Hospital Escolar Veterinário - Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.
Hospital Veterinario Anicura Valencia Sur, Valencia, Spain.
Comp Immunol Microbiol Infect Dis. 2022 Apr;83:101783. doi: 10.1016/j.cimid.2022.101783. Epub 2022 Feb 24.
Xanthinuria is a significant adverse effect in dogs on long-term allopurinol for treatment of leishmaniosis. The study aims to investigate how the Iberian veterinary community (IVC) identifies, manages, and proactively prevents xanthinuria secondary to allopurinol treatment. A cross-sectional study was conducted using an online survey, translated into two languages, and disseminated to the IVC via social networking forums. Respondents were asked to share their treatment regimens, adverse effects attributed to treatment, as well as preventive and reactive measures against xanthuria. Of two-hundred and thirty respondents, 99.6% prescribe allopurinol for canine leishmaniosis. Xanthinuria was estimated to happen in less than one out of every four dogs by 91.7% of the clinicians. Xanthinuria has been detected by 71.6% of respondents at least once. Three out of every four respondents inform owners about deleterious effects of allopurinol, and 28.4% consider implementing a change in diet in advance of treatment as a proactive measure. To monitor xanthinuria, urinalysis and diagnostic imaging are used by 71.2% and 31% of clinicians respectively. When xanthinuria is detected, 43.2% of the respondents discontinue allopurinol, 24% replace it by nucleotide-analogs, 14.9% reduce its dosage, and 3.1% split its dosage but increase administration frequency. Additional measures are taken by 72.1% of the respondents, 59.4% of whom prescribe a low-purine diet. The IVC recognizes xanthinuria as a fairly common secondary effect of long-term allopurinol treatment in dogs with leishmaniosis and recommends periodically monitoring and preventive measures.
黄嘌呤尿症是犬长期使用别嘌醇治疗利什曼病的一种严重不良反应。本研究旨在调查伊比利亚兽医界(IVC)如何识别、管理和主动预防别嘌醇治疗引起的黄嘌呤尿症。本研究采用横断面研究设计,通过在线调查进行,翻译成两种语言,并通过社交网络论坛向 IVC 传播。受访者被要求分享他们的治疗方案、治疗相关的不良反应以及针对黄嘌呤尿症的预防和反应性措施。在 230 名受访者中,99.6%的人开别嘌醇治疗犬利什曼病。91.7%的临床医生估计不到四分之一的狗会发生黄嘌呤尿症。71.6%的受访者至少检测到过一次黄嘌呤尿症。四分之三的受访者告知主人别嘌醇的有害作用,28.4%的人考虑在治疗前改变饮食,作为一种主动措施。为了监测黄嘌呤尿症,71.2%的临床医生使用尿液分析,31%的临床医生使用诊断成像。当检测到黄嘌呤尿症时,43.2%的受访者停止使用别嘌醇,24%的人用核苷酸类似物替代,14.9%的人减少剂量,3.1%的人将剂量减半但增加给药频率。72.1%的受访者采取了其他措施,其中 59.4%的人开低嘌呤饮食。IVC 认为黄嘌呤尿症是犬利什曼病长期使用别嘌醇治疗的一种相当常见的继发性副作用,并建议定期监测和预防措施。