Presumed masitinib-induced nephrotic syndrome and azotemia in a dog

Masitinib mesylate is a tyrosine-kinase inhibitor approved for the treatment of nonresectable or recurrent, Grade 2 or 3 mast cell tumors in dogs. This report describes nephrotic syndrome and acute kidney injury attributed to masitinib and illustrates the need for regular monitoring of serum creatinine concentration, urinalysis, and urine protein:creatinine ratio during its use.

Severe chemosis caused by nephrotic syndrome in a goat: a case report

A 3-year old female goat with nephrotic syndrome was presented because of severe bilateral chemosis. The diagnosis was based on clinical findings, decreased packed cell volume, increased serum urea and creatinine, decreased serum protein and protein loss via the urinary tract. At post mortem examination, a chronic glomerulonephritis and interstitial nephritis were found. In addition to severe conjunctival oedema, ascites and subcutaneous oedema in the region of the larynx were noted. Immunohistochemistry for the detection of chlamydial antigen in the conjunctiva was negative. This is the first report of severe chemosis caused by nephrotic syndrome in a goat.

Nephrotic syndrome associated with administration of sulfadimethoxine/ ormetoprim in a dobermann

This case report describes sulphonamide-induced nephrotic syndrome in a young dobermann dog. The clinical signs and laboratory abnormalities resolved shortly after discontinuation of the sulphonamide antibiotic and with generalised supportive care. Since nephrotic syndrome typically carries a guarded prognosis in veterinary medicine and is poorly responsive to therapy, a thorough drug history should be an important part of the investigation of any animal with a protein-losing nephropathy.

Characteristic changes in carbohydrate profile in the kidneys of hereditary nephrotic mice (ICGN strain)

The ICR-derived glomerulonephritis (ICGN) mice consist of heterozygous and homozygous groups and are considered to be a good model for human idiopathic nephrotic syndrome. To reveal changes in cell-surface carbohydrate construction, 24 lectins were applied to kidney sections of 10-, 30- and 50-week-old male heterozygous and homozygous ICGN mice and age-matched male ICR mice. Bandeiraea simplicifolia lectin-I (BSL-I), which specifically binds to alpha-D-galactopyranosyl groups, showed positive staining in the glomeruli of ICGN mice, but not in those of ICR mice. Positive BSL-I staining was observed only in distal tubules of homozygous ICGN mice. Lectin blotting for BSL-I demonstrated characteristic glycoproteins (45, 58 and 64 kD) in ICGN but not in ICR mice, and the levels of these molecules augmented in homozygous ICGN mice with the progression of renal failure. Moreover, succinylated wheat germ agglutinin, Dolichos biflorus agglutinin, Aleuria aurantia lectin and Ulex europaeus agglutinin-I showed positive staining only in the glomeruli of homozygous ICGN mice, but not in those of heterozygous ICGN or ICR mice. The staining intensities of Ricinus communis agglutinin-I, Phaseolus vulgaris agglutinin-E and -L, Lens culinaris agglutinin and Erythrina cristagalli agglutinin (ECL) in the glomeruli of homozygous ICGN mice were stronger than those of heterozygous ICGN and ICR mice. In conclusion, lectin histochemistry provided useful information for the diagnosis and prognosis of nephrotic lesions. Characteristic BSL-I binding glycoproteins may be pathogenic factors which cause renal disease in ICGN mice and are good tools to investigate the molecular mechanism of renal disorders in ICGN mice.

Cranial edema associated with a protein-losing nephropathy in a golden-mantled flying fox (Pteropus pumilus)

An adult golden-mantled flying fox (Pteropus pumilus) was diagnosed with nephrotic syndrome on the basis of the findings of proteinuria, hypoalbuminemia, hypercholesterolemia, and cranial edema. Membranoproliferative glomerulitis and interstitial nephritis were confirmed antemortem by renal biopsy. The bat had received seven injections of oxytocin in the period immediately prior to presentation. The possible role of oxytocin in the development of the nephropathy is discussed. Supportive care and treatment with a single plasma transfusion, furosemide, and prednisone led to a gradual but complete resolution of the nephrotic syndrome in this animal.

Nephrotic syndrome resulting in thromboembolic disease and disseminated intravascular coagulation in a dog

Thromboembolic disease and progression to disseminated intravascular coagulation (DIC) are potential life-threatening complications for dogs with nephrotic syndrome. Platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), plasma concentration of fibrinogen degradation products (FDPs), antithrombin III (ATIII), protein C, and plasminogen were used to identify hemostatic abnormalities in a dog with nephrotic syndrome. Pulmonary thromboembolic disease was diagnosed by thoracic radiography, arterial blood gas analysis, and pulmonary scintigraphy. Prompt recognition and treatment of hemostatic complications is necessary in dogs with nephrotic syndrome.

