Abstract. Phenytoin, given to a cat in proportions therapeutic for man (5 to 8 mg/kg), induced severe dermal atrophy with excessive fragility of the skin following daily oral administration for 3 weeks. Dermal collagen was depleted, but remaining collagen seemed structurally normal. Upon cessation of phenytoin treatment, the cat recovered. In an effort to establish an association between phenytoin treatment and a dermal collagen disorder, phenytoin treatment was repeated and the dermal lesion confirmed.Phenytoin is an important and common drug for the management of convulsive disorders in man and, to a lesser extent, in animals. The compound is generally regarded as safe, but has a number of side effects [20], such as gingival hyperplasia caused by the drug's influence on connective tissue [lo, 201. Although there is an increase in collagen in these lesions, this is a reflection of an increased number of cells rather than increased collagen production by each cell [lo, 141. It has been demonstrated that phenytoin stimulates the proliferation of cultured fibroblasts but inhibits protocollagen proline hydroxylase in vitro [ 141; but there is no existing evidence that phenytoin inhibits collagen synthesis in vzvo. These effects are probably negligible in most species because of metabolic detoxification of the drug. The cat, however, is unable to metabolize phenytoin [3] and thus could theoretically manifest collagen disorders during treatment with phenytoin, as our cat did. Cause and effect are not proved; the effects may have been secondary or related to previously described heritable or spontaneous cutaneous collagen disorders in cats 15, 18, 211.
Materials and MethodsOur cat was an orange tabby, young adult, short hair male. In February, 1976, electrodes were implanted into the thalamus, hippocampus and mesencephalic reticular formation [ 1 I] for neurobehavioral studies. In May, the cat was started on a 6-week oral phenobarbitol regimen and in June, oral phenytoin treatment began, consisting of single doses of 5 mg/kg per day for 2 weeks, then 8 mg/kg for about one more week. During the phenytoin course, the cat became anorectic and slightly atactic. Body weight had fallen from 3.5 kg in February to 489
470Barthold, Kaplan and Schwartz 2.0 kg in August. The cat had dry, scruffy hair, conjunctivitis and pyrexia, and the skin was thin with many poorly defined areas of excoriation on the abdomen. When the cat was manipulated for clinical workup, a large area of skin over the thorax and neck was torn. The wound was cleaned and sutured and the cat was treated with intravenous and oral ascorbic acid and intravenous fluids. Several spontaneous lacerations occurred during the next few days and were sutured. A skin biopsy was taken from the lateral thorax. About one month later, the cat had improved. The skin was no longer friable and felt thicker. A second skin biopsy was taken from the contralateral thorax. By November 1976, the cat was apparently normal, and weighed 5.2 kg.Phenytoin was suspected as the cause...