Low purine diets, does it get any more confusing?

 

Purines are natural substances found in plant and animal cells that are vital to the chemical structure of genes. Purines can be found in any food group (i.e. meat, vegetables, fruit etc.), but are higher in meat and fish, than other food groups.

 

Having spoken to many owners of dogs with Leishmaniasis, I can certainly understand their confusion. How can you put together a LOW PURINE diet that is natural and healthy for your dog, when meat is high in purines and dogs need meat?

 

To answer this question we need to look at why your dog is being recommended a low purine diet, and then what is actually a low purine diet for a dog?

 

There is ONE reason for a dog owner wanting to put their dog on a low purine diet.

 

Risk of Bladder/ Kidney Stones

 

Leishmaniasis and low purine diets for dogs

 

Acquired xanthinuria (bladder/ kidney stones) is a common complication in dogs that are being treated with the drug allopurinol for urate urinary tract stones or leishmaniasis. 

 

The only reason a dog with Leishmaniasis is being recommended a low purine diet is because of the allopurinol. However it’s worth noting that allopurinol is not always necessary then nor is a low purine diet.

 

A dog who is in remission from Leishmaniasis should be on a management dose of allopurinol, which is taking it for ONE WEEK PER MONTH. Studies have shown that administration of allopurinol is an effective way of maintaining clinical remission in dogs with leishmaniasis. (1) 

 

In the LeishVet guidelines:

Allopurinol can be discontinued when: 

 

  1. The presence of complete physical and clinicopathological recovery evaluated by a thorough physical examination, CBC, full biochemistry panel and urinalysis. 

 

  1. A marked decrease of antibody levels (to negative or borderline by a quantitative serological assay). 

 

  1. If it is not possible to control or decrease the xanthinuria with low purine diets or by reducing the drug’s dosage, to avoid the risk of urolithiasis, if massive xanthine crystalluria is present.

 

How to reach a point where allopurinol can be discontinued

 

Diet

It has long been established that a dog’s nutritional intake is intrinsically connected to the immune response and, therefore, the progression of Leishmaniasis (2,3). 

Unfortunately, the majority of tinned dog foods provide sub-optimal dietary benefits due to the fact that protein levels are lessened due to intensive food processing, denaturing proteins, reduced nutrient availability, and low-quality food sources. 

As well as a low-quality, low-protein diet, obesity can also contribute to the advance of Leishmaniasis.

 

Weak Immune System

Having a weakened immune system plays a crucial role in the clinical manifestations of canine Leishmaniasis and is a fundamental aspect in the development and progression of the disease (4). Both Cutaneous and Visceral Leishmaniasis protection relies on cell-mediated immunity.

 

Inflammation

As inflammation is related to progressive diseases, reducing inflammation decreases the likelihood for both the emergence and resurgence of the disease (5,6,7,8). Inflammation is reduced by the specific fresh food diet plan detailed below, as well as a reduction in stress, exercise, and increased oxytocin (more time gazing lovingly at your dog) (9).

Inflammation is caused by:

 

Dangers of long term allopurinol use

 

Allopurinol is associated with clinical relapse and its side effects include urinary conditions, with one study finding that 45% of dogs taking allopurinol develop urinary issues 

There are also several side effects in the case of long-term usage of allopurinol, such as xanthinuria, renal mineralisation, and urolithiasis. (10,11).

 

How to make a low purine diet for a dog with Leishmaniasis using allopurinol?

 

The recommended methods of minimising the risk of urinary stone formation are: 

 

 

 

 


 

 

 

 

Here is a list of foods and there purine content

 

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  7. S. Hosein, D. P. Blake, and L. Solano-Gallego, “Insights on adaptive and innate immunity in canine leishmaniosis,” Parasitology, vol. 144, no. 1, pp. 95–115, 2017.View at: Publisher Site | Google Scholar
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  10. L. Manna, R. Corso, G. Galiero, A. Cerrone, P. Muzj, and A. E. Gravino, “Long-term follow-up of dogs with leishmaniosis treated with meglumine antimoniate plus allopurinol versus 
  11. Torres, M., Pastor, J., Roura, X., Tabar, M.D., Espada, Y., Font, A., Balasch, J. and Planellas, M., 2016. Adverse urinary effects of allopurinol in dogs with leishmaniasis. Journal of Small Animal Practice57(6), pp.299-304.

 

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