An odd case (involving 2 dogs!) - ideas please!

RE: An odd case (involving 2 dogs!) - ideas please!

Martin Atkinson — Tue, 10 Jan 2017 14:03:14 GMT

[quote user="Hannah Wynne Richards"]

If lead, I'd expect to see signs in RBCs

Wynne

[/quote]I wouldn't use that as a diagnostic test - the dog in my case didn't have any basophilic strippling it was diagnosed on blood lead levels but we'd already started treatment based on history of probable exposure before we got the result. And the dog we had which suffered a life threatening anaemia following onion ingestion didn't have any Heinz bodies. They don't always read the textbooks.

RE: An odd case (involving 2 dogs!) - ideas please!

Hannah Wynne Richards — Mon, 09 Jan 2017 20:43:34 GMT

If lead, I'd expect to see signs in RBCs

Wynne

RE: An odd case (involving 2 dogs!) - ideas please!

Martin Atkinson — Mon, 09 Jan 2017 16:41:19 GMT

[quote user="Anthony Todd"]Duhr, because I've seen it in an old house being done up and it's dangerous to people and it is a possibility and it's sensible to think of all the possibles and then eliminate them.[/quote]I've seen it as well in a dog that chewed the window frames in an old house, twice actually but the owner was switched on enough to realise the significance of this and told me straight away so we were able to get a quick diagnosis/treatment. They didn't give it other weird stuff and and it didn't get Fanconi syndrome!

RE: An odd case (involving 2 dogs!) - ideas please!

Anthony Todd — Mon, 09 Jan 2017 14:35:06 GMT

[quote user="Martin Atkinson"]Why go looking for lead? [/quote]

Duhr, because I've seen it in an old house being done up and it's dangerous to people and it is a possibility and it's sensible to think of all the possibles and then eliminate them.

Vet would look silly if a child becomes involved and the vet didn't mention lead when the dogs had possible symptoms....

RE: An odd case (involving 2 dogs!) - ideas please!

Martin Atkinson — Mon, 09 Jan 2017 14:11:47 GMT

[quote user="Anthony Todd"]

[quote user="grumpyoldman"]Lead poisoning[/quote]

?old paintwork too, or sanded and dust licked off feet etc.

[/quote]Why go looking for lead? They've already admitted giving it mercury, in homeopathic dilution or not, they are clearly nutters and I would have lost the will to spend too much time on this case already. What else have they given they've not admitted to?

RE: An odd case (involving 2 dogs!) - ideas please!

Anthony Todd — Mon, 09 Jan 2017 11:37:24 GMT

[quote user="grumpyoldman"]Lead poisoning[/quote]

?old paintwork too, or sanded and dust licked off feet etc.

RE: An odd case (involving 2 dogs!) - ideas please!

Anna Battek-Kosiorowska — Sun, 08 Jan 2017 15:43:56 GMT

Interesting one. Mercury has been involved here (hopefully only memory of it) but if enough was ingested to cause Fanconi syndrome then where are the other symptoms? No diarrhoea, no neuropathy, no other nasties.

Very interesting. I join the 'jerky treat team' here at this point

RE: An odd case (involving 2 dogs!) - ideas please!

Nicola Lawlor — Fri, 06 Jan 2017 20:39:00 GMT

+1, the "rawhide" may not all have been rawhide perhaps? A well intentioned family member perhaps has given them something assumed to be rawhide.

We've just had a case caused by duck jerky treats, RVC looking into the case further after referral to them.

RE: An odd case (involving 2 dogs!) - ideas please!

Martin Atkinson — Fri, 06 Jan 2017 08:59:17 GMT

[quote user="Andrew Kent"]Frustrating but I would still be most suspicious of a jerky treat that they have forgotten about :-)[/quote]Agreed. Considering the other crap they are giving it I doubt you could rely on an honest answer from them.

RE: An odd case (involving 2 dogs!) - ideas please!

grumpyoldman — Thu, 05 Jan 2017 22:35:00 GMT

sight hounds generally have a very different set of normal numbers to other dogs, the anaemia maybe more significant than you think . possibly worth a smear ? basophilic stipling etc? Chronic Lead poisoning, a bit old hat but still pops up now and again when they accidentally munch on some Lead flashing ? could be worth re visiting the kennelling housing arrangements ??

RE: An odd case (involving 2 dogs!) - ideas please!

Andrew Kent — Thu, 05 Jan 2017 21:31:57 GMT

Hi Chris,

I agree that there are various other toxins that have been associated with acquired Fanconi but in the absence of a known ingestion I would probably give it a few weeks on a good quality diet before going further.

The trouble with heavy metals is that serum levels are not always a reliable way of measuring tissue levels so investigating that possibility can be easier said than done.

Do keep us posted with how things progress

Andy

RE: An odd case (involving 2 dogs!) - ideas please!

ChrisBVSc — Thu, 05 Jan 2017 18:55:28 GMT

Thanks Andy!

So just as a final question for now, is it probably not worth pursuing the possibility of heavy metal testing? (More to the point, would there be anything you could even do about it by now?) I only mention this because the BSAVA clin path manual lists heavy metals as a possible cause of acquired Fanconi's.

Otherwise should I be looking at follow up bloods & urine over the next couple of weeks, then considering more advanced testing for Fanconi's if no improvement?

RE: An odd case (involving 2 dogs!) - ideas please!

