Management of Neuropathic Pain in a Domestic Shorthair Cat
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An approximately 3-year-old, intact female domestic sh01thair presented to her local shelter with a chronic fracture of the right pelvic limb. She underwent an amputation of her right pelvic limb via coxofemoral disarticulation. Upon adoption two weeks following the amputation, discomfort was evident on palpation of the amputation stump. Additionally, episodes of crying out and excessive grooming of the amputation stump were observed. The signs and history were most consistent with neuropathic pain, pain that results from damage to the nervous system. Medical management using a multimodal approach was pursued. Meloxicam (a non-steroidal anti-inflammatory), gabapentin (an antiepileptic and neuropathic pain modulator), and amitriptyline (a tricyclic antidepressant) were used. Due to persistence of pain, a locoregional analgesic procedure was performed, which involved injection oflocal anesthetic, corticosteroid, and opioid into the epidural space using fluoroscopic guidance. There was marked improvement in pain perceived following the epidural injection. Neuropathic pain following amputation is commonly reported in humans; while the understanding of its role in amputee veterinary patients is still to be eluded, reports indicate a similar phenomenon.