In the past 10 years, there has been an apparent rise in the number of dogs and breeds that are being diagnosed with copper hepatopathy either as a primary disease process (Labrador Retriever, Doberman Pinscher, Bedlington Terrier, and West Highland White are examples of highly prone breeds) or copper can accumulate in the liver and be a complication to other disease processes in the liver known as secondary copper hepatopathy. 

Why is this incidence increasing?

While some of this is speculation, as nutritionists, we think some dog foods may have too much copper. Copper is essential for the body's functions, such as energy production, making red blood cells, and maintaining healthy cartilage and blood vessels. About 1.8 mg per 1000 kcals is recommended for adult dogs, while puppies need around 3.1 mg per 1000 kcals. However, many dog foods contain about 6-10 mg per 1000 kcals, sometimes even more.

In the late 1990s, cupric oxide, a common source of copper, was banned from dog foods. Instead, copper sulfate became the standard. Nowadays, there are newer mineral forms called chelates, where trace minerals like copper are combined with organic molecules like gluconate or amino acids. These chelates likely have better absorption rates, around 10-30% more than copper sulfate.

Many high-quality dog foods are using these newer chelates, but they may not be adjusting for the increased absorption. While this isn't usually a problem for most dogs, it's something to consider if you're feeding a breed prone to copper buildup.

What is the treatment?

There are different ways to help dogs with copper buildup in their liver, which is known as copper hepatopathy. One common treatment is to give them a diet that has less copper. Dogs with severe copper buildup and liver damage may need additional therapies. These treatments aim to remove copper from the liver cells more rapidly and improve liver function. They include:

• D-penicillamine: This medication binds to copper and helps eliminate it from the body through urine. It is often prescribed with vitamin B6 to prevent a deficiency. It can sometimes cause stomach upset and other side effects.
• Zinc: This mineral reduces the absorption of copper from the diet, trapping it in the gut. However, high doses of zinc can cause stomach upset and even anemia.
• Denamarin® or Denosyl®: These supplements contain SAMe, an antioxidant that helps neutralize free radicals produced by copper in the liver, reducing damage to liver cells. They may cause stomach upset in some cases.
• Vitamin E: Another antioxidant that is generally well-tolerated and helps protect cells.

Your vet can tell you more about these treatments and if they're right for your dog. They can also explain any side effects in more detail.

What diet should I use?

Thankfully, two pet food brands offer diets for controlling copper without adding extra copper beyond what's naturally in the ingredients. These diets are Hill’s l/d therapeutic diet and Royal Canin Hepatic Support. They come in either canned or dry form and are commonly used to help manage copper buildup in the liver.

Royal Canin Hepatic Support has been studied extensively in Labradors with primary copper disease. One study found that after treatment with D-penicillamine, the levels of copper in the liver stayed low for about 9 months. They also examined whether adding 10 mg/kg of zinc gluconate, which stops the body from absorbing copper, along with the diet, made any difference. They found that using zinc didn't provide any extra benefits compared to using a low-copper diet alone. These diets have about 1.2-1.3 mg of copper per 1000 kcals and are considered the best choice for veterinarians.

It's hard to find a commercial diet with such low copper levels in regular pet stores because the American Association of Feed Control Officials regulates pet food sales state by state. They require that pet food has at least 1.8 mg of copper per 1000 kcals. However, a few diets come close to this level and don't add extra copper during manufacturing. These diets are made by Voyager Dog Foods, a company started by a veterinarian who saw a need in the market for these specific diets.

What if my dog will not eat commercial dog food?

As nutritionists, we're frequently tasked with creating diets for dogs with primary copper hepatopathy. Other health issues often complicate this condition, making our intervention necessary on multiple fronts. However, when dealing with a straightforward case, such as a young to middle-aged dog diagnosed with the disease, creating a diet plan is relatively easy if we follow some basic guidelines.

1. No organ meats
2. No complex grains
3. No shellfish 
4. No mushrooms 
5. Fewer green leafy vegetables 

With this in mind, we have formulated three diet plans below with approximately 300 kcals and a relatively low copper content when using an all-in-one supplement from Balanceit.com. As a veterinary therapeutic company, Balance It® has made a wonderful supplement to ensure proper nutrient intake without any copper added to the supplement called Balance It® Canine-Cu.  This is the only supplement to use, and others cannot be substituted – it makes it very easy to put together an adequate diet plan that is even lower than the average copper content found in commercial therapeutic diets.

tsp = teaspoon

All the meat weights mentioned in the diets are for cooked meat. These are simple diet plans meant to support a dog's health during treatment and beyond, especially when dealing with primary copper-related hepatopathy.

Please discuss with your vet how much of this homemade diet to feed your dog based on its current calorie intake. For instance, a Yorkie might only need half of the amounts listed in the diet, while a Labrador may need four times the proportions to maintain weight. Regular weigh-ins are crucial. You may need to adjust the proportions on this diet plan if your dog is gaining or losing weight.

As with any medical change for your dog, talk to your vet to see if this approach suits your dog's condition and stage of disease. They can advise on any concerns regarding feeding commercial or homemade foods.

Updated June 2024