Based on interviews with Dr. Steve Gonto of Savannah, Georgia, Professor of Anesthesiology and Critical Care Medicine (human) and the developer and author of the "Fanconi Management Protocol for Veterinarians."
Description of Fanconi Syndrome and its Control
In this condition, the renal tubules of the kidney begin to fail to do their proper job of resorbing nutrients into the dog's system. Without testing and subsequent oral supplementation, the dog's internal organs begin to falter, the dog looses condition, and will ultimately die. With current supplementation techniques, a Fanconi-afflicted dog can often be expected to live a reasonably normal, healthy life-span.
A dog with Fanconi Syndrome may, however, acquire any other health problems that dogs may get, as well as potentially being at higher risk for some disorders such as GME, a multi-site brain cancer. Not all Fanconi dogs do develop other problems, though, and the link to other disorders such as GME is still unknown.To use a far-oversimplified analogy, Fanconi is as if the renal tubules of the kidneys had become "leaky sieves," and the dog loses buffers, protein, glucose, amino acids, water-soluble vitamins and other things necessary for good health into the urine instead of passing them into the body for proper utilization. Left untreated, the dog's acid/base blood balance will go off and begin to compromise internal organs, the dog will lose condition and musculature, and the dog will slowly die.
The "control" is to feed the missing nutrients back to into the dog in the form of inexpensive supplements according to instructions in the Fanconi Protocol for Veterinarians.
The supplements used include: buffers (sodium bicarbonate tablets), protein (high-protein diet), glucose (more frequent feedings), amino acids (Amino Fuel), vitamins and minerals (Pet-Tabs and Centrum vitamins), calcium/phosphorus (dicalcium phosphate powder or Pet-Cal), potassium (Tumul-K, Uricit-C or potassium Gluconate). Some of these supplements will stay in the body and keep the dog stable and healthy during its nearly full lifetime.
Occurrence
Fanconi can be acquired by any mammal (including all breeds of dogs, cats, horses and people) via either genetics or pharmacological induction.
Mode of Acquisition
The mode of acquisition of Fanconi Syndrome is thought to be genetic in Basenjis, and the exact mode of genetic inheritance is still under active study. Fanconi can also be induced in mammals via a number of routes such as ingestion of zinc or outdated antibiotic use.
Onset
In Basenjis, the usual age of onset is four to eight years of age, but has been discovered as early as age 1-1/2 and as late as age sixteen.
Identification
Glucose (sugar), and other nutrients and buffers spill into the dog's urine from the faltering renal tubule system of the kidneys; however, the dog will be found to have a normal to low BLOOD glucose. This condition may be mistaken for diabetes and disastrously mistreated. Blood glucose would be HIGH in diabetes.
A dog's urine can easily and inexpensively be checked for glucose with glucose test strips found at any drugstore in the diabetic supplies section. This form of testing can pick up oncoming Fanconi Syndrome well before any of the overt symptoms appear. Overt symptoms are: frequent urination, excessive water-drinking, and loss of weight and condition. Early detection means easier treatment and less permanent damage.
Glucose test stripping at one-month intervals is highly recommended for Basenjis of any age, and for a dog of any breed suspected of having Fanconi Syndrome. Simply hold the glucose testing stick (or diabetic test tape) under the dog's urine, remove, and wait the appropriate amount of seconds. Report any abnormalities in color to your veterinarian and have him do a blood glucose test. If the dog is spilling glucose in the urine and the blood glucose test reading is normal to low, a presumptive diagnosis of Fanconi Syndrome may be made. A subsequent venous blood gas analysis should confirm this diagnosis and tell you the status of the disease process.
Outlook
The outlook is exceptionally good with early detection and treatment. This condition can now be controlled but not cured.
Treatment
Approximately every six to eight months, a multivalent blood workup, a urinalysis, and a venous blood gas test need to be done on a Fanconi-afflicted dog by your veterinarian. Based on the dog's individual tests, appropriate, individually-tailored, and easily-obtainable nutrients are included with the dog's daily meals. These oral supplements resupply the nutrients which the tests identify as being lost in the urine.
Fanconi Management
Protocol for Veterinarians
Be sure to print out a copy of the Fanconi Protocal for your veterinarian. The Protocol is self explanatory. If, however, you or your veterinarian, are not on-line, you can obtain a copy of the protocol by writing Dr. Steve Gonto, 1 Savy Lane, Savannah, Georgia 31411 or calling Dr. Gonto at (912) 598-5067.
It is not necessary to send your dog’s individual test results to Dr. Gonto, but he is available for consultation by veterinarians or owners via e-mail (most preferred) at outdoc@aol.com, or by telephone and U.S. mail, if problems should arise.
Predictive Tests
On July 14, 2007, the Basenji Health Endowment reported that Dr. Gary Johnson of the University of Missouri has released the linked marker DNA test for Fanconi Syndrome in Basenjis. While this is not a direct test which identifies the exact gene responsible for a specific condition and is not claimed to be 100% accurate, accuracy appears to be fairly high. Research for a direct test is still ongoing, but this test is a very important first step in identifying carriers, afflicted and indeterminates for Fanconi Syndrome in Basenjis and is available now. More information for the test can be found at: http://www.basenjihealth.org/linkage-faq.html and http://www.basenjihealth.org/bhe071207.pdf
Support Group
If your dog becomes actively Fanconi-afflicted, you might benefit from joining the e-mail support group for owners of Fanconi-afflicted dogs. To join the list, write to: fanconidogs-owner@yahoogroups.com.
Ongoing Fanconi Syndrome
Treatment Research
Dr. Steve Gonto
1 Savy Lane
Savannah, Georgia 31411
e-mail: outdoc@aol.com
phone: (912) 598-5067
Article copyright © 2004 by Betsy Polglase.
All rights reserved