Copper-associated hepatic cirrhosis in a Friesian horse.

A six-year-old Friesian stallion suffered from exercise intolerance, stiff gait, hind weakness, and increased liver enzymes due to a substantial amount of copper accumulating in the liver, ultimately leading to severe cirrhosis and Heinz body anaemia. Although the cause of the copper accumulation could not be determined, the study suggests considering such a condition when trying to diagnose hepatic cirrhosis and Heinz body anaemia in horses.

Study Presentation

• The study focuses on a specific case of a Friesian stallion showing signs of disease related to liver malfunction. The symptoms included exercise intolerance, stiff gait, symmetrical hind weakness and increased liver enzymes observed through blood tests.
• The horse also showed muscle atrophy in its hindquarters. However, there were no neurological disturbances identified.
• Lab tests revealed prolonged prothrombin time (time taken for blood to clot) and increased levels of specific indicators related to liver function and disease such as alkaline phosphatase, aspartate aminotransferase, gamma-glutamyl-transferase, lactate dehydrogenase and bile acids.

Diagnosis and Outcome

• Further histological examination of the liver showed severe cirrhosis, a late stage of scarring of the liver caused by many forms of liver diseases.
• A unique observation was the presence of intracytoplasmic greyish brown granules in almost all hepatocytes, sinusoidal Kuppfer cells, and macrophages. These granules stained strongly for copper, indicating abnormal accumulation of copper in the liver.
• Unfortunately, a haemolytic crisis occurred in the horse following diagnosis and prognoses of the liver disease were poor. This led to the decision by the horse’s owners to have it euthanized.

Implications of the Study

• Although the cause of excessive copper accumulation in the liver was not determined, this study draws attention to the potential of such a condition affecting the health of horses and perhaps other animals too.
• From a diagnostic point of view, this report suggests that abnormal copper accumulation could be a factor to consider when diagnosing conditions such as hepatic cirrhosis and Heinz body anaemia in horses.