Objective: To characterize the indications and techniques for catheterization of the epidural space to treat pain in dogs and cats in a veterinary teaching hospital intensive care unit, and describe the analgesic regimens used in those patients. To provide a detailed description of the technique of epidural catheterization in companion animals.
Design: Retrospective case series and clinical practice review.
Setting: The Veterinary Teaching Hospital at the North Carolina State University College of Veterinary Medicine.
Animals: Records from 160 dogs and 22 cats that had epidural catheters placed were identified.
Interventions: Epidural catheterization for the purpose of providing analgesia for a variety of surgical and medical disorders was performed on both awake and anesthetized patients.
Measurements and main results: The most frequently used analgesic agents were preservative-free morphine and bupivacaine. 2The range of duration of catheter dwell time was 1.3–332 hours, with a mean duration of 50 hours and a median of 39 hours. Suspicion of catheter malpositioning prompted radiographic imaging of the catheter in 44 patients, and malpositioning was confirmed in 6 of those. Catheter tip positioning was recorded in 46 patients. The tip was located at L3-L6 in 16, and T5-L3 in 30. Twenty-seven of those 30 patients were catheterized to treat pain associated with thoracotomy, forelimb amputation, pancreatitis, or peritonitis. Fifty-one (28%) patients received no analgesics beyond those provided by the epidural catheter.
Conclusions: Epidural administration of analgesia appeared to provide significant pain relief and was adequate as a sole analgesic treatment in some patients. Serious complications in these critically ill animals appeared to be uncommon. (J Vet Emerg Crit Care 2001; 11(2): 95–103)