I have found that Avoderm Lamb and Rice has only 7.5 mg copper, which is only slightly more than the therapeutic low-copper diet for liver disease provided by Royal Canin. Lots less expensive too. Better food.

I'm very sorry about what your dog has gone through. Kudos to you for doing so much research, and for sharing your findings with the rest of us.

I have a young girl whose breeder told me that the dam was sensitive to copper, and to be careful about copper levels in her food. Which food have you found to be the lowest in copper levels?

Got back my girl's bloodwork today. Nearly all of her liver values were smack dap in the middle of normal. Only her Total Protein and Albumin were slightly lower than normal, but they were both improved from her testing three months ago and greatly improved from January when she was diagnosed. I feel as if I won the lottery!!!

Kate,
I am so happy for you and your gal! This gives me much encouragement. My Folly was just diagnosed with a UTI and I am even more determined to get her completely of the prednisone. We go back to OSU for bloodwork next Thursday!

Thanks for sharing the good news!

Cindy

Cindy, My girl also got a UTI when she was on pred. Took a long time to cure. Haven't had another one since she has been off pred. I guess pred is a blessing and a curse. Kate

I read your post regarding adding B6. My doberman was diagnosed with copper storage hepatitis in June. He is currently taking Denamarin and d-penicillamine twice a day; Uridisol; and Vitamin E. Although his ALT levels are still high, they have gone down some. He was on Royal Canin Hepetatic, but no longer will eat it. In fact, he doesn't seem interested in any dog food. Food he liked last week, he won't eat this week. However, he will eat any dog treat, cheese, meat scraps, basically anything "people". I'm wondering if his fickleness is related to a B6 deficiency. How much would I give him? He weighs 70 lbs. Thank you.

From Dr. Center's papers on CuAH: "Because d-penicillamine imparts an anti-pyridoxine (vitamin B6 inactivation) effect in man, pyridoxine supplementation is advised (25 mg pyridoxine/day)."

If that doesn't help the anorexia, you could try ask your vet to let you try mirtazapine. It's a pretty good appetite stimulant. You want to avoid all those human foods/treats and get him back on his Hill's in order to minimize his copper intake. As a last resort, a very low dose of pred can get them eating again, but of course that needs to be discussed with your vet and your internal specialist.

Lisa, You are describing how my girl reacted to d-pen. Lowering the dose helped some, but the effect of B6 was remarkable. A deficiency in B6 effects how foods taste. We give 25 mg of B6 daily, and she loves the same food she would not eat before we added the B6.

Overall, I can't recommend the Hills Diet because it still has considerably more copper than my home made diet with a special supplement to balance the nutritional needs without copper. My homemade diet and special supplement came from www.balanceit.com. A prescription for the diet and supplement from your vet is necessary to order the supplement.

We have also added 625 mg of Denamarin and 900 mg of PhosChol to repair and improve liver function. I highly recommend both. My girl's liver enzymes have returned to normal since June when they were still off the charts.

Hi Lisa, my 10 year old lab was diagnosed in January. He also takes the 25mg B6. My guy has done extremely well. In July his twice daily regimen of 500mg of d-penicillamine was reduced to once daily. Last week he went in for a follow up and the vet further reduced the d-penicillamine regimen to one 500mg capsule every other day. The vet said I could also reduce the B6 to every other day but I have kept it on a daily schedule. In July Theo's ALT was 41, (down from 2084 at diagnosis). Last week his ALT was 39. All other blood test results continue to be in the normal range. His next trip back to the vet will be at year end. You will be surprised and pleased with the effect of the B6.

I just saw a FB post from Lisa G. Shaffer from Paw Print Genetics. It was a couple weeks old. It said, PPG is "seeking samples from Labrador retrievers with a diagnosis of Copper Storage Disease. Samples submitted must be from a dog confirmed with the disease through liver biopsy. We understand that many of these dogs can be deceased and can accept any stored material such as DNA, blood or semen. Would also like to collect samples from obligate carrier parents." The FB post said to contact Lisa G. Shaffer of PPG with any questions.

Theo's breeder contacted PPG some months ago and started the ball rolling on this and our samples have all been submitted. It would be great to have a genetic test for CSD. Please spread the word.

