University of Maryland Medical Center. Description. An in- depth report on the causes, diagnosis, treatment, and prevention of gout. Alternative Names. Hyperuricemia. Highlights. Gout is a painful inflammatory arthritis condition caused by deposits of uric acid crystals in the joints and soft tissues. The painful attacks often begin at night and may last for a week. U. S. This number is growing because of an aging population, the rise in obesity, increasing numbers of people who also have other conditions such as heart disease, kidney disease, and/or diabetes. The use of diuretics by persons with cardiovascular disease is another cause of the increase in gout. Treatment and Management. Medications are aimed at treating acute attacks by reducing pain and inflammation in the joints and other tissues. Medications also prevent future attacks by lowering uric acid in the body. Lifestyle changes are important in preventing attacks and managing the condition. Measures include losing weight, limiting foods and beverages that have the chemical purine, and limiting alcohol. Introduction. Gout is a painful and common type of arthritis. It is caused when there is too much uric acid in the blood. This is called hyperuricemia. Uric acid is a waste product in the body and is normally excreted through urine. Buildup of uric acid results in needlelike crystals forming in the joints, soft tissues, and organs. Cases of gout have increased in recent years. This increase is likely due to an aging population, dietary and lifestyle changes, greater use of medicines, such as diuretics (water pills), all of which can lead to a high uric acid level in the body. The process leading to hyperuricemia and gout begins with the metabolism, or breakdown, of purines. Purines are compounds that are important for energy. Purines can be divided into two types. Endogenous purines are manufactured within human cells. Kidney stone formers often ask us whether their soda drinking caused their kidney stones. Many have already taken the initiative to cut out all their soda, thinking. Therefore modern diet for gout recommendations focus on several factors: healthy weight management, the avoidance of high cholesterol levels, circumventing any degree. Kate Middleton's French Diet - The hottest diet in the UK, The Dukan Diet has also been a hit with Jennifer Lopez and Gisele Bundchen. But its strict rules may turn. Did you know your diet can trigger a painful gout attack? See which foods can help and hurt your chronic gout. Most mammals, except humans, have an enzyme called uricase. Uricase breaks down uric acid so it can be easily removed from the body. Because humans lack uricase, uric acid is not easily removed and can build up in body tissues. Uric Acid and Hyperuricemia. Purines in the liver produce uric acid. The uric acid enters the bloodstream. Most of the uric acid goes through the kidneys and is excreted in urine. The remaining uric acid travels through the intestines where bacteria help break it down. Normally these processes keep the level of uric acid in the blood below 6. L. But sometimes the body produces too much uric acid or removes too little. In either case, the level of uric acid increases in the blood. This condition is known as hyperuricemia. If uric acid reaches 7 mg/d. L or higher, needlelike crystals of a salt called monosodium urate (MSU) may form. The higher the level of uric acid, the higher the risk of crystal formation. As crystals build up in the joints, they trigger inflammation and pain. These are the symptoms of gout. Symptoms. Symptoms of gout depend on the stage of the disease. Gout can be divided into four stages: Asymptomatic hyperuricemia. A gout diet is key! What is a gout diet? Well read all my posts here on this site and check out my ebook if you can. Basically, your husband needs to.Acute gouty arthritis. Intercritical gout. Chronic tophaceous gout. Asymptomatic Hyperuricemia. Asymptomatic means there are no symptoms. Increase in blood uric acid is the first stage of gout. This stage may last 3. Note: Hyperuricemia does not always lead to gout. Less than 2. 0% of cases devleop into arthritic gout disease. Symptoms of Acute Gouty Arthritis. Acute gouty arthritis occurs when the first symptoms of gout appear. Sometimes the first signs of gout are brief twinges of pain (petit attacks) in an affected joint. These attacks can last several years before the full- blown condition occurs. Symptoms of acute gouty arthritis often start in one joint and include any of the following: Severe pain at and around the joint: may feel like . Gout that occurs in one joint is called monoarticular gout. About 6. 0% of all first- time monoarticular gout attacks in middle- aged adults occur in the big toe. This is known as podagra. Symptoms can also occur in other locations such as the ankle or knee. Polyarticular Gout. If more than one joint is affected, the condition is known as polyarticular gout. Multiple joints are affected in only 1. Older people are more likely to have polyarticular gout. The most frequently affected joints are the foot, ankle, knee, wrist, elbow, and hand. The pain usually occurs in joints on one side of the body and it is usually, though not always, in the lower legs and the feet. People with polyarticular gout are more likely to have a slower onset of pain and a longer delay between attacks. People with polyarticular gout are also more likely to experience low- grade fever, loss of appetite, and a general feeling of poor health. An untreated attack peaks 2. Some attacks last only hours, while others go on for as long as several weeks. Though symptoms can subside, the crystals are still present and future attacks are likely to occur. Intercritical Gout. Intercritical gout is the term used to describe the periods between attacks. The first attack is usually followed by a complete disappearance (remission) of symptoms. But, untreated, gout nearly always returns. Over two- thirds of patients have at least one more attack within 2 years of the first attack. By 1. 