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Urothelial carcinoma (UC) occurs uncommonly in cats and no association has previously been observed with long-term indwelling urinary implants. An 18-year-old male castrated domestic shorthair cat initially was presented for hematuria, leading to the diagnosis of a right-sided ureterolithiasis and severe pyelectasia on ultrasound examination, prompting right-sided subcutaneous ureteral bypass (SUB) device placement. The cat subsequently had intermittent hematuria and dysuria, without ultrasonographic abnormality of the bladder or positive urine culture. Thirteen months later the patient developed refractory lower urinary tract signs, azotemia, a proliferative mass in the region of the cystostomy tube component of the SUB device and evidence of left ureteral obstruction. Cystostomy tube revision and left-sided SUB device placement were performed, as well as a partial cystectomy for removal of the mass. Upon histopathology, the mass was diagnosed as a UC. To our knowledge, UC associated with a long-term indwelling cystostomy catheter component of a SUB device has not been reported in veterinary medicine., (© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Objective: To determine the complications, outcomes, and patency of a permanent epidural catheter and subcutaneous access port system (ECAPS) as part of conservative management of degenerative lumbosacral stenosis in dogs., Animals and Procedure: Medical records of 11 client-owned dogs that underwent an ECAPS insertion were evaluated retrospectively. Clinical signs, complications related to the procedure, and system patency are reported., Results: All dogs had lumbosacral pain at their initial neurological assessment, with comfort levels adequately controlled following epidural infiltrations. None suffered from complications related to the ECAPS procedure. In 10 dogs, there were no malfunctions for the duration of the study. However, in 1 dog, there was a suspected leak at Day 814. The longest duration of patency reported in this study was 870 d (at the time of writing)., Conclusion: Placement of an ECAPS is a feasible technique and a viable option to permit repeated epidural injections of steroids in dogs with degenerative lumbosacral stenosis that is managed conservatively. Further studies are required to evaluate complication rates., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Objective: To describe the use of small-bore wire-guided catheters in the management of peritoneal effusion in cats and dogs and to detail any associated adverse events., Design: Retrospective study., Setting: University teaching hospital ANIMALS: Forty-five client-owned animals that had peritoneal catheters placed for management of peritoneal effusion between July 2010 and June 2021., Interventions: None., Measurements and Main Results: Forty-five cases were included (25 dogs and 20 cats). Twenty-eight animals had the catheter placed to aid management of a uroabdomen, 8 of which recovered without surgical management, 11 had the catheter placed to allow autotransfusion of hemoabdomen, 3 had peritonitis, and 3 had ascites secondary to cardiac disease. Twenty-seven cases (15 dogs and 12 cats) received sedation (n = 24) or local anesthesia alone (n = 3) to facilitate catheter placement, and 6 cases had the catheter placed while under general anesthesia. Median length of catheter persistence was 24 hours (range: 2-144 h). The most common adverse events reported were impaired drainage (n = 7) and leakage at the insertion site (n = 4)., Conclusions: Peritoneal catheters can be inserted percutaneously for management of peritoneal effusion. Indications include stabilization and conservative management of uroabdomen, and autotransfusion. They can often be placed with minimal or no sedation and adverse events appear infrequent in occurrence., (© 2022 The Authors. Journal of Veterinary Emergency and Critical Care published by Wiley Periodicals LLC on behalf of Veterinary Emergency and Critical Care Society.)

Objective: To report outcomes and complications after placement of a subcutaneous vascular access port (SVAP) in the jugular (jSVAP), axillary (aSVAP), and femoral or external iliac vein (fSVAP) in dogs., Study Design: Retrospective., Methods: Medical records from a single hospital, covering a period between September 2015 and October 2020, were reviewed to identify dogs that had an SVAP placed. Complications and outcomes for dogs who had an SVAP placed in the axillary vein, or femoral/external iliac vein during amputation for appendicular skeletal neoplasm, and in the external jugular vein were recorded and analyzed statistically., Results: Subcutaneous vascular access ports were placed in the axillary vein in 13 dogs, femoral/external veins in 4 dogs, and in the jugular vein in 19 dogs. The SVAPs fulfilled their purpose throughout treatment in 12/13 aSVAP, 4/4 fSVAP, and 15/19 jSVAP. Dogs were followed for a median of 145.5 days (range 30-945 days). Minor and major complications were recorded in 1/13 and 2/13 aSVAPs, 0/4 and 0/4 fSVAPs, and 3/19 and 4/19 of jSVAPs. Two dogs with jSVAPs were euthanized due to SVAP-related complications. No difference in complication rate was detected between groups (P = .12)., Conclusion: No difference in short-term outcome was detected between implantation sites for subcutaneous vascular access ports., Clinical Significance: The axillary or femoral/external iliac veins offer alternative sites for placement of SVAP in dogs undergoing limb amputation., (© 2022 American College of Veterinary Surgeons.)

