Peer-reviewed veterinary case report
Copper-associated hepatic cirrhosis in a Friesian horse.
- Journal:
- Tijdschrift voor diergeneeskunde
- Year:
- 2012
- Authors:
- Ankringa, Nynke et al.
- Affiliation:
- Utrecht University · Netherlands
- Species:
- horse
Plain-English summary
A 6-year-old Friesian stallion was brought in because he was having trouble exercising, had a stiff walk, and weakness in his back legs. He also had muscle wasting in his hindquarters and showed high levels of liver enzymes in blood tests. Further tests revealed severe liver damage with signs of copper buildup in the liver cells. The horse was given treatment to help slow down the liver damage, including medication and a special diet, but soon developed a serious blood condition that led to his owners deciding to euthanize him. This case shows that too much copper in the liver can be a serious issue in horses with liver disease.
Abstract
A 6-year-old Friesian stallion was examined because of signs of exercise intolerance, stiff gait and symmetrical hind weakness, and increased serum liver enzymes. On presentation, the horse showed muscle atrophy of the hindquarters. Neurological investigation showed no abnormalities. Laboratory findings revealed a prolonged prothrombin time and increased levels of alkaline phosphatase (AF), aspartate aminotransferase (ASAT), gamma-glutamyl-transferase (GGT), lactate dehydrogenase (LDH), and bile acids. Histological evaluation of the liver revealed severe cirrhosis and intracytoplasmic greyish brown granules in almost all hepatocytes, sinusoidal Kuppfer cells, and macrophages. These granules stained strongly for copper. Treatment to slow hepatic fibrosis was advised and included oral prednisolone administration for at least 1 month. A diet to support liver function was formulated by a nutritional specialist, and vitamin E was advised as dietary supplement to support neuromuscular function. Soon after diagnosis, the animal showed signs of intravascular haemolysis, with the presence of Heinz bodies in peripheral blood smears, and haemoglobinuria. On the basis of this haemolytic crisis and the poor prognosis of the chronic hepatic disease, the horse was euthanized at the owners' request. Although we could not establish the cause of the hepatic copper accumulation, this case report highlights that excessive copper in the liver should be considered in the differential diagnosis of hepatic cirrhosis and Heinz body anaemia in the horse.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/22667176/