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Fanconi Syndrome

 

Hello to all Basenji Owners,

 

I am happy to report that a large number of you are doing routine strip testing of your pets on a monthly basis and a lot of the new Fanconi cases we have had recently have been found very early and are thus much easier to treat. My kudos go out to all of you who are testing and all who are so successfully treating your Fanconi afflicted little companions. My thanks likewise, go out to the INCREDIBLE work of publications like this, who have been increasing awareness of, and promoting education about testing and treatment for this disease.

 

I have been surprised lately at the numbers of NON Basenji dogs and other animals we now have under treatment, but as veterinarians have become increasingly familiar with Fanconi, I believe they are now making the correct diagnosis in more and more cases.

 

I enjoyed meeting a number of you at the 2002 Basenji Nationals, as I look forward to being a health speaker at the 2003 Nationals.

 

At the 2002 Nationals, I met with the Basenji Health Committee and at that time an issue was raised, where some of the members were concerned that I held a different idea then they about Fanconi. It took only a minute to realize that we were ALL on the "same page" about it, but that because of wording and semantics in past write ups, I may have fostered some misunderstanding about the disease. Let me clear this up right now.

 

We always define Fanconi by the Glucosuria (positive urine glucose) in the absence of increased blood glucose. In the past I have used the words "we then CONFIRM the diagnosis by using the blood gas." This is the point where some people have become confused. I am sorry about that. The fact is, the next step after finding positive urine glucose with normal blood glucose, IS diagnostically, indeed a blood gas. A venous blood gas, showing loss of bicarbonate makes the diagnosis pretty concrete and also gives us the bicarbonate loss levels we need to know to institute appropriate therapy. Having said this, however, a blood gas which comes back NORMAL does NOT mean the dog does not have Fanconi. There are VERY few other problems that can cause the loss of glucose in the urine like this, and thus the operative diagnosis of Fanconi STILL REMAINS IN EFFECT.

 

In this age where people are performing routine urine strip testing, we are finding more and more dogs early, and thus before any significant change has occurred in their acid/base status. This is GOOD news for treatment, but it does not change the fact that these dogs have Fanconi. Other problems, like infection, or tumors CAN cause loss of glucose in the urine, but these are rare and will develop into other symptoms in short order.

 

I have heard the "stories" of some dogs supposedly spilling sugar in the urine but progressing no further. I am here to say that in the many hundreds and hundreds of dogs who I have been presented with over the last fifteen years, I have seen only THREE that met this criteria. Induced Fanconi (caused by ZINC toxicity or exposure to certain pesticides or outdated antibiotics) can be "self limiting" and progress no further, IF the toxic agent are removed from the dogs environment. These cases are, I think, pretty rare also. Veri Kennels no longer have Zinc screws, Zinc is not present in Chicken Wire or fencing as it used to be, Tetracycline is not a common antibiotic anymore...etc.

 

For the most part, if a dog has the urine sugar and normal blood sugar, it should be considered to have Fanconi unless proven otherwise. The terms "Idiopathic Glucosuria" or "Primary Glucosuria" which I have heard tossed around, are really silly names given to conditions to sound "medically important," when all they really mean is "we don't know what is causing this." Negative medical events do NOT happen without "pathology." In-other-words, you do NOT spill sugar without something being WRONG in the kidney. Period.

Thankfully, Fanconi has proven manageable for extended periods of time in many, many dogs. Thus, I think we should be honest in recognizing when we have a dog with the disease and not try to pretend it is something else then what it is, when we have the symptoms or findings occur. Dogs spilling sugar should simply not be bred by conscientious breeders.

 

I hope and pray that we will soon have a genetic test for Fanconi and can breed this disease out of existence forever. In the meantime, I will keep assisting all of you as best as I can, with the information needed to manage your beloved little companions with the superb care and incredible level of compassion and skill with which you have done so over these last fifteen years.

Keep up the great work.

 

Steve Gonto, MMSc, PhD, Medical Science, Author, Fanconi Management Protocol for Veterinarians

 

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