Objectives: The aims of this study were to describe the indications for percutaneous pigtail catheter placement in cats requiring urine diversion, and to report the associated intra- and postoperative complications., Methods: The medical records of cats that underwent percutaneous pigtail catheter placement for urine diversion between January 2011 and May 2021 were retrospectively reviewed., Results: Twenty-five cats were included. Indications for pigtail catheter placement were medical management of obstructive urinary tract disease (n = 12), urinary tract damage after traumatic injury (n = 8) and neurological bladder dysfunction (n = 5). Catheters were in place for a median time of 8.28 days (range 3-27), and the duration of the catheter placement was not different between the medical, traumatic and neurological groups. Ten cats (40%) developed pigtail catheter complications including dislodgement, urine leakage, urinary tract infection and bladder rupture. The majority of complications were easily resolved and did not require surgical intervention., Conclusions and Relevance: The results suggest that percutaneous pigtail catheter placement can facilitate urine diversion in both the emergency setting and in the long-term management of urine retention without many complications.

Objective: Complications associated with indwelling intravenous catheters vary from minor to severe. Changes in tissue architecture and vein structure may be detectable prior to clinical alterations. The aim of the study was to characterize and compare changes in a catheterized vein and surrounding tissue by clinical and ultrasonographic examination. Microbiological infestation of catheter specimens was assessed., Material and Methods: In this prospective, observational, clinical study 55 horses with an indwelling intravenous catheter have been included. Subsequent to catheter placement, vein and surrounding tissue were daily examined clinically and by ultrasonographic examination at predetermined localizations. After sterile removal of the catheters, specimens underwent microbiological testing and scanning electron microscopy. Obtained data were analyzed via descriptive statistics. Thickness of the venous wall was compared at predetermined localizations and time points for several parameters with the help of non-parametric tests (level of significance at p < 0.05, post-hoc Bonferroni correction)., Results: Overall, in 41.8 % of the horses transient alterations (swelling) of the surrounding tissue occurred during catheterization. Median catheterization was 69.5 hours (19 hour-10 days). With ultrasonography, venous valves and collateral vessels could be detected reliably. Significant alterations in wall thickness during catheterization were associated with various factors (location site [p ≤ 0.001], season [p = 0.006], anesthesia [p ≤ 0.001]).Microbiological analysis revealed a positive result in 23.5 %, 12 of the 51 samples; raster electron microscopy showed presence of bacteria in 25.0 %, 4 of the 16 investigated catheter samples., Conclusion and Clinical Relevance: Local tissue changes at the insertion site of the catheter are commonly associated with catheterization, and are easily detectable with ultrasonography. Despite the easy performance in a clinical setting, the benefit of routine ultrasonographic monitoring of catheterized veins might be questionable with regard to early identification and prediction of catheter-associated venous disease. Bacteria might be detectable morphologically on the catheter but frequently lack a positive result from standard bacterial cultivation., Competing Interests: Die Autoren bestätigen, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Diagnostic serial venous blood sampling has the potential to introduce stress-related artifactual elements into the analytical results. We have evaluated the use of a wearable automated serial blood sampling device in a canine model that obviates a need for multiple manual venipuncture. Efficacy in measuring cortisol levels during prolonged serial blood sampling is described. Automated serial blood sampling from the jugular vein was performed in two Beagle dogs. Over two separate 22-h periods, serial blood samples were withdrawn for routine cell counting and blood chemistries from each animal, whilst animal behavior along with durability of catheter placement and tolerability by the vascular system were assessed. During the study, no behavioral changes attributed to the serial blood sampling device were seen and no stress-related deviations from normal blood cell counts and cortisol levels were detected. Minor erythema was eident at the sites of catheter placement, which was consistent with the presence of an indwelling catheter. The wearable, serial blood sampling device performed well and was tolerated by the animals without stress-related changes in blood analysis or behavioral observation. This study has demonstrated the potential significant benefit of the Fluispotter® device for serial blood sampling in veterinary and clinical settings. The samples collected are free from stress-related signatures in blood chemistry otherwise common to serial blood sampling protocols requiring repeated venipuncture. This device has valuable implications for use in routine preclinical pharmacology and toxicology studies., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Urethral obstruction (UO) has a negative effect on welfare of cats., Objectives: This study aimed to determine incidence, case management, and outcomes of UO in cats in primary-care practice in the United Kingdom., Animals: All male cats under veterinary care within the VetCompass database in 2016., Methods: A retrospective cohort study was performed. The electronic records of all male cats with a clinical note during the study period were searched for UO cases and were manually reviewed for inclusion. Additional demographic and clinical information were extracted on cases., Results: From the study cohort of 237 825 male cats, there were 1293 incident cases. The estimated UO incidence risk during 2016 was 0.54 (95% CI: 0.51-0.57). Demographic and clinical data were available for 1108 cases. Antibiotics were administered to 641/1108 (57.9%) cases. Overall repeat catheterization rate was 253/854 (29.6%). Repeat catheterization at 48 hours was less frequent in patients with indwelling catheters (10.1%) vs those that had a catheter placed and then immediately removed (14.8%; P = .04). Death during a UO episode was 329/1108 (29.6%), and 285/329 (88.0%) deaths involved euthanasia., Conclusions and Clinical Importance: Antibiotics were commonly prescribed in cats for treatment of UO despite minimal evidence in the clinical records of bacterial cystitis. Repeat catheterization was common and case fatality rate during a UO episode was high. Repeat catheterization within 48 hours of elective removal of a urethral catheter was less common in cats that had previously had indwelling catheters. The majority of cats requiring repeat catheterization survived until the end of the study., (© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Background: For horses requiring prolonged daily cephalic intravenous regional limb perfusion (IVRLP), the use of a totally implantable catheter (TIC) could be indicated to reduce complications associated with frequent venipuncture or external catheterization. This study aims to evaluate the implantation technique of the TIC in the cephalic vein of horses for IVRLP, describe the complications associated with the device's placement and use, and assess its viability up to 60 days after implantation. Totally implantable catheters, cut to 15 cm (n = 5) and 46 cm (n = 5) in length, were implanted into one cephalic vein in ten adult horses (n = 10). Twenty-four hours following placement, IVRLP with contrast was performed via the TIC and evaluated with radiography. Physical examinations, lameness evaluation, hematologic assessment, and the catheter patency tests were performed at scheduled intervals for the duration of catheterization (7-60 days)., Results: Catheters were implanted without difficulty and allowed for IVRLP 24 h post implantation. Complications resulted in removal of the catheters, with four maintained for 7 days, three in place for 15 days, and three catheters maintained for 60 days. Complications included lameness, limb swelling, catheter kinking, and venous thrombosis., Conclusions: The implantation technique of the TIC in the cephalic vein of horses is feasible and requires minimal technical effort. Although TIC allows venous access without the need for repeated venipuncture, its long-term use presents complications. For horses requiring prolonged daily cephalic IVRLP, the use of a TIC could be indicated. However, the high incidence of venous thrombosis may limit clinical application., (© 2021. The Author(s).)

