Severe calcinosis circumscripta in multiple foot pads in a 5- month old pomeranian puppy secondary to renal disease – a case report

Abstract

A 5-month old Pomeranian puppy with lameness in all four limbs, polydipsia, polyuria, vomiting, and melena observed approximately for one month was presented to the Veterinary Teaching Hospital, University of Peradeniya. The metacarpal and metatarsal foot pads of all four limbs were swollen with chalky white, mottling. The differential diagnoses for the foot pad lesions were fungal granuloma, calcinosis circumscripta, and neoplasia. The fine needle aspirates obtained from the foot pad lesions were chalky white, gritty, and microscopically consistent with mineral deposits. Plain radiographs of the metacarpals revealed deposition of radiopaque material in metacarpal and digital foot pads with normal bones and joints. Based on the gross lesions, radiography, and fine needle aspiration cytology, a tentative diagnosis of calcinosis circumscripta of foot pads was made. Haematology and serum chemistry revealed microcytic hypochromic anaemia and mild azotaemia. Abdominal ultrasonography revealed small right and left kidneys with increased overall echogenicity and poor corticomedullary differentiation. The historical, clinical, radiographic, and ultrasonographic findings were suggestive of calcinosis circumscripta in multiple foot pads with concurrent renal disease. The very young age of the dog was highly suggestive of renal dysplasia as the cause of concurrent renal disease. Despite the supportive and symptomatic treatments, the puppy died five days after the presentation. This appears to be the first report of calcinosis circumscripta of foot pads with evidence of renal disease diagnosed in a dog less than one year old.