Roles of reactive oxygen species and antioxidant enzymes in murine daunomycin-induced nephropathy

We evaluated the roles of reactive oxygen species and intrinsic antioxidant enzymes in the development of daunomycin (DM)-induced nephropathy in mice. A single dose of DM (20 mg/kg intravenously) induced proteinuria by day 7 and the nephrotic syndrome by day 14 in DM-sensitive strain (A/J) but not in DM-resistant strain (C57BL/6J) (B6). Renal cortical lipid peroxide levels in the A/J mice significantly increased at days 2, 4, and 7 after DM injection, whereas no increase was observed in the B6 mice. The resistance to DM in B6 mice was associated with higher activities in renal cortical superoxide dismutase and glutathione peroxidase. The administration of superoxide dismutase or of dimethylthiourea significantly suppressed the DM-induced proteinuria in the A/J mice. Four days of superoxide dismutase or dimethylthiourea administration suppressed the proteinuria. These findings suggested that murine DM-nephropathy appeared to be mediated by reactive oxygen species and that intrinsic antioxidant enzyme activities may play an important role in the susceptibility to DM-induced nephropathy in mice.

Splenic vein thrombosis resulting in acute anemia: an unusual manifestation of nephrotic syndrome in a Chinese shar pei with reactive amyloidosis

Nephrotic syndrome in a seven-year-old Chinese shar pei resulted in oliguric renal failure, coagulopathy, and acute anemia. Renal amyloidosis and widespread thromboses were diagnosed postmortem. Splenic vein thrombosis caused significant splenic congestion, coagulative necrosis, and acute anemia. Splenic vein thrombosis is reported here as an unusual consequence of nephrotic syndrome in the dog.

Early ultrastructural glomerular alterations in neonatal nephrotic mice (ICGN strain)

ICGN is a strain of mice with hereditary nephrotic syndrome of an unknown cause. In this study, early glomerular alterations in newborn ICGN mice were observed with electron microscopy to gain a better insight into the onset of the disease. Development of the glomeruli was normal until fusion of epithelial and endothelial basement membranes in the developing capillary stage. From the maturing glomerulus stage onward, the fused glomerular basement membrane (GBM) increased in thickness by excessive accumulation of the basement membrane material secreted from the epithelial cells. This accumulation was followed by overall loss of epithelial foot processes in the glomeruli. These findings indicate that the disease in ICGN mice is caused by some defect(s) in the GMB maturation process, which may be crucial for the generation of the glomerular permselectivity.

Treatment of membranoproliferative glomerulonephritis and nephrotic syndrome in a dog with a thromboxane synthetase inhibitor

A 2-year-old spayed female Whippet with membranoproliferative glomerulonephritis and nephrotic syndrome was treated with a specific thromboxane synthetase inhibitor (3-methyl-2[3-pyridyl]-1-indoleoctanoic acid), resulting in decreased proteinuria and resolution of ascites and edema. Glomerular histology, however, appeared unaffected by treatment. Discontinuation of treatment for 10 weeks resulted in increased proteinuria and decreased serum albumin concentrations that were again attenuated when treatment was reinitiated. Thromboxane synthetase inhibitors have been used successfully to treat experimentally induced glomerulonephritis in several species and this treatment appears to hold promise for naturally occurring glomerulonephritis in dogs.

Experimental immune complex glomerulonephritis and the nephrotic syndrome in cats immunised with cationised bovine serum albumin

Membranous nephropathy was induced in four cats by repeated intravenous injections of 120 mg cationic bovine serum albumin (BSA, pI 9.5). All four cats developed diffuse granular deposits of IgG and C3 along the glomerular capillary walls as early as five weeks which persisted until the end of the experiment at 17 weeks. Ultrastructural studies revealed many subepithelial electron dense deposits. Two cats developed severe proteinuria and the nephrotic syndrome characterised by hypoalbuminaemia and oedema. An additional four cats received repeated injections of unmodified native BSA (pI 4.5) and remained basically normal. This is the first report of membranous nephropathy and the nephrotic syndrome in an experimental animal model which, unlike other animal models, is subject to the spontaneously occurring disease.

Hemostatic abnormalities in nephrotic syndrome

Nephrotic syndrome is often associated with a hypercoagulable state and thrombotic complications. Thrombosis may be due to a number of abnormalities in blood, including AT III deficiency, increased concentrations of fibrinogen, factors V and VIII, and platelet hyperaggregability. The therapeutic approach to thrombosis in nephrotic syndrome is the use of anticoagulants as a preventive measure or an attempt at thrombolysis with streptokinase, urokinase, or stanozolol.

