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Intrathecal morphine overdose in a dog.

Anderson F da Cunha¹, Jennifer E Carter, Michael Grafinger

¹Department of Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA.

Journal of the American Veterinary Medical Association

|June 5, 2007

Summary

A canine patient experienced severe myoclonic seizures following an inadvertent intrathecal morphine overdose. Prompt, intensive supportive care, including atracurium, led to a full neurological recovery.

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Area of Science:

Veterinary Anesthesiology
Neurology
Pharmacology

Background:

A 6-year-old spayed female Boxer underwent surgery for a ruptured cranial cruciate ligament.
The patient inadvertently received an overdose of morphine (1.3 mg/kg) via subarachnoid injection.

Observation:

Fifty minutes post-injection, multifocal myoclonic contractions began in the tail and progressed cranially.
These seizures intensified throughout the surgery and were refractory to midazolam, naloxone, phenobarbital, and pentobarbital.

Findings:

Atracurium was the only effective treatment for the myoclonus.
The patient developed hypertension, dysphoria, hyperthermia, and hypercapnia.
Intensive supportive care included propofol, diazepam, atracurium, and naloxone infusions.

Implications:

Intrathecal morphine overdose can cause severe, potentially fatal complications in dogs.
Complete recovery is possible with immediate and extensive supportive care.
This case highlights the critical need for careful drug administration and preparedness for adverse events.