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Acute Liver Injury vs Copper Storage

Vomited Sunday. Held food Sunday night and Monday but wanted to eat Monday evening. Fine Tues but vomiting again and just not acting like our wonderful Freyja.

Was able to get her into the one vet that I like yesterday. Blood panel revealed that her Liver values (ALT and ALP) are unreadable…so high it cannot be recorded, which designates severe liver injury. Freyja stayed and is hospitalized.

I have zero idea what in the hell is going on. She is not an eater and is a smart girl. She is practically with me 24/7. The vet said he saw a recent case of this from dog ingesting xylitol- a sugar free substitute in chewing gum. I do not chew gum.
Vet said probably gum, sago palm or toxic mushroom.

No Sago palms.

It has been raining here the last week so mushrooms are budding up.

We have been running alot (rain or shine) prepping for FastCAT this weekend and a 2.5mile race in Dec. Maybe something at a local park?? I just cannot figure it out.

Freyja is such a sweet soul, your thoughts would be appreciated.
Found a good article at Copper Content in Dog Foods entitled Copper Content in Foods. It gives copper levels in brands of dog food. It was done in 2011 and may be incomplete. However, there is a really good link to another article in there….Copper Toxicosis you might want to read. I found it to be very informative on this Issue.
 
Got home today from work and checked her eyes and the yellow tint is gone…fingers crossed.

Her poop is sorta pumpkin colored but am hoping that’s from the Royal Canin hepatic wet food. It does appear to be the same color as the poop.

I have been doing heavy research on CSD and the cause(s). If caught at the right time, it can most definitely be treatable with low copper food and meds.

So onward to finding a good food source. Handmade RAW is the best but I don’t have the ability to feed raw. The problem I have with RC is that it has a low protein % and it’s mostly plant based. The primary concern is to get Freyja back to good health and when this happens, it sure would be nice to have her run alongside me again. With a low protein % food, this will not be good for a high muscle energy demand. @Ravenbird is spot on with beef having the most copper.

A while back Ravenbird posted about The Scoop dog food (now known as Voyager), so I researched and it appears really legit- low copper content with a good protein source. I messaged them and they are very responsive and answered all my questions. They invited me to converse with the owner/founder, Dr Pete Van Vranken. He is one of the founding authorities on CSD and has been a vet for over 50yrs. I think I may take them up on that offer and interrogate the shit out of this guy….haha.

Really interested in this because the Voyager website addresses copper and has a low value of 7.5. The site has many picts/stories of working Labradors too- apparently this is a major issue in Labs.
 
This was on WebMD for people health, but thought I should share this here since so many of us use treats that are based with liver or entirely liver, such as freeze dried. I'm going to assume that drying concentrates the copper further since there is no water weight, so a very small amount of liver treats daily may add up.

Beef liver contains the most amount of copper per serving of any food. Whether braised or fried, a 4-ounce serving contains 16,070 micrograms, more than 18 times your daily value. It’s such a rich copper source that sources advise eating it only once weekly to avoid possible toxicity symptoms. Chicken liver is a good alternative at 566 micrograms, 62% of your daily total.

Compare to 4 oz ground beef:

Beef, ground, 85% lean meat / 15% fat, raw, 1 serving ( 4 oz )
Protein (g)21.01
Copper, Cu (mg)0.08
Manganese, Mn (mg)0.01
Selenium, Se (mcg)17.85
Great info, especially about the treats! Check the website I posted earlier. Be careful on the “units” here
This was on WebMD for people health, but thought I should share this here since so many of us use treats that are based with liver or entirely liver, such as freeze dried. I'm going to assume that drying concentrates the copper further since there is no water weight, so a very small amount of liver treats daily may add up.

Beef liver contains the most amount of copper per serving of any food. Whether braised or fried, a 4-ounce serving contains 16,070 micrograms, more than 18 times your daily value. It’s such a rich copper source that sources advise eating it only once weekly to avoid possible toxicity symptoms. Chicken liver is a good alternative at 566 micrograms, 62% of your daily total.