Nancy, Very interesting and exciting. Sassy definitely had copper in her liver by biopsy but no one ever gave her the diagnosis "copper storage disease." Kate

I'm so glad I've found this post!
My girl Ginn was diagnosed early June with hepatitis and we already suspected copper-storage since we know that in her ancestors there was copper storage (hope my English isn't too clumsy, I'm from the Netherlands ;) ) A few weeks into treatment, we learned that she has Addison's disease also (and it was probably thanks to the pred she got for the hepatitis that she didn't go into crisis...). With medication her Addison is stable now and after a biopsy we started D-penicillamine 3,5 weeks ago. Two weeks ago, she started vomiting, what could be Addison- or D-penicillamine-related. Addison was ruled out then, but she also started eating again so we picked up the penicillamine-treatment and she seemed ok.

Last week, she had an osteopathic treatment (because she also has two bad knees, for which she had surgery in January but are still not ok...) and after that, she started vomiting on Friday. Saturday was fine, Sunday she didn't want to eat her kibble (Royal Canin Hepatic). And after that it was on and of, one day she ate, the other day she didn't. We stopped with penicillamine on Tuesday. Yesterday she ate, this morning too but she's definitely not feeling well.

We're going to see the vet this afternoon to do some bloodwork. We were supposed to go next Tuesday, since she was 4 weeks on D-penicillamine then, but will do it now to see if we can get a clue what's going on.
And then, I read your post about the B6 Kate! I will definitely get her some of that. She also gets Milk Thistle, alpha lipoid acid and, SamE. But I think a few days ago the SamE together with tramadol (for her knee) and metoclopramidehydro-chloride (it's called Emeprid but don't know what it's called in other countries?) caused her a slight serotonins-problem.. So will stop with the SamE...

I can't wait to see what her liver-enzymes are now... Because I desperately want to get her off the pred (37,5 mg, she weighs about 70 lbs/38 kg) but every vet I talk to says she needs it for her liver.....

Monique, 37.5 mg is a large dose of prednisone for her size dog. 30 mg was as high as my girl of a similar size took. And my girl had many side-effects from the steroid--including dramatically elevated liver enzymes. My rheumatology friend said that 30 mg would be a lot for a human with liver disease. And Dr. Twedt who is a canine liver expert said that he does not usually use prednisone for copper storage disease and would not give more than 30 mg if he did.

Find another vet or get a consultation from a vet such as Dr. Center in the US. Keep us posted.

I am also struggling with the prednisone issue. We are working with three different vets including the Ohio State University and all of them want to keep our toller on a maintenance dose of 10 mg every other day. They are trying to connect with Dr. Center at my request. But to date have not heard back from her. We go back to OSU today for more blood work and hopefully some treatment updates. Her last blood work showed all enzyme levels back to normal except for one which was slightly elevated. Hoping all are back to normal today.

Fortunately we have had no issues with the Penicillamine. We are also giving the B-6. We are in our 7th week of treatment and Folly wants to eat anything and everything in sight. We had to cut back all of the hostas (highly toxic) in our yard as she was trying to nibble on those the other night. We are back to doing one or two therapy dog visits a month. I also put Folly back in her agility class (low or no contacts and low jumps) for exercise and fun. With her increased appetite, we are trying to keep the excess weight off.

As to the genetic samples. After reading this forum, I contacted one of my toller breeder friends and was put in touch with a breeder in California who is also a professor at UC Davis (I think she was a student of Dr. Center's)and has a genetics lab where "all things toller" are kept. I'm not aware of any other toller with the CSD diagnosis so I forwarded blood samples and Folly's health records to her lab. I am hoping that it proves useful to them.

Thanks for all of the info and advice!

Cindy

We got our latest test results from the Ohio State and after 7 weeks on Penicillamine, our toller's liver enzymes are all in the normal range. She is much more animated, playing with toys and acting like her old self. Our vet ordered our next 3 month supply of the Pen along with another year scrip as her copper values were so high, I am guessing will need more than the usual 6 month treatment. They are encouraging another biopsy early next year. I am worried about another surgery and anesthesia with a diseased liver. Thoughts?

