conscious male cat urinary catheterisation

Re: conscious male cat urinary catheterisation

Anthony Todd — Fri, 10 Sep 2010 23:53:34 GMT

[quote user="Martin Atkinson"]If you're giving ACP that's hardly entirely conscious is it? [/quote]

My criterion was that, with just ACP, they certainly let you know if you weren't gentle, so I therefore assumed urethral trauma was minimal or nil.

Some you could do with no ACP just patience and minimal restraint.

Re: conscious male cat urinary catheterisation

Michael Woodhouse — Fri, 10 Sep 2010 20:59:03 GMT

[quote user="Martin Atkinson"]A tad of butorphanol & meditomidine would work more effectively but they sometimes complain even with that however you can at least reverse it quickly[/quote]

I can't find a reference but I was once told by an anaesthetist that medetomidine caused uretheral spasm and shouldn't be used in blocked cats/dogs.

That's why I give them ACP/ket/torb.

Re: conscious male cat urinary catheterisation

Martin Atkinson — Fri, 10 Sep 2010 15:05:52 GMT

[quote user="Anthony Todd"]

No probs. ACP then drip the tip of the penis with local and squirt local up the penis with a 20 -22g I/Vcannula, without the needle[!!]

[/quote]

If you're giving ACP that's hardly entirely conscious is it? A tad of butorphanol & meditomidine would work more effectively but they sometimes complain even with that however you can at least reverse it quickly. I don't routinely leave indwelling catheters (I find if you flush the bladder out enough times they don't re-block) although I have in the past with no problems but I believe most urologists think its OK again now up to a week. The only bladder/ureter I've managed to perforate was one I was serially catheterising so in retrospect it would have been better leaving it in.

Re: conscious male cat urinary catheterisation

Mark Holmes — Fri, 10 Sep 2010 11:50:31 GMT

[quote user="Anthony Todd"]

Sorry this is so late!

I would be grateful for more details if you would mind, bearing in mind the "over-hydration" of cats on I/V fluids cautionary tales.

Did you use a pump? iif not then the volume per hour is fine [at least that way the patient got the fluid it needed without alarm.....

What rate/min or hour?

I suspect cats can tolerate vast amounts of fluids without depurr and your's may be a good example, or, at least, one of those discredited anecdotes.....

[/quote]

I forget all the details and unfortuneately the animals name. I have been searching through our system to fine the records but no look I am afraid so will have to go from memory.

The cat had been obstructed and developed post renal renal failure and was unfortuately one of those with muscle spasm, that just doesn't want to respond to muscle relaxants. We had tried indwelling catheters which were not really being successful so eventually resorted to tube cystostomy and with an indwelling foley catheter. I seem to recall that the cat was drinking staggering amounts of water despite being on iv fluids at 10ml/kg/hr which I thought was odd. He also had a mild skin tent and sunken eyes. Danielle GM suggested that that post obstruction diuresis might be a problem and suggested we match urine output with fluid input until voluntary water intake reduced to normal levels. We just matched the fluids in during the next time period with those passed in the last time period I think. The azotaemia resolved as the voluntary water intake reduced. Once we were happy he was fully hydrated and renal function appeared ok we reduced the fluids in on a 10% daily basis and monitored body wiehgt such that he never lost more than 5% bodyweight, with the intention of increasing medullary solutes. It was a long process but he eventually did ok.

Re: conscious male cat urinary catheterisation

Anthony Todd — Thu, 09 Sep 2010 17:51:03 GMT

[quote user="Mark Holmes"]Incidentally look out for post obstruction diuresis, we has a cat who was losing fluid so fast we struggled to keep up with the iv fluids for 72 hrs, it was persistantly azotaemic due to prerenal renal failure and dehydrated . When we measured urine output it was always greater than input until we were running 3-5 litres of fluid through the cat. (cannot quite remember the figures) Would have been easy to assume renal failure but responded to massive fluids. Once dehydration and azotaemia resolved we gradually reduced fluids on a 10% daily reduction but it took about a week to resolve it[/quote]

Sorry this is so late!

I would be grateful for more details if you would mind, bearing in mind the "over-hydration" of cats on I/V fluids cautionary tales.