Compare to 4 oz ground beef:

Beef, ground, 85% lean meat / 15% fat, raw, 1 serving ( 4 oz )
Protein (g)21.01
Copper, Cu (mg)0.08
Manganese, Mn (mg)0.01
Selenium, Se (mcg)17.85
Great information…..be careful comparing because of the “units”. 16,079 micrograms is 16 milligrams (mg) and usually it should be reported as miligrams per kilogram (of product)…so to compare, you need to convert the 0.08 mg of copper in 4 oz of ground beef to kg.
 
be careful comparing because of the “units”. 16,079 micrograms is 16 milligrams (mg)
Yeah, after I posted I realized I was just copying the statements. but still 16 mg in beef liver compared to .08 mg in ground beef is a huge difference. I think I did the math right, they were both figures for 4 oz.
 
I am at work and don’t have the numbers but I am close.

Alt levels when Freyja was showing signs of sickness and lethargy.
11/15- the highest the computer registers is >2000. Freyja’s ALT was 2,300.
In hospital for 4days- started meds, IV, etc.

11/16- ALT was 2,100

11/18- ALT was 1187
11/22- ALT was 445.
So her numbers are definitely trending downward. Normal levels should be between 12-118.

My plan is to continue with the vet recommended meds and RC hepatic diet until the meds run out or she normalizes out. Today I am ordering the Voyager dog food which specializes in no copper sulfate/chelate and good/pure protein.

Dr. VanVranken called me yesterday morning from Battle Creek, MI and we talked for a good 45mins. Very nice, humble guy that just wanted to help Freyja if he could.

Thank y’all for your thoughts and support.
 
Those numbers were truly terrifying. Imo the fact that they came down quickly has to be a good sign! :love:

The copper buildup must have been happening for a long time but Freyja didn't appear unwell until those really high numbers? That scares me silly!

Hoping she continues her good recovery.
 
So with that fast of a drop in ALT, is this something that is considered an acute flair up of a chronic problem? It makes you wonder if it went up as quickly as it came down?
 
So with that fast of a drop in ALT, is this something that is considered an acute flair up of a chronic problem? It makes you wonder if it went up as quickly as it came down?
I'm thinking with the dates @Ddski5 listed, it sounds like getting her to the hospital and getting meds into her is what brought the numbers down. And what I'm reading sounds like they don't really show symptoms until the numbers are way up, so without regular checking we'd never know they were climbing like that. I'm guessing, I'm sure he will answer with more clarity about it.
 
11/15- the highest the computer registers is >2000. Freyja’s ALT was 2,300.
In hospital for 4days- started meds, IV, etc.
Scary numbers when you know what they mean! Now, your quick action had to play a part in her recovery and having insurance surely had to have a part in there too. ? I mean, how many times do we 'wait and see'?? At what point would it have been 'too late'? Reminds me of what @Rits said about insurance.. that she runs to the vet for the slightest sniffle.. because she can! 😁 What were Freyjas symptoms again? Vomit? Lethargy? Seems those end up in the 'wait and see' spectrum a lot, right? What motivated you to go to the vet the most?
 
So with that fast of a drop in ALT, is this something that is considered an acute flair up of a chronic problem? It makes you wonder if it went up as quickly as it came down?
You know…I am really pondering on this also.

I have to fix a bent up electric garage door that came down on a standing broom but I will post my thoughts on this when I get a chance.
 
how many times do we 'wait and see'?? At what point would it have been 'too late'? Reminds me of what @Rits said about insurance..
Trust me, we don't "wait and see" if there's a problem, even without insurance.

I'm guessing, I'm sure he will answer with more clarity about it.
That would be my guess too since every visit seems to bring new findings after time and records.
 
So everyone pretty much knows I am not necessarily a fan of vets- not because I feel I know more- but because I have a difficulty finding one that I think cares for mine and not just another dog.

With Freyja, things just wasn’t making sense to me. She is not an eater of all things. She vomited bits of her food and I could not find a catalyst for that. She was lethargic and would not come off the couch, she moves when I move…there was no explanation. The last straw was that her urine was fluorescent green and her poop was clay colored. It’s soo damn beneficial to be a detective when watching your Doberman. @Kaiser2016

The one vet that I do favor is very busy but he had an open schedule that afternoon so I jumped on it. He was very thorough and the initial labs showed very high liver values but her BUN and creatine was normal(kidneys). We discussed acorns, xylitol, mushrooms (we have some extremely toxic shrooms in La.) but again she is not an eater.

His clinic had a round table about Freyja and one of the new vets brought up CSD, so he asked me my thoughts and said the meds wouldn’t hurt- only help. I told him to go for it and the next labs showed a decrease in ALT. BAM…something was working- slowly but working.