0 years, over 9. Symptoms of Chronic Tophaceous Gout. Chronic Tophaceous Gout and Tophi. After several years, persistent gout can develop into a condition called chronic tophaceous gout. This long- term condition often produces tophi. These are solid deposits of MSU crystals that form in the joints, cartilage, bones, and elsewhere in the body. In some cases, tophi break through the skin and appear as white or yellowish- white, chalky nodules that have been described as looking like crab eyes. Without treatment, tophi develop about 1. Tophi are more likely to appear early in the course of the disease in older people. In the elderly, women are at higher risk of developing tophi than men. Persons who have had an organ transplant and are on the medicine cyclosporine also have a high risk of developing tophi. Chronic Pain. When gout remains untreated, the intercritical periods become shorter and shorter and the attacks, although sometimes less intense, can last longer. In about 1. 0 to 2. Gout may later affect several joints, including those that may have been free of symptoms at the start of the disorder. In rare cases, the shoulders, hips, or spine are affected. Location of Tophi. Tophi may form in the following locations: Curved ridge along the edge of the outer ear. Forearms. Elbow or knee. Hands or feet - - older patients, particularly women, are more likely to have gout in the small joints of the fingers. Around the heart and spine (rare)Tophi are usually painless. But they can cause pain and stiffness in the affected joint. In time, they can also wear aways cartilage and bone and destroy the joint. Large tophi under the skin of the hands and feet can cause severe deformities. Complications. Uric Acid Nephrolithiasis (Kidney Stones). Persons who have kidney stones that formed from uric acid are more likely to have a higher level of uric acid in their blood than in their urine. This suggests that hyperurecemia is responsible for this type of kidney stone. Not all kidney stones in patients with gout are made of uric acid. Some are made of calcium oxalate, calcium phosphate, or substances combined with uric acid. Uric acid stones can also form in a person who does not have gout or hyperuricemia. Chronic Uric Acid Interstitial Nephropathy. Chronic uric acid interstitial nephropathy occurs when crystals slowly form in the structures and tubes that carry fluid from the kidney. This condition is reversible and not likely to injure the kidneys. Kidney Failure. Sudden overproduction of uric acid can sometimes block the kidneys and cause them to fail. This occurrence is very rare but can develop after any of the following: Chemotherapy for leukemia or lymphoma, particularly acute forms of the disease. Other cancers, such as breast cancer and lung cancer. Epileptic seizures. Pregnancy related preeclampsia or eclampsia. Use of medications to prevent kidney transplant rejection, such as cyclosporine. Causes and Risk Factors. Gout is considered either primary or secondary, depending on the causes of the high uric acid level in the blood (hyperuricemia). Nearly all cases of primary gout cases are idiopathic. This means that the cause of the hyperuricemia cannot be determined. Primary gout is most likely the result of a combination of genetic, hormonal, and dietary factors. Secondary gout is caused by medicines or by medical conditions other than a metabolic disorder. The following factors increase the risk of gout: Advancing age. Male gender. Family history of the condition; genetic predisposition. Obesity. Medicines, including diuretics (water pills), low- dose aspirin, cyclosporine, or levodopa. Binge drinking. Lead toxicity. Organ transplant. Thyroid problem. Other serious illness. People with gout are at an increased risk of having metabolic syndrome. Metabolic syndrome is a collection of health problems, such as abdominal obesity, high blood pressure, and low . This syndrome increases a person's risk of heart disease and stroke. Therefore, lifestyle changes are an important aspect of preventing gout and improving overall health. Each risk factor is discussed below. Age. Middle- Aged Adults. Gout usually occurs in men in the mid- 4. Men of this age group who have gout are often obese, have high blood pressure, unhealthy cholesterol levels, and drink large amounts of alcohol. Elderly. Gout occurs equally in men and women. In this group, gout is most often associated with kidney problems and the use of diuretics. It is less often associated with alcohol use. Children. Gout in children is uncommon except for rare inherited genetic disorders that cause hyperuricemia. Gender. Men. Men are at much higher risk of gout than women. In men, uric acid level normally rises at puberty.
