Epidural anaesthesia for treatment of neuropathic pain associated with pelvic limb amputation in a domestic shorthair cat. Issue 4 (12th October 2017)

• Record Type: Journal Article
• Authors: Primason, Lily Knox; Gleed, Robin; Boesch, Jordyn M
• Is Part Of: Veterinary record case reports. Volume 5:Issue 4(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-10-12
• Subjects: pain -- analgesia -- amputation -- anaesthesia -- neuropathology; Veterinary medicine -- Case studies -- Periodicals; Veterinary medicine -- Periodicals; 636.08905
• DOI: 10.1136/vetreccr-2017-000527
• Languages: English
• ISSNs: 2052-6121

Abstract

Abstract : An approximately 3‐year‐old, intact female, domestic shorthair cat presented to a shelter with a chronic fracture of the right femur. She underwent amputation of her right pelvic limb at the coxofemoral joint. On adoption two weeks following amputation, her owner noted clinical signs of pain associated with the stump, including resentment of stump palpation, paroxysmal vocalization and excessive grooming of the stump. Physical examination, including orthopaedic and neurological evaluation, was unremarkable except for subtle resentment of stump palpation. The history and clinical signs were consistent with neuropathic pain associated with the stump. A multimodal analgesic protocol consisting of oral meloxicam, gabapentin and amitriptyline was initiated; however, only mild improvement was noted and these medications were discontinued. A lumbosacral epidural injection of bupivacaine, buprenorphine and triamcinolone was performed under fluoroscopic guidance. The epidural injection resulted in immediate, complete resolution of clinical signs of pain that had not returned nine months later.