Objective: To compare hemostatic variables performed on blood samples obtained from indwelling jugular catheters or direct venipuncture over a 72-hour period., Design: Prospective experimental study., Setting: University research laboratory., Animals: Five healthy neutered male purpose-bred Beagle dogs., Interventions: Each dog was sedated to facilitate placement of a long-stay 20-Ga polyurethane IV catheter into the jugular vein. Blood samples were obtained from the preplaced catheters at 4 time points corresponding to 0, 24, 48, and 72 hours relative to placement. Blood samples were also obtained by direct venipuncture of a peripheral vein using a 21-Ga butterfly catheter and evacuated blood tubes at the same time points. Platelet count, platelet closure time, prothrombin time, activated partial thromboplastin time, fibrinogen, and kaolin-activated thromboelastography were performed on these paired samples at each time point. The patency of the indwelling catheters was maintained by flushing every 6 hours with heparinized saline., Measurements and Main Results: No significant differences were identified in any of the hemostatic variables obtained by either blood collection technique at any time point during the study (P > 0.05). There was also no significant day-to-day variation in any catheter-derived hemostatic variable obtained from individual dogs identified over the course of the study., Conclusions: These data suggest that accurate hemostatic variables may be obtained using blood collected from indwelling jugular catheters, maintained with heparinized saline for at least 72 hours, in healthy dogs., (© Veterinary Emergency and Critical Care Society 2021.)

Objective: To identify characteristics of arterial catheter use, including indwelling times and reasons for removal, and analyze potential risk factors for complications based on patient- and catheter-related variables., Design: Prospective clinical study from July 2012 to September 2016., Setting: University teaching hospital., Animals: One hundred ninety-eight dogs and 29 cats with an arterial catheter monitored in the ICU., Interventions: None., Measurements and Main Results: A questionnaire was used to obtain patient and catheter information for arterial catheters monitored in the ICU during the study period. Two hundred twenty-seven catheters met the inclusion criteria. Most catheters were placed in the dorsal metatarsal artery in dogs (90.4%) and either the dorsal metatarsal artery (51.7%) or coccygeal artery (48.3%) in cats. Weights ranged from 1.5 to 64 kg in dogs and 0.77 to 8.7 kg in cats. The median indwelling time was 24 hours for dogs and 12 hours for cats. Minor complications occurred in 19.2% of catheters in dogs and 17.2% of those in cats with removal of catheter due to complications in 13 of 198 (6.6%) for dogs and 2 of 29 (6.9%) for cats. There was no association between the incidence of complications and patient weight, catheter indwelling time, species, insertion site, catheter size, or level of consciousness during placement. There was also no association between the method of catheter maintenance (intermittent flushing or continuous pressure transducer) and the failure of a catheter to aspirate or flush., Conclusions: Arterial catheter-related complications were relatively frequent, but most complications were minor and did not justify removal of the catheter. This suggests that the use of arterial catheters in both species is relatively safe. However, further research is needed to assess complications related to longer catheter indwelling times, particularly in cats., (© Veterinary Emergency and Critical Care Society 2021.)

