Subject(s)
Brain Diseases/veterinary , Central Nervous System Parasitic Infections/veterinary , Dog Diseases/pathology , Parasitic Diseases, Animal/complications , Animals , Anthelmintics/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Brain Diseases/parasitology , Brain Diseases/pathology , Central Nervous System Parasitic Infections/pathology , Dexamethasone/therapeutic use , Diphenhydramine/therapeutic use , Dog Diseases/drug therapy , Dog Diseases/etiology , Dog Diseases/parasitology , Dogs , Female , Histamine H1 Antagonists/therapeutic use , Ivermectin/therapeutic use , Parasitic Diseases, Animal/diagnosis , Parasitic Diseases, Animal/pathologyABSTRACT
A 12-year-old male castrated domestic shorthair developed chronic urinary retention, constipation and a decreased perineal reflex following a single lumbo-sacral epidural injection of morphine during general anesthesia. Similar adverse effects have been reported in humans following epidural analgesia, but this is the first reported case of both urinary and bowel dysfunction in a cat purportedly from an epidural. The cat was medically managed with manual bladder expressions, intermittent enemas, and various medications including bethanechol, cisapride and stool softeners. The cat continues to have long-term neurologic dysfunction 15 months post-onset. This case report describes a rare but serious potential risk of lumbo-sacral epidural injections in cats.
Subject(s)
Anesthesia, Epidural/veterinary , Cat Diseases/etiology , Constipation/veterinary , Injections, Epidural/veterinary , Urinary Retention/veterinary , Anesthesia, Epidural/adverse effects , Animals , Cat Diseases/therapy , Cats , Cisapride/therapeutic use , Constipation/drug therapy , Constipation/etiology , Gastrointestinal Agents/therapeutic use , Injections, Epidural/adverse effects , Male , Morphine/administration & dosage , Narcotics/administration & dosage , Pennsylvania , Treatment Outcome , Urinary Retention/etiology , Urinary Retention/therapyABSTRACT
The histologic characteristics that are the basis for diagnosis of central nervous system conditions cannot be visualized directly using magnetic resonance (MR) methods, but clinical diagnosis may be based on the frequency and pattern of MR imaging signs, which represent predominantly the gross morphologic features of lesions. Additional quantitative MR measures of myelination, cell swelling, gliosis, and neuronal loss may also be used for more specific characterization of lesions. These measures include magnetization transfer ratio, apparent diffusion coefficient, and the concentrations or ratios of metabolites identified by spectroscopy. Confidence that an MR abnormality is responsible for the clinical signs depends primarily on the degree of correspondence between the site of the lesion and the neuroanatomical localization.