I went and visited her every night and poor thing looked like shit but her nub tail was still wagging. The issue of her refusing to eat was very concerning. On the third night, they brought in some RC hepatic food and I can’t blame her for not eating that. Behind closed doors I told her to eat and reluctantly, she ate. She will eat, drink, pee and sometimes poop on command.

As far I as researched and read, the only way to diagnose CSD is through a full on liver biopsy and I said no. The vet said that sometimes if the liver is so full of copper that it will spill over into the bloodstream, so her sent a specific blood draw to LSU for analysis. They confirmed she had too much copper in her blood and he then diagnosed it as CSD.

Through all of my research and inquiries on the internet, I came across Voyager dog food which emphasizes no copper sulfate and copper chelate. For some crazy reason, after the 70’s copper sulfate and chelate was added to dog food and the increase of liver injury and CSD deaths rosé substantially. I started conversing with the CEO and he recommended that I talk with the founder of the company who is a vet with 50 yrs experience. He founded the company because his dog died of CSD.

On Thanksgiving morn at 0730, Dr VanVranken calls me with concerns and questions about Freyja. We had a very long discussion and I quoted him four different liver values of >2000- being put on anti copper meds and liver meds- and liver values gradually trending down. I even told him about the specific blood test sent to LSU to identify excess copper in the bloodstream. He stated that with that evidence, Freyja does not have CSD. If she had CSD, there’s no way it would have come down so fast from >2000 to 445. CSD would have taken much longer to trend down. He said she had a significant liver injury of some sort prob due to toxicity. He pretty much discounted the blood test sent to LSU on excess copper in the bloodstream. He did say that this year was a millennial year for acorn dropping and tannin toxicity is higher during these years. Idk….Freyja does not chow down on acorns.

So….what gives?? Maybe a perfect storm of some acorns, a mushroom?? She is always with me, I did not see it. Did someone throw a pack of xylitol gum over the fence??? I just can’t figure it out.

I can tell you this….Be it CSD or acute live injury (@Kswoodssue), Idk.she did have an excess of copper in her liver or else the anti copper meds would not have pulled her ALT liver values down.

We will continue on the vet prescriptions until empty, and get another liver panel in one month. I did order the Voyager food because of the no copper sulfate/chelate and it has a better/cleaner/increased protein % than RC. We are still scheduled to run our first 2mile race together on Dec 16th, so she needs that protein.

She looks fantastic and is doing very well. I thank all for your thoughts and support.
 
So everyone pretty much knows I am not necessarily a fan of vets- not because I feel I know more- but because I have a difficulty finding one that I think cares for mine and not just another dog.

With Freyja, things just wasn’t making sense to me. She is not an eater of all things. She vomited bits of her food and I could not find a catalyst for that. She was lethargic and would not come off the couch, she moves when I move…there was no explanation. The last straw was that her urine was fluorescent green and her poop was clay colored. It’s soo damn beneficial to be a detective when watching your Doberman. @Kaiser2016

The one vet that I do favor is very busy but he had an open schedule that afternoon so I jumped on it. He was very thorough and the initial labs showed very high liver values but her BUN and creatine was normal(kidneys). We discussed acorns, xylitol, mushrooms (we have some extremely toxic shrooms in La.) but again she is not an eater.

His clinic had a round table about Freyja and one of the new vets brought up CSD, so he asked me my thoughts and said the meds wouldn’t hurt- only help. I told him to go for it and the next labs showed a decrease in ALT. BAM…something was working- slowly but working.

I went and visited her every night and poor thing looked like shit but her nub tail was still wagging. The issue of her refusing to eat was very concerning. On the third night, they brought in some RC hepatic food and I can’t blame her for not eating that. Behind closed doors I told her to eat and reluctantly, she ate. She will eat, drink, pee and sometimes poop on command.

As far I as researched and read, the only way to diagnose CSD is through a full on liver biopsy and I said no. The vet said that sometimes if the liver is so full of copper that it will spill over into the bloodstream, so her sent a specific blood draw to LSU for analysis. They confirmed she had too much copper in her blood and he then diagnosed it as CSD.

Through all of my research and inquiries on the internet, I came across Voyager dog food which emphasizes no copper sulfate and copper chelate. For some crazy reason, after the 70’s copper sulfate and chelate was added to dog food and the increase of liver injury and CSD deaths rosé substantially. I started conversing with the CEO and he recommended that I talk with the founder of the company who is a vet with 50 yrs experience. He founded the company because his dog died of CSD.