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Best Cat Food For Diabetic Cats 2. The exact cause of diabetes in cats isn’t known but it seems to affect overweight and obese cats more than other cats. This is probably because being overweight makes the body less sensitive to insulin’s effects. Diabetes is also more likely to occur in older cats – which are also more likely to be overweight. If your cat is diagnosed with diabetes it is usually a frightening time for an owner. Symptoms typically include lethargy, increased urination, increased thirst, and loss of appetite. Your cat’s urine may be sticky to the touch because it literally contains sugar excreted from his body. Left untreated, diabetes can become life- threatening. However, many cats have diabetes and live long, happy lives with proper management. Following your vet’s diagnosis, you will probably have to give your cat regular doses of the hormone insulin to help control his condition. Feeding your cat a diet suited to his condition can also help manage his diabetes. Quick Look : Top 4 Best Diabetic Cat Foods. Feeding the diabetic cat. You probably already know that cats require meat in their diets. They need more meat and protein than dogs and they are not as good at breaking down carbs and starches as dogs. This is even more true when it comes to diabetic cats. Their bodies have greater difficulty moving sugar/glucose from the bloodstream to distribute it to the cells in the body. This is why sugar builds up in the cat’s bloodstream and can become harmful. As you might guess, it makes sense to feed a diabetic cat a diet that has less starch in it so it won’t break down into more sugar/glucose. According to the latest research, diabetic cats can benefit from diets that are high in protein and fat and low in carbohydrates. Kitten foods (especially canned kitten foods) can supply high protein and fat for this kind of diet. You can also find really good new diets today that have been made especially for diabetic cats such as Purina Pro. Plan DM Dietary Management Feline. Best Friends Foods, Best Feline Friend or Best Friends Forever. Our foods are just that -- The best you can get for your furry little feline purr machine!You probably won’t like some of the ingredients. But prescription diets are often very effective. They are often a food of last resort for some owners and their pets.) Some vets may also prescribe a starch blocker called acarbose to help prevent or slow your cat from digesting the starches in their diet. This drug requires a veterinarian’s prescription. Cats fed a high protein/low carb diet that take acarbose can often discontinue their insulin injections (under their vet’s guidance), or have their diabetes regulated on a lower dose of insulin. If you are interested in following a high protein/low carb diet for your diabetic cat, most people recommend that you feed canned cat food. They have always had higher protein and fewer carbs than dry cat food. Semi- moist cat foods are not recommended for diabetic cats because they often contain high amounts of sugar. Alternate diet. There is another diet for diabetic cats but it is not as popular as the high protein/low carb diet. This is a high fiber diet. Cat foods that have lots of fiber can slow the absorption and metabolizing of glucose and fat in the cat’s body. The glucose in the food won’t be absorbed as fast from the digestive track. This means that the cat doesn’t experience a glycemic high in his blood glucose level soon after eating. This diet can also help an overweight or obese cat lose weight. Unlike some of the high protein/low carb diets that are high in fat, high fiber diets are lower in fat and the fiber is filling. The cat feels full without eating as many calories. It is important for a high fiber diet to contain large amounts of complex carbs. Complex carbs break down slowly – again avoiding a spike in the blood sugar – but they continue to help the cat remain full and satisfied. A high fiber diet can help decrease a diabetic cat’s insulin requirements. However, there are some drawbacks with these diets. Since they contain so much fiber, they tend to produce flatulence. They also tend to increase the amount of stool the cat produces, as well as the number of bowel movements. Finally, a high fiber diet is sometimes not as palatable to a cat as a high protein diet. But they are another option to consider, especially if your cat has other health problems that might preclude being able to eat a high protein/low