Proximal tubular nephropathy in two dogs diagnosed with lead toxicity

Abstract

Lead toxicity was diagnosed in two dogs presenting with vague clinical symptoms. Complete blood count, biochemical testing and imaging changes showed a metarubricytosis in dog 1, but were largely normal in dog 2. Both dogs had glucosuria and proteinuria on urinalysis consistent with damage to the proximal renal tubules. Both animals returned elevated blood lead levels. A history of ingestion of lead was reported by the owner in one dog and elucidated from the second owner once the animal had recorded elevated blood lead levels. Lead toxicity is rarely reported in the human literature as a cause of proximal tubular dysfunction. To the author's knowledge this is the first case report specifically examining this in the dog. The clinical awareness that lead is a potential cause of proximal renal tubular dysfunction offers another tool to assist the clinician in the diagnostic process. This is particularly important given that the clinical signs and minimum database findings in animals with lead toxicosis are highly variable. Evidence of proximal tubular dysfunction should trigger the clinician to closely examine the history for a potential source of lead exposure and consider submitting samples to test blood lead levels.