Gold Coast could be without two vital members of their spine for some weeks after AJ Brimson and Kieran Foran were injured in their 24-12 loss to North Queensland.
The duo were strong for a fast-starting Titans outfit that enjoyed an early lead in the second Queensland derby in 24 hours but Gold Coast lost their way before the Cowboys clung on to victory in an error-strewn and chaotic final 20 minutes.
Foran went down with a calf issue after 22 minutes, and moments later Brimson was treated for a problem with his hamstring. Jayden Campbell and Erin Clark replaced them for the remainder of the match.
Cowboys winger Murray Taulagi was the next casualty, escorted from the field after suffering a suspected medial ligament injury on the stroke of halftime.
He was one of three Cowboys to depart the contest, with James Tamou hobbling off with a foot injury and centre Gehamat Shibasaki limping out with a hamstring complaint.
Despite the loss of Brimson and Foran, it was the Titans who took an 8-6 lead into the break after Alofiana Khan-Pereira dotted down in the third minute for his fourth try in as many games.
Tanah Boyd added two more points off the tee before the Cowboys finally cracked a stalwart Titans defensive line through Jeremiah Nanai on 35 minutes to trail by two at the break.
Tamou scored shortly after the second-half restart for his first try in Cowboys colours since September 2016, to put his side 12-8 in front before Valentine Holmes intercepted a long, arcing pass and ran 90 metres to score North Queensland's third.
Khan-Pereira crossed for his second soon after and the Titans looked set to fight down to the wire.
But the Cowboys sealed the result with seven minutes remaining when Tom Chester dotted down with his fingertips after a falcon and the ball ricocheting off a number of players.
Holmes was the standout for North Queensland, registering a game-high 225 metres but he was not without his own errors.
Jordan McLean became the only Cowboys forward to crack 100 running metres in their last two outings, while skipper Tino Fa'asuamaleaui led the charge for the Titans with 174 of his own.