Background: Complicated transurethral urinary bladder catheterization in female dogs is a commonly encountered urologic problem, often causing inadvertent trauma to the lower urinary tract and breach in aseptic technique., Key Concepts: A novel method for transurethral insertion of urinary catheters in female dogs is described. The main variation from current procedures involves the application of the Seldinger technique with the use of an introduction catheter that is specifically designed to feed into the urethra, and the use of a guidewire to replace the introducer with an indwelling balloon catheter., Significance: The technique presented offers a step-by-step approach that could improve success in urinary catheter placement. This modification may facilitate catheter insertion, be less traumatic, and offer better control of asepsis, especially with challenging urethral catheterization. The technique also offers an easy method to replace the catheter. Application of the technique may reduce catheter-associated urinary tract infections as it addresses certain infection-related risk factors. Prospective validation studies are needed to support its advantages over current urinary catheter placement techniques., (© 2020 The Authors. Journal of Veterinary Emergency and Critical Care published by Wiley Periodicals LLC on behalf of Veterinary Emergency and Critical Care Society.)

Objective: To investigate the influence of urinary catheter type on recurrence rate (rUO) in cats with urethral obstruction., Design: Retrospective study., Setting: Two private referral hospitals., Animals: Ninety-one cats diagnosed with urethral obstruction treated with a 3.5-Fr Argyle (AR) or 3.5-Fr red rubber (RR) indwelling catheter presenting in 2014., Measurements and Main Results: One hundred sixty-six cats were identified using diagnostic code search with 91 cats meeting inclusion criteria. All were treated with IV fluids, buprenorphine, prazosin, and an indwelling urethral catheter with a closed collection system. Catheter groups did not differ statistically in baseline characteristics, medication treatment, or catheterization time. Follow-up was available for 91 cats at 24 hours, 86 cats at 7 days, and 84 cats at 30 days. There was no statistical difference in rUO between cats with different catheter types at any time in this retrospective study., Conclusions: No difference in rUO was found in cats treated for urethral obstruction with a 3.5-Fr AR or RR catheter, however, due to the retrospective nature of this study the inability to detect a difference may be due to the small sample size of this study. Recurrent urethral obstruction in this study at 30 days was 11%., (© Veterinary Emergency and Critical Care Society 2020.)

Guinea pigs are a premier small animal model for infectious disease research, and chronic indwelling venous access ports may be used to facilitate various procedures. Here we report catheter-related lesions in 5 uninfected Dunkin-Hartley guinea pigs with chronic jugular vein catheters used for imaging studies. Three guinea pigs were found dead with no premonitory signs. At necropsy, there was severe bilateral pulmonary atelectasis due to 20 to 29 mL of pleural effusion resulting from catheter-related thrombosis and cranial vena cava syndrome. In addition, one of these 3 guinea pigs had a polymicrobial catheter infection with abscessation. A 4th clinically normal guinea pig was euthanized at the end of the study, having spontaneously lost its catheter 7 mo prior, and had 17 mL of pleural effusion. The 5th guinea pig was euthanized following pooling of contrast material around the distal catheter in the cranial vena cava on CT. By histology, affected animals had recent and remote thrombosis or fibrosis (or both) of the cranial vena cava and right atrial wall, with osseous and cartilaginous metaplasia. Cranial vena cava syndrome should be considered as a differential for dyspnea or death in chronically catheterized laboratory animals.

Background: Intravenous catheter (IVC) use in hospitalized ruminants is a common procedure. Limited information is available describing complications associated with IVCs., Hypotheses: Prevalence of IVC infections in hospitalized ruminants is >50%. Intravenous catheters maintained for >5 days are more likely to be infected than those maintained for <5 days. Intravenous catheters placed non-aseptically have a higher risk for infection than those placed aseptically., Animals: Thirty-four cattle, 39 goats, and 33 sheep were hospitalized in a university teaching hospital., Methods: Prospective observational study. The IVCs from cattle, goats, and sheep admitted for medical and surgical procedures were randomly selected and submitted for bacteriological culture and susceptibility testing., Results: Prevalence values (95% confidence interval) of infected catheters were 61.8 (45.5, 78.1), 51.3 (35.3, 66.7), and 42.4% (25.2, 58.8) in cattle, goats, and sheep, respectively. Coagulase-negative Staphylococcus spp was the most frequently isolated bacterium. Catheter type/placement technique was a significant (P = .03) predictor of IVC infection in goats but not in cattle (P = .65) and sheep (P = .47). Antibiotic use and reason for catheter placement were not significant predictors of IVC infection in all species. Catheters maintained for >4 days had a higher likelihood of being infected than those maintained for <4 days in all species., Conclusions and Clinical Importance: Clinicians should consider replacing catheters maintained for >4 days to reduce IVC infection., (© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Mesothelioma is a very aggressive malignant tumor with low survival rates that is often diagnosed belatedly. Pericardial effusion is a common consequence in cases of mesothelioma, with pericardiocentesis and pericardiectomy indicated; therefor thoracocentesis is necessary to drain the contents no longer retained in the pericardium. The present report describes a mesothelioma-carrying dog with a history of cardiac tamponade that underwent thoracoscopic pericardiectomy and, later, thoracoscopic implantation of a fully implantable catheter to function as a thoracic drain. In the consulted literature, there is no use of a fully implantable catheter for this purpose. The authors consider that there was an improvement in the quality of life.