Did you use a pump? iif not then the volume per hour is fine [at least that way the patient got the fluid it needed without alarm.....

What rate/min or hour?

I suspect cats can tolerate vast amounts of fluids without depurr and your's may be a good example, or, at least, one of those discredited anecdotes.....

Re: conscious male cat urinary catheterisation

HMC — Fri, 03 Sep 2010 16:31:48 GMT

Update on the cat: we failed to get a urine sample. I did not try the conscious urinary catheterisation after reading the comments here! he did not use the katkor but the vetbed instead.

nevermind, there was no dire need for the urine sample- just checking his kidneys (already on fortekor and renal diet) so sedation not really justified IMHO.

Re: conscious male cat urinary catheterisation

Vikki Halliday LLB — Fri, 03 Sep 2010 10:38:42 GMT

[quote user="Anthony Todd"]If you really ask me really nicely I'll tell you about my urethral stone and its endoscopic removal.[/quote]

Er, if you don't mind, I won't ask!

Re: conscious male cat urinary catheterisation

Anthony Todd — Fri, 03 Sep 2010 10:27:13 GMT

[quote user="Vikki Halliday"]I can vouch for the ouch![/quote]

Human medicos are not known for their sensitivity or sympathy at all. Hope your urethra wasn't damaged....

Hard to smear cream on a cat's slippery penis.

There is a zylocaine gel specifically for the male urethra as I can vouch for. If you really ask me really nicely I'll tell you about my urethral stone and its endoscopic removal.

"No, you'll really ,really, need a GA" said the urologist.

Re: conscious male cat urinary catheterisation

Anthony Todd — Fri, 03 Sep 2010 10:20:49 GMT

[quote user="Mark Holmes"]I used to go for indwelling catheters post obstruction but now I avoid them where possible[/quote]

So do I!

1. Have had stiffish catheters puncture the bladder. [Jacksons]

2. They always lead to an "infection" somewhere in the UT [and in humans too]

3. They often get pulled out by the cat, even when stitched in.

4. They sometimes get chewed through leaving some of it in the bladder!!

5. You don't know if this has happened as the bit may have been lost or eaten.

6. Twice daily "quick" unblocks, which are really a squirt of local through the urethra into the bladder are well tolerated, easy ,quick and no probs usually.

7. From my experience I perceive that having local gently squirted up an urethra twice daily post a urethra procedure would be rather nice.

Re: conscious male cat urinary catheterisation

Vikki Halliday LLB — Fri, 03 Sep 2010 09:05:55 GMT

[quote user="Anthony Todd"]

If it's an [quote user="Hannah Wynne Richards"]OUCH !!!!!!!!!!!!!!!!!!!![/quote]

Then you're probably, if not certainly damaging the delicate urethra.

That's why I always did it conscious

[/quote]

Hmm, having been the recipient of this procedure when in labour, and most definately conscious, I can vouch for the ouch!

However in human males, I am also aware that repeated catheterisation is possible and not painful, perhaps uncomfortable. Would still prefer sedation if possible.

Anyone tried using Emla cream to desensitise the external sphincter?

Re: conscious male cat urinary catheterisation

Anthony Todd — Thu, 02 Sep 2010 18:12:12 GMT

If it's an [quote user="Hannah Wynne Richards"]OUCH !!!!!!!!!!!!!!!!!!!![/quote]

Then you're probably, if not certainly damaging the delicate urethra.

That's why I always did it conscious

Re: conscious male cat urinary catheterisation

katja wagner — Thu, 02 Sep 2010 14:50:36 GMT

agree,tried this in the past and it worked brilliant,just need to be gentle and patient!

katja

Re: conscious male cat urinary catheterisation

Mark Holmes — Thu, 02 Sep 2010 10:37:16 GMT

I have changed my view on this I used to go for indwelling catheters post obstruction but now I avoid them where possible. I keep one in if massively azotaemic and needs some fluids but otherwise flush and rely on heavy muscle relaxation to prevent spasm. I find cats generally resent the catheter, the penis is often swollen and the prepuce irritated by the sutures. I have tried loads of ways to secure collection bags without pulling on the penis and nothing is satisfactory in my opinion and a stressy cat needs pissing off as little possible for recovery. They can reblock occasionally but rarely more than a couple of times.

