Spinal cord injury in a 5 month old cat after single-shot lumbosacral epidural injection

Abstract

This report presents the anatomical and histopathological findings observed in a 5 month old Domestic Short Hair cat euthanized owing to long-lasting pelvic limb paralysis. Paralysis occurred after a lumbosacral epidural injection for perioperative pain management during femoral fracture repair. A lumbosacral epidural injection was performed according to established veterinary recommendations, with no immediate complications noted during surgery. On postoperative examinations, the cat had severe pelvic limb neurological deficits, which did not improve over the 6 week follow-up period. Necropsy revealed a traumatic spinal cord injury attributed to needle insertion. Histopathological examination revealed reactive gliosis, axonal degeneration and fibroblasts adjacent to the needle track, significantly altering its architecture. This report underlines the potential risks of spinal cord injury during epidural injections at spinal levels containing the spinal cord. Although there is considerable worldwide experience with lumbosacral epidurals in cats, further studies are needed to better define the risks associated with this procedure, considering anatomical and developmental differences in this species.

Keywords: neuraxial anesthesia; paralysis; paraplegia; perioperative complication; reactive gliosis; spinal cord trauma.