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Pentosan and Question Regarding Liver

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  • Pentosan and Question Regarding Liver

    I know there are several pentosan threads on here but after searching, I still couldn't find an answer to my question.

    To the users of Pentosan, were you ever concerned about any effects on the liver? I know it's a weak blood thinner but I wasn't aware about any potential side effects on the liver. I see for the warnings for the equine Pentosan, Contraindications: Use in horses with clotting defects, traumatic haemhorrage, infection, renal or hepatic failure, or within 48 hours of surgery.

    I saw on the ELMIRON web site (pentosan for people) it can cause abnormal liver function tests but has anyone observed this in horses? My horse did run into liver problems at then end of summer 2010 (liver biopsy showed mild-moderate liver damage but he responded to SAMe and milk thistle) and after Dec. 2010, liver panels have come back clean and have been clean since. Now I'm wondering if it would be risky to try this. My vet did write me a prescription but did express a bit of a concern about watching his liver so for sure I'd be running a liver panel after the loading dose (I also got my vet to pull blood and do a liver panel in case I decide to try the Pentosan).
    Last edited by Larbear; Apr. 4, 2012, 10:35 AM. Reason: title of thread

  • #2
    I did a quick search and found this statement:

    "Pentosan polysulfate sodium is metabolized through the liver. Patients with liver failure will not be as efficient at removing this compound from their bodies and dosage adjustment will likely be needed."

    To me this doesn't say the Pentosan may contribute to liver damage, but the liver his needed to metabolize it. So Pentosan may not work for your boy. I think Adequan would also be metabolized this way.
    Boyle Heights Kid 1998 16.1h OTTB Dark Bay Gelding
    Tinner's Way x Sculpture by Hail to Reason
    "Once you go off track, you never go back!"


    • Original Poster

      BoyleHeightsKid, thanks, I went and checked that out. I also saw that for people, there can be some elevations on the liver enzymes (GGT, AST, ALT and LDH). I guess if someone had chronic liver problems it make would it difficult to metabolize the drug and lead to elevated levels in the system. I can't seem to find anything/anywhere on if there was an episode of liver injury, the safety of Pentosan. I wonder if there'd be some benefit to supplementing with milk thistle and/or SAMe if there's some concern?


      • #4
        If you're concerned about it I can't see where it would hurt If his liver checks out okay then I would start him on the Pentosan and keep an eye on him. The great thing about the liver is it can repair itself to a certain extent, so if he starts showing any problems you can stop with the Pentosan.
        Boyle Heights Kid 1998 16.1h OTTB Dark Bay Gelding
        Tinner's Way x Sculpture by Hail to Reason
        "Once you go off track, you never go back!"


        • #5
          Just about any drug is going to have a general precaution about using it in the setting of liver impairment, and many drugs in clinical trials will have a few incidences of elevated LFTs.

          To say Pentosan is a "weak blood thinner" is an overstatement, IMO. EXTREMELY weak to the point of being a non-issue except in extreme circumstances would be more like it.

          I use it without particular concerns, but have (thank goodness) all healthy horses with no chronic health problems that would make me think twice. I would never add milk thistle or any other product to a drug to make the drug "safer". I consider milk thistle a drug in its own right and try to never add one drug to make another one "safer". The road to hell.
          Click here before you buy.