Because of a recent UTI, we are weaning off the prednisone. She is now on 5 mg every other day and within another week, will go off completely.

We will retest after a month, and if things are stable, hopefully she can just continue the chelation process and liver support drugs (Vitamin E, Denamarim, ursodial and PhosChol.

Keeping our fingers crossed that things remain stable...

Cindy

My 10 year old lab started on d-pen (500 mg twice a day) in February of this year. In July we started the weaning process and he went to 500mg once a day. In September his dose was further reduced to one 500mg capsule once every other day. His next visit will be at the end of the year. At that point he will have been on the d-pen for 11 months.

His copper level was above 2000 when first diagnosed (1500 is considered toxic). His liver enzymes were very high initially (ALT 2084) but started to drop as soon as he started all of the "liver friendly" meds--even before the chelation started. In fact, by the time he had his liver biopsy and subsequently started the d-pen most of his scores were back in or close to the normal range (due to the liver meds)... But at that point his liver was still full of toxic levels of copper. The only way to see if the copper is gone is to do a liver biopsy. That said, my vet told me that most people don't do it. The procedure is very expensive and comes with all the risks associated with anesthesia and surgery. My guy will turn 11 next April so I doubt that I will do another biopsy but he is and will continue to be followed closely by his GP vet and his Internal Medicine specialist. Plus I scrutinize his every movement and have him in to the vet if see ANYTHING!

There is a big part of me that wants to know the exact level of copper in his liver when he is finished with chelation but the surgical/anesthesia risks for a dog his age are high. With the exception of the d-pen and B6 he will be staying on the rest of his liver drugs forever and he will be monitored closely.

Hi Nancy,
I have the same concerns about another biopsy as anesthesia is not kind to dogs with diseased livers. Folly will be 6 in January...so she is still very young. I think that is why they want to see her copper levels. Her level was also high..2470....

She too will remain on liver support meds for the rest of her life...The vet was also suggesting prednisone but the jury is still out and hopefully we can avoid the steroids.

Hi all, I was wondering where everyone purchases there B6 and how you administer it.

I buy B6 25-mg tablets off Amazon. You can get them anywhere really.

I also get my B6 on Amazon. My vet recommended 25mg of Jarrow brand B6.

The 25 mg version of B6 was not carried by any of my local pharmacies, but my favorite pharmacist orders it for me. It's the least expensive of all the medications my girl is taking by far.

Does anyone give Vitamin E? We use to use TwinLabs but they dont make it anymore. I found a new one and wanted to see if anyones ever used it. Aqua-E Water-Soluble Vitamin E; Tocopherols & Tocotrienols; 8 fl oz (237 ml) Glass Bottle

I give a water soluble vitamin E...200 IU ...one gel tab a day. My vet just had me purchase from a local pharmacy. I got mine in a health food store.

Our most recent bloodwork showed all enzyme levels back to normal so we are not taking the pred. Just the chelation meds and liver support meds.

We go back in a month for more blood work and are hoping things remain stable.

Our toller got into her denamarin last night and ate about 12 chewable tablets! She is eating everything in sight! From what I read, there should be no ill effects.

Cindy

I give a water soluble vitamin E...200 IU ...one gel tab a day. My vet just had me purchase from a local pharmacy. I got mine in a health food store.

Our most recent bloodwork showed all enzyme levels back to normal so we are not taking the pred. Just the chelation meds and liver support meds.

We go back in a month for more blood work and are hoping things remain stable.

Our toller got into her denamarin last night and ate about 12 chewable tablets! She is eating everything in sight! From what I read, there should be no ill affects.

Cindy

My 9 year old lab was recently diagnosed with Chronic Hepatitis...and the liver biopsy results came back with a high level of copper (700). In doing my research, I came across this forum...and thank you for sharing what you have learned!

River had no symptoms of liver disease, until a round of Rimidyl...and we hit a storm. ALT numbers over 2000. She spent two days in the hospital, IV fluids, antibiotics and anti-nausea drugs. She has since then been on Uracil and Denomarin. Her ALT numbers have drastically decreased, to around 500.

