The use of multimodal anaesthesia and analgesia is desirable as part of a complete analgesic plan. Analgesic strategies for perioperative pain treatment include combinations of drugs with different means of action to increase their efficacy and to reduce the required doses and adverse effects. Local anaesthetics prevent the transduction and transmission of painful stimuli through their action on neuronal cell membranes. They undergo minimal systemic absorption and are therefore ideal alternatives to drugs that could result in systemic toxicity. Numerous benefits have been recognised for the use of local anaesthesia, such as a decreased need for systemic analgesics and decreased hospitalisation periods. Local anaesthetics have been used in veterinary medicine in several ways. Anatomical landmarks can be used to identify the target nerves and the clinician can employ an electrical nerve stimulator or ultrasound guidance to perform a more accurate injection. Local anaesthetic techniques can implement other drugs, apart from or in combination with local anaesthetics, such as opioids, α₂−adrenergic agonists or vasoconstricting agents. This review article presents and discusses the most common techniques of local anaesthetic use in small animals, with the aim of providing the clinician with further and comprehensive information regarding the analgesic options during the perioperative period.

The administration of lidocaine as part of multimodal analgesia in dogs undergoing ovariohysterectomies demonstrates variable analgesic efficacy. The aim of this prospective, double–blinded clinical study was to evaluate the effectiveness of lidocaine 2% irrigation on the ovarian suspensory ligament, followed by localised massage, in achieving sufficient intraoperative analgesia. Thirty-eight female dogs were randomly divided to two groups and received either a splash block of 0.5 ml lidocaine 2% on each ovarian suspensory ligament (GL) or an equal volume of saline (GNS). All dogs were premedicated with dexmedetomidine (5 μg·kg⁻¹) and buprenorphine (20 μg·kg⁻¹) intramuscularly and meloxicam (0.2 mg·kg⁻¹) subcutaneously. Anaesthesia was induced with propofol and maintained with isoflurane. The surgical procedure was initiated after an adequate depth of anaesthesia was achieved. Heart rate (HR), respiratory rate (f_R) and mean arterial pressure (MAP) were continuously monitored. Fentanyl (2 μg·kg⁻¹) was administered as rescue analgesia in case of a 30% increase in HR, f_R, or MAP, compared to their values before manipulation of the ovaries. Data were analysed using a mixed model for repeated measures ANOVA and Pearson’s Chi-Square test. The need for rescue analgesia differed significantly between the two groups (p < 0.0005). In GNS, 89.47% (17/19) of the dogs required rescue analgesia, compared to 10.53% (2/19) of the dogs in GL. The relative risk of rescue for the GNS compared to the GL was approximately 8.5. In conclusion, intraoperative analgesia during ovariohysterectomies in dogs can be enhanced using a lidocaine 2% splash block combined with massage of the ovarian suspensory ligament.

Locoregional anaesthesia is vital in modern equine veterinary practice. It effectively manages acute pain and may reduce the anaesthetic requirements and adverse effects associated with general anaesthesia. This review summarises the currently described local anaesthetic techniques used in horses, with emphasis on epidural approaches, peripheral nerve blocks, and fascial plane techniques. The relevant literature was identified through searches of PubMed, Web of Science, and Scopus databases. The review discusses the pharmacological properties of commonly used local anaesthetics, differences between short- and long-acting agents, and the potential role of adjuvants in prolonging analgesia. In addition, the available evidence regarding ultrasound-guided and nerve stimulator-guided techniques is presented, including their applications in thoracic, abdominal, and reproductive procedures. Attention is given to recently described fascial plane blocks and to the growing use of ultrasound guidance for improving anatomical identification and needle placement. The available evidence suggests that locoregional anaesthesia can contribute to multimodal analgesia in horses while potentially reducing perioperative systemic analgesic requirements. However, the clinical evidence supporting several techniques remains limited, and further controlled studies are required to evaluate their efficacy, safety, and reproducibility under clinical conditions.

