Page 2175 - Cote clinical veterinary advisor dogs and cats 4th

1085.e4 Cystogram

Postprocedure
• Remove the needle from the full syringe, and
VetBooks.ir aliquot of urine in a sterile tube for culture
replace with a clean needle before placing an
and susceptibility testing (e.g., red-top tube,
urine culture transport tube). This can be
saved in a refrigerator for culture until
urinalysis completed (if bacteria or pyuria
identified on urinalysis) or mailed out for
culture immediately.
• Place any additional aliquots needed for
special testing in appropriate containers, and
fill the conical urine tube with the remainder
of the sample for urinalysis.
• Allow dogs to be taken outside to void their
bladder, or place cats in a cage with a litter
box.

Alternatives and Their
Relative Merits
• Free-catch urine sample: a voided sample is
always safe to obtain and is often appropriate
for routine urinalysis but is less than ideal for CYSTOCENTESIS The syringe should be held in the
culture. Contamination can be minimized by dominant hand in a position that will allow aspiration
after the needle is in place without need to rearrange
cleaning the area around the vulva or prepuce the fingers. This will minimize the risk of extraneous
and catching the sample in midstream. needle movement and accidental bladder injury.
Free- catch samples cannot distinguish the
origin of cells from the urinary or genital
tract.
• Urethral catheterization: simple in male dogs CYSTOCENTESIS Ultrasound guidance can be used
but more difficult in female dogs or cats to visualize the bladder and to confirm appropriate
(sedation usually required). Preferred method needle placement before aspiration. Ultrasound is
especially useful for obese animals or those with
of sample collection for culture from animals small bladders.
with urinary TCC
Pearls RELATED CLIENT EDUCATION
Have clinic staff ask dog owners to avoid SHEET AUTHOR: Savannah Smith, RVT
allowing the pet to urinate on the way into EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
the clinic. Consent to Perform Cystocentesis Thompson, DVM, DABVP

Cystogram

Difficulty level: ♦♦ • Nonvisualization of the bladder after Equipment, Anesthesia
abdominal or pelvic trauma; suspected • General anesthesia or heavy sedation
Overview and Goal bladder rupture • Agents
• A cystogram is a radiographic study of the • Abnormally shaped or abnormally located ○ Negative-contrast cystogram: room air,
urinary bladder obtained after intraluminal bladder carbon dioxide, nitrous oxide
administration of positive contrast, negative • Congenital abnormalities ○ Positive-contrast cystogram: iodinated
contrast, or both. Evaluation of the urinary • Recurrent or nonresponsive urinary tract contrast medium (sodium iothalamate,
bladder with ultrasound has largely replaced infection (UTI) (p. 232) sodium diatrizoate) or noniodinated
many functions of the cystogram. • Suspected neoplasia, polyps, or radiolucent contrast medium (iohexol, iopamidol)
• A cystogram may be useful if the urinary calculi • Urinary catheter with inflatable bulb
bladder is not visualized on survey radio- • Posturethral/cystic surgical evaluation (Foley catheter) appropriately sized for the
graphs or if further detail (e.g., identification Specific studies for suspected disease: animal
of luminal filling defects) is warranted. • Negative-contrast study: bladder position • Tomcat catheter used for male cats
• Positive-contrast study: bladder rupture, • Sterile lubricating jelly
Indications bladder position • Surgical gloves
• Dysuria, pollakiuria, hematuria, stranguria • Double-contrast study: mucosal thickness • Sterile syringe for contrast
• Evaluation of caudal abdominal masses (cystitis), mucosal margination, luminal • Sterile syringe for withdrawing urine from
• Increased or decreased opacity associated contents (calculi), neoplasia bladder
with the bladder • Sterile syringe to inflate Foley balloon

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