Castration/ovariohysterectomy pain (cats)

WSAVA guideline

Key findings

• Pain severity varies with surgical trauma; post-op analgesia may be needed up to 3 days (OHE; cryptorchid laparotomy); same NSAID pre- and post-op (card; §3.1).
• Premed: opioid + acepromazine (0.01–0.05 mg/kg) OR α2 ± ketamine (5–10 mg/kg IM; higher IM doses for hard-to-handle cats) (Tables 18–19).
• "Kitty magic": IM opioid + α2 + ketamine = premedication, induction AND maintenance; plan extension; intubation equipment ready; venous access advised (§3.1).
• Intratesticular LA: 0.2–0.3 mL/testicle (card) vs 0.1–0.25 mL (Fig 32, kitten/adult) [verify]; reduces inhalant needs, blunts sympathetic response (§2.5).
• IP bupivacaine 2 mg/kg (dilute 1:1 saline) before OHE or at closure — early post-op analgesia; LAs mandatory when opioids unavailable (§2.5, §3.5).
• Opioid-free protocol (ketamine 5 mg/kg + midazolam 0.25 mg/kg + dexmedetomidine 40 µg/kg IM + IP bupivacaine 2 mg/kg; meloxicam 0.2 mg/kg post-op): anaesthesia adequate, analgesia suboptimal — more rescue in adults (Diep 2020); one pre-op buprenorphine dose eliminated rescue (Rufiange 2022) (§2.2).
• Metamizole 25 mg/kg q24h or 12.5 mg/kg q12h = meloxicam 0.1 mg/kg in OHE cats (§2.3). Non-drug: cold therapy, photobiomodulation, acupuncture.

Drugs named in WSAVA’s own guideline text

As printed in WSAVA’s document, not this app’s own extracted data — see “Related drugs in this reference” below for that.

• Buprenorphine (Cat)

  Premed; post-op pain (OHE)

• Meloxicam (Cat)

  Post-op NSAID; take-home

• Dexmedetomidine (Cat)

  Sedation + analgesia where opioids unavailable

• Induction/maintenance agents (Cat)

  Induction/maintenance; kitty magic

• Lidocaine / bupivacaine (Cat)

  Castration block; OHE incisional + IP/ovarian-ligament block

• Metamizole (dipyrone) (Cat)

  Non-controlled alternative

Recommendations

• GA + preventive/multimodal analgesia for all feline neutering

  "Strongly recommended" (card; §3.1)

• LA techniques in all cases; mandatory when opioids unavailable

  Expert consensus (GPC)

• Same NSAID pre- and post-op; no perioperative switching

  Expert consensus (GPC)

• Analgesia up to 3 days post-op (OHE, cryptorchid)

  Expert consensus (GPC)

• OTM buprenorphine — cat-specific effective route

  Species-specific (Table 12)

• Opioid-free protocols acceptable if no opioids — expect more rescue (adults)

  Evidence (Diep 2020, Rufiange 2022)

• Score with FGS (rescue ≥4/10) or UFEPS-SF (≥4/12)

  Validated tools (Table 4)

• Reversible agents in feral cats; non-drug modalities

  Expert consensus (Repro GL §2.4)

Related drugs in this reference (2)

The quoted line under each drug is its own already-extracted indication text that matched this condition — the reason it’s listed, not a paraphrase. Open a drug for its full species/route breakdown, calculator, and complete adverse-effect list.

Showing 2 of 2 linked drug records. Open a record for species, route and source details.

• MELOXICAM

  “Single-dose post-op pain (ovariohysterectomy, orthopedic, castration)”

  Source dose preview: 0.2 mg/kg loading, then 0.1 mg/kg, q24h, PO/SC/IV (Dog)

  Adverse-effect notes: GI (vomiting, diarrhea, ulceration) — Most common · Renal injury — Reported at ≥0.3–0.5 mg/kg and higher (dog); with repeated/dehydrated dosing (cat)

• ROBENACOXIB

  “OstiRobe Injection is indicated for the control of postoperative pain and inflammation associated with orthopedic surgery, ovariohysterectomy and castration in…”

  Source dose preview: 1–2 mg/kg, q24h, PO (Dog)

  Adverse-effect notes: GI (vomiting, soft feces, diarrhea) — Most common, usually mild/self-limiting · ↑ Liver enzyme activity — With long-term oral use (not always associated with pathology)