Fin is a 5-year-old, spayed female, domestic shorthair cat who was attacked by a dog. The attack resulted in severe trauma to her abdominal organs and abdominal wall. Her owners rushed her to the Companion Animal Hospital’s Emergency Room, where she was stabilized. Fin was then transferred to the Soft Tissue Surgery Service for emergency abdominal surgery. The Anesthesiology and Pain Medicine Service anesthetized her for surgery, and after a successful procedure, she was transferred to the Intensive Care Unit (ICU) under the care of the Critical Care Service.

Despite multiple intravenous infusions of analgesic drugs, Fin was severely painful post-operatively. The Anesthesiology and Pain Medicine Service was consulted. Fin was sedated right in the ICU for an epidural injection at the sacrococcygeal space. The sacrococcygeal space of the vertebral column is the intervertebral space between the sacrum and the tail, as shown in the image below.

The Comparative Pain Program, funded by the Cornell Feline Health Center, has been conducting research on sacrococcygeal epidural injection in cats.

Thanks to the data gained from this research, the appropriate drugs, doses, and total volume of solution to inject were known. The improvement in Fin’s comfort was dramatic after the injection, which was repeated twice during her ICU stay.

It is not uncommon for patients with severe trauma to fail treatment with intravenous analgesic drugs and require neuraxial drug injection (i.e., around the spinal cord, in either the epidural space or directly into the spinal fluid).

Fin was discharged to the care of her owners after approximately one week in the hospital and is thriving at home! Her case is an excellent example of how multiple services throughout the hospital work together to control pain.

All images used with owner permission