Acute and severe haemorrhage following pentosan polysulfate injection in a Cornish Rex

Tong MX, Romine JF, Hardcastle MR · JFMS Open Reports

Collapse within hours of the injection, hypotensive shock, a packed cell volume of 11% falling to 5% the next day, a normal platelet count, and post-mortem findings of severe subcutaneous and intermuscular haemorrhage over the neck and thorax. Coumarin poisoning was excluded on liver assay; a pre-existing cardiomyopathy contributed to the death.

Population

A 14-year-old cat with undiagnosed cardiomyopathy

Intervention

The second 3 mg/kg subcutaneous injection of a four-weekly course of a product containing PPS 100 mg/ml with glucosamine 168 mg/ml (Synovan), off-label for feline arthritis, after two uneventful courses in the previous two years

Comparator

None

Limitations

One cat, off-label use of a combination product in a species with no licensed indication, and pre-existing heart disease; no clotting times could be drawn; a single case cannot establish incidence, and the authors' call is for the feline trials that do not exist. No funding, no conflicts.