We are all experienced with the use of a local anesthetic when a cavity is filled at the dentist. Sensation goes away for the couple hours that we are numb, but the great thing is the pain is totally removed and there is no need for a general anesthetic.
As well, many high-end surgeries such as knee or hip replacements are done under a spinal block.
Keeping a patient conscious for a surgical procedure is a great innovation.
The same is true in veterinary medicine, especially on the large animal side. Caesarian sections can be done on standing conscious bovine animals, and we also use epidurals on cows during embryo transfers.
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Local anesthesia has become more widespread in veterinary medicine in general, from nerve blocks when dehorning to freezing the scrotum for large castration in bovine or equine species.
From an animal welfare perspective, taking away the pain is imperative, and then depending on what the issue is, often NSAIDs are given for the long-term pain.
Lidocaine is absolutely necessary in certain circumstances where there is no alternative. Freezing and pain removal are needed not only for surgery but also to properly examine a severely lame foot or to stop severe straining.
General anesthetics are out of the question with cattle for most procedures because of cost, safety and the fact that few clinics have a large animal gas anesthetic machine.
Lidocaine is also mandatory for major operations such as caesarian sections, claw amputations, eye enucleations and displaced abomasums surgeries in dairy cattle.
Epidurals are also necessary to take away the pain and feeling when putting in prolapses of any sort or when blocking the tail to gently place embryos deep into the uterine horns.
The newest use is impregnating lidocaine in castration bands. There are many uses in veterinary medicine for which there is no good substitute.
Unfortunately, veterinary clinics recently faced a lidocaine shortage. The situation would have been dire in Western Canada if a pharmaceutical company hadn’t had active ingredient on hand and was able to manufacture enough to meet the shortfall.
One solution would be for regulatory authorities to allow what we call a compounded product to be manufactured and sold until the companies that used to supply the product can get their manufacturing back in line.
The product would still be manufactured and bottled under strict sterility conditions, but it would fill a shortfall that, if it had materialized, would have been disastrous for the cattle industry, not only economically but also from an animal welfare perspective.
Human medicine also faces lidocaine shortages occasionally. Maybe the human health and veterinary health industries need to get together and help each other with these shortages. I am sure both human grade and veterinary grade are made to the same standards.
These worldwide shortages seem to be increasing.
The manufacturing sites that supply the worldwide demand for products such as lidocaine are large but few in number.
I’m not sure if we need to stockpile production for a rainy day or increase production facilities as demand continues to rise.
Lidocaine use in large animal practices has actually gone down as the number of caesarian sections fall due to calving ease and smaller birth weights in calves.
The issue is that use has gone up in other aspects of veterinary medicine as well as human medicine and dentistry.
Lidocaine must be given by a licensed veterinarian or under their guidance, and we must always think of the withdrawals, although that will rarely be needed.
The milk withdrawal is 96 hours and the slaughter withdrawal about five days. The other medications you may be using along with lidocaine will generally have much longer withdrawal times.
I know it is your veterinarian’s responsibility, but make sure to ask about their supply because it is something we simply cannot be without in large animal practice.
Pain control is mentioned many times in the beef code of practice. That may mean the use of lidocaine in certain instances, and NSAIDs in other cases.
There is a maximum dose of five milligrams per kilogram, which for our two percent solutions means about one cc per five kg. A large cow caesarian would require 60 cc.
Lidocaine has a sedative effect that also makes procedures easier.
Allergic reactions occur occasionally and are treated like any other allergic reaction.
I definitely want this very necessary local anesthetic to always be in my kit.
Roy Lewis works as a veterinarian in Alberta.
