Epidural analgesia reduces or eliminates neuropathic pain refractory to oral medications in dogs and cats for weeks to months.

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.