Background: Monitoring of intracranial pressure (ICP) is a critical component in the management of intracranial hypertension. Safety, efficacy, and optimal location of microsensor devices have not been defined in dogs., Hypothesis/objective: Assessment of ICP using a microsensor transducer is feasible in anesthetized and conscious animals and is independent of transducer location. Intraparenchymal transducer placement is associated with more adverse effects., Animals: Seven adult, bred-for-research dogs., Methods: In a prospective investigational study, microsensor ICP transducers were inserted into subdural and intraparenchymal locations at defined rostral or caudal locations within the rostrotentorial compartment under general anesthesia. Mean arterial pressure and ICP were measured continuously during physiological maneuvers, and for 20 hours after anesthesia., Results: Baseline mean ± SD values for ICP and cerebral perfusion pressure were 7.2 ± 2.3 and 78.9 ± 7.6 mm Hg, respectively. Catheter position did not have a significant effect on ICP measurements. There was significant variation from baseline ICP accompanying physiological maneuvers (P < .001) and with normal activities, especially with changes in head position (P < .001). Pathological sequelae were more evident after intraparenchymal versus subdural placement., Conclusions and Clinical Importance: Use of a microsensor ICP transducer was technically straightforward and provided ICP measurements within previously reported reference ranges. Results support the use of an accessible dorsal location and subdural positioning. Transient fluctuations in ICP are normal events in conscious dogs and large variations associated with head position should be accounted for when evaluating animals with intracranial hypertension., (Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Objectives: The aim of this study was to investigate the incidence of complications associated with arterial catheterization in cats in a veterinary hospital, and to document which factors may increase the incidence of complications., Methods: Medical records at a referral veterinary hospital were retrospectively reviewed to identify cats that had an arterial catheter placed between January 2010 and October 2014., Results: Thirty-five cats having 38 arterial catheters were included in the study. There was a relatively high incidence of minor complications (23.7%), with the most common being catheter occlusion. The incidence of major arterial catheter complications was low (2.63%). Duration of catheter use was positively correlated to the incidence of complications. There was also a significant correlation between catheters used for intensive care unit monitoring and incidence of complications. All cats with catheter complications survived to discharge., Conclusions and Relevance: The low incidence of major arterial catheter complications in this population of cats illustrates that arterial catheterization is a safe monitoring and diagnostic tool. The duration of catheter placement is significantly associated with the incidence of catheter complications.

OBJECTIVE To test for an association between indwelling urethral catheter placement in cats with urethral obstruction (UO) and the short-term (30-day) risk of recurrent urethral obstruction (RUO). DESIGN Prospective cohort study. ANIMALS 107 client-owned male cats with UO. PROCEDURES Owners were offered standard care for their cats, including hospitalization, placement of an indwelling urethral catheter, IV fluid therapy, and other supportive treatments (inpatient group). One-time catheterization and outpatient care were offered (outpatient group) if standard care was declined. Data regarding signalment, measures of metabolic compromise and urinalysis findings at enrollment, catheterization-related variables, and supportive treatments of interest were collected. Risk of RUO ≤ 30 days after urethral catheter removal was determined for the outpatient vs inpatient group by OR and 95% confidence interval calculation. Other variables were compared between cats that did and did not develop RUO with Fisher exact and trend tests. RESULTS 91 cats completed the study; 19 (5/46 [11%] inpatients and 14/45 [31%] outpatients) developed RUO. Risk of RUO was significantly greater for cats of the outpatient group (OR, 3.7; 95% confidence interval, 1.2 to 11.4). Among inpatients, increasingly abnormal urine color at the time of catheter removal was significantly associated with RUO. No other significant associations were identified. CONCLUSIONS AND CLINICAL RELEVANCE Hospitalization and indwelling catheterization significantly reduced the risk for RUO ≤ 30 days after treatment for the population studied. Results suggested that removal of an indwelling catheter before urine appears grossly normal may be associated with development of RUO. One-time catheterization with outpatient care was inferior to the standard care protocol but was successful in many cats and may be a reasonable alternative when clients cannot pursue standard care.