I am still sorting all this out (which came first the Copper Storage issue or the Chronic Hepatitis?). However, she has not had any further symptoms of Hepatitis...no ascites, yellowing of her eyes, aneroxia etc. I plan to get a second opinion on course of treatment, likely with Cornell as you suggested.

I am researching liver diet dog foods...and I am NOT impressed. One wants to feed them trees (cellulose) the other corn, both are extremely low in protein and available calories. My dogs are currently on Fromm's, and I love this company and their food, but from their website...the copper is 20 mg/kg.

I am interested in Flint River for my River, what formula did you find to have the lowest copper amounts? what is the Crude Protein and protein source? I don't believe she needs to be on a strict protein reduction...as her liver is processing proteins just fine.

Thank you for your input!
Tracy Harper & 'River'

I use the grain-free fish diet, and it has 10.6 mg copper. I think the regular formula is slightly less copper. But you can call the company.

Nearly a year after my girl became so ill both of my vets thought she was going to die, she is celebrating her first year anniversary by running, playing and eating. It's been a steep learning curve, but I now have some confidence she will enjoy the pleasures of living another year. Many thanks to those who accompanied us on this journey that I hope no one else has to take.

Last week when filling Sassy's pill box. I omitted the B6 by accident. 4 days later she started vomiting and refusing the food she loves. At that point I realized my B6 mistake and popped one immediately in her mouth. She got another one with her morning meal, which she ate reluctantly. But by evening she was no longer nauseated and ate vigorously.

B6 supplementation is essential to d-penicillamine chelation because the d-pen causes a deficit of B6, which causes nausea and taste aversions.

We were fortunate to have found this forum and started using the B6 from the beginning and have not had any issues with eating or nausea.

We are nearing the end of the 6 months treatment period for our toller although the vets from OSU have ordered up another years worth of penicillamine.

We are concerned about doing another biopsy as surgery can be hard on the liver. What are your thoughts about a second biopsy after treatment?

Folly's copper levels were extremely high.

Currently, she has lots of energy...is doing agility classes and continuing with her therapy dog work once a week. She has put some weight on and we are working to
get that under control.

Thanks

Cindy

We were fortunate to have found this forum and started using the B6 from the beginning and have not had any issues with eating or nausea.

We are nearing the end of the 6 months treatment period for our toller although the vets from OSU have ordered up another years worth of penicillamine.

We are concerned about doing another biopsy as surgery can be hard on the liver. What are your thoughts about a second biopsy after treatment?

Folly's copper levels were extremely high.

Currently, she has lots of energy...is doing agility classes and continuing with her therapy dog work once a week. She has put some weight on and we are working to
get that under control.

Thanks

Cindy

Right before Christmas Theo saw his internist. It was almost a year from when this journey started. He got a clean bill of health and all of his liver scores and other blood scores were normal. The vet had been weaning Theo from the penicillamine for some time and I was looking forward to the day when Theo would no longer need penicillamine. But that is not to be. My internist vet is following the protocol provided to her by Dr. Center. Per the protocol, Theo will stay on a low dose of penicillamine (and B6) for the rest of his life.

Dr. Center's protocol got us to where we are today so I have no complaints. Plus it does provide some peace of mind. Theo is taking classes to become a certified therapy dog. He has his CGC and at the end of this course he will be therapy certified and have his CGCA. The exercise for the "leave it" command is a challenge for Theo. After performing it correctly a few times, he made a dive for the treat-- a turkey brownie! At that point I was glad he is still on the penicillamine. Poor Theo, he got tired of Craisins and animal crackers as training treats!

During the weaning process Theo first transitioned from 1 capsule twice a day to one capsule once a day. After several months he then transitioned to 1 capsule every other day. After 3 or 4 more months and good blood tests he transitioned to his maintenance dose which is 1 capsule twice a week. So for the rest of his days Theo will be taking his penicillamine--1 capsule every Monday and Thursday--- always accompanied by his B6. The other meds he will always take are: Phoschol, milk thistle, SAMMe and vitamin e. Theo will turn 11 years old in April. God bless all of the wonderful, knowledgable vets who saved him.

The gold standard is a second biopsy to evaluate the efficacy of the treatment; however, most owners don't do it. In that event, Dr. Center has a standard protocol based on the copper quantification from the first biopsy, the extent of liver injury from the pathology, and looking at the liver enzymes, which should return to normal.

