Urine collection

Question 1

which urine of the day is best for collection?

Answer 1

1st urine of the morning
it is best for accuracy of urinalysis since it doesn’t have cellular components

Question 2

how do you locate the bladder for expression?

Answer 2

mentally draw an X over the last 2 sets of mammary glands, bladder located in the middle of the X
feels like a water balloon

Question 3

what should you do before collecting a voided sample?

Answer 3

clean the prepuce/vulva with diluted antiseptic

Question 4

why do we perform manual expressions?

Answer 4

to relieve the bladder when patient is unable or for routine testing

Question 5

when not to do manual expression

Answer 5

obstructed patients, pyometras, abdominal surgery patients

Question 6

what position should the patient be in for manual expression of the bladder?

Answer 6

while patient is standing or can do laying down for cats

Question 7

why do we use urinary catheters?

Answer 7

for repeat testing urinalysis, constant emptying of bladder, to monitor urine output, to relieve obstruction, and for cystography using contact

Question 8

why would we not use a urinary catheter?

Answer 8

could cause trauma

Question 9

where are urinary things located in the body

Answer 9

ventrally

Question 10

where are reproductive things located in the body?

Answer 10

dorsally

Question 11

how long should a urinary catheter be left in for?

Answer 11

maximum 24 hours to prevent a UTI from developing

Question 12

indications for urine collection

Answer 12

concerns with bladder or kidney

Question 13

types of catheters

Answer 13

polypropylene, tom cat, red rubber, foley

Question 14

types of urinary catheter systems

Answer 14

open or closed

Question 15

sizes for catheter tubing

Answer 15

cats: 3.5 french
small dogs: 5 french
medium dogs: 8 french
large dogs: 10-12 french

Question 16

procedure for putting in a urinary catheter

Answer 16

1. clip long hair
2. cleanse area
3. flush 5 times with 0.05% chlorohexidine (1 mL in smaller patients, 10 mL in larger patients)
4. don sterile gloves and check foley if using
5. lubricate
6. cut end of package near insertion tip
7. cut another ~1-2” away from 1st cut

Question 17

how is a urinary catheter placed for a female?

Answer 17

sedated patient in ventral recumbency with pelvic limbs draped over end of the table
use a rolled towel to support hip region

Question 18

visualization method of placing a urinary catheter

Answer 18

use speculum to open vaginal vault and insert catheter under the “button”

Question 19

digital method of placing a urinary catheter

Answer 19

occlude vestibule by placing finger dorsal to urethral opening, insert catheter ventral to finger and guide into urethral orifice
*catheter shouldn’t be palpable under finger if placed correctly

Question 20

closed collection drainage system

Answer 20

in-dwelling catheters should be attached to a sterile closed collection bag
prevents urine scalding, skin infections, facilitates bladder emptying, and can measure output
keep bag below patient

Question 21

csytocentesis

Answer 21

percutaneous aspiration of urine from the bladder

Question 22

why would we do a csytocentesis?

Answer 22

sterile urine sample, #1 for culture

Question 23

why would we not do a csytocentesis?

Answer 23

insufficient urine in the bladder, patient resisting restraint, recent abdomen surgery, pyometra, bleeding disorder

Question 24

disadvantages of a csytocentesis

Answer 24

can lacerate bladder, cause trauma or laceration to other anatomy (like descending aorta, caudal vena cava), cause iatrogenic hematuria, cause isolated disease to a specific part of urinary tract

Question 25

how do you perform a csytocentesis?

Answer 25

palpate before poking
can be ultrasound guided: aim needle towards trigone to minimize trauma to ureters and abdominal vessels
can see uroliths and thickened bladder wall on ultrasound too

Question 26

what to monitor for in urine cases

Answer 26

urine output (should be ~ 1 mL/kg/hr or 20 mL/kg/day), water intake, mentation especially for polyuric patients (because electrolyte imbalances), fluid overload