Pain management of a mandibular fracture in an alpaca (Vicugna pacos) via epidural catheter placement in the mandibular foramen

Stathopoulou, T and Seymour, C and McSloy, A and Adams, J and Viscasillas, J (2019) Pain management of a mandibular fracture in an alpaca (Vicugna pacos) via epidural catheter placement in the mandibular foramen. Veterinary Record Case Reports, 7 (4).

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Abstract

A nine-year-old female alpaca with a history of a recurrent tooth root abscess presented for further investigation of a swelling of the left mandible and possible tooth extraction. During the manipulation of the mandible in surgery, the mandibular body fractured, and due to active infection it was left to heal by secondary intention. After surgery, the alpaca became dull and inappetent. Analgesic drugs included buprenorphine and meloxicam, which were ineffective according to the alpaca’s clinical appearance. An inferior alveolar nerve block was achieved by repeated administration of local anaesthetic (ropivacaine 0.75 per cent) every six hours via an epidural catheter placed in the mandibular foramen under CT guidance. Despite the adequate level of comfort achieved, discharge from surgical site resumed and the owner elected euthanasia. In conclusion, the placement of an epidural catheter in the mandibular canal, under CT guidance, was proven to successfully provide analgesia to an alpaca suffering from mandibular fractures.

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