American journal of veterinary research · 2026
Epidural analgesia reduces or eliminates neuropathic pain refractory to oral medications in dogs and cats for weeks to months.
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Bergstein Olivia, Boesch Jordyn M, Thomson Alexander C S, Todd-Donato Amy
Аннотация
OBJECTIVE: To describe epidural injection for neuropathic pain in dogs and cats and report outcome.
ANIMALS: Medical records of patients presented to an academic pain medicine service from 2015 through 2026 with clinical signs of neuropathic pain and a somatosensory nervous system lesion or disease that underwent epidural injection after failing treatment with at least 2 oral analgesics were reviewed; incomplete records were excluded. Six animals met these criteria.
CLINICAL PRESENTATION: 4 domestic shorthair cats and 2 dogs (Dalmatian and mixed-breed) presented with neuropathic pain beginning after amputation (2 cats), blunt force trauma (1 cat, 1 dog), hemilaminectomy (1 dog), or parturition (1 cat). Abnormalities included paroxysmal, spontaneous self-mutilation, body-focused repetitive behavior, panic, and/or vocalization; signs of allodynia; teeth chattering; tail and skin twitching; abnormal posture or gait; and/or inability to perform normal activities.
RESULTS: MRI was not performed in feline amputees but showed intervertebral disk disease in 2 cats and the Dalmatian and sciatic nerve neoplasia in the mixed breed. At least 1 epidural injection containing triamcinolone (0.1 to 0.5 mg/kg) and 0.125% to 0.250% bupivacaine or ropivacaine (with or without other analgesics) was performed. In 1 feline amputee, 1 injection was curative. In the other cats, injection mitigated or eliminated pain for a median of 6 months (range, 0.25 to 8); in 2 cats, repeat injections lasted 5 and 2.5 months. In the Dalmatian and mixed breed, initial and repeat injections lasted 6 and 3 weeks and 4 and 2 weeks, respectively.
CLINICAL RELEVANCE: Epidural analgesia may relieve neuropathic pain when oral analgesics fail.
ANIMALS: Medical records of patients presented to an academic pain medicine service from 2015 through 2026 with clinical signs of neuropathic pain and a somatosensory nervous system lesion or disease that underwent epidural injection after failing treatment with at least 2 oral analgesics were reviewed; incomplete records were excluded. Six animals met these criteria.
CLINICAL PRESENTATION: 4 domestic shorthair cats and 2 dogs (Dalmatian and mixed-breed) presented with neuropathic pain beginning after amputation (2 cats), blunt force trauma (1 cat, 1 dog), hemilaminectomy (1 dog), or parturition (1 cat). Abnormalities included paroxysmal, spontaneous self-mutilation, body-focused repetitive behavior, panic, and/or vocalization; signs of allodynia; teeth chattering; tail and skin twitching; abnormal posture or gait; and/or inability to perform normal activities.
RESULTS: MRI was not performed in feline amputees but showed intervertebral disk disease in 2 cats and the Dalmatian and sciatic nerve neoplasia in the mixed breed. At least 1 epidural injection containing triamcinolone (0.1 to 0.5 mg/kg) and 0.125% to 0.250% bupivacaine or ropivacaine (with or without other analgesics) was performed. In 1 feline amputee, 1 injection was curative. In the other cats, injection mitigated or eliminated pain for a median of 6 months (range, 0.25 to 8); in 2 cats, repeat injections lasted 5 and 2.5 months. In the Dalmatian and mixed breed, initial and repeat injections lasted 6 and 3 weeks and 4 and 2 weeks, respectively.
CLINICAL RELEVANCE: Epidural analgesia may relieve neuropathic pain when oral analgesics fail.