Case Report: MRI Diagnosis of Wilson's Disease in a 3-Year-Old Dalmatian

A 3-year-old Dalmatian was presented with anorexia, vomiting, and lethargy that progressed to neurological signs with a mixed hepatopathy. MRI identified bilaterally symmetric, ill-defined hyperintensities in the thalamus, medial and lateral geniculate bodies, and red nuclei on T2-weighted (T2W) and transverse T2W fluid-attenuation inversion-recovery (T2-FLAIR) images, and bilaterally symmetric, ill-defined T1-hyperintensities in the lentiform nuclei and thalamus suggestive of an underlying metabolic dysfunction. Systemic workup revealed an underlying hepatopathy. A hepatic biopsy revealed severe copper-associated hepatitis with a digital copper quantification of 3052 µg/g dry weight. Clinical signs and MRI changes both improved following chelation therapy. The MRI findings and hepatic biopsy results led to a diagnosis of copper storage hepatopathy, consistent with Wilson's disease. This is the first description of brain MRI findings secondary to Wilson's disease in dogs.