Page 377 - Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice

Technical Aspects of Fluid Therapy 367

D E

F G

Figure 15-5 cont'd D, The dilator has been removed and the catheter threaded over the exposed
portion of the guide wire. It is essential to confirm that the end of the guide wire is visible beyond the Luer
catheter connection before advancing the catheter into the vein. E, Once confirmed, the guide wire is
held stationary, and the catheter is advanced into the vein. F, The wire is removed, and a syringe and “T” piece
assembly have been attached to the catheter, and all air has been aspirated out. G, The catheter has
been partially withdrawn to the ideal depth, and a catheter collar has been attached and is securely sutured to
the skin at the insertion site. The catheter is then bandaged as for through-the-needle catheters.

or matted, it is worth the time and effort to clip it the jaws; and repeat this step three to five times to
first. Relatively stable, conscious animals should completely free up the vein. This is critical to allow
receive a local anesthetic with a 1% to 2% lidocaine/ rapid, reliable access to the vein lumen in the next step.
bicarbonate 9:1 mixture. 5. Close the forceps jaws; pass the instrument tip under
2. Create a 0.75- to 2-inch (1.3- to 5-cm) incision with a the cranial edge of the vein; and advance it caudally to
No. 11 Bard-Parker blade cranial and parallel to (not stretch the vein over the handles at the finger holds
directly over) the vein. Orient the cutting edge of the (Figure 15-6, F).
blade away from the leg; poke the tip through a fold of 6. If your hands are steady, you can attempt direct cath-
elevated (tented) skin over the lateral tibia; and lift the eterization of the vein with an over-the-needle style
blade as you advance it up the leg in a sweeping catheter. This is more difficult than it may first appear
motion (Figure 15-6, B). because the fascia around the vein no longer anchors
3. Retract the wound to expose the vein, and push it, and if your hands tremble, there is a high chance
against the vein from underneath the leg with an index you will lacerate the vein and lose your chance for
finger to elevate it from the wound (Figure 15-6, C). success.
4. Vigorously push the closed jaw tips of a curved mos- a. Grasp the mosquito forceps handle with your non-
quito forceps directly down on the vein, and then dominant hand, and pull the vein toward the foot
open the jaws along the long axis of the vessel to strip to stretch and stabilize it.
perivascular fascia away from the vein (Figure 15-6, b. With the needle bevel oriented away from the vein,
D and E). Lift the forceps from the wound; close puncture the tough superficial wall with the tip