Mine is having her second biopsy middle of February, after 10 months of chelation. Her ALT only returned to the normal range in December.

Kate,

"From another Lab breeder I have learned that Dr. Twedt at Colorado State is now trying to avoid the use of d-pen and use zinc, which also has side effects. Partly this change is due to the fact that a shortage of d-pen raw ingredients has occurred. The research on zinc efficacy for this kind of chelation is much less favorable than d-pen. "

Do you know how Dr. Twedt is using zinc instead of d-pen? how girl is not tolerating the d-pen very well even with the B6.

Charity,

Have you tried adding Cerenia? Khalil had horrible side effects from D-pen (mainly vomiting and low appetite) As soon as we added Cerenia he is doing much better.

Our vet just recommended it but didn't give me directions on when is the best time to give it. This is only her second case of Copper Toxicosis. Did you give it at the same time as the D-pen or at another time? Also, her Cerenia is quite expensive life $40 for just two doses. Any suggestions?

Charity, what dose B6 are you using?

Charity at first we gave Cerenia everyday an hour and a half before D-pen. Then over a couple months now give it every other day an hour and a half before D-pen. We actually take a 16mg pill and split it into fours. Khalil only weighs 11 pounds though. Also We actually started at a really low dose of D-pen and over the months titrated up

Nancy,

We are giving B6 50mg because we feel like she already has a pretty large deficiency in it, split in morning and night.

My guy weighs about 100. He was getting 25mg of B6 with each dose of d-penicillamine. So initially when he was taking d-pen twice a day he was getting 50mg a day. Now he only gets B6 twice a week when he gets the d-pen. Even though he is only taking the D-pen twice a week now his dosage is still 500mg. Sorry that it isn't helping your girl.

When I first started chelation, I had to use a lot of Zofran to deal with nausea and vomiting. I think the nausea and vomiting was more due to her liver disease than the chelation. Over time as her liver healed, I was able to drop the Zofran and only use B6.

Hope this helps. Kate

Hi,

In last December one of my dogs was diagnosed with chronic hepatitis and as I was feeding them with Orijen, I was searching the net for a possible relation, that's why I found this forum. I decided to share my experience, maybe it will be useful for others too...

I have 3 dogs, all of them are mixed breeds and I can only guess about their origins, but probably my above mentioned dog have labrador retriever (or golden retriever) blood in his veins. I started feeding my dogs with Orijen 6 Fish and Orijen Red around Ferbruary, 2012 and on the regular yearly blood screen check (21st of September, 2013) he was detected with elevated ALT enzymes (214). The vet recommended to take a human medication called Silegon, which is based on a thistle extract. I gave that to my dog for a month, but on the next check, his ALT value was a bit higher (225).

Then (in November, 2013) I took him for a biliary stress test, which came up with a negative result, but the new vet, who performed this test, recommended to take Samyling dust and Glutamax tablets for a month. After that treatment the ALT value dropped to 172.

After a few months of waiting, in April 2014, the next blood screen check came up with a shocking result of ALT level 366, so our next way was for an ultrasound check, which came up with a negative result too. That vet also performed an ammonia test, which was also negative.

From May, 2014 we started the earlier Samylin/Glutamax treatment once again, but this time I had to switch the food for this dog from Orijen to Royal Canin Hepatic. After a month ALT dropped to 254, so I continued to feed my dog with the Royal Canin food. After a few months of waiting, in August the next blood screen check showed ALT level of 158, which was a bit relaxing news.

While continuing to feed with the Royal Canin Hepatic food, in November I made another blood check and the ALT level was 195.

In April 2015 (still on Royal Canin), the next check showed ALT level of 191 and the advice of my vet, I stopped feeding with the hepatic food and switched back to Orijen (that was not my vet's advice, just my idea).

At the end of the year we went to the regular blood screen test with my dogs and I got completely devastated by the result. The above mentioned dog had an ALT level of 515 and the AST level (which was still within normal limits until now) of 105. As we basically tried everything already, the vet recommened a laparoscopic liver biopsy and I accepted that. From the sample they made a bacterial test (which came uo negative), a copper test (also negative) and a histology test, which diagnosed an early stage of chronic hepatitis.

