Page 2393 - Cote clinical veterinary advisor dogs and cats 4th

Urinary Catheterization 1183.e3

Male cat (p. 1176): Alternatives and Their SUGGESTED READINGS
• Sedation required Relative Merits Bubenik LJ, et al: Frequency of urinary tract infection
VetBooks.ir • Gently clip excess fur around prepuce to aid vasive but the presence of bacteriuria must culture and susceptibility testing results for catheter-
• Free-catch/voided urine samples are nonin-
• Place cat in lateral or dorsal recumbency
in catheterized dogs and comparison of bacterial
ized and noncatheterized dogs with urinary tract
in maintaining sterility
be interpreted cautiously.
infections. J Am Vet Med Assoc 231:893-899, 2007.
• With gentle traction push prepuce caudally
avoids urethral contamination, does not
to align the urethra parallel with the spine • Cystocentesis is more invasive but is faster, Segev G, et al: Evaluation of urinary catheters coated
• Insert a well-lubricated urinary catheter into require sedation, and causes less discomfort with sustained-release varnish of chlorhexidine in
the urethra, and gently advance the catheter than catheterization. mitigating biofilm formation on urinary catheters
in dogs. J Vet Intern Med 27:39-46, 2013.
into the bladder. Smarick SD, et al: Incidence of catheter-associated
○ Stiffer catheters are best for relief of Pearls urinary tract infection among dogs in a small
obstruction, but red rubber catheters • The use of prophylactic systemic antibiotics animal intensive care unit. J Am Vet Med Assoc
best for use as indwelling catheter. Place- in animals with indwelling urinary catheters 224:1936-1940, 2005.
ment of an indwelling catheter often is not recommended and may predispose to
follows use of a stiffer catheter to relieve development of resistant bacteria. Prophy- AUTHOR: Megan van Eeden, DVM
EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
obstruction. lactic antibiotic therapy may be ineffective Thompson, DVM, DABVP Procedures and Techniques
• If an obstruction is present, use 0.9% sterile at preventing catheter-associated UTIs as a
saline to gently flush and relieve the obstruc- result of biofilm formation.
tion. Use patience, and do not force passage • Previous studies report an incidence of
of the urinary catheter. catheter-associated UTIs of up to 55%.
• After the indwelling catheter is in place in Risk increases with age and duration of time
the bladder, connect it to a sterile closed that the indwelling catheter is in place. Each
collection system. additional day increases the incidence by
• Place stay sutures into either side of the 27%.
prepuce. • Due to increased risk of infection with dura-
• Secure the white adhesive tape to the catheter tion of indwelling time, urinary catheters
near the prepuce, to function as “wings” off should be removed as soon as they are no
the catheter. Then use nylon suture to secure longer medically necessary.
the white tape to the stay sutures. • Traumatic/diagnostic catheterization as a
• Obtain a post-placement lateral abdominal diagnostic tool for transitional cell carcinoma
radiograph to confirm proper catheter involves the aggressive rubbing of a red
placement. rubber catheter over an area of suspected
tumor. The catheter is passed into the
Postprocedure bladder, which is then emptied. Ultrasound
• Care of indwelling urinary catheter (p. 1182) guidance can help greatly to locate the tumor
○ It is important to wash hands before and site and catheter; using palpation (rectal and/
after handling the urinary catheter and or abdominal), the catheter is rubbed back
collection system. and forth over the suspected tumor site. A
○ Keep the urine collection bag below the small amount of saline is flushed in and
patient. then removed through the catheter. This fluid
○ Inspect and clean the urinary catheter and can be prepared for cytology by Cytospin
collection system daily. or gentle centrifugation. URINARY CATHETERIZATION Materials used to
set up a closed urine collection system for indwelling
urinary catheters. An empty fluid bag serves as an
economical collection reservoir.

Urethra Vagina

Bladder
Pelvis

Catheter

URINARY CATHETERIZATION A section of the
URINARY CATHETERIZATION Female anatomy for urethral catheterization. It is crucial to understand the sterile wrapper can be cut to hold as a tab to advance
anatomy of a female dog to correctly place a urinary catheter. a red rubber catheter for use in a male dog.
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