Copper
Hepatotoxicity
- sheep are very susceptible
- they have poor ability to excrete copper in the bile
- copper accumulates in hepatocytes until it reaches a critical level
- the hepatocytes die and release the copper into the blood
- causes haemolysis of the red blood cells
- this haemolysis further damages the hepatocytes
- releases even more copper
Predisposing factors
- contamination of foodstuffs and pasture with copper
- any damage to the biliary system as in ragwort poisoning
- pastures low in molybdenum
- increases the availability of dietary copper
- molybdenum combines with copper to form insoluble complexes in the gut
Gross
- carcass
- jaundiced
- reddish
- liver
- swollen
- soft
- orange in colour
- kidneys
- deep red
- red urine due to haemoglobinuria
Microscopically
- periacinar hepatic necrosis and profuse bile due to haemolysis and cholestasis
- copper can be demonstrated with special stain - rhodanine
Genetic inheritance
- Bedlington and West Highland White Terriers
- copper toxicosis susceptibility
- inherited as autosomal defect
- copper levels can be very high in the livers of these animals
- there is no haemolytic crisis
Clinical
- ill thrift
- progressive neurological signs due to liver failure
Gross
- liver is small and fibrosed
- jaundice is not a consistent feature
Copper and liver disease
- Copper – cofactor for enzymes (lysyl oxidase), electron transport proteins (cytochrome c oxidase) and antioxidant molecules (superoxide dismutase).
- Primarily absorbed through the small intestine and stomach (upper small intestine in the dog).
- Enterocyte regulation of absorption – metallothionein and a copper transport protein – ATPase7A.
- Metallothionein is a low molecular wt cytoplasmic protein, in all tissues; expression in response to heavy metals, various hormones and stress. metallothionein in cytoplasm of enterocytes leads to absorption of copper.
- ATPase7A – transmembrane copper transporter in a number of cell types.
- Defective in people with Menke’s disease – the animal model is the mottled mouse – results in faulty transport of copper out of the cell –leads to copper accumulation in enterocytes. Liver and brain that have little of the transporter experience copper deficiency.
- Chronic diet XS of copper leads to accumulation in the liver .
- Serum copper – in 2 pools
- Exchangeable pool – loosely bound to carrier molecules; 80% of it bound to transcuperin, the rest bound to albumin.
- Other pool – tightly bound to carrier molecules.