I have to make a small detour here and mention two of my other dogs. One of them is a possibly german shepherd and husky/malamute mix, the other was a still yong (1 year old) foxhound mix. The former dog was eating the same Orijen food for more than 3 years and her liver values were completely normal all the time. However the foxhound had a blood check in April, where the results were completely normal and around that time I switched to feed her with Orijen too. When the next check came in December her ALT and AST values were above the limit (ALT went from 42 to 94, AST went from 51 to 81 in 8 months).

After the liver biopsy I decided to stop feeding my dogs with Orijen immediately and switched to Dogchow, which was just a quick cheap / lighter in protein choice. After a month the foxhound's liver values went back to normal (ALT from 94 to 63, AST from 81 to 44).

Back to my first dog... After the histology diagnosis, my vet told me that I have two choices, either I start a steroid treatment or we try Cyclosporin, which, as he told, is a lighter medicament with less side effects and as we are in an early stage, he would recommend that. As it was my dog's life at stake, I decided to get at least two other vet's opinion before making a decision.

Next I went to the university of veterinary science and spoke with a professor, who was expert in liver diseases. She checked the dog, the earlied blood values, the result of the biopsy and told me that we should forget Cyclosporin, we have to treat the dog with Prednisolone for 6 weeks. She also said, that with the steroid we might catch the inflamation, but as the cause is unknown, it is possible that it will reoccur again. She was so confident that even while I was heavily against using steroids for the liver problem, I started to accept it, that we don't have any other choice.

However I already had a time reservation at a homeopathic vet, who was recommended by some friends, telling that sometimes he can make miracles. I am not a big believer of homeopathy, but as I already had a reservation, I decided that we can't loose anything with the extra check.

I told everything to him, with all the results, opinions, etc. and told him that I have to choose between the two treatment and came for an advice about which one to choose. After checking my dog and the lab results, he said that his opinion won't help with my decision, because he don't recommend any of those two treatments. His opinion was that the condition of my dog was the result of the feeding with dry food and I have to switch to raw feeding. He also prescribed the following as a treatment:

- Carduus Marianus D6 (probably vitamine D6)
- Xiao Yao Wan (a chinese herbal mix that stimulate the liver and looks like lead balls)
- Em-bio (I think this is a bacterial culture for supporting the switch between digesting raw meat instead of the dry food)

As this treatment seemed to be the most promising with the least side effects, I decided to give it a shot and try it for 1-2 months, if it is not effective I can still try using steroids...

The medicaments lasted for about 3-4 weeks, after that I was still feeding my dog with raw food. After one and half month, I went to the local vet to check the liver values to see which direction they went. I told the vet all the previous history including the last ALT/AST values (515/103). She seemed to be scepticist when I told about the current treatment but was quite surprised whenshe called me with the results. The ALT value went to 125 and the AST value dropped to 62!

I was very happy hearing those results, but I try to be careful about it as it might be an error with the blood check or only a temporary success, but we will do another big blood screen test in May and if that remains the same or better, I might believe in the raw feeding/homeopathy... :)

If I have more news, I will post an update, but if anybody need details, feel free to contact me...

Regards,

Csaba

I have switched all my dogs to AvoDerm original Lamb & Brown Rice. It is costing me about $1.70 per pound of dog food so it is not either the most expensive nor the least expensive dog food available. The dogs seem to like it. And gastrointestinal products look OK. The copper content is 7.5 mg/kg, which is just slightly above the 7 mg/kg therapeutic diet produced by Royal Canin for liver disease.

Two flies in the ointment are that I must special order it from my local retail store or buy online and that Breeder's Choice who produce Avoderm had a recall in 2012 for salmonella.

Another possible food was Honest Kitchen but this is a dehydrated food that needs to be reconstituted with water before serving and is incredibly expensive.

Months of searching. Hope it helps someone else. Kate

I have a 10lb chiweenie who is struggling hard with liver disease. I am curious about PhosChol , and what a dosage would be like for her. My vet doesn't know about it, and I talked to another that said dosage for such a small dog is hard - and to not do it. YET, I'm afraid because H.E is getting bad.

