title: Suspected epidural morphine analgesia induced chronic urinary and bowel dysfunction in a cat.
abstract: 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.
authors.affiliation: Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. rachel.baek@gmail.com
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Song
authors.forename: Johnny R
authors.initials: JR
authors.lastname: Cross
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Golder
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Callan
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000662:veterinary*; D000818:Animals; D002371:Cat Diseases / Q000209:etiology* / Q000628:therapy; D002415:Cats; D020117:Cisapride / Q000627:therapeutic use; D003248:Constipation / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D007268:Injections, Epidural / Q000009:adverse effects / Q000662:veterinary*; D008297:Male; D009020:Morphine / Q000008:administration & dosage; D009294:Narcotics / Q000008:administration & dosage; D010414:Pennsylvania; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy / Q000662:veterinary*
chemical_list: D005765:Gastrointestinal Agents; D009294:Narcotics; D009020:Morphine; D020117:Cisapride