Page 2171 - Cote clinical veterinary advisor dogs and cats 4th

Cystoscopy 1085

1− blood, but DEA 1− dogs should only for blood donors and prior transfusion
receive DEA 1− blood. incompatibilities. Different labs test for
VetBooks.ir hemolysis or agglutination, the cross-match • A feline genetic mutation associated with
• When the recipient autocontrol shows
different dog erythrocyte antigens.
cannot be interpreted. In such cases, use DEA
the B blood group exists, and a DNA test
1− blood or universal blood (determined by
an early age from a buccal swab, which may
extensive prior blood typing as a mail-out). has been developed. Cats can be tested at
• If all available units are incompatible, the least be useful for cat breeders to avoid neonatal
reactive unit may need to be administered. isoerythrolysis. The DNA test does not dis-
• Cats with a positive result in both wells of tinguish between types A and AB, however.
blood-typing cards should be retested; if
result persists, they should be retested in a SUGGESTED READING
reference laboratory for the rare AB blood Tocci LJ: Canine recipient screening. In Yagi K,
type. et al, editors. Manual of veterinary transfusion
CROSS-MATCH AND BLOOD TYPING Gel- medicine and blood banking. Ames, IA, 2016,
based major cross-match test kit (DMS Laboratories, Alternatives and Their Wiley-Blackwell, pp 117-129. Procedures and Techniques
Flemington, NJ). Relative Merits
• Canine and feline EDTA-collected blood AUTHORS: Søren R. Boysen, DVM, DACVECC;
Marie-Claude Blais, DMV, DACVIM
samples can be sent to commercial labora- EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
tories for extensive blood typing: advised Thompson, DVM, DABVP

Cystoscopy Client Education Bonus Material
Sheet
Online

Difficulty level: ♦♦♦ • Calculi: urethral or cystic calculi retrieval and • Water-soluble sterile lubricant with or
identification (pp. 1014, 1016, and 1019) without lidocaine jelly
Overview and Goal • Cancer: urethra, bladder, prostate, vagina • Bacterial culture tubes
Transurethral cystoscopy (urethrocystoscopy) • Urethral stricture: diagnosis, interventional • Biopsy jars with 10% buffered formalin
involves the use of rigid or flexible endoscopes dilation, and/or stent placement (p. 1179) • Flexible-tipped ureteral guide wires can be
for examination of the lower urinary tract. Most • Uncommon: removal of small polyps and helpful for bypassing obstructions, strictures,
anatomic structures can be visualized: vulvar tumors via endoscopic loops and electrocautery and tears (serving a stylet-type function),
vestibule, vagina, urethral orifice, urethra, • Ureteroscopy: for advanced endoscopists; then allowing catheters to be passed over
urinary bladder, and ureteral orifices. Success requires concurrent fluoroscopy them. Human ureteral dilation catheters
is favored by proper training and experience. • Holmium-doped yttrium, aluminum, garnet can be used with the guide wires if urethral
Several sizes and lengths of endoscopes need (Ho:YAG) laser: used for laser lithotripsy. stricture is present.
to be available to be prepared for the breadth CO 2 lasers are used for ablative treatment • Accessory implements include sterile brushes,
of patient sizes and each sex. This procedure is of intraluminal tumors and ectopic ureter. guide wires, biopsy forceps, balloon catheters,
done commonly in specialty practice. sterile catheters, stone retrieval baskets,
Contraindications and polypectomy snares (with or without
Indications • Animal size and sex are the most common electrocautery).
Suspicion of any of the following disorders limiting factors; the exact limitations depend • Appropriate light source and light cable
or presence of the listed clinical signs can be on the endoscope’s external diameter relative • Documentation equipment (digital video
indications for transurethral cystoscopy: to the patient (see below). capture is most common, VCR)
• Anatomic abnormalities: vaginal strictures, • Known severe bacterial urinary tract infection • Flexible endoscopes
persistent vaginal membranes (p. 1027), (UTI) is a relative risk factor. ○ Size of scope selected varies by length and
ectopic ureters (p. 282), urachal diverticula • Pre-existing perforation or rupture of bladder diameter of the segment to be assessed
• Cystitis: chronic infectious (p. 232), idio- or urethra (e.g., measure from the cranial tip of filled
pathic, interstitial bladder to perineum, and consider the
• Posttraumatic or postoperative assessment: Equipment, Anesthesia diameter of the urethra).
pelvic fractures, abdominal trauma, prior To be prepared for most sizes and sex of patient ○ Ancillary catheters, brushes, stone retrieval
surgery may require a mix of six or seven rigid and baskets, and biopsy forceps to fit selected
• Hematuria: examination to identify origin of flexible endoscopes. scopes
bleeding and observation of ureteral orifices • General anesthesia with tracheal intubation ○ Flexible endoscopes require more posi-
(unilateral vs. bilateral hematuria of renal is required. tioning and manipulation of the animal
origin) • Preparation of the preputial or perineal because they tend to be deflected easily
• Urethritis: infectious, inflammatory, granu- area by clipping interfering hair and gentle by external pressures.
lomatous/proliferative cleansing • Rigid endoscopes
• Stranguria, dysuria, pollakiuria, urinary • Between 1 and 2 L of body-temperature, ○ A wide array of rigid endoscopes from
incontinence: identification of possible sterile saline for flush and infusion during human medicine can be used for trans-
causes; therapeutic periurethral submucosal procedure using an intravenous (IV) infusion urethral cystoscopy, including purpose-
injections of collagen for urethral sphincter set. A second IV infusion set is used for designed cystoscopes, small laparoscopes,
mechanism incompetence (p. 538) drainage by collection from the opposite port. and adapted arthroscopes.

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