Epidural analgesia reduces or eliminates neuropathic pain refractory to oral medications in dogs and cats for weeks to months.

Epidural triamcinolone with local anesthetic may provide weeks to months of neuropathic pain relief when oral analgesics fail.

This retrospective case series describes the use of epidural injections for managing neuropathic pain refractory to oral analgesics in six companion animals (4 domestic shorthair cats and 2 dogs). Cases were drawn from an academic pain medicine service between 2015 and 2026. Inclusion required clinical signs of neuropathic pain, a confirmed somatosensory nervous system lesion or disease, and failure of at least two oral analgesics. Etiologies included post-amputation pain (2 cats), blunt force trauma (1 cat, 1 dog), hemilaminectomy (1 dog), and parturition-associated pain (1 cat). Clinical presentations encompassed spontaneous self-mutilation, body-focused repetitive behaviors, allodynia, teeth chattering, skin twitching, abnormal posture or gait, and inability to perform normal activities. MRI findings included intervertebral disk disease in two cats and the Dalmatian, and sciatic nerve neoplasia in the mixed-breed dog. All patients received epidural injections containing triamcinolone (0.1–0.5 mg/kg) combined with 0.125%–0.250% bupivacaine or ropivacaine, with or without additional analgesics. Outcomes varied by species: one feline amputee achieved complete resolution after a single injection. In the remaining cats, pain relief lasted a median of 6 months (range 0.25–8 months), with repeat injections providing 2.5–5 months of additional relief. Dogs experienced shorter durations of 3–6 weeks per injection. The authors conclude that epidural analgesia is a viable intervention for neuropathic pain when oral medications are insufficient, offering meaningful relief for weeks to months.

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