Transient Postoperative Hemorrhage from Elbow Arthroscopy Portals following Intra-Articular Pentosan Polysulfate Sodium Injection

Parker LA, Wustefeld-Janssens B, Dundas JM · Case Reports in Veterinary Medicine

All four dogs bled from arthroscopy portals within 1–3 hours of injection, with no intraoperative bleeding beforehand, at doses of 12.0–35.7 mg/kg — four to twelve times the label's subcutaneous dose; the one dog tested at 2 hours had a prothrombin time above 70 s and an aPTT above 120 s, normal again at 18 hours, while buccal bleeding times stayed normal. The pattern indicates that joint-injected PPS at these doses is absorbed well enough to anticoagulate the whole animal.

Population

4 dogs undergoing bilateral elbow arthroscopy for fragmented medial coronoid process

Intervention

5 ml of PPS injected into each elbow joint after arthroscopy — off-label route and dose

Comparator

None

Limitations

Four dogs, retrospective, and a route and dose the label does not sanction; the practical reading is about timing an injection around a procedure, not about the licensed subcutaneous dose.