Peer-reviewed veterinary case report
Pain relief options for male cats with blocked urethra using epidurals
By Pratt, Chap L et al.·Published in Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)·2020·Department of Clinical Sciences and Advanced Medicine-Philadelphia, United States·View original on PubMed →
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Original publication title: A prospective randomized, double-blinded clinical study evaluating the efficacy and safety of bupivacaine versus morphine-bupivacaine in caudal epidurals in cats with urethral obstruction.
- Species:
- cat
Plain-English summary
Eighty-eight male cats with urethral obstruction (a blockage in the urinary tract) were treated with either a bupivacaine epidural, a combination of bupivacaine and morphine, or a sham (fake) epidural. The cats receiving the bupivacaine or the combination had less need for anesthesia during catheterization and experienced longer pain relief compared to those who received the sham treatment. Importantly, there were no complications from the epidural procedures. This suggests that using a caudal epidural can be a safe and effective way to manage pain in cats with urinary blockages.
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Abstract
OBJECTIVE: To investigate the efficacy and safety of the caudal epidural technique in cats with urethral obstruction (UO). DESIGN: Prospective, double-blinded, randomized, sham-controlled study. ANIMALS: Eighty-eight male cats with UO. INTERVENTIONS: Thirty cats randomized to bupivacaine epidural (BUP), 28 cats to bupivacaine-morphine epidural (BUP/MOR), and 30 cats to sham epidural (SHAM). MEASUREMENTS AND MAIN RESULTS: Time to perform the epidural and efficacy of the epidural was assessed by evaluation of tail and perineal responses. The amount of propofol for urinary catheterization and time to administration of rescue analgesia (buprenorphine) was recorded. Cats were monitored for epidural complications. The median time to perform the epidural was 2 min (range, 0.2-13 min and range, 0.5-13 min), with an epidural success rate of 70%. The median amount of propofol administered for urinary catheterization was significantly less in the BUP (2.1 mg/kg; range, 0-7.5 mg/kg) and MOR/BUP cats (1.85 mg/kg; range, 0-8.6 mg/kg) as compared to SHAM cats (4 mg/kg; range, 0-12.7 mg/kg) (P = 0.006, P = 0.0008, respectively). The median time to administration of rescue analgesia was also significantly longer in the BUP (10 h; range, 2-32 h) and MOR/BUP cats (10 h; range, 4-45 h) as compared to SHAM cats (4 h; range, 2-36 h) (P = 0.0026, P = 0.0004, respectively). There were no recognized complications related to the epidural. CONCLUSION: Caudal epidural appears to be safe, may reduce the amount of IV anesthesia needed to facilitate urinary catheterization, and can be used to provide long-term analgesia in the hospital.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/32100466/