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Pentosan Polysulfate for Dogs and Horses

By Barbara Forney, VMD

Last reviewed: 7/13/2022

Commonly prescribed for: Osteoarthritis

Species: Dogs and Horses

Therapeutic Class: Disease Modifying Osteoarthritis (OA)

Basic Information

Pentosan polysulfate (PPS) is a heparin-like, semi-synthetic polysaccharide ester derived from beechwood hemicellulose. PPS is a mild anticoagulant, with anti-inflammatory, fibrinolytic, and hypolipidemic properties. In human medicine, PPS is used to treat interstitial cystitis, particularly in women.

In veterinary medicine, PPS is used to manage and treat OA. PPS is thought to help preserve cartilage integrity and to improve joint health by supporting anabolic activity of chondrocytes and synoviocytes. It also provides protection from catabolic events within the joint by reducing levels of cytokines and inflammatory mediators within cartilage matrix and synovial fluid.


PPS is used systemically in horses as a part of conservative management/treatment of OA. Studies have shown therapeutic levels in synovial fluid following intramuscular (IM) administration. PPS usually is administered by IM injection once a week for a series of four weeks. It also may be administered intra-articularly.


PPS is used in the medical management of OA and after joint surgery in dogs. In both instances, PPS is injected either subcutaneously or IM once a week for four consecutive weeks.

Pentosan Polysulfate Side Effects

  • PPS generally is well tolerated.
  • Horses: Systemic PPS has been shown to elevate PTT for up to 24 hours. When used intra-articularly, there is the possibility of intra-articular bleeding. Appropriate bandaging and rest post injection are recommended.
  • Dogs: Mild GI disturbances including vomiting, anorexia.


PPS affects clotting time. It should be used with caution in animals receiving anti-coagulants or those undergoing surgery in the near future.

Drug Interactions

Although no specific drug interactions were found, PPS should be used with care in animals receiving other drugs that affect clotting function.
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