Reduced renal status – Fanconi syndrome
Rarer syndromes sometimes appear in the clinic. Recently, we had a patient admitted who had been asked the diagnosis of Fanconi syndrome at another clinic – but they lacked some of the specialized equipment to follow it up – and so it ended up in our hands. I will return to this patient later in the post.
Table of contents
Fanconi syndrome is a condition in which the dog's kidney condition is reduced and this results in an altered reabsorption of glucose, amino acids, bicarbonate, potassium and phosphate, among other things. This can have serious consequences if left untreated. The acid-base regulation becomes unbalanced because the kidneys excrete important electrolytes which are essential to keep this in balance.
Pees and drinks a lot
The main reason that the owner notices something is wrong is because the dog is urinating and drinking a lot. This is called polyuria and polydipsia in the medical language. If you suspect this – it is important to contact a veterinarian who can investigate the cause of this.
Can affect all breeds
Reduced kidney function can be hereditary in some breeds – such as the Basenji, Shiba Inu and other small breeds. However, it is more common for it to be acquired and can therefore affect all breeds. The mechanism behind this disease is not well known – but it is believed that there is a connection between Fanconi syndrome and dried treats. Common to the reports that show this connection is that the treats are made of dried chicken, duck or sweet potato and are imported from Asia. This type of acquired disease has been shown to be mostly transient – to varying degrees. It can last from a few weeks to several months – but some can also have permanent kidney damage.
Some common symptoms and signs of Fanconi syndrome in dogs include:
- Increased thirst (polydipsia): The dog will drink more water than normal due to increased excretion of water in the urine.
- Increased urination (polyuria): Frequent urination often follows increased thirst.
- Sugar in the urine (glucosuria): Fanconi syndrome causes glucose (sugar) to leak into the urine – which can be detected by urine tests.
- Thinner dogs: Due to the loss of nutrients and electrolytes in the urine, the dog may gradually lose weight and become thinner.
- Electrolyte imbalance: Low levels of potassium (hypokalemia), low phosphorus and metabolic acidosis can also occur in dogs with Fanconi syndrome.
- Dehydration: Due to increased urination and loss of electrolytes, dehydration can be a problem.
Our patient Nelly
Now back to our patient Nelly – a small 4 year old dog who suddenly had her world turned upside down. Her owner noticed that she had started to urinate and drink large amounts. She was referred from another local clinic to NMBU in Oslo – but was eventually discharged from there to return home to her owners who live in Larvik.
Since a large part of both diagnosis and monitoring involves measuring blood gas values, the dog was referred to us here at A-Vet as we have the necessary equipment for this. Like thousands of other FS patients, Nelly had also been given dried chicken treats. Unfortunately, there was one thing that made her situation extra complicated – Nelly was pregnant when the diagnosis was made. It was uncertain for a long time whether she would be able to go through a birth and not least be a nursing mother as this requires a lot of energy.
Brave little puppy
Nelly had reduced general condition – drinking and urinating large amounts when she came to us. She was initially on intravenous fluids every day – but we saw that she was gradually managing more and more on her own. The weeks passed and the tests fortunately looked better and better. Although a planned cesarean section would have been the safest option for Nelly, for several reasons she had to go through a normal birth. A 24-hour clinic was ready to assist if complications arose. She made it through the birth without any problems – but the puppy was unfortunately stillborn.
Nelly was very brave after the loss of the puppy and is now almost completely back to her old self. The latest tests have also shown that Nelly is now almost completely healthy. We must therefore say that this turned out to be an ever so small sunshine story after all!
