The safety and efficacy of butorphanol for postoperative analgesia following onychectomy were investigated in 63 cats randomly assigned in a 1:2 control to treatment distribution. Cats were premedicated with ketamine (5 mg/kg IM) and glycopyrrolate (0.011 mg/kg IM) and chamber-induced with isoflurane (5%) and oxygen prior to intubation. At extubation, control cats (C) received IV saline and treated-cats (B) received butorphanol (0.4 mg/kg IV). Rescue medication (butorphanol or acepromazine) was administered to cats based on analgesia score, dysphoria, or at the discretion of the attending clinician (20 C cats and 7 B cats); butorphanol was administered first if both acepromazine and butorphanol were administered. Heart rate, respiratory rate, and rectal temperature were recorded and recovery, sedation, and analgesia were subjectively scored for 24 hours postoperatively. Temperament was scored preoperatively and postoperatively. Food and water were offered and urination/defecation were recorded at 5, 16-18, and 24-26 hours. Four hours after extubation, C cats received saline and B cats received butorphanol (0.4 mg/kg) SQ. The next 2 days, C cats received a placebo tablet and B cats received butorphanol (2.5 mg) PO TID. Owners naive to treatment responded to a questionnaire at the end of the first and second days home. Chi-square analysis (P < 0.05) indicated treatment differences; only statistically significant results are reported. More C (81%) than B (55%) cats were painful at extubation; more C (33%) than B (12%) cats received poor recovery scores. At 5, 16-18, and 24-26 hours, analgesia was better in B cats. At discharge, 2% of B cats and 19% of C cats were markedly lame. During hospitalization, 28% more B cats than C cats ate. At home, 52% of C cats and 74% of B cats ate normally. C cats were less active than B cats at home. At the end of Day 1, 33% of C cats and 5% of B cats were lame. By Day 2, there were no differences. Postoperative butorphanol, the day of onychectomy and for 2 days after surgery, improves recovery, analgesia, appetite, and gait as determined subjectively during hospitalization by a naive observer and at home by the owner.
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