Hi. What are possible side effects of penicillimine? My mixed breed dog has Chronic hepatitis (asymptomatic), very high liver enzymes, severe copper storage seen in liver biopsy. Vet plans to use penicillimine for chelation therapy and keep feeding homecooked diet. Are organic foods better than nonorg. for less copper? Do you know of a particular water brand with low or no copper? Thank you.
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From Plumb's Veterinary Drug Handbook: In dogs, the most prevalent adverse effects associated with penicillamine are: -Nausea, vomiting, and depression. While penicillamine should be given on an empty stomach (at least 30 minutes before feeding), if the animal develops problems with vomiting or anorexia, four remedies have been suggested: -Give the same total daily dose, but divide into smaller individual doses and give more frequently. -Temporarily reduce the daily dose and gradually increase to recommended dosage. -Give a long-acting antiemetic one-hour before dosing. -Give with a small amount of food (e.g., cheese or bread) if one of the first three do not alleviate vomiting. -Although thought infrequent or rare, fever, lymphadenopathy, skin hypersensitivity reactions, or immune-complex glomerulonephropathy may occur. A case of hemolytic anemia in a cat has been reported. -Penicillamine can reduce GI dietary mineral (zinc, iron, copper, and calcium) absorption and cause deficiencies with long-term use. Pyridoxine deficient states may occur; supplementation advised.
Dietary restriction of copper intake is an important part of therapy but does not replace copper chelation if excessive copper storage is already present. Dietary copper is restricted to <5 mg/kg (ppm, dry matter basis). Most puppy and adult dog foods contain 15-25 mg/kg (ppm, dry matter basis). Prescription hepatic diets contain lower levels of copper. For example, Hills L/D contains 4.9 mg/kg copper (ppm, dry matter basis). Organic diets may or may not have an appropriate copper level - being organic does not necessarily mean it is healthier.
You may want to contact your local municipal authority or water utility company to inquire about mineral contents. Copper level could also be increased if you house uses copper pipes. you can get your water tested. If the water contains more than 100 micrograms per liter, then bottled demineralized water should be used. This water should contain only 1 microgram of copper per liter. Demineralized water and distilled water are processed differently and may not contain the same amount of copper. I am not aware of the specific copper contents of different brands, you may have to call the information number for a specific brand to ask about the copper contents.
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