Andrew Kent — Thu, 05 Jan 2017 17:55:26 GMT

Hi Chris,

Frustrating but I would still be most suspicious of a jerky treat that they have forgotten about :-)

The cases I have dealt with have started to improve quite quickly (over a week or so) once the treat has been discontinued.

If the changes persist then it's worth submitting the samples to prove Fanconi and then potentially treating. There is an established treatment protocol for that disease called the Gonto protocol which you can easily find through google!

Andy

RE: An odd case (involving 2 dogs!) - ideas please!

ChrisBVSc — Thu, 05 Jan 2017 17:18:10 GMT

By the way - that should actually say 10 to the power of 32 molecules of water in the swimming pool, not 1032!!

RE: An odd case (involving 2 dogs!) - ideas please!

ChrisBVSc — Thu, 05 Jan 2017 17:17:00 GMT

Thanks for all the replies.

Just spoken to the owner, unfortunately (for the purposes of reaching a diagnosis) there is no known history of jerky-based treats. They occasionally get rawhide chews, & usually eat Aldi mixer with added 'human' meats. Also, they've occasionally had a dose of a homeopathic remedy from Dorwest called 'merv-viv' which is actually derived from mercury, but according to the website is a 15C dilution. To quote wikipedia, " There are on the order of 1032 molecules of water in an Olympic-size swimming pool and if such a pool were filled with a 15C homeopathic preparation, to have a 63% chance of consuming at least one molecule of the original substance, one would need to swallow 1% of the volume of such a pool, or roughly 25 metric tons of water." So unless something has gone wrong in manufacturing, this seems an unlikely cause!!

Getting them in tomorrow to check electrolytes as didn't do this originally (wasn't expecting this outcome!).

So still a bit of a mystery.

For the similar cases above, did you put the dogs onto renal diets? The owner seems very keen on increasing their protein intake in an attempt to regain weight, but I'm not so sure this is such a good idea at the moment?

RE: An odd case (involving 2 dogs!) - ideas please!

Roland Bulkyn-Rackowe — Thu, 05 Jan 2017 16:05:01 GMT

I have seen two, one three years ago was straight after starting a new diet with sweet potato (country of origin unknown), the other last year after eating dried Jerky treats. Other than problems with thirst and house soiling both recovered after a couple of months.

RE: An odd case (involving 2 dogs!) - ideas please!

Rob Davis — Thu, 05 Jan 2017 15:23:07 GMT

[quote user="Andrew Kent"]PS not always obvious the treats come from China - but anything of a jerky type possible. Often from discount stores. [/quote]

I had one a couple of years ago, suspect was caused by chicken jerky treat from Home Bargains - the packaging didn't specify where it came from and when I tried to get more information from Home Bargains they were less than helpful...

Diagnosis was confirmed with fractional excretions done at Penn (need to send frozen urine sample so is fairly expensive). Dog has recovered well and seems to have no ongoing renal issues.

RE: An odd case (involving 2 dogs!) - ideas please!

Andrew Kent — Wed, 04 Jan 2017 21:54:20 GMT

PS not always obvious the treats come from China - but anything of a jerky type possible. Often from discount stores.

Andy

RE: An odd case (involving 2 dogs!) - ideas please!

Andrew Kent — Wed, 04 Jan 2017 21:52:51 GMT

Hi Chris,

Fanconi-like syndrome can be confirmed by looking at urine excretion ratios (initially of electrolytes then of amino acids if compatible). You can run this through CTDS or Pennsylvania.

That disease can be variable in how it presents in terms of severity of electrolyte imbalance (Potassium, phosphate, bicarb).

Most of the jerky cases in this country have resolved with discontinuation of the treat, but there have been some deaths.

Youll see lots of info on this from the USA if you google it. There is also a registry running via VPIS.

we did have a previous thread on this but can't find it now!

Andy

RE: An odd case (involving 2 dogs!) - ideas please!

ChrisBVSc — Wed, 04 Jan 2017 21:44:20 GMT

[quote user="Clare Tapsfield-Wright"]

No fruit cake gone awol over Christmas ? Raisins ? Just a thought.

[/quote]

Nothing like that has come to light so far on questioning. But.. What I'm finding a bit odd is the fact we've got normal urea & creatinine, and highly concentrated SG, in both dogs. They are both symptomatic however with poydipsia and obviously losing weight (the smaller dog is looking worryingly thin). Wouldn't raisins generally result in a more "classic" renal failure presentation rather than this Fanconi-like disorder?

More owner questioning tomorrow - and will definitely ask about any Chinese jerky treats as well as anything else that could affect the kidneys.

RE: An odd case (involving 2 dogs!) - ideas please!

Clare Tapsfield-Wright — Wed, 04 Jan 2017 21:08:25 GMT

No fruit cake gone awol over Christmas ? Raisins ? Just a thought.

RE: An odd case (involving 2 dogs!) - ideas please!

ChrisBVSc — Wed, 04 Jan 2017 20:32:07 GMT

Thanks Andy - very interesting I hadn't come across that one yet. Do we know why these jerky treats are causing it??

What I'm really trying to establish at the moment is 1) Is it worth me running any further tests and if so in what order, and 2) is there anything I can actually do about this??

Many thanks,

Chris.

RE: An odd case (involving 2 dogs!) - ideas please!

Andrew Kent — Wed, 04 Jan 2017 19:36:27 GMT

Hi Chris,

sorry this is brief as on phone but most common cause of acquired fanconi is now jerky treats coming from China so would start by asking carefully about what the dogs have been given recently.

Perhaps a Christmas present?

Andy