carb diet for some reason. Changing your diabetic cat’s diet. It’s important to work closely with your vet if your cat has diabetes. The type of insulin your cat takes, the dose, and how often he gets his dose are determined by a blood glucose profile for your cat while he is eating a specific diet. If you change his diet, the blood glucose profile will also change. This means that your vet will need to make adjustments in your cat’s insulin dosage. Even if you just change your cat’s diet from wet to dry it could make a big difference in his blood glucose profile. You should also let your vet know if your cat is not eating well or doesn’t like the food you are feeding. Please be sure to discuss changes to your cat’s diet with your vet and let him or her know about any changes you plan to make to the diet. It’s very important to keep your cat’s insulin dosages adjusted correctly. 6: Spice it up. Add spices or chilies to your food for a flavor boost that can help you feel satisfied. Discover the power of Hill's Prescription Diet cat food products; specially formulated to help improve the quality of your cat's life. Check out our best wet cat food list for 20, feed your cat the best way possible! We have evaluated the best cat food out there, to help you! Raw Food Diet - What Can We Learn From Pottenger's Cats? The “Pottenger’s Cats” study is a well documented scientific research study of 900 cats conducted. Weight and the diabetic cat. Most diabetic cats are overweight and can stand to lose a little weight. However, there are some diabetic cats that are underweight. This can occur if they have had diabetes for some time and the condition has gone unnoticed and untreated. In either case, you can manage your diabetic cat’s diet to help him get to a healthier weight. Diabetic cats usually have the same calorie needs as other cats. If your cat is overweight or obese, the calorie intake per day can be reduced by up to 2. It is important that you do not try to make your cat lose more than 2- 3 percent of his body weight per week. This may not seem like much but it is a lot to a cat that only weighs a few pounds. Slow, steady weight loss is better than making your cat feel hungry all the time by cutting his food or calories too drastically. In addition, rapid weight loss can result in a condition called heptatic lipidosis. This is a condition in which a large amount of fat collects in the liver and the liver stops functioning normally. It can be fatal. So, aim for slow weight loss for your diabetic (or any) cat. As your cat loses weight, your vet will also need to reduce the insulin dosage. If your cat is underweight, you can feed a cat food that is higher in calories to help him gain weight. Again, slow weight gain is better than trying to make your cat gorge. How to feed the diabetic cat. Since diet and insulin are closely related, your vet can benefit from knowing your cat’s eating habits when he or she starts your cat’s insulin regimen. Most cats with diabetes are fed on one of two schedules.
If you normally feed your cat two or three meals per day, you can probably continue on this schedule. In this case, you will probably give your cat insulin twice per day, at 1. It is important that you give your cat his insulin about the same time that he eats. Otherwise his blood glucose level can get too low. If your cat is a picky eater you may need to feed your cat just before it is time to give the insulin injection. In this case, if your cat won’t eat, you can call your vet and he or she may suggest that you wait to give the injection or make the dose smaller. If you free feed your cat and he is used to eating small amounts whenever he wants throughout the day, you can probably continue to do so. You may need to vary the type of insulin administered, the dosage, and how often you give the injection. Talk to your vet about how to work with this feeding method. As you can see, it’s more than possible to use your cat’s diet as a way to help control your cat’s blood glucose level if he has diabetes. You can also help your diabetic cat get to his ideal weight. Most people recommend a high protein/low carb wet diet for diabetic cats today but you can also feed a high fiber diet if that would be better for your cat for some reason. Remember that changing your cat’s diet in even small ways can change his blood glucose profile and affect the insulin dose he needs. Work with your veterinarian to manage your cat’s diabetes. |
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