Probable cutaneous adverse drug reaction to piroxicam in a cat

Abstract

Case summaryA 9-year-old male neutered Devon Rex cat presented with bilaterally symmetrical ulcerative lesions with mucopurulent exudate that developed rapidly. The lesions were apparent on the axillae, ventral abdomen and inguinal areas. The cat was systemically well. Piroxicam was being administered for palliative treatment of a previously diagnosed salivary adenocarcinoma. Histopathology revealed severe extensive epidermal ulceration with focal dyskeratotic keratinocytes in the stratum granulosum without lymphocyte satellitosis. Resolution of skin lesions was observed after discontinuing piroxicam. Similar lesions developed after previous piroxicam administration, further suggesting a possible adverse reaction to this drug. In addition, the Naranjo score indicated that piroxicam was a probable cause for the ulcerative skin lesions.Relevance and novel informationThis is the first report of piroxicam, a non-steroidal anti-inflammatory drug, as a probable cause of ulcerative skin lesions in a cat.

Cutaneous adverse drug reaction in a dog following firocoxib treatment

“…Three dogs diagnosed with neutrophilic dermatosis, resembling Sweet's syndrome, died following treatment with carprofen (Mellor et al., 2005; Vitale et al., 1999). Meloxicam induced cutaneous and ocular reactions in a dog, and piroxicam was reported as a probable cause of ulcerated lesions in a cat (Niza et al., 2007; Young et al., 2018).…”

“…Furthermore, drug challenge for a definitive ADR diagnosis was not possible due to recurrent reactions, which may have triggered severe and life‐threatening events (Young et al., 2018). However, the causality of ADRs was assessed using the Naranjo scale, a standardised method to establish a causal association between drugs and adverse events in human medicine (Naranjo et al., 1981).…”

“…The incidence of CADRs in dogs and cats with skin diseases was 2% and 1.6%, respectively, following treatment with drugs, such as topical agents, sulfonamides, penicillin and cephalosporins (Scott & Miller, 1998, 1999). Non‐steroidal anti‐inflammatory drugs (NSAIDs) have also been associated with skin eruptions in both human and veterinary patients, although the major side effects tend to be gastrointestinal (GI) and renal (Stringer et al., 2012; Johnson et al., 2009; Young et al., 2018). Firocoxib, a selective cyclooxygenase (COX)‐2 enzyme inhibitor, is an NSAID routinely used to treat veterinary cases of osteoarthritis (Hanson et al., 2008).…”