Canine Xanthine

Radiograph

General Information

Hereditary xanthinuria is a rare autosomal recessive disorder of purine metabolism caused by mutations in xanthine dehydrogenase (Type I) or molybdenum cofactor sulfarase (Type II) genes, and causes xanthine uroliths. Breeds with hereditary xanthinuria include Toy Manchester Terrier, Cavalier King Charles Spaniel, English Cocker Spaniel, Dachshund, Chihuahua, and mixed breed dogs. Xanthine uroliths can also develop as an adverse consequence of xanthine dehydrogenase inhibitors (allopurinol), especially when given in higher doses and without dietary purine/protein reduction. Xanthine uroliths associated with allopurinol administration can be rapidly dissolved by stopping allopurinol and feeding a low-purine, urine-alkalinizing diet.

Diagnostic

• Determine if xanthine dehydrogenase inhibitors (allopurinol) were administered. • Genetic tests for Type 1 (xanthine dehydrogenase deficiency) and Type 2 (molybdenum cofactor sulfurase deficiency) genetic variants.

Medical

• Discontinue or reduce xanthine dehydrogenase inhibitors. • Potassium citrate if urine pH is consistently <6.5 (starting dose: 75mg/kg q12-24h).

Nutritional

• Low purine/protein foods that produce neutral or alkaline urine (e.g. L/d, i/d Sensitive, u/d, HA vegetarian, others). If needed, feed canned therapeutic foods or add water to achieve a urine specific gravity <1.020.

Monitoring

Urinalysis every 3 to 6 months to adjust pH to ≥ 6.5, and urine specific gravity < 1.020. Medical imaging every 3 to 6 months to detect recurrence. Recurrence is an indication for further evaluation and alternative treatment strategies.

Disclaimer

We advise reviewing manufacturer's literature regarding selected therapeutic foods to determine indications and contraindications. For pets with multiple health concerns,we suggest that the selection of diet should take into consideration all health needs of the pet.

Link to Full Recommendation PDF

Canine Xanthine
Back