Background: Evaluation of coagulation status is an important component of critical care. Ongoing monitoring of coagulation status in hospitalised horses has previously been via serial venipuncture due to concerns that sampling directly from the intravenous catheter (IVC) may alter the accuracy of the results. Adverse effects such as patient anxiety and trauma to the sampled vessel could be avoided by the use of an indwelling IVC for repeat blood sampling., Objectives: To compare coagulation parameters from blood obtained by jugular venipuncture with IVC sampling in critically ill horses., Study Design: Prospective observational study., Methods: A single set of paired blood samples were obtained from horses (n = 55) admitted to an intensive care unit by direct jugular venipuncture and, following removal of a presample, via an indwelling IVC. The following coagulation parameters were measured on venipuncture and IVC samples: whole blood prothrombin time (PT), fresh plasma PT and activated partial thromboplastin time (aPTT) and stored plasma antithrombin activity (AT) and fibrinogen concentration. D-dimer concentration was also measured in some horses (n = 22). Comparison of venipuncture and IVC results was performed using Lin's concordance correlation coefficient. Agreement between paired results was assessed using Bland Altman analysis., Results: Correlation was substantial and agreement was good between sample methods for all parameters except AT and D-dimers., Main Limitations: Each coagulation parameter was tested using only one assay. Sampling was limited to a convenience sample and timing of sample collection was not standardised in relation to when the catheter was flushed with heparinised saline., Conclusions: With the exception of AT and D-dimers, coagulation parameters measured on blood samples obtained via an IVC have clinically equivalent values to those obtained by jugular venipuncture., (© 2017 EVJ Ltd.)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

OBJECTIVE To compare the effect of blood collection by a push-pull technique from an indwelling IV catheter versus direct venipuncture on venous blood gas values before and after administration of alfaxalone or propofol to dogs. DESIGN Prospective randomized clinical study. ANIMALS 30 healthy client-owned dogs that weighed ≥ 10 kg (22 lb) and were anesthetized for elective surgical procedures. PROCEDURES All dogs were premedicated with methadone (0.5 mg/kg [0.2 mg/lb], IM), and 20 to 30 minutes later, anesthesia was induced with either alfaxalone (1 to 3 mg/kg [0.5 to 1.4 mg/lb], IV to effect; n = 15) or propofol (2 to 6 mg/kg [0.9 to 2.7 mg/lb], IV to effect; 15). Immediately prior to premedication and after anesthesia induction, paired blood samples were collected from the cephalic veins; 1 by direct venipuncture and 1 by use of a push-pull technique from a 20-gauge catheter. All blood samples underwent venous blood gas analysis immediately after collection. Results were compared between sample collection techniques before and after anesthesia induction and between anesthesia induction protocols. RESULTS All results were within established reference ranges. For many variables, statistically significant but clinically irrelevant differences were detected between samples collected by direct venipuncture and those collected by the push-pull technique but not between the 2 anesthesia induction protocols. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated the push-pull technique was an acceptable method for collection of blood samples from dogs for venous blood gas analysis that could be used instead of direct venipuncture for patients with patent IV catheters.

Objective: To describe the ultrasound (US) evaluation of the cervical, thoracic and lumbar spinal tracts in piglets and to evaluate the feasibility of the ultrasound guided spinal catheter placement in newborn and paediatric piglets., Study Design: Prospective experimental study., Animals: A total of two piglet cadavers (age, 7 and 14 days) and eight commercial crossbreed piglets divided into four groups according to age: 7 (P7), 14 (P14), 21 (P21) and 28 (P28) days., Methods: In the first part of the study an ultrasound examination of the spinal tract was performed in piglet cadavers applying the transverse and the longitudinal approaches in sternal and lateral recumbencies. In the second phase, the piglets were anaesthetized with sevoflurane. A US examination with a 10 MHz linear probe was performed and a spinal catheter was introduced between the spinous processes of L2 and L3 lumbar vertebrae using an in-plane technique and its advancement was monitored with the probe. At the end of procedure, the catheter was removed. The piglets recovered from anaesthesia and were monitored for one week., Results: In phase I the authors identified the paramedian longitudinal approach as the most feasible for spinal structure evaluation in piglets. In phase II, the paramedian longitudinal views enabled a good visualization of the spinal cord and of the catheter advancement up to the cisterna magna in groups P7 and P14. In groups P21 and P28 it was not possible to visualize the neuroaxial structures and the spinal catheter using the same approach. No clinical alterations were recorded during the procedure or the following days., Conclusions and Clinical Relevance: US-guided spinal catheter placement appeared a feasible technique in piglets younger than 14 days but it is not useful in older piglets., (Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Tube cystostomy is a surgical method used for managing obstructive urolithiasis and involves placement of a Foley catheter into the urinary bladder. We identified and evaluated the antibiotic resistance patterns of bacteria isolated from indwelling Foley catheters following tube cystostomy in goats with obstructive urolithiasis. Urine samples collected over a 10-y period from catheter tips at the time of removal were submitted for bacteriologic culture and antibiotic susceptibility testing. Resistance patterns to antibiotics, trends in the resistance patterns over the study period, and the probability of a bacterial isolate being resistant as a function of the identity of the isolate and antibiotic tested were determined. A total of 103 urine samples from 103 male goats with obstructive urolithiasis managed surgically with tube cystostomy were included in the study. Aerococcus (36.9%) and Enterococcus (30.1%) were isolated most frequently. The susceptibility patterns of all bacteria isolated did not change over the study period ( p > 0.05). Proportions of isolates resistant to 1, 2, and ≥3 antibiotics were 36.9%, 18.5%, and 23.3%, respectively. Thus, 41.8% of bacterial isolates were resistant to 2 or more antibiotics tested. The probability of Aerococcus spp., Escherichia coli, and Pseudomonas aeruginosa isolates to be resistant to ampicillin, ceftiofur, erythromycin, penicillin, or tetracycline ranged from 0.59 to 0.76.

