13/04/2026
UPDATE ON LOCAL ANAESTHESIA IN CATS
Recently, a prominent Veterinary Specialist Ophthalmologist Clinic in Melbourne (Victoria) released a newsletter discussing transoral local anaesthesia used in feline dentistry and subsequent ophthalmic complications, predominantly needle stick injuries to the globe that consequently were resulting in uveitis. Many of these cases are unable to be managed medically and were needing affected globes enucleated to treat.
Anecdotally, the ophthalmologists were seeing 1-2 cases every few months, suggesting this is not a rare complication, and something our general practitioners veterinarians needed to be made aware of.
Given the unique anatomy and close proximity of the globes to the mouth in our feline patients (and Brachycephalics!), needle stick ophthalmic injuries are a known and recognised complication of maxillary nerve blocks.
Upon further discussion with the ophthalmologists, the cases that were being treated for uveitis secondary to needle stick injuries were predominantly associated with the caudal maxillary nerve block, and less commonly with the infra-orbital, despite the risk being present for both.
There are currently many veterinary dentists, including the ones from Mobile Pet Dentistry that are currently still performing both of these transoral maxillary nerve blocks. Based on cadaver dissections, Dr Tony Caiafa has shown many veterinarians that the maxillary nerves in cats run more medially, and the previous recommendation of placing the block just caudal to the last molar is likely to be less effective and more likely to result in ophthalmic injury. Coupled with use of an appropriate size needle, depth of insertion and technique can significantly reduce the risk of ophthalmic complications. To our knowledge, MPD has not encountered this type of ophthalmic complications.
Based on this information, Mobile Pet Dentistry strongly encourages veterinarians to seek continuing education, specifically a hands on practical workshop to ensure they have the most up to date knowledge of the nuanced oral anatomy and they have a sound understanding of the anatomical locations where it is appropriate and safe(er) to place these maxillary nerve blocks.
We do not recommend relying solely on theoretical knowledge and self learning for these specific nerve blocks, as the risk of harm increases. In these instances, it will be safer to NOT place a transoral block and to rely on other modalities of analgesia.
Mobile Pet Dentistry would love to hear your thoughts on the matter, do you agree? Disagree? Have you ever encountered such a complication? Send us a message or comment below.