I have her on: cerenia, prednisone (1mg day), ursodial, zinc, vitamin e, milk thistle, samE (I use to have her on denamin, but didn't seem to be doing much so I switched samE), tumeric, missing link supplement (gonna switch to Balance CU)...

I also give her low/no fat yogurt with manuka honey for snacks, but her appetite is good. I give her sweet pototates/white potatoes/ground turkey, sometimes egg whites/ white rice....

But I feel like I do not have things dialed in, she is getting worse -- though she just stopped metronizadole for 3 weeks.. though I don't think that it helped much after the first week. (previously, it worked well, this time, seemed to make her HE worse).

any ideas/thoughts?

Thanks for the food info, Kate. My lab, Lincoln and I are just starting down the Copper Storage Disease path and everyone's comments here make me feel much better. Lincoln flatly refused to eat the Royal Canin hepatic(perhaps this just shows his basic good sense) although he has never refused to eat anything ever before. Anyway, with our vet's approval we are going to try the AvoDerm Lamb meal and brown rice. I noticed that their red meat and potato formula also has 7.5 mg/kg of copper. Your information saved me hours of searching and I really appreciate it.

I just came across your post in a search for low copper dog food recipes. Our Black Forest Hound was also just diagnosed with Copper Storage Disease. Everything I have read so far points to genetics, but his breed is not known to be genetically predisposed, and we are in touch with his breeder and there have been no reported cases in his blood line. Could it be that his dog food has poisoned him due to the excessive copper content? Even the prescription food we have order in exceeds the amounts of copper that I have been able to find as the recommended maximums with Copper Storage Disease (the references I have found state < 5mg/kg of body weight, and the prescription food contains 7mg/kg of body weight). I was thinking about giving him some prescription food and supplementing with other low copper foods (I am a Registered Dietitian, and have worked with humans with Wilson's Disease, so feel comfortable with doing this, however, I am not that knowledgable about canine nutritional requirements, and don't want to cause micronutrient deficiencies by not giving him the right amounts of food). Any suggestions on low copper home-made meal recipes that would meet his nutritional requirements?

I hope that you read this entire thread because it addresses many of the issues that your posts has. I feed a copper-free diet that is made from recipes I got from Balance It. They provide a nutritional supplement so that the recipes contain what a dog needs without copper. The recipes and supplements are designed by a veterinary nutritionist who started Balance It. I highly recommend it.

I feed all my other dogs Avoderm Lamb & Rice which contains 7.5 mg/kg, the lowest food I have been able to find.

Kate

My lab has this condition. He is taking, and tolerating well, Pencillimine, which he has been on for 4 months. His enzyme levels are improving slowly. He also has epilepsy, which we are managing well, although he had to change from Phenobarbital to Keppra because of his liver condition. Otherwise he is in good health, unfortunately he doesn't like the prescription dog foods. He refuses to eat Hills, wet or dried, and is now going off Royal Canine. Does anyone have any suggestions? He's not a fussy eater otherwise, happy to eat the bits of cheese, egg white and chicken I use to get him to eat the quantity of pills he has to take.

Avoderm Lamb and Rice has only slightly more copper than the prescription diets.

Honest Kitchen.

Homemade recipes from BalanceIt.

Good luck with your boy. Kate

Thank you so much for your forum and for all the work you've done researching this condition. I'm definitely going to check out AvoDerm and run it past my vet. Nelson loves lamb so he should be pleased.

My 4 year old lab had copper storage disease confirmed this summer. His surgeon did find scarring during his liver biopsy. We have been treating him with penicillamine for four months. He was also taking cyclosporine but we had to discontinue that because he kept getting infections. I'm writing to see if anyone else has had issues with the blood protein levels (albumin) being slow to come back up to normal. Bandit's are still low, even though his other levels are now in a normal range (they were off the charts when we first discovered his condition this summer). Also, I read that some of you are continuing penicillamine treatments at low doses for life. Is that correct? I just want him to have the best chance possible. We love our boy and want him to keep getting better. I'm open to all suggestions (medicine, diet, etc) that have worked for you guys.