This case series describes the management of two critically ill animals with pneumothorax of different etiologies. The first case involves a five year old male mixed breed dog that sustained multiple thoracic bites. The dog was presented with severe respiratory distress, subcutaneous edema, pale mucous membranes, tachycardia and crackling respiratory sounds. Thoracic radiographs revealed pneumothorax, pneumomediastinum, atelectasis and flail chest due to rib fractures. Initial stabilization included oxygen therapy, thoracocenteses, intravenous fluids, analgesics and antibiotics. Due to persistent air accumulation, autologous blood patch pleurodesis (ABPP) was performed, resulting in initial clinical improvement. However, respiratory deterioration necessitated the placement of a thoracostomy tube with continuous suction. Forty-eight hours later pneumothorax was dissolved, and the dog was discharged. Two years post discharge, the dog remains asymptomatic. The second case involves a 10 month old female cat with chronic respiratory distress due to trauma. Clinical examination revealed abdominal breathing, paradoxical movement and dysmporphy of the thoracic wall. Radiographs were indicative of diaphragmatic hernia. Surgical repair via midline laparotomy was performed, and thoracocentesis was conducted to manage the pneumothorax. However, due to severe postoperative dyspnea and persisted air accumulation in the thorax, repeated thoracocenteses, thoracostomy tube placement and ultimately autologous blood patch were deemed necessary. Suspicion of a ruptured pulmonary bulla led to an exploratory thoracotomy, during which a pulmonary defect was identified and resected. Unfortunately, the cat succumbed due to presumed prolonged hypoxia during surgery. These cases highlight the complexity of managing pneumothorax in small animals. The series underscores the need for a combination of classic pneumothorax management techniques with more recently described options, such as autologous blood pleurodesis. It also emphasizes the importance of advanced diagnostic imaging in managing such patients and the variable prognoses as well.

Congenital external auditory canal atresia (EACA) is a rare developmental anomaly in dogs with limited information to guide management. This report describes the clinical presentation, diagnostic work-up, surgical technique, and long-term outcome in two young dogs with unilateral congenital EACA. An 8-month-old Caucasian Shepherd and a 9-month-old Maltese presented with left-sided otalgia and absence of the external canal opening. Computed tomography identified segmental atresia of the vertical canal with intraluminal soft-tissue attenuating material and mild otitis externa and media in both dogs. Cytology and culture of canal contents were unremarkable, supporting a congenital, non-infectious origin. Both dogs underwent a canal-preserving vertical canal-to-external acoustic meatus anastomosis using a pull-through approach. Minor postoperative complications (partial wound dehiscence, mild canal stenosis) were successfully managed. At the 5-year and 1.5-year follow-up, respectively, both dogs remained free of clinical signs, with preserved hearing, supporting this procedure as a functional, cosmetically acceptable option in carefully selected dogs.

To evaluate sedation quality following two consecutive dexmedetomidine doses or a subsequent sedative drug injection following an initial dose of dexmedetomidine. Prospective, blinded, crossover, randomised study. Six healthy, adult laboratory Beagles. Each dog was given seven different drug combinations, delivered intramuscularly. Sedation was assessed using a 21-point sedation scale. An initial dexmedetomidine dose (5 μg kg^-1) was given at T0, followed by a subsequent injection of dexmedetomidine (2.5 μg kg^-1, group DD), butorphanol (0.2 mg kg^-1, DBt), buprenorphine (0.02 mg kg^-1, DBp), tramadol (2 mg kg^-1, DTr), ketamine (2 mg kg^-1, DK), midazolam (0.1 mg kg^-1, DM) or saline (0.5 mL, DS-Control) at T1 (when two sedation scores were equal or a score decreased). Following evaluations, atipamezole was given intramuscularly at T2 (defined as for T1). Sedation scores were analysed with a quantile regression model. The second drug was injected 34.2 ± 1.6 minutes (mean ± standard deviation) after the initial dose of dexmedetomidine. Median (range) sedation score in the DD group was not significantly higher at T2 compared to T1 [10 (7 - 15), 9.5 (7 - 12) respectively; p = 0.054]. At T2, median sedation score in the DBt, DBp, and DTr groups was significantly higher compared to the DS group (all p < 0.035). Sedation score in the DM group was significantly lower at T2 compared to all groups except DS and DK (all p < 0.05). The addition of ketamine resulted in seizure-like activity in three dogs. A second injection of dexmedetomidine or midazolam, approximately 34 minutes after an initial low dexmedetomidine dose, does not increase sedation and is not recommended. By contrast, addition of butorphanol, buprenorphine or tramadol at the same time point increased sedation.