Nephrotic syndrome

From Dog
Peripheral edema associated with nephrotic syndrome in a dog[1]

Nephrotic syndrome is a relatively common urological disease of dogs.

This syndrome has a number of defining clinical features - hypoalbuminemia, proteinuria, hyperlipidemia and interstitial edema[2].

Nephrotic syndrome has been associated with, in order of importance:

It is thought that aberrant renal tubule retention of sodium with resultant increase in hydrostatic pressure or a systemic increase in vascular permeability may be the primary defects responsible for development of interstitial fluid accumulation[10].

Clinically affected dogs usually present with anorexia, lethargy, ventral edema, hypertension and cystitis.

Laboratory analysis of urine usually reveals underlying hypoalbuminemia, high urine protein:creatinine ratios (UPC), proteinuria and increased concentrations of fibrinogen, factors V and VIII, and platelet hyperaggregability[11] associated with hypercoagulable thrombotic complications[12].

Nephrotic syndrome is associated with poorer prognosis in dogs with non-azotemic glomerular disease[13]. resulting in thromboembolic disease and disseminated intravascular coagulation[14].

References

  1. Kosvi
  2. Klosterman ES & Pressler BM (2011) Nephrotic syndrome in dogs: clinical features and evidence-based treatment considerations. Top Companion Anim Med 26(3):135-142
  3. Jaenke RS & Allen TA (1986) Membranous nephropathy in the dog. Vet Pathol 23(6):718-733
  4. Choi EW & Lee CW (2004) Development of canine nephrotic syndrome model. J Vet Med Sci 66(2):169-174
  5. Segev G et al (2012) Renal amyloidosis in dogs: a retrospective study of 91 cases with comparison of the disease between Shar-Pei and non-Shar-Pei dogs. J Vet Intern Med 26(2):259-268
  6. Clements CA et al (1995) Splenic vein thrombosis resulting in acute anemia: an unusual manifestation of nephrotic syndrome in a Chinese shar pei with reactive amyloidosis. J Am Anim Hosp Assoc 31(5):411-415
  7. Vasilopulos RJ et al (2005) Nephrotic syndrome associated with administration of sulfadimethoxine/ormetoprim in a dobermann. J Small Anim Pract 46(5):232-236
  8. Koutinas AF et al (1999) Clinical considerations on canine visceral leishmaniasis in Greece: a retrospective study of 158 cases (1989-1996). J Am Anim Hosp Assoc 35(5):376-383
  9. Font A & Closa JM (1997) Ultrasonographic localization of a caudal vena cava thrombus in a dog with leishmaniasis. Vet Radiol Ultrasound 38(5):394-396
  10. Rondon-Berrios H (2011) New insights into the pathophysiology of oedema in nephrotic syndrome. Nefrologia 31(2):148-154
  11. Green RA et al (1985) Hypoalbuminemia-related platelet hypersensitivity in two dogs with nephrotic syndrome. J Am Vet Med Assoc 186(5):485-488
  12. Abdullah R (1988) Hemostatic abnormalities in nephrotic syndrome. Vet Clin North Am Small Anim Pract 18(1):105-113
  13. Klosterman ES et al (2011) Comparison of signalment, clinicopathologic findings, histologic diagnosis, and prognosis in dogs with glomerular disease with or without nephrotic syndrome. J Vet Intern Med 25(2):206-214
  14. Ritt MG et al (1997) Nephrotic syndrome resulting in thromboembolic disease and disseminated intravascular coagulation in a dog. J Am Anim Hosp Assoc 33(5):385-391