GSD with Calcinosis circumscripta

Re: GSD with Calcinosis circumscripta

Rebecca MacMillan — Thu, 26 May 2011 15:33:41 GMT

Update - Renal parameters didn't really improve despite being on IV fluids for nearly 3 days. Decided to send the dog home on Friday with a poor prognosis, thought she may as well have spend her final days at home given that hospitalisation wasn't helping her much. The dog was brought back in today for euthanasia as she had gone downhill. She had gone lame on her left fore now as well and wasn't really eating.

Interesting case, but I still can't find much info on the link between renal disease and calcinosis circumscripta in GSDs, other than it seems to exist...

Re: GSD with Calcinosis circumscripta

Rebecca MacMillan — Thu, 19 May 2011 17:31:30 GMT

Thanks everyone for your replies. She did eventually urinate yesterday, but it was overnight and all soaked into the newspaper so couldn't sample it! We managed to get a urine sample via ultrasound guided cysto today though, which showed an SG of 1.010 and was otherwise unremarkable. We also performed an ultrasound scan of both kidneys, the left measured 7.07cm and the right was 6.67cm in length. No cystic structures were noted, but possibly a bit of subtle speckling in the cortex of the right kidney? But as I said before, none of us here are expert ultrasonographers so we may not pick up on subtle changes. I was thinking along similar lines as Vincent - address the renal disease initially.

There just doesn't seem to be alot of information out there on this condition!

Re: GSD with Calcinosis circumscripta

Vincent Wager — Thu, 19 May 2011 16:48:41 GMT

I think as the others I would be most worried regarding the renal parameters. Urine specific gravity is needed ideally. The mass on the thigh is unlikely to be resectable and even if it was it is likely she is in chronic renal failure. If the renal parameters improved after fluid therapy and USG showed concentrating ability then further investigation may be warranted otherwise concentrating on the kidneys for now may be better. If you have access to in house protein:creantinine ratio then may be worth checking which would be fairly cost effective and also would be worth performing a culture and sensitivity as often CKD tends to have concurrent UTI. Otherwise renal diets, phosphate binders etc may improve and slightly extend quality of life.

Re: GSD with Calcinosis circumscripta

Ruta — Thu, 19 May 2011 13:30:54 GMT

First of all, I would try to get urine sample and to see is any changes in there. Elevated AMYL blood levels can indicate kidney disease, especially with high CREA.

So, I would think about renal mineralization. And of course ultrasound would be the first of choice for further investigation.

Good luck.

Ruta

Re: GSD with Calcinosis circumscripta

Andrew Kent — Thu, 19 May 2011 09:09:27 GMT

I think I would be most worried by the high renal parameters initially, an ultrasound would certainly be helpful there.

You could also investigate the hypercalcaemia (iCa/PTH/PTHrP) but there is a fair cost associated with that.

How are the renal parameters looking now? Survey radiographs may be useful to see if there is evidence of mineralisation of other tissues.

My feeling is that this may be difficult to manage on a tight budget!

Andy

Re: GSD with Calcinosis circumscripta

Richard Fox — Wed, 18 May 2011 20:56:06 GMT

Solitary calcinosis circumscripta is unlikely to be caused by renal disease. Althought this disease is idiopathic and generally occurs on growing medium and large breed dogs it can be seen in any dog at any age and the second most common side apart from the limbs is the tongue. If no other lesions are present I doubt it is of renal origin if it truely had the morphology of CC rather than true connective tissue mineralisation (i.e. lakes of mineral surrounded by numerous macrophages). I have heard they regress but we rarely get follow up - most are solitary but some are multifocal.

However the renal parameters are a little concerning esp the Crea! Were these values repeatable after any dehydration was corrected? I would think if the calcium and phos are normal they are unlikely to cause CC? If the renal params are still present I would investigate for renal disease?