Epidurals for Urethral Obstruction Pain

They reduce anesthesia required and help with pain control

A study published in the February 2020 Journal of Veterinary Emergency and Critical Care (San Antonio) evaluated the use of a caudal epidural to assist with placing a urinary catheter in 88 male cats with urethral obstruction. The goal was to determine the efficacy and safety of the technique.

The cats were randomly assigned to groups for the study: 30 received a bupivacaine epidural, 28 a morphine-bupivacaine epidural, and 30 a sham epidural. There was a 70% success rate in performing the epidurals, and no cats had complications resulting from the epidural. The cats in the test groups required significantly less anesthetic drug (propofol was used for this study) to allow placement of a urinary catheter than the sham group and remained comfortable for longer periods of time before needing additional pain medication. The researchers concluded, “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.”

Pratt CL, Balakrishnan A, et al. 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. J Vet Emerg Crit Care (San Antonio). 2020 Feb 26.