1)     Intratesticular blocks

a)      This is a very effective, low-cost application of local anesthetic agents

b)      Mix 1.0 mg/kg bupivacaine with 1.0 mg/kg lidocaine as your base

i)        Adding a mu agonist opioid has been shown to effectively double the duration of analgesia

ii)       Opioid options include 0.075 mg/kg morphine, 0.015 mg/kg hydromorphone, and 0.003 mg/kg buprenorphine

c)      Use a 25g or 27g 5/8” needle for most cats and a 22g 1 to 1 ½“ needle for dogs

d)      Place the needle through the testicle starting from the caudal pole aiming for the spermatic cord

e)      It is OK, even desirable, for the needle to exit the testicle proximally as it is the spermatic cord that will receive the direct clamp stimulation

f)        ASPIRATE BEFORE INJECTING

i)        Inject, expecting firm backpressure, while withdrawing the needle

ii)      Expect to use about 1/3 to 1/2 of the drug volume per testicle leaving the organ firmly turgid

g)      Repeat for other testicle

h)      The left over drug can/should be used to place a dermal incisional block

i)       The total time for this procedure should be 1 to 2 minutes

j)       Drugs costs (lidocaine + bupivacaine):

i)        3 kg cat = $0.09

ii)      25 kg dog = $0.71

k)      Drugs costs (lidocaine + bupivacaine + hydromorphone):

i)        3 kg cat = $0.11

ii)      25 kg dog = $0.84