A nephrotic-like syndrome with an associated mesangio-proliferative glomerulopathy in a cow

A 3-year-old Limousin cow was admitted to the University of Georgia Teaching Hospital with a history of chronic weight loss and diarrhea of more than 1 year's duration. Clinical laboratory findings included proteinuria and hypoproteinemia and were suggestive of a nephrotic-like syndrome. Necropsy findings included generalized edema of the visceral organs and diffuse red glistening foci on the capsular and cut surfaces of the cortex of both kidneys. Microscopically, the kidney had hypercellular and hypersegmented glomeruli, focal glomerulosclerosis, periglomerular fibrosis, and tubular nephrosis. The glomerular hypercellularity was confirmed by electron microscopy to be due to increased mesangial cells.

Naturally occurring canine nephrotic syndrome is a potentially hypercoagulable state

Fourteen dogs with naturally occurring nephrotic syndrome were evaluated for abnormalities in the hemostatic system. Histopathologic diagnoses included 8 dogs with membraneous glomerulonephritis, 1 dog with acute glomerulon-ephritis, 2 dogs with idiopathic glomerulopathy, and 2 dogs with amyloidosis. The coagulation protein assays performed included concentrations of factors V, VII, VIII: C, IX, X, fibrinogen (I), anti-thrombin III, and plasminogen. Thrombocyte counts were also performed. All of these analytes were significantly elevated (P < 0.05) with the exception of ATIΠ which was significantly decreased (P < 0.05). Five of the dogs had histologic evidence and 1 dog had angiographic evidence of thrombosis and thromboembolism. Naturally occurring canine nephrotic syndrome thus represents a potentially hypercoagulable state and may serve as a valuable model in the study of certain components of the human disease.

Nephrotic syndrome associated with renal amyloidosis in a colony of Syrian hamsters

A 6% incidence of nephrotic syndrome was noted in a colony of 400 Syrian hamsters (Mesocricetus auratus) over a period of 2 years. Clinical findings consisted of severe ascites and anasarca, anorexia, cachexia, and papular dermatitis. Serum and urine chemical analysis revealed proteinuria and hypoalbuminemia in all animals tested; hypoproteinemia and high concentrations of serum cholesterol, triglycerides, and creatinine were detected in some of the affected hamsters. Demodex aurati was detected in skin scrapings from 4 of 8 hamsters. Necropsy findings included subcutaneous edema, ascites, and hydrothorax, as well as atrophic kidneys and testes. Extensive deposits of type AA amyloid were detected histologically in kidney, liver, spleen, and adrenal gland; smaller deposits were found in thyroid gland and intestine. Other histologic findings included periodontitis and hyalinization of the small arteries of the testes.

Some unusual features of mesangioproliferative glomerulonephritis in horses

Seven horses ranging from three to 15 years of age had nephrotic syndrome; at necropsy, renal tissue of all seven horses had the morphologic lesions of mesangioproliferative glomerulonephritis (membranoproliferative glomerulonephritis). Homogeneous eosinophilic material which filled the glomerular capillary lumina was found in five horses. Ultrastructurally, this material primarily consisted of electron-dense deposits with a fibrillar pattern in five horses and in one horse, rhomboid crystalline deposits which resembled deposits seen in human cryoglobulinemia. The association of mesangioproliferative glomerulonephritis with cryoglobulinemia is well documented in man. The presence of intracapillary deposits, with the histologic and ultrastructural lesion of mesangioproliferative glomerulonephritis, suggests a similar association in these horses.

Laboratory aspects of cancer

Hematologic alterations unrelated to neoplastic bone marrow involvement include polycythemia, anemia, leukocytosis, leukopenia, thrombocytosis, thrombocytopenia and coagulopathies. Serum globulin levels may be increased or decreased, depending on the type of neoplasm. Plasma fibrinogen and fibrin degradation product concentrations are usually elevated in cancer patients, whereas cancer patients with DIC have low plasma fibrinogen concentrations. Hypercalcemia can be a sequel of osseous metastases. Neoplasia may cause the nephrotic syndrome in some patients. Effusions should be examined microscopically for signs of malignancy. Elevated serum enzyme levels are not specific in neoplastic disease.

Idiopathic immune complex glomerulonephritis in dogs with multisystem involvement

Renal specimens obtained by biopsy and/or at necropsy from 4 dogs with nephrotic syndrome were studied using light, immunofluorescence, and electron microscopies. The glomerulonephritis observed in these dogs was considered an idiopathic immune complex glomerulonephritis associated with multisystem involvement because causes of glomerulonephritis in these dogs could not be established. Immunoglobulin A was observed in granular deposits in the mesangial and subendothelial regions of the glomeruli. The relationship of the clinical and pathologic features of this disease in dogs to various renal syndromes in human beings are described.

