Evaluation of the side-effects and thermal antinociceptive effects of intravenous hydromorphone in cats

Hydromorphone (H) may be an effective analgesic agent in cats, but fear of negative behavioral side‐effects associated with opioids is cited as a reason for avoiding this class of analgesics in cats. This study was designed to assess onset and duration of antinociception using an established feline thermal threshold model in cats, given an accepted clinical dose of 0.1 mg kg^?1 of H. In addition, cats were observed for changes in behavior and other side‐effects. Six adult cats from an established colony (four spayed females and two castrated males, 4.7–7.0 kg) received 0.1 mg kg^?1 H IV following establishment of baseline thermal threshold (TT) values. TT was tested at 15 minutes post‐injection, then at every 30–60 minutes for 12 hours. Side‐effects and behavior changes were recorded for 12 hours. Changes in TT over time were analyzed using a one‐way anova ; a p‐value <0.05 was considered significant. TT increased from a pre‐treatment value of (mean ± SD) 40.9 ± 1.65 °C to instrument cutout (55.5 °C) within 30 minutes for 5/6 cats. Mean TT was significantly elevated above baseline from 15 to 450 minutes after treatment. There was a significant increase in skin temperature from 15 to 300 minutes with peak increase of 1.55 °C at 135 minutes. Side‐effects included mydriasis (6/6) and nausea (4/6), characterized by licking, foaming, and gagging. Mydriasis occurred within 10–30 seconds of injection and persisted for 5–7 hours. Nausea was noted within 2 minutes of injection and persisted for 30–90 minutes; no vomiting occurred. Commonly observed behavioral changes included ventral tail curl (6/6 cats, onset 5–45 minutes, duration 4–5 hours) and euphoria (5/6 cats, onset <6 minutes for 4/6, duration 1–6 hours). 2/6 cats were profoundly sedate. Three cats showed signs of dysphoria with or without increased motor activity with variable onset and duration. Dysphoric behavior included staring, pacing, vocalizing, and sudden movements. 3/6 cats exhibited both euphoria and dysphoria at different times during the study. At no time were cats difficult to restrain or work with. Return to baseline behavior occurred 7–8.5 hours post‐injection. Mydriasis did not correlate closely with antinociception. Signs of sedation and euphoria corresponded with onset of antinociception, but not duration. Tail curl signs correlated with antinociception. In this model, H proved to be a rapid acting, potent, analgesic with a long (7.5 hours) duration of action. The most common behavioral changes noted were ventral tail curl, euphoria, and sedation. Mydriasis and nausea were noted as side‐effects.