Use of hyaluronidase for the treatment of extravasation of chemotherapeutic agents in six dogs

Six dogs had perivascular extravasation of antineoplastic agents during IV administration. Treatment with 300 units of hyaluronidase injected locally in the affected site was initiated following the extravasation event. Injections were repeated weekly until signs of toxic effects within the tissues resolved satisfactorily. All dogs recovered within 6 weeks, and residual fibrosis at the extravasation sites most was considered minimal. Many chemotherapeutic agents cause severe cytotoxic reactions when extravasated during cycles of chemotherapy, resulting in tissue necrosis with ulceration and sloughing of skin during the following weeks. Surgical treatments and skin grafting are often necessary to achieve healing. The sequelae of extravasation may result in discontinuation of chemotherapy or euthanasia of the animal. Hyaluronidase appears to be a safe treatment for the adverse effects of extravasation of various chemotherapeutic agents and may be used effectively to reduce the severity of cutaneous toxicosis.