An immunohistological study of feline glomerulonephritis using the peroxidase-antiperoxidase method

Twenty-two cases of feline glomerulonephritis were investigated for the presence of immune complexes within the glomerulus using the peroxidase-antiperoxidase (PAP) method. This method was used with formalin-fixed paraffin-wax embedded tissues which were pretreated with trypsin and with frozen sections of kidney tissue. Of a total of 25 kidney specimens examined (two cats had repeated biopsies) the composition of the deposits was 23/25 IgG, 17/25 C3, 11/25 IgM and 2/25 IgA. Serial studies of two cats showed a progression of the disease from initial nephrotic syndrome to chronic renal failure. With the more severe form of the disease there was a tendency for the deposition of complement and more than one class of immunoglobulin within the glomeruli.

Nephrotic syndrome and collagenizing glomerulopathy in PVG/c rats treated with the alpha-mannosidase inhibitor "swainsonine"

Weanling PVG/c rats treated with the alpha-mannosidase inhibitor swainsonine developed increasing proteinuria which terminated as a severe nephrotic syndrome after 35 to 45 days. This was associated with a glomerulopathy characterized by the production of collagen fibrils adjacent to endothelial and mesangial cells, foot process expansion, subepithelial projections of the basement membrane, and splitting of the lamina densa. The swainsonine-induced glomerulopathy appeared to be an exacerbation of a spontaneous abnormality in this strain of rat.

The nephrotic syndrome in a heifer due to glomerulonephritis

An 18-month-old Friesian heifer, which was admitted in November with a history of weight loss, diarrhoea and submandibular oedema, was found to have an enlarged left kidney and a massive proteinuria. Laboratory investigations revealed that there was a marked hypoalbuminaemia and that the range and the proportions of the individual proteins in the urine were almost identical to those in the serum. Consequently, the nephrotic syndrome was diagnosed. On gross and histopathological examination of the kidneys, there was evidence of pyelonephritis. However, immunofluorescence studies revealed a striking diffuse deposition of immunoglobulin in a predominantly linear pattern along the glomerular basement membranes. Abnormalities of the basement membranes. Abnormalities of the basement membranes were seen on ultrastructural examination and evidence of a flomerular protein leak was detected but changes typical of immune-complex deposition were absent. The immunofluorescence findings suggested a diagnosis of glomerulonephritis mediated by antiglomerular basement membrane antibody.

Membranous nephropathy in the cat: a clinical and pathological study

A series of 13 cases of feline membranous nephropathy is presented. Two groups were distinguished clinically; eight cats had the nephrotic syndrome and five others were in renal failure but not nephrotic. The definitive diagnosis was based on histological, immunofluorescence and ultrastructural examinations of renal tissue obtained at renal biopsy or necropsy. Glomerular lesions were classified according to the degree of glomerular change into three distinct groups; mild, moderately severe and advanced. A relationship was established between the mild and moderately severe groups and cats with the nephrotic syndrome, and the advanced group and cats in renal failure. Diuretic therapy was satisfactory in initial control of oedema in the nephrotic cases. Monitoring of previously nephrotic cats for up to three years indicated that the disease is progressive, although in some cases it is sufficiently slow for a cat to live a relatively normal life without continuing treatment. The prognosis for cats presented in renal failure is hopeless.

Natural remission of nephrotic syndrome in a dog with immune-complex glomerular disease

A nephrotic syndrome caused by immune-complex glomerular disease was diagnosed in a 4-year-old male Great Dane. The syndrome was characterized by proteinuria, hypoproteinemia, hypoalbuminemia, hypercholesterolemia, and subcutaneous edema. Renal biopsy revealed segmental membranous glomerular disease. The edema underwent complete remission 18 days after admission. Two months after admission, there was no clinical or laboratory evidence of glomerular disease. Periodic reevaluation of the dog during the next 2 years revealed recurrence of proteinuria, but no other clinical or laboratory abnormalities. Serial renal biopsies revealed persistence, but no appreciable increase, in the severity of the segmental membranous glomerular disease. The natural course of the nephrotic syndrome and immune-complex glomerular disease has been associated with unpredictable variability. It was concluded that the widespread use of corticosteroid or immunosuppressant therapy in dogs with immune complex glomerular disease should be withheld until the natural course of the disease has been evaluated in a significant number of patients and until the results of well-controlled clinical studies confirm or deny their therapeutic value.