Renal Glucosuria in a Dog

개에서 신성 당뇨 일례

  • Kang Ji-houn (Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University) ;
  • Cho Min-haeng (Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University) ;
  • Kim Min-jun (Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University) ;
  • Chang Dong-woo (Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University) ;
  • Na Ki-jeong (Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University) ;
  • Yang Mhan-Pyo (Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University)
  • 강지훈 (충북대학교 수의과대학 동물의료센터) ;
  • 조민행 (충북대학교 수의과대학 동물의료센터) ;
  • 김민준 (충북대학교 수의과대학 동물의료센터) ;
  • 장동우 (충북대학교 수의과대학 동물의료센터) ;
  • 나기정 (충북대학교 수의과대학 동물의료센터) ;
  • 양만표 (충북대학교 수의과대학 동물의료센터)
  • Published : 2005.12.01

Abstract

A 2-year-old 16-kg, intact female lindo was presented with weight loss and poor hair coat. Abnormal serum biochemical values included mild hypokalemia (3.9 mmol/L, reference range 4.37 to 5.35 mmol/L) and mild hyperglycemia (124 mg/dl, reference range 65 to 118 mg/dl). in the complete blood count and diagnostic imaging examination, abnormal changes wer not seen. The analysis of urine sample obtained from cystocentesis revealed glucosuria (> 100 mg/dl) and mild proteinuria. Repeated analysis after admission showed persistent glucosuria and hypokalemia. But blood glucose values did not exceed the renal threshold fur glucose reabsorption. To differentiate cause of the glucosuria, the glucose tolerance test and the low-dosage dexamethasone suppression test were indicated. Results of both tests were normal. In addition, the serum total thyroxine $(T_4)$ value was within normal range. The arterial blood gas analysis showed no remarkable changes. The fractional reabsorption rates of amino acids and phosphorus were calculated above $97\%$. Based on these findings, the dog was diagnosed as renal glucosuria due to proximal renal tubular dysfunction. But this persistent renal glucosuria with hypokalemia may be the initial sign of Fanconi's syndrome or proximal renal tubular acidosis.

Keywords

References

  1. Bovee KC, Joyce T, Reynolds R, Segal S. The fanconi syndrome in Basenji dogs: a new model for renal transport defects. Science 1978; 201: 1129-113l
  2. Deinhofer M. Paradoxic glucosuria (Fanconi syndrome) in a bull. Vet Rec 1996; 138: 395-396 https://doi.org/10.1136/vr.138.16.395
  3. Easley JR, Breitschwerdt EB. Glucosuria associated with renal tubular dysfunction in three basenji dogs. J Am Vet Med Assoc 1976; 168: 938-943
  4. Ehrenkranz JR, Lewis NG, Kahn CR, Roth J. Phlorizin: a review. Diabetes Metab Res Rev 2005; 21: 31-38 https://doi.org/10.1002/dmrr.532
  5. Ettinger SJ, Feldman EC. Renal tubular diseases. In: Veterinary internal medicine, 6th ed. St. Louis: Elsevier Saunders. 2005: 1824-1828
  6. Finco DR. Familial renal disease in Norwegian Elkhound dogs: physiologic and biochemical examinations. Am J Vet Res 1976; 37: 87-91
  7. Freeman LM, Breitschwerdt EB, Keene BW, Hansen B. Fanconi's syndrome in a dog with primary hypoparathyroidism. J Vet Intern Med 1994; 8: 349-354 https://doi.org/10.1111/j.1939-1676.1994.tb03249.x
  8. Guillam M-T, Dupraz P, Thorens B. Glucose uptake, utilization, and signaling in GLUT2-null islets. Diabetes 2000; 49: 1485-1491 https://doi.org/10.2337/diabetes.49.9.1485
  9. Hostutler RA, DiBartola SP, Eaton KA. Transient proximal renal tubular acidosis and Fanconi syndrome in a dog. J Am Vet Med Assoc 2004; 224: 1611-1614 https://doi.org/10.2460/javma.2004.224.1611
  10. Kanai Y, Lee WS, You G, Brown D, Hediger MA. The human kidney low affinity $Na^{+}$/glucose cotransporter SGLT2. Delineation of the major renal reabsorptive mechanism for 0glucose. J Clin Invest 1994; 93: 397-404 https://doi.org/10.1172/JCI116972
  11. Kleta R, Stuart C, Gill FA, Gahl WA. Renal glucosuria due to SGLT2 mutations. Mol Genet Metab 2004; 82: 56-58 https://doi.org/10.1016/j.ymgme.2004.01.018
  12. MacEwan NA, Macartney L. Fanconi's syndrome in a Yorkshire Terrier, J Small Anim Pract 1987; 28: 737-742 https://doi.org/10.1111/j.1748-5827.1987.tb01291.x
  13. Melnick JZ, Baum M, Thompson JR. Aminoglycoside-induced Fanconi's syndrome. Am J Kidney Dis 1994; 23: 118-122
  14. Settles EL, Schmidt D. Fanconi syndrome in a Labrador Retriever. J Vet Intern Med 1994; 8: 390-393 https://doi.org/10.1111/j.1939-1676.1994.tb03256.x
  15. Stockham SL, Scott MA. Urinary system. In: Fundamentals of Veterinary Clinical Pathology. Ames: Iowa State Press. 2002: 277-336
  16. 연세대학교 신장질환연구소 편저. 신장학. 서울: 의학문화사. 1999: 84-134