A nearly 2-year-old, male, neutered pug was referred for a 1-month duration of progressive gastrointestinal signs and lethargy, and possible seizure activity. Blood analyses before referral had shown marked increases in hepatocellular and hepatobiliary enzymes and increased pre-prandial and post-prandial bile acids, with normal bilirubin. Physical exam revealed a quiet mentation and blood analyses at the time of presentation found persistent increases in hepatic enzymes, and hypoalbuminaemia. Abdominal ultrasound identified intra-abdominal free fluid and ileocolic lymphadenopathy. Cytology of the abdominal effusion, liver and abdominal lymph nodes identified organisms of the Cryptococcus genus. The dog had a positive Cryptococcus antigen lateral flow assay titre of 1:>10,000, confirming cryptococcosis. The dog was euthanased following diagnosis. This is the first report describing a case of disseminated cryptococcosis causing liver dysfunction in a veterinary species. Cryptococcus infection should be considered in a young dog presenting with gastrointestinal signs and liver enzymopathy.

Case summary A 14-year-old male castrated Cornish Rex cat was referred for lethargy progressing rapidly to collapse in the hours following a subcutaneous injection of a product containing 100 mg/ml pentosan polysulfate sodium and 168 mg/ml glucosamine. Physical examination revealed the cat to be in hypotensive shock with swelling and interstitial oedema around the cranial thorax and caudal cervical regions without cutaneous haemorrhage. Initial diagnostics revealed a severe anaemia (packed cell volume 11%) which later deteriorated further, necessitating a blood transfusion and aggressive fluid therapy. Post-transfusion, the patient remained dyspnoeic and subsequent diagnostics found evidence of pre-existing cardiomyopathy and congestive heart failure. The cat was euthanased 24 h following presentation due to increasing dyspnoea. Post-mortem findings were of severe subcutaneous and intermuscular haemorrhage over the neck and thorax, among other changes. There were no detectable levels of coumarin anticoagulants in the liver. Relevance and novel information This is the first reported case of acute subcutaneous and intermuscular haemorrhage of this severity suspected to be related to the off-label use of an injectable product containing pentosan polysulfate in a cat. Given the popularity of its use for feline arthritis, there is a need for large-scale clinical trials to evaluate the safety and efficacy of products containing pentosan polysulfate for cats, and any side effects to be reported.