AUTHOR=Dawson Katherine Ann , Blong April , Walton Rebecca 

TITLE=Case report: Focal segmental glomerulosclerosis and nephrotic syndrome following treatment with pamidronate for calcitriol toxicity

JOURNAL=Frontiers in Veterinary Science

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2022.956153

DOI=10.3389/fvets.2022.956153

ISSN=2297-1769

ABSTRACT=Abstract 
Objective: To describe a case of glomerulosclerosis resulting in nephrotic syndrome following administration of pamidronate disodium to treat clinical calcitriol toxicity in a dog.
Case Summary: A 12-week-old intact male Labrador Retriever weighing 11.8 kg presented with lethargy and vomiting 20 hours after ingesting a 100 g tube of topical antipsoriatic cream (3 mcg/g of calcitriol)a. Severe hypercalcemia was present on the day of presentation. Hypercalcemia treatments such as saline diuresis, furosemideb, and dexamethasone sodium phosphatec were initiated. The dog was also administered a single dose of pamidronate disodiumd on the day of presentation. Initially the patient’s clinical signs improved, and the hypercalcemia resolved. One-hundred and thirty hours post-pamidronate disodiumc administration the patient developed biochemical abnormalities and severe edema, consistent with nephrotic syndrome and was euthanized. Necropsy results revealed evidence of focal segmental glomerulosclerosis.
Unique Information:  Pamidronate disodium, commonly used for treatment of hypercalcemia, may have resulted in glomerulosclerosis and nephrotic syndrome in a dog with calcitriol toxicity. This complication should be taken into consideration when monitoring patients treated with pamidronate disodium for hypercalcemia.