Urinary Catheterization

Question 1

What are the different types of urinary catheters?

Answer 1

• Polypropylene
• Red Rubber
• Foley

Question 2

What is the size of a urinary catheter?

Answer 2

• Sized useing French (Fr) scale
• 1 French = 0.33mm in diameter

Question 3

What is the polypropylene catheter?

Answer 3

• May be clean, but not sterile
  
  • Should be individually packaged and sterilized prior to use
• Significant risk for urethral and/or bladder trauma due to rigidity
• Should never be used as indwelling catheters in small animals
• Used for select procedures:
  
  • Unblock male cats
  • Perform traumatic catheterization
    
    • diagnose bladder cancer
  • Prostatic wash

Question 4

What is the Red Rubber catheter?

Answer 4

• Made o polyvinyl
• Packaged indiviuually, and sterile
• Flexible for patient comfort yet rigid enough to pass without the need for guidewires
• Range in size from 3.5 - 24 Fr
• Available in 30cm or 50 cm for females and males

Question 5

What is they Foley catheter/

Answer 5

• Latex or silicone
• Packaged individually, and sterile
• Very flexible, may need an internal guidewire
• Inflatable balloon for added catheter security and to ensure proper location within the bladder
• Range in size from 6 - 36 Fr
• 2 Lengths 30cm to 55cm
• Recommened for indwelling urinary catheters

Question 6

What are Tom Cat Catheters?

Answer 6

• Variety of Materials
  
  • Polypropylene (A)
  • Ployvinyl (B)
  • Polytetrafluoroethylene (C)
  • Polyurethane (D)
• Diameter 3.5 and 5 Fr
• Lengths: 11, 14, & 30 cm
• Open and closed end design

Question 7

How do you prep a male dog for urinary catheterization?

Answer 7

• Sedation/anesthesia are generally not required
• Penis is exteriorized by an assistant
  
  • Do not hold too tightly - will occlude the urethra
• Distal penis is cleanded with an antibacterial solution
• Distal end of the catheter should be well lubricated with a water based lubricant
  
  • ensure proper aseptic technique is used

Question 8

How do you place a urinary catheter in a male dog?

Answer 8

• The tip is then placed into the distal urethra and advanced to the level of the bladder
• Ensure the entire length of the catheter is kept sterild during this process
• The catheter should be held parallel to the ventral body wall
  
  • holding perpendicular creates more pressure on the catheter or on the penis
• 2 points of resistance:
  
  • Os penis
  • brim of the pelvis

Question 9

What is Temporary Catheterization

Answer 9

• Catheterized only to obtain urine sample or for another short-term reason
• If aseptic technique was followed there is no reason for preventive antibiotics.

Question 10

What is Indwelling Catheterization?

Answer 10

• Catheterized patient in hospital where the catheter will remain in for hours to days
• Catheter will be secured to patient
• Needs to be connected to a closed urine collection system (line and bag)
• Patient will need E-Collar to prevent catheter from becoming dislodged

Question 11

How do you secure a catheter to a male dog?

Answer 11

• Inflate the bulb of the Foley catheter
• For Red Rubbers:
  
  • Place stay sutures in the prepuse using nylon suture
  • Secure a piece fo white tape to the catheter
  • Suture teh tape to the stay sutures

Question 12

What is a closed collection system?

Answer 12

• Collects the patient’s urine where it can be measured and disposed of at regular intervals
• At no point should the catheter be alowed to drip into the cage
  
  • impacts cleanliness
  • inceases likelihood of UTI

Question 13

How do you prepare a Female Dog for urinary catheterization?

Answer 13

• Sedation/anesthesia may be required
• Flush vestibule with 0.05% Nolvasan solution (6.3 mls in 250mls of sterile water)
• Place lidocaine jelly into vestibule for pain
• Do not clip hair to the levvel of the skin - will cause irritation
  
  • can trim, careful about length

Question 14

How do you prepare equipment for Female dog urinary catheterization?

Answer 14

• Test inflate Foley catheters before insertion
• Distal end should be well lubricated with a water-based lubricant
  
  • ensure proper aseptic technique
• If using a Foley catheter may need to prep with a guidewire

Question 15

How do you blind place a urinary catheter in a female dog?

Answer 15

• Don sterile gloves (open gloving)
• Insert well lubricated finger into the vestibule directing the finger cranially and dorsally
  
  • Tip of the finger should exted just beyond the urethral papilla
• With second hand, place urinry catheter ventralto your finger and direct the catheter ventrally using your finger
• Advance catheter to the bladder
• Confirm location
  
  • Presence of urine
  • Palpating: should paplate the catheter as it dives underneath the mucosa
• Difficult takes a lot of patience and practice

Question 16

How do you place a catheter in a female dog with visualization?

Answer 16

• A vaginal speculum can be utilized to visualize he urethral papilla to allow for direct placement
  
  • Killian vaginal speculum

Question 17

How do you secure a urinary catheter in a female dog?

Answer 17

• Inflate the bulb of a Foley catheter
  
  • preferred catheter as it prevents urin leakage
• For Red rubber:
  
  • Place 2 stay sutures in the vulva using nylon suture
  • Secure a piece of white tape to the cathetr
  • Suture tap to the stay sutures
• Catheter or line of closed collection system can be taped to the patient’s tail for added security

Question 18

What is Obstructive Urinary Disease?

Answer 18

• “Blocked Cat”
• Mostly seen in males
• ~60% are caused by urethral plugs, not stones
  
  • Plugs are comprised of proteinaceous matrix and struvite crystals
• Emergncy - should be evaluated immediately

Question 19

Why is Obstructive Urinary Disease more common in male cats?

Answer 19

• The male urethr is more narrow, particularly at the distal end