fall into one of three categories:

1. Subclinical disease: a condition where the disease is present in the organ or body, but not detectable by abnormal signs or changes in the animal
2. Acute (sudden) disease which most frequently affects young cats; associated with a condition that causes the death of liver tissue (hepatic necrosis)
3. Chronic progressive disease in which symptoms are observed in middle-aged and older cats with chronic hepatitis, with damage and scarring of the liver (cirrhosis)

Conversely, secondary copper hepatopathies show symptoms of progressive signs of liver disease due to chronic hepatitis or progressive cirrhosis. Liver disease in which the flow of bile is slowed or stopped is known as cholestatic liver disease; the abnormal flow of bile results in secondary copper retention.

Both types may display symptoms in their acute or chronic forms; these forms are as follows:

Acute:

• Lethargy
• Anorexia
• Depression
• Vomiting
• Yellowish discoloration of skin and moist tissues (icterus or jaundice)
• Moist tissues of the body (mucous membranes) are pale due to low red blood cell count; simply referred to as anemia
• Dark urine due to the presence of bilirubin (bilirubinuria)
• Hemoglobin in the urine (hemoglobinuria)

Chronic signs:

• Lethargy
• Depression
• Anorexia
• Weight loss
• Vomiting
• Diarrhea
• Excessive thirst and urination (polydipsia and polyuria)
• Abdominal distention due to fluid build up in the abdomen (ascites)
• Yellowish discoloration of skin and moist tissues (icterus or jaundice),
• Spontaneous bleeding, black or tarry stools (melena)
• Nervous system dysfunction due to the liver being unable to break down ammonia in the body (hepatic encephalopathy)

Causes

The cause of copper storage hepatopathy in cats remains largely unknown. However, it is suspected that those cats that are affected do not metabolize or excrete copper properly.

Diagnosis

A complete blood profile will be conducted, including a chemical blood profile, a complete blood count, and a urinalysis. You will need to give a thorough history of your pet's health, including a history of its symptoms, and possible incidents that might have precipitated this condition. The history you provide may give your veterinarian clues as to whether the condition is of primary or secondary origin.

A tissue sample will then be taken from your cat's liver for laboratory analysis, and ultrasound images will be taken of the abdominal area to examine the condition of the liver.