Objectives: To report the short- and long-term complications and clinical outcomes of a cohort of dogs managed for gastric dilatation-volvulus using a modified right-sided tube gastropexy technique., Materials and Methods: Retrospective case series., Results: Of 31 dogs treated, 29 (93·5%) had an excellent short-term outcome, and gastric dilatation-volvulus did not recur in any dog. Twenty-six dogs (84%) were initially fed via the gastrostomy tube postoperatively; three (9·7%) suffered a major complication including septic peritonitis (n=1), and premature tube removal (n=2). Fourteen dogs (45·1%) had minor complications including mild, self-limiting discharge from the stoma site in 13., Clinical Significance: Modified tube gastropexy using a mushroom-tipped silicone catheter is an effective and safe surgical method for the management of gastric dilatation-volvulus. The gastrostomy tube allowed early enteral feeding and easy administration of medications, including gastroprotectants., (© 2017 British Small Animal Veterinary Association.)

A 10-year-old neutered male Labrador Retriever dog was diagnosed with idiopathic megaesophagus. Despite receiving conventional treatments including elevated feeding, the dog showed repeated regurgitation and aspiration pneumonia, consequently developing weight loss and severe malnutrition. For the purpose of controlling regurgitation, an esophagostomy tube was placed for draining the esophageal fluid. Additionally, an esophagogastric tube was placed for nutritional support. After tube placement, the average frequency of regurgitation was reduced from 2.4 times a day to 0.1 times a day. The nutritional state of the dog improved gradually, and the body weight increased from 18.5 to 27.9 kg. The dog died on day 951, and necropsy revealed a gastric ulcer (2.5 cm in diameter), presumably esophagostomy tube-induced injury. This case report suggests that patients with idiopathic megaesophagus and persistent regurgitation might benefit from esophageal drainage through an esophagostomy tube.

Objectives: To describe the clinical practice of insertion of arterial catheters in anesthetized dogs and cats, to document complications of arterial catheterization, and to determine risk factors associated with the complications., Design: Prospective clinical study and retrospective evaluation of medical records., Setting: University teaching hospital., Animals: Dogs (n = 251) and 13 cats anesthetized for clinical procedures with arterial catheters inserted for blood pressure monitoring., Interventions: None., Measurements and Main Results: Details of the animal and catheter were collected at the time of anesthesia. On the following day, the catheter site was palpated and observed for abnormalities and the medical records of all animals were reviewed retrospectively for complications. Details of catheter placement were available for 216 catheters: 158 catheters in a dorsal pedal artery, 50 catheters in the median caudal (coccygeal) artery, 6 in the median artery, and 1 each in a cranial tibial and lingual artery. Blood pressure was obtained from 200 catheters, and 12 catheters failed before the end of anesthesia. Postoperative observational data obtained from 112 catheters described a palpable arterial pulse at 73 sites and no pulse at 21 sites. No risk factor for arterial occlusion was identified. No complications resulting from arterial catheterization were noted in the medical records., Conclusions: Arterial catheterization resulted in loss of a peripheral pulse postoperatively in 21/94 (22.3%) of animals examined, although no evidence of tissue ischemia was noted in the medical records of any of the patients in this study. These results suggest that insertion of a catheter in the dorsal pedal or coccygeal arteries was not associated with a high risk for complications. However, the course of arterial occlusion postoperatively warrants further investigation., (© Veterinary Emergency and Critical Care Society 2016.)

It is difficult to collect untainted urine specimens over short intervals of time during renal studies with rabbits. This is because both the ureters and the bladder of this species are relatively friable and minor manipulation can easily cause intraluminal bleeding. We have developed and refined an effective technique and protocol for placing an indwelling urinary bladder catheter into an anesthetized rabbit. The procedure is easy to perform and completely effective and reliable, allowing high-quality urinary specimens to be collected at intervals of 15-20 min over a period of 3-4 hours during a study of acute metabolic acidosis.