On Thanksgiving morn at 0730, Dr VanVranken calls me with concerns and questions about Freyja. We had a very long discussion and I quoted him four different liver values of >2000- being put on anti copper meds and liver meds- and liver values gradually trending down. I even told him about the specific blood test sent to LSU to identify excess copper in the bloodstream. He stated that with that evidence, Freyja does not have CSD. If she had CSD, there’s no way it would have come down so fast from >2000 to 445. CSD would have taken much longer to trend down. He said she had a significant liver injury of some sort prob due to toxicity. He pretty much discounted the blood test sent to LSU on excess copper in the bloodstream. He did say that this year was a millennial year for acorn dropping and tannin toxicity is higher during these years. Idk….Freyja does not chow down on acorns.

So….what gives?? Maybe a perfect storm of some acorns, a mushroom?? She is always with me, I did not see it. Did someone throw a pack of xylitol gum over the fence??? I just can’t figure it out.

I can tell you this….Be it CSD or acute live injury (@Kswoodssue), Idk.she did have an excess of copper in her liver or else the anti copper meds would not have pulled her ALT liver values down.

We will continue on the vet prescriptions until empty, and get another liver panel in one month. I did order the Voyager food because of the no copper sulfate/chelate and it has a better/cleaner/increased protein % than RC. We are still scheduled to run our first 2mile race together on Dec 16th, so she needs that protein.

She looks fantastic and is doing very well. I thank all for your thoughts and support.
Thanks for the info.! Sorry for all the questions.
 
That honestly sounds very encouraging. I hope the numbers continue to go down until they're normal and life can go back to normal as well.

I'm glad we don't have those mushrooms or acorns around here since these two are constantly grazing on everything they can find in the yard.
 
Trust me, we don't "wait and see" if there's a problem, even without insurance
Good for you! I admit, I do not run to the vet with every vomit. I'm sure I'm not alone. Vomit alone isn't always a sure sign of a serious illness. I do not have insurance. But I'm thinking if I did, maybe I would run at the slightest thing. 🤷‍♀️ I don't know! My vet is also pretty far away. (At least 25 minutes or more) That's why in situations like Freyjas, I like to know the symptoms that prompted a vet visit. It's all a learning process. 👍
 
In summary:
-Nov12 Sun- vomiting and lethargic,
-Nov13 Mon-clay poop and bright urine.
-Nov 15 Wed- to vet- ALT 2300
-Nov 16 at vet not eating- ALT 2100
-Nov 17 at vet diagnosed with CSD, got her to eat food
-Nov 18 at vet upgraded from 50 to 75% recovery potential. ALT 1187
-Nov 19 discharged home on a lot of meds
-Nov 20 doing fine at home
-Nov 22 to vet- liver values down to ALT 445, very spunky acting normal.
-Nov 23 allowing her to run outside and chase ball, outside with me all day. Really have to tame her down some she wants to run all out with the ball. Difficult to slow her down, she wants to go.
Nov 25-present- really no issues, seems back to normal, allowing her to run all out in back yard.

Be it CSD or acute liver injury??

So all in all a good recovery so far, I find it very hard to hold her back when she is overtly looking good.
- coat looks good
- eating and drinking well
- white eyes- not yellowish
- urine is clear, BM is solid and good color
- very energetic and ready to go.

Pretty much off of all the meds sent home by vet except for Denamarin and Zinc- local vet said she will be on this for life. Kinda on the fence with this. The expert CSD vet I talked to from Michigan said she does not have CSD but thinks it’s acute liver injury that caused an inflamed liver thus back up of copper. So trying to figure out how to engage this conversation with local vet as not to bruise his ego and question his diagnosis. So plan is to schedule an appt to see new liver values and hope they are down more and then wait until completely normal before I think about adjust current liver meds.

We went through three cases of RC hepatic wet food and have completely transitioned to Voyager kibble dog food- just better food imo….
 
I was wondering how it was going and I'm glad to hear she's doing well.
CSD vet I talked to from Michigan said she does not have CSD but thinks it’s acute liver injury that caused an inflamed liver thus back up of copper. So trying to figure out how to engage this conversation with local vet as not to bruise his ego and question his diagnosis.
It seems like they guy in MI knows his stuff so hopefully bringing this up with your vet isn't a problem. Our vet constantly communicated with the U when Phoebe was sick so they could be on the same page.
 

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