Troublesome case - is it Fanconi's syndrome

Re: Troublesome case - is it Fanconi's syndrome

Vikki Halliday LLB — Sat, 15 May 2010 00:36:17 GMT

[quote user="Bob Russell"]Not unless uripets come ready contaminated!!![/quote]

Oh but the mind boggles at the answer to that one!

Re: Troublesome case - is it Fanconi's syndrome

Bob Russell — Fri, 14 May 2010 18:08:24 GMT

Not unless uripets come ready contaminated!!!

Re: Troublesome case - is it Fanconi's syndrome

Rob Davis — Fri, 14 May 2010 17:04:16 GMT

[quote user="Bob Russell"]urine sample collected by owner showed glucose+++ strong bilirubin trace of protein.[/quote]

I'm sure you've considered this already, but if the owner-collected sample contained lots of glucose, and subsequent sample did not, have youd considered contamination, eg the old jam jar used as collection pot?!

Re: Troublesome case - is it Fanconi's syndrome

Bob Russell — Thu, 13 May 2010 16:42:45 GMT

Potassium normal every time we have blood tested. bicarb normal.

My worry is that the glucosuria is a red herring and I am missing something else!

I would love to refer this one but the owner is not particularly keen! Thanks for the help.

Re: Troublesome case - is it Fanconi's syndrome

Bob Russell — Thu, 13 May 2010 16:25:11 GMT

Great reply - thanks - we suspect tubular disease and are running tests above as I type!!! Will update as we get further results.

We had a 3 years old Labrador with Fanconis a number of years ago - we gave grave warnings about renal failure etc but for reasons best known to Mother Nature the glucosuria went away after a year of close monitoring. She now lives in Florida and is grossly overweight but very happy!!!

I suspect this is not Fanconis but renal disease. The dog was given antibiotics and infection may explain the 'improvement' in the urine.

Re: Troublesome case - is it Fanconi's syndrome

Ian Battersby — Thu, 13 May 2010 16:09:51 GMT

Hi Robert,

Glucosuria in the face of normoglycemia does suggest a tubular disorder.

Your main 2 differentials would be fanconis or Primary renal glucosuria.

Renal glucosuria is when the kidneys are essentially only loosing glucose inappropiately the rest of the renal function is fine. Some dogs can be PUPD but some can be assymptomatic but they are prone to recurrent UTI's. these dogs are generally fine and only.So in those cases regular culture culture sediments are all that are idicated. However a patient could initially present with only glucosuria and progress to fanconi

Fanconi - you can get a variety of different losses ranging from HCO3, Na, K to some amino acids.

Given the glucosuria - culture and sediment on urine is indicated incase of UTI e.g. pyelo in absence of lower urinary signs

Are there any other electrolyte abnormalities - that would increase the suspicion of fanconis. e.g. hypokalaemia which could help account for the weakness

Are you able to check Blood bicarbonate levels - this can occur in fanconi pateints and the patient would be acidotic

A fractional excretion of electrolytes would be required to further assess tubular function to fully assess the possibility of fanconis.

However to completely throw you a curve ball. It could be this dog has an assymptomatic primary glucosuria and is a red herring

Apologies for the rather rushed reply

All the best

Ian Battersby