warfarin and Foot-Diseases

Topics: Aged; Anticoagulants; Cardiovascular Diseases; Female; Foot Diseases; Humans; Pigmentation Disorders; Syndrome; Toes; Warfarin

Purple toes syndrome is an extremely uncommon, nonhemorrhagic, cutaneous complication associated with warfarin therapy. It is characterized by the sudden appearance of bilateral, painful, purple lesions on the toes and sides of the feet that blanch with pressure. The syndrome usually develops 3-8 weeks after the start of warfarin therapy. A 47-year-old man with a history of purple toes syndrome that resolved after discontinuing warfarin--prescribed for a deep vein thrombosis (DVT) in his right lower leg--experienced an acute, proximal DVT in his other leg. Warfarin again was prescribed; 1 week later, purple toes syndrome developed in that extremity. Warfarin therapy again was discontinued, and intravenous unfractionated heparin was started; the patient's clinical picture indicated a possible pulmonary embolism, and laboratory analysis suggested antiphospholipid syndrome. The patient's toe pain resolved, but the purple discoloration persisted. Follow-up laboratory analysis confirmed antiphospholipid syndrome, and warfarin was restarted with close monitoring. No further complications occurred with long-term therapy. Although a rare complication of therapy, clinicians should monitor for the development of purple toes syndrome in patients taking warfarin.

Topics: Anticoagulants; Antiphospholipid Syndrome; Color; Drug Eruptions; Drug Monitoring; Foot Diseases; Humans; Male; Middle Aged; Syndrome; Toes; Warfarin

Topics: Anticoagulants; Arteriosclerosis; Contraindications; Fingers; Foot Diseases; Hemorrhage; Humans; Phenindione; Toes; Warfarin

Twenty horses suffering from navicular disease were treated with warfarin given orally. The dosage was to effect, to give a 2 to 4 second prolongation of the one stage prothrombin time (OSPT). Dosage was initially at a rate of 0.018 mg/kg, changing the dose by amounts of 20 per cent until the required dose was achieved. Final dose rates varied from 0.012 mg/kg to 0.75 mg/kg. All the cases treated received warfarin daily throughout the trial. Seventeen of the animals became sound and the remaining 3 showed a marked improvement in their gait. The mean of the ages of the horses was 7.5 years, the mean of the periods of lameness 9 months and the mean of the time taken to recovery one treatment was commenced was 7 weeks.

Topics: Administration, Oral; Animals; Foot Diseases; Forelimb; Hematoma; Horse Diseases; Horses; Osteitis; Warfarin