Management/treatment practice subscale was separately analyzed in and presented in Figure 1, showing that a majority of participants (88.1%) would recommend a low-purine diet and lifestyle changes to patients with AH, while 27.4% would prescribe short-term ULT and 21.9% would prescribe long-term ULT.
According to ACR and ACP guidelines, the sole therapeutic options warranted for AH are a low-purine diet and lifestyle changes; 88.1% of the physicians in this study concurred.
Prescribing Practice Percentage Low-purine diet and lifestyle recommendations 88.1% Short-term ULT 27.4% Long-term ULT 21.9% NSAIDs 10.9% Colchicine 1.0% Corticoids 0.0% Note: Table made from bar graph.
A low-purine diet
excludes alcohol, fizzy drinks and processed food but includes fruit and vegetables, whole grains and dairy.
Dietary recommendations Patients Fruits and vegetables 26 Low-sodium diet 15 Low-purine diet
5 High magnesium diet 2 Non specified diet 18 Table 2.
His owner, Shelley Gallagher of Sandy, Utah, had been feeding Armstrong a low-purine diet
, giving him extra fluids to help dilute his urine, letting him out to urinate every few hours (including every night at 2 am), and obsessively monitoring him--all, ultimately, to no avail.
Although a strict low-purine diet
isn't necessary, think about reducing your intake of foods such as liver and other offal, fish roe, meat extracts, poultry and pulses for five days out of seven.
Feeding a low-purine diet
helps prevent urate stones, but the problem can be so severe that in some cases the only option is euthanasia.
The key to keeping urate-forming dogs healthy is to feed them a low-purine diet. Without the purines that trigger urate stone formation, even susceptible dogs can lead normal lives.
On average, it takes about VA months for stones to dissolve using allopurinol in combination with a low-purine diet and urinary alkalizination, but it can take as little as one month or as long as 18 months.
Mandell generally doesn't prescribe extremely strict low-purine diets
. "I give patients some leeway," he says.
It was formerly thought that low-purine diets
were effective, but with such drugs as NSAIDs to relieve the initial attacks of pain and inflammation, and allopurinol and other drugs for long-term therapy when necessary, these bland diets are of little value.