The effect of disease on the urinary purine metabolite concentrations in dogs

Rivara, C. M.; Johnson, Craig R.; Lulich, Jody P.; Osborne, Carl A.; Murtaugh, Maureen A.

doi:10.1136/vr.101237

Cited by 4 publications

(3 citation statements)

References 37 publications

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“…Purine metabolite concentrations were determined in the urine of 103 dogs with neoplasia with or without chemotherapy . There was a statistically significant increase in the total purine metabolite to creatinine ratios (median values of 1.58 vs 1.08) and the uric acid to creatinine ratios (median values of 0.15 vs 0.06) in 58 dogs with chemotherapy, but these changes were mild, and no dog had massive amounts of uric acid excretion such as the dog in this report.…”

Section: Discussionmentioning

confidence: 59%

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Massive uric acid crystalluria and cylinduria in a dog after l‐asparaginase treatment for lymphoma

Tvedten

Lilliehöök

Rönnberg

et al. 2019

Veterinary Clinical Pathol

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A 10-year-old Golden Retriever bitch was treated for diarrhea and vomiting that lasted about 1 month without a specific diagnosis until a hepatic biopsy provided a histopathologic diagnosis of lymphoma. The dog was referred to the Swedish University of Agricultural Science and treated with one dose of L-asparaginase. The day after chemotherapy, the urine was dark yellow, very turbid, and had large amounts of small amorphous crystals and many casts made of similar appearing material identified by infrared spectroscopy to be 100% uric acid dihydrate. Serum uric acid was elevated at 224 μmol/L (RI 0-59). The dog's illness became worse after chemotherapy. Lymphoma treatment was not continued, and the dog was euthanized 9 days after the L-asparaginase treatment. Among other problems were persistent proteinuria with a urine protein-to-creatinine ratio of 2.3 and severe hypoalbuminemia. Serum protein electrophoresis performed 3 weeks prior to chemotherapy indicated hyperproteinemia (total protein 78 g/L) having a biclonal gammopathy with 35 g/L β-2 globulins and 11 g/L γ globulins. Despite prominent cylinduria and crystalluria, the patient did not develop azotemia or isosthenuria.

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Section: Discussionmentioning

confidence: 59%

“…Dogs and most other mammals have uricase (urate oxidase) which converts uric acid further to allantoin . Allantoin is 5‐10 times more soluble than uric acid and more easily excreted by the kidneys . Dogs should be able to metabolize uric acid to allantoin and thus avoid TLS.…”

Section: Discussionmentioning

confidence: 99%

Massive uric acid crystalluria and cylinduria in a dog after l‐asparaginase treatment for lymphoma

Tvedten

Lilliehöök

Rönnberg

et al. 2019

Veterinary Clinical Pathol

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“…In contrast to people, the vast majority of urine purine metabolites in dogs are comprised of allantoin. People and higher nonhuman primates lack functional urate oxidase, the enzyme that converts uric acid into allantoin . Allantoin is 5–10 times more soluble than uric acid, and the reason this dog developed crystalluria is unknown.…”

Section: Discussionmentioning

confidence: 99%

What is your diagnosis? Urine crystals in a dog

Meichner

Olsson

Stewart

et al. 2015

Veterinary Clinical Pathol

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A 24.1 kg, 1.5-year-old intact male Labrador Retriever was presented to the North Carolina State University Veterinary Hospital (NC State VH) Emergency Service for a 3-day history of vomiting, hematochezia, fever, and generalized lymphadenopathy. The referring veterinarian treated the dog with a single dose of enrofloxacin 130 mg IV and discharged him with oral minocycline 10 mg/kg once daily. The dog vomited all oral medications. At NC State VH, CBC abnormalities included mild normocytic anemia (HCT 30.6%, reference interval [RI] 37-55%; MCV 69.9 fL, RI 60-72 fL) with mildly elevated MCHC (39.8 g/dL, RI 34-38 g/dL), marked leukocytosis (180,900/ lL, RI 4390-11,610/lL), characterized by marked monocytosis (103,113/lL, RI 75-840/lL), moderate neutrophilia (25,326/lL, RI 2840-9112/lL), marked left shift (12,663 band neutrophils), marked increase in intermediate-and late-stage myelomonocytic precursors (25,326/lL), moderate lymphocytosis (14,472/lL,, and thrombocytopenia (52,000/lL, RI 200,000-500,000/lL). In the absence of hemolysis, gross lipemia, and Heinz bodies, MCHC was considered falsely increased due to extreme leukocytosis. 1 Results of a biochemical panel including urea (17 mg/ dL, RI 7-25) and creatinine (1.0 mg/dL, RI 0.3-1.4) were within normal limits. Voided urinalysis included a sediment examination ( Figure 1). Acute leukemia was diagnosed and the dog was euthanized. Based on clinical signs, cytology of peripheral lymph node aspirates, microscopic blood smear review, peripheral blood flow cytometry, and necropsy, final diagnosis was acute monocytic (AML-M5) or acute myelomonocytic (AML-M4) leukemia. Figure 1. Urine sediment from a dog. Unstained wet mount, 910 objective. Urine sediment interpretation: Allantoin crystalluriaUrine was opaque, brown, with a specific gravity of 1.065, 3+ protein, 2+ bilirubin, 2+ blood, negative glucose, negative ketones, and undeterminable pH (Chemstrip 10; Roche Diagnostics, Indianapolis, IN, USA). The reason why pH was not determinable is unclear. Urine sediment examination revealed 2-5 fine granular casts/low-power field (9100), 0-5 RBC/high-power field (hpf, 9400), 0-5 WBC/hpf, and moderate numbers of long, needle-like, colorless to slightly yellow-brown crystals occurring singly and in bundles, sheaves, and fans (Figure 1). Sizes of crystals varied from 5 9 20 to 100 9 400 lm. Lignin test for sulfonamides was negative. Crystals did dissolve in 1N sodium hydroxide and were insoluble in 5% acetic acid. Sediment was submitted to the Minnesota Urolith Center for further evaluation and crystalline material was 100% allantoin. DiscussionSimilar to xanthine and uric acid, allantoin is a renally excreted, terminal metabolite of purine metabolism derived from nucleic acid break down. 2 In contrast to people, the vast majority of urine purine metabolites in dogs are comprised of allantoin. People and higher nonhuman primates lack functional urate oxidase, the enzyme that converts uric acid into allantoin. 3,4 Allantoin is 5-10 times more soluble than uric acid 2 , and the re...

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