Abstract
Tigilanol tiglate (TT; Stelfonta) is a novel intratumoral injection approved for the treatment of non-metastatic canine mast cell tumors (MCTs). Although the majority of reported adverse effects are localized and self-limiting, this case describes severe systemic and wound complications in a 10-year-old male Vizsla treated with a single 2 mL intratumoral injection for a subcutaneous mast cell tumor on the left lateral hock. Within 24 h, the dog developed vomiting, diarrhea, hypovolemic shock, and pancreatitis, requiring hospitalization and intensive supportive care. The cause of these systemic complications could not be definitively linked to Stelfonta, as multiple alternative diagnoses were also possible. Local tissue necrosis and wound infection subsequently progressed despite repeated surgical debridement, open wound management, and antibiotic therapy, culminating in distal limb necrosis and coxofemoral amputation 8 weeks post-injection. Histopathology confirmed proximal cicatrix formation, necrosuppurative inflammation, and fibrosis without residual neoplasia. This case highlights that while TT can be effective for local tumor control, clinicians must recognize the potential for rare but severe localized complications that may require surgical intervention.