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Following product recalls, Fanconi-like syndrome outbreak abates in Australia

Cause remains unknown

September 23, 2009
By Edie Lau

An outbreak in dogs of acquired proximal renal tubulopathy, also known as Fanconi-like syndrome, appears to have ended in Australia since two different kinds of dog chews and treats were pulled from the market.

The kidney conditions, sometimes fatal, were associated with the feeding of chicken jerky treats made by KraMar and grain-based dental chews made by Virbac. Analysis of both products revealed no contaminants or toxicants, however.

KraMar pulled two products — Supa Naturals Chicken Breast Strips 150G and 110G — in December 2008, after receiving more than a dozen reports of dogs having eaten the chicken snacks falling ill with Fanconi-like syndrome.

The illness is so called because it resembles Fanconi, a usually inherited condition in which the kidneys lose electrolytes and nutrients in urine rather than resorbing them properly into the body. Symptoms include excessive drinking and urination (polydipsia and polyuria, PUPD) and glucose in urine (glucosuria). Lethargy, loss of appetite and vomiting also are common.

Dr. Linda Fleeman, a senior lecturer in small animal medicine at the University of Sydney who treated some of the dogs and has tried to track down the cause, reported that 99 dogs that were fed the Supa Naturals Chicken Breast Strips had confirmed cases. They acquired the disease between August 2007 and January 2008. Five of the dogs died (some through euthanasia). For the survivors, recovery took anywhere from less than two weeks to six months.

Once the chicken jerky products were withdrawn from the market, incidence of the disease declined significantly, Fleeman said, although a few new cases this year came up, associated with KraMar’s Supa Naturals Chicken Breast Bites, which retailers sold at a discount because the line was discontinued.

Then in May, several more new cases of acquired proximal renal tubulopathy surfaced that were associated not with dried chicken treats but with VeggieDents, a corn-, soy- and rice-based dental chew that had been introduced in March by Virbac through veterinarians. Virbac pulled the product from the market in Australia on June 1.

Fleeman told the VIN News Service by e-mail that she is aware of only one new case since the Virbac recall, and that was associated with a KraMar product.

Although Virbac’s laboratory analysis of VeggieDents could identify no link to the disease, the company is keeping the product out of the country for the time being, said Stephane Wojtkowiak, a spokesman in Virbac headquarters in France. “They have not scheduled yet the return of products to the shelves as Virbac Australia is willing to work closely with the local authorities to better understand the reason of Fanconi-like syndrome,” he told VIN News Service by e-mail.

No cases of Fanconi-like syndrome have been associated with VeggieDents outside of Australia, so the product is still available in Europe, Asia and the United States.

The chews are made in Vietnam. Virbac has said that the product in Australia, unlike those sold elsewhere, is irradiated as required by the Australia Quarantine and Inspection Service.

Pet food irradiation at the levels used in Australia has been linked to neurological disease, including ataxia and tetraplegia, in cats; dogs are not known to be affected. The Australian government in late May banned irradiation of cat food because of compelling scientific evidence that the sterilization process may harm cats. How irradiation may induce toxicity is unknown.

Outside of Australia, cases of Fanconi-like syndrome occurred in the United States in 2007 among dogs that ate various brands of chicken jerky that, like the KraMar products, were made in China. Authorities were unable to identify a cause.

VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email

Information and opinions expressed in letters to the editor are those of the author and are independent of the VIN News Service. Letters may be edited for style. We do not verify their content for accuracy.


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