Incidentally look out for post obstruction diuresis, we has a cat who was losing fluid so fast we struggled to keep up with the iv fluids for 72 hrs, it was persistantly azotaemic due to prerenal renal failure and dehydrated . When we measured urine output it was always greater than input until we were running 3-5 litres of fluid through the cat. (cannot quite remember the figures) Would have been easy to assume renal failure but responded to massive fluids. Once dehydration and azotaemia resolved we gradually reduced fluids on a 10% daily reduction but it took about a week to resolve it

Re: conscious male cat urinary catheterisation

Simon Neuhoff — Thu, 02 Sep 2010 09:42:24 GMT

[quote user="Niall Taylor"]

I like the tip about the local anaesthetic but why not use an indwelling catheter for a few days in recurrent 'blockers'? Surely repeated re-catheterisation is going to increase the risk of urethrospasm and fibrosis?

Niall

[/quote]

There seem to be two schools of thought about this - one that indwelling catheters cause significant inflammation and more harm than good (I think this is Andy Sparkes' view - but I apologise if I'm wrong!) - and others feel that indwelling catheters - if you use the softer ones anyway - are a good idea. I tend to avoid indwelling catheters as much as possible - reserving them for those that block again immediately after unblocking.

Re: conscious male cat urinary catheterisation

Niall Taylor — Thu, 02 Sep 2010 09:05:22 GMT

Niall

Re: conscious male cat urinary catheterisation

Hannah Wynne Richards — Thu, 02 Sep 2010 09:03:00 GMT

I would either insist on a GA or do without the sample

OUCH !!!!!!!!!!!!!!!!!!!!

Cat and veterinarian

Wynne

Re: conscious male cat urinary catheterisation

Anthony Todd — Wed, 01 Sep 2010 23:53:36 GMT

No probs. ACP then drip the tip of the penis with local and squirt local up the penis with a 20 -22g I/Vcannula, without the needle[!!]

Then a catheter coated with KY jelly should do it. Be gentle and patient, wait for the ACE and local to work too.

Cat in lateral recumbancy or sort of on its rear end, penis gently held and extruded with a gauze swab.

Only rarely, if ever, is a GA needed. Can do it twice or thrice daily in a reblocking cat.

The important advantage is if you are hurting, then you are traumatising the delicate urethra which probably the major cause IMHO of recurrent FLUDT [apart from diet, of course]

Re: conscious male cat urinary catheterisation

Louise6732 — Wed, 01 Sep 2010 23:11:20 GMT

Why on God's sweet earth would you even consider doing this conscious?! Apart from being rather impossible, I cannot begin to imagine how stressful this would be for the wee cat! Please don't do it! There are lots of anaesthetic combos to use. Give him lots buprenorphine :-)

Re: conscious male cat urinary catheterisation

Niall Taylor — Wed, 01 Sep 2010 21:41:55 GMT

Don't do it under any circumstances - it's inhumane beyond belief.

Niall

Re: conscious male cat urinary catheterisation

Stephen Ashman — Wed, 01 Sep 2010 19:34:03 GMT

It depends on the cat I think. I've certainly done it in a few cats, admittedly stranguria cases so they may not have been at their fighting best, but if it's a nice cat it may be easy enough. You will know pretty soon after starting whether it is a feasible option or not though!

Re: conscious male cat urinary catheterisation

Mark Holmes — Wed, 01 Sep 2010 18:11:21 GMT

Or bind cysto... very easy if bladder only moderately full much easier than concious catheterisation. If you are going to give catheterisation a go let us know and we can all have a sweepstake on your injuries

Re: conscious male cat urinary catheterisation

Michael Woodhouse — Wed, 01 Sep 2010 17:39:37 GMT

[quote user="Hannah Chilton"]Your thoughts?[/quote]

You're either brave or crazy!

Why would you want to do such a thing? To collect a urine sample? If you cage them for long enough most will pee in a tray.

You don't always need to palpate the bladder to squeeze some urine out, caudal abdominal pressure will produce something if the bladder is full.

Cage the cat for a day with some non-absorbant litter? If it's not produced anything in 8 hours should be good to squeeze?

Or sedate/anaesthatise and pass catheter. I use the BSAVA recipie of ACP/ketamine/torb.