Ammonium tetrathiomolybdate treatment of copper‐associated hepatopathy in dogs

Abstract Background Copper‐associated hepatopathy (CAH) is a common cause of liver disease in dogs. Although d‐penicillamine can be an effective treatment, some dogs fail treatment or develop adverse effects. Ammonium tetrathiomolybdate (TTM) has been used to treat pathologic copper accumulation in...

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Main Authors: Daniel K. Langlois, Janice R. Querubin, William D. Schall, Nathan C. Nelson, Rebecca C. Smedley
Format: Article
Language:English
Published: Wiley 2019-05-01
Series:Journal of Veterinary Internal Medicine
Subjects:
Online Access:https://doi.org/10.1111/jvim.15474
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author Daniel K. Langlois
Janice R. Querubin
William D. Schall
Nathan C. Nelson
Rebecca C. Smedley
author_facet Daniel K. Langlois
Janice R. Querubin
William D. Schall
Nathan C. Nelson
Rebecca C. Smedley
author_sort Daniel K. Langlois
collection DOAJ
description Abstract Background Copper‐associated hepatopathy (CAH) is a common cause of liver disease in dogs. Although d‐penicillamine can be an effective treatment, some dogs fail treatment or develop adverse effects. Ammonium tetrathiomolybdate (TTM) has been used to treat pathologic copper accumulation in other species, but its therapeutic potential for CAH is unknown. Objectives To investigate short‐term safety and efficacy of TTM for treatment of CAH. Animals Ten dogs with CAH. Methods Prospective study. All dogs were treated with TTM PO for 6 weeks, and hepatic biopsies were performed after the treatment course. Dog experiencing initial decreases in hepatic copper concentrations ([Cu]H) received 6 additional weeks of TTM treatment and underwent 1 additional biopsy. Physical and laboratory examinations were performed every 2 weeks for study duration. Results Eight of 10 dogs had decreases in [Cu]H. Compared to baseline (median, 1606 μg/g; range, 572‐5158 μg/g), [Cu]H were decreased at 6 weeks (1033 μg/g, 450‐2975 μg/g; P = .04) and 12 weeks (931 μg/g, 218‐1677 μg/g; P = .02). Hepatic molybdenum concentrations increased >50‐fold (P < 0.001). Changes in histologic scores and hematologic and biochemical test results were variable and not significantly different from baseline. One dog developed presumed immune‐mediated anemia and thrombocytopenia, but it was unclear if this was related to TTM administration. Conclusions and Clinical Importance Results suggest that TTM can effectively decrease [Cu]H in some dogs with CAH. Larger studies are needed to determine the overall safety and efficacy of TTM for treating CAH and how it compares with current treatments.
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spelling doaj.art-b2da66a11dc543449b8492ab30d69d122022-12-22T00:24:05ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762019-05-013331336134310.1111/jvim.15474Ammonium tetrathiomolybdate treatment of copper‐associated hepatopathy in dogsDaniel K. Langlois0Janice R. Querubin1William D. Schall2Nathan C. Nelson3Rebecca C. Smedley4Department of Small Animal Clinical Sciences College of Veterinary Medicine, Michigan State University East Lansing MichiganDepartment of Small Animal Clinical Sciences College of Veterinary Medicine, Michigan State University East Lansing MichiganDepartment of Small Animal Clinical Sciences College of Veterinary Medicine, Michigan State University East Lansing MichiganDepartment of Small Animal Clinical Sciences College of Veterinary Medicine, Michigan State University East Lansing MichiganVeterinary Diagnostic Laboratory College of Veterinary Medicine, Michigan State University East Lansing MichiganAbstract Background Copper‐associated hepatopathy (CAH) is a common cause of liver disease in dogs. Although d‐penicillamine can be an effective treatment, some dogs fail treatment or develop adverse effects. Ammonium tetrathiomolybdate (TTM) has been used to treat pathologic copper accumulation in other species, but its therapeutic potential for CAH is unknown. Objectives To investigate short‐term safety and efficacy of TTM for treatment of CAH. Animals Ten dogs with CAH. Methods Prospective study. All dogs were treated with TTM PO for 6 weeks, and hepatic biopsies were performed after the treatment course. Dog experiencing initial decreases in hepatic copper concentrations ([Cu]H) received 6 additional weeks of TTM treatment and underwent 1 additional biopsy. Physical and laboratory examinations were performed every 2 weeks for study duration. Results Eight of 10 dogs had decreases in [Cu]H. Compared to baseline (median, 1606 μg/g; range, 572‐5158 μg/g), [Cu]H were decreased at 6 weeks (1033 μg/g, 450‐2975 μg/g; P = .04) and 12 weeks (931 μg/g, 218‐1677 μg/g; P = .02). Hepatic molybdenum concentrations increased >50‐fold (P < 0.001). Changes in histologic scores and hematologic and biochemical test results were variable and not significantly different from baseline. One dog developed presumed immune‐mediated anemia and thrombocytopenia, but it was unclear if this was related to TTM administration. Conclusions and Clinical Importance Results suggest that TTM can effectively decrease [Cu]H in some dogs with CAH. Larger studies are needed to determine the overall safety and efficacy of TTM for treating CAH and how it compares with current treatments.https://doi.org/10.1111/jvim.15474chelationcopper toxicosishepatitisLabrador Retrieversmolybdenum
spellingShingle Daniel K. Langlois
Janice R. Querubin
William D. Schall
Nathan C. Nelson
Rebecca C. Smedley
Ammonium tetrathiomolybdate treatment of copper‐associated hepatopathy in dogs
Journal of Veterinary Internal Medicine
chelation
copper toxicosis
hepatitis
Labrador Retrievers
molybdenum
title Ammonium tetrathiomolybdate treatment of copper‐associated hepatopathy in dogs
title_full Ammonium tetrathiomolybdate treatment of copper‐associated hepatopathy in dogs
title_fullStr Ammonium tetrathiomolybdate treatment of copper‐associated hepatopathy in dogs
title_full_unstemmed Ammonium tetrathiomolybdate treatment of copper‐associated hepatopathy in dogs
title_short Ammonium tetrathiomolybdate treatment of copper‐associated hepatopathy in dogs
title_sort ammonium tetrathiomolybdate treatment of copper associated hepatopathy in dogs
topic chelation
copper toxicosis
hepatitis
Labrador Retrievers
molybdenum
url https://doi.org/10.1111/jvim.15474
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AT williamdschall ammoniumtetrathiomolybdatetreatmentofcopperassociatedhepatopathyindogs
AT nathancnelson ammoniumtetrathiomolybdatetreatmentofcopperassociatedhepatopathyindogs
AT rebeccacsmedley ammoniumtetrathiomolybdatetreatmentofcopperassociatedhepatopathyindogs