Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report

A 20-year-old Quarter Horse gelding was presented with severe right forelimb lameness (5/5 AAEP Lameness Scale) due to a tear of the superficial digital flexor muscle which was diagnosed via palpation of swelling and ultrasonography revealing major muscle fiber disruption and hematoma formation. Whe...

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Autores principales:	Amanda R. Watkins, Klaus Hopster, David Levine, Samuel D. Hurcombe
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	epidural morphine analgesia equine opioid supporting limb laminitis Veterinary medicine SF600-1100
Acceso en línea:	https://doaj.org/article/b28d679f6fd14ec9890d4b0c73a8cbe5
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spelling	oai:doaj.org-article:b28d679f6fd14ec9890d4b0c73a8cbe52021-11-04T05:30:09ZCervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report2297-176910.3389/fvets.2021.749713https://doaj.org/article/b28d679f6fd14ec9890d4b0c73a8cbe52021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fvets.2021.749713/fullhttps://doaj.org/toc/2297-1769A 20-year-old Quarter Horse gelding was presented with severe right forelimb lameness (5/5 AAEP Lameness Scale) due to a tear of the superficial digital flexor muscle which was diagnosed via palpation of swelling and ultrasonography revealing major muscle fiber disruption and hematoma formation. When traditional systemic therapy (non-Steroidal anti-inflammatories) did not restore clinically acceptable comfort and the risk of supporting limb laminitis became a reasonable concern, a cervical epidural catheter was placed between the first and second cervical vertebrae in the standing, sedated patient using ultrasound guidance. The gelding was treated with epidural morphine (0.1 mg/kg every 24 h then decreased to 0.05 mg/kg every 12 h) and was pain-scored serially following treatment. Spinal analgesia was provided for 3 days. Pain scores significantly decreased following each treatment with morphine, and the gelding was successfully managed through the acutely painful period without any adverse effects associated with the C1-C2 epidural catheter placement technique, the epidural morphine, or contralateral limb laminitis. At the 2-month follow-up, the gelding was walking sound with no complications seen at the catheter insertion site. In this case, spinal analgesia using epidural morphine administered via a cervical epidural catheter was an effective and technically achievable option for pain management associated with severe forelimb muscle injury in a horse.Amanda R. WatkinsKlaus HopsterDavid LevineSamuel D. HurcombeFrontiers Media S.A.articleepiduralmorphineanalgesiaequineopioidsupporting limb laminitisVeterinary medicineSF600-1100ENFrontiers in Veterinary Science, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	epidural morphine analgesia equine opioid supporting limb laminitis Veterinary medicine SF600-1100
spellingShingle	epidural morphine analgesia equine opioid supporting limb laminitis Veterinary medicine SF600-1100 Amanda R. Watkins Klaus Hopster David Levine Samuel D. Hurcombe Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report
description	A 20-year-old Quarter Horse gelding was presented with severe right forelimb lameness (5/5 AAEP Lameness Scale) due to a tear of the superficial digital flexor muscle which was diagnosed via palpation of swelling and ultrasonography revealing major muscle fiber disruption and hematoma formation. When traditional systemic therapy (non-Steroidal anti-inflammatories) did not restore clinically acceptable comfort and the risk of supporting limb laminitis became a reasonable concern, a cervical epidural catheter was placed between the first and second cervical vertebrae in the standing, sedated patient using ultrasound guidance. The gelding was treated with epidural morphine (0.1 mg/kg every 24 h then decreased to 0.05 mg/kg every 12 h) and was pain-scored serially following treatment. Spinal analgesia was provided for 3 days. Pain scores significantly decreased following each treatment with morphine, and the gelding was successfully managed through the acutely painful period without any adverse effects associated with the C1-C2 epidural catheter placement technique, the epidural morphine, or contralateral limb laminitis. At the 2-month follow-up, the gelding was walking sound with no complications seen at the catheter insertion site. In this case, spinal analgesia using epidural morphine administered via a cervical epidural catheter was an effective and technically achievable option for pain management associated with severe forelimb muscle injury in a horse.
format	article
author	Amanda R. Watkins Klaus Hopster David Levine Samuel D. Hurcombe
author_facet	Amanda R. Watkins Klaus Hopster David Levine Samuel D. Hurcombe
author_sort	Amanda R. Watkins
title	Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report
title_short	Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report
title_full	Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report
title_fullStr	Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report
title_full_unstemmed	Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report
title_sort	cervical epidural spinal analgesia for acute management of severe unilateral forelimb lameness: case report
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/b28d679f6fd14ec9890d4b0c73a8cbe5
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Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report

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