Udon - diagnosed with renal carcinoma
Udon, a spirited and determined 9-year-old Scottish Terrier was unfortunately diagnosed with renal carcinoma with metastases to the cervical, thoracic and lumbar spine at another referral hospital. However, the main concern for the owner was that Udon was demonstrating uncontrolled and worsening pain and subsequently referred to the Animal Pain Relief Clinic (APRC) at Harvest Veterinary Oncology Centre (HVOC).
The initial APRC consultation
At the initial APRC consultation, Udon was tremoring, unwilling to stand up and or raise his head at all. He also had an ataxic gait, pronounced stiffness in all four limbs, and a tense, painful abdomen on palpation. The baseline pain score filled in by Udon’s owner using the Canine Brief Pain Inventory (CBPI)* further confirmed that pain was substantially affecting Udon’s quality of life. This was every owner’s worst fear and in Udon’s case an emergency painful condition that needed to be addressed.
Chronic neuropathic pain induced by the primary tumour
Dr Christopher Sun, specialist in anaesthesia and analgesia and head of the APRC, diagnosed Udon with chronic neuropathic pain induced by the primary tumour that had spread to the lumbar region, with progressive and worsening neuropathic pain particular in the cervical spinal regions. To relieve this pain, Udon was treated using two methods, an analgesic infusion course to treat the chronic pain caused by the metastasis to the spine, and a long acting locoregional block to instantly relieve the lower back pain that was causing the majority of the tremouring, stiffness and reluctance to move.
Dr. Christopher Sun, performed an Erector Spinae Plane (ESP) block at the thoracolumbar region where the majority of the lumbar-related pain originates. The ESP block is a relatively new technique and requires ultrasound guidance in the identification of specific landmarks close to the spine, hydrodissection to confirm the fascial plane and successful administration of the local anaesthetic medications. The pain relief then spreads through the fascial plane to block the nerves causing pain from the renal carcinoma. Under general anaesthesia and sterile surgical conditions, the locoregional block was performed and Udon recovered unevenffully.
Over the next day or two, Udon’s pain relief was dramatically improved, with him now being able to regain a good quality of life despite the dreadful diagnosis. Udon’s owner could not be any happier that Udon is now feeling much better than before, and Udon’s pain is being continuousy monitored by the APRC team. At HVOC, we walk hand in hand with families, blending compassion and science to ensure every patient receives exceptional care.