It will be 2 years this January that my now 11 and a half year old lab was diagnosed and began treatment. Theo takes his penicillamine and B6 twice a week. The vet said he will always stay on a low dose penicillamine. He is also taking his Phoschol, SAMe, vitamin e and milk thistle. He has a great quality of life and got certified as a therapy dog earlier this year. Theo's blood tests haven't shown any issues with albumin. His issue recently has been very slightly elevated creatinine levels. I hope your lab does well. Eventually all of "this" becomes your new normal. My vet said Theo's life expectancy will not be affected by copper storage disease. Best wishes!

Welcome, Deborah, to the thread no one ever wants to join. I'm so sorry for your boy, but I am glad that you are getting help.

My girl Sassy was first diagnosed about two years ago when I started this journey and this thread. She had great difficulty tolerating the d-penn so she was taking a reduced amount until April of this year when she began to have intermittent bouts of vomiting and diarrhea.

I took her off the d-penn because it appeared to be causing her GI distress. We could not figure out the whole picture and her weight dropped from 65 lbs to 47 lbs. We began treating her as if she had inflammatory bowel disease using steroids and many small meals a day. For the last two months we have decreased the steroids and slowly increased her food through small meals. She is gaining weight and is off the steroids for the last couple of weeks.

I doubt that I will ever risk putting her back on the d-penn because she nearly died from the GI problems. So for now she is taking only Vitamin E, PhosChol, and Omega 3. When she gets back up to a normal weight, I will add back the Denamarin.

She will be 11 in February, but at diagnosis she was not expected to live. So I think we are doing well managing her liver disease.

About the albumin levels, she is normal. Kate

Hi Kate and all,
I have a Duck Tolling Retriever, Folly, who was diagnosed with CAH almost two years ago in March. Later that spring, we found she had crazy high copper levels and began our journey trying to control this issue. I found this thread to be extremely helpful as I educated my own vet through this process.

As her liver showed much scaring and damage, we started Folly out with steroid treatments that are typical with chronic active hepatitis but Folly did not do well with the pred. We stopped the steroids after several months.

She currently takes D-Penn, vitamin E, Vitamin B-6, Ursodial, and Denamarin (with Phoscol thrown in from time to time) She is on a liver diet.

My dilema...Folly has been on her full dose of D-Penn for 16 months now. She seems to tolerate it well...in fact the vets at Ohio State want her to lose a few pounds. I am concerned about long term D-Penn usage but have not been able to find out anything about this topic.

Folly's liver enzymes tend to fluctuate somewhat from normal to a slight elevations in ALT. We do bloodwork quarterly. We don't know why the fluctuations occur.

Her energy level is good...she does agility and is a therapy dog.

I know a second liver biopsy is recommended but we just lost our other toller to cancer and I dread the thought of putting Folly through a second surgery.

Any thoughts on long term D-Penn usage. Folly will only be 7 in January. When diagnosed almost two years ago, she was given a guarded prognosis.

Thanks

Cindy

Cindy, about 20-30% of people being treated for Wilson's disease discontinue treatment with d-penn because of side effects, especially GI side effects but also kidney problems. In one study nearly half of the participants had to stop taking the d-penn. Kate

Kate,
Thanks for the info. Maybe that explains why my vet also does a urinalysis when they do the quarterly bloodwork on Folly? We will be doing more bloodwork this month. I am hoping everything is back in the normal range.

Cindy

Your vet should get a creatinine and/or BUN level to assess kidney function. Ask for it. These may be part of the blood work that your vet plans, but I would ask to be sure because some vets don't know that d-penn can affect kidney function. Good luck and keep us posted. I think we all learn from these experiences. Kate

Great...Thanks again Kate. I will ask about these other tests. As always, you and this site have been a wealth of information.


Cindy and Folly

What is the dosage and brand of B6 vitamin supplements that you give while dog is undergoing 400mg 2/x per day of D-penacillimine treatment. Thnx!

From the earliest days when he was taking d-penicillamine twice a day, 7 days a week until now (2 years later) when he takes 1 capsule only 2 days a week the B6 dose has remained steady at 25mg.

The brand I use is Solgar. I buy this on Amazon because local shops didn't carry the 25mg dosage.