Long-term or repeated venous access in chelonians is difficult to obtain and manage, but can be critically important for administration of medications and blood sampling in hospitalized patients. Jugular catheterization provides the most rapid and secure route for vascular access, but catheters can be difficult to place, and maintaining catheter patency may be challenging. Long multilumen polyurethane catheters provide flexibility and sampling access, and minimize difficulties, such as catheter displacement, that have been encountered with traditional over-the-needle catheters. We describe placement of 4 Fr. 13-cm polyurethane catheters in three chelonians with the use of a modified Seldinger technique. Venous access was obtained with the use of an over-the-needle catheter, which allowed placement of a 0.018-in.-diameter wire, over which the polyurethane catheter was placed. Indwelling time has ranged between 1 and 4 mo currently. All tortoises were sedated for this procedure. Polyurethane central catheters provide safe, long-term venous access that allows clinicians to perform serial blood sampling as well as intravenous administration of medications, anesthetic agents, and fluids. A jugular catheter can also allow central venous pressure measurement. Utilization of central line catheters was associated with improvements in diagnostic efficiency and therapeutic case management, with minimal risks and complications.

Objectives: This study aimed to determine the standards of care for urethral catheters (UCs) placed in male cats for treatment of urethral obstruction (UO). It also assessed whether these standards were influenced by year of graduation of the veterinary surgeon (VS)., Methods: One hundred veterinary practices were randomly selected, and a telephone survey was conducted with a VS in the practice. Regarding the last urethral catheterisation performed for a male cat with UO, the VS was asked about the use of antibiotics while the catheter was in situ, whether a closed urinary collection system was used, whether aseptic skin preparation of the patient was performed and whether aseptic hand preparation was performed. A χ(2) test was used to determine whether there were significant differences in these percentages when considering year of graduation., Results: Twenty-seven percent of VSs did not use antibiotics while the urethral catheter was in place, 44% used closed urinary collection systems, 41% performed aseptic skin preparation of the patient and 60% aseptically prepared their hands and wore sterile gloves. There was a statistically significant (P <0.01) difference in antibiotic usage, closed collection system usage and aseptic hand preparation across graduation year groups., Conclusions and Relevance: Non-sterile urethral catheter placement with open urinary drainage and antibiotic prophylaxis is still a widespread practice among VSs; however, more recent graduates are more likely to perform the procedure aseptically with a closed urinary collection system and withholding of antibiotics. There is a need for further education for postgraduate veterinarians in the prevention of catheter-associated urinary tract infections in cats and further research to provide evidence-based guidelines for feline urethral catheter care., (© ISFM and AAFP 2015.)

Biomedical translational research frequently incorporates collection of CSF from NHP, because CSF drug levels are used as a surrogate for CNS tissue penetration in pharmacokinetic and dynamic studies. Surgical placement of a CNS ventricular catheter reservoir for CSF collection is an intensive model to create and maintain and thus may not be feasible or practical for short-term studies. Furthermore, previous NHP lumbar port models require laminectomy for catheter placement. The new model uses a minimally invasive technique for percutaneous placement of a lumbar catheter to create a closed, subcutaneous system for effective, repeated CSF sample collection. None of the rhesus macaques (Macaca mulatta; n = 10) implanted with our minimally invasive lumbar port (MILP) system experienced neurologic deficits, postoperative infection of the surgical site, or skin erosion around the port throughout the 21.7-mo study. Functional MILP systems were maintained in 70% of the macaques, with multiple, high-quality, 0.5- to 1.0-mL samples of CSF collected for an average of 3 mo by using aspiration or gravitational flow. Among these macaques, 57% had continuous functionality for a mean of 19.2 mo; 50% of the cohort required surgical repair for port repositioning and replacement during the study. The MILP was unsuccessful in 2 macaques, at an average of 9.5 d after surgery. Nonpatency in these animals was attributed to the position of the lumbar catheter. The MILP system is an appropriate replacement for temporary catheterization and previous models requiring laminectomy and is a short-term alternative for ventricular CSF collection systems in NHP.

Nine Holstein cows fitted with rumen cannulas and indwelling catheters in splanchnic blood vessels were used to study the effects of supplementing AA on milk lactose secretion, whole-body rate of appearance (WB-Ra) of glucose, and tissue metabolism of glucose, lactate, glycerol, and β-OH-butyrate (BHBA) in postpartum dairy cows according to a generalized randomized incomplete block design with repeated measures in time. At calving, cows were blocked according to parity (second and third or greater) and were allocated to 2 treatments: abomasal infusion of water (n=4) or abomasal infusion of free AA with casein profile (AA-CN; n=5) in addition to the same basal diet. The AA-CN infusion started with half the maximal dose at 1 d in milk (DIM) and then steadily decreased from 791 to 226 g/d from DIM 2 to 29 to cover the estimated essential AA deficit. On DIM 5, 15, and 29, D[6,6-(2)H2]-glucose (23.7 mmol/h) was infused into a jugular vein for 5h, and 6 blood samples were taken from arterial, portal, hepatic, and mammary sources at 45-min intervals, starting 1h after the initiation of the D[6,6-(2)H2]glucose infusion. Trans-organ fluxes were calculated as veno-arterial differences times plasma flow (splanchnic: downstream dilution of deacetylated para-aminohippurate; mammary: Fick principle using Phe+Tyr). Energy-corrected milk and lactose yields increased on average with AA-CN by 6.4 kg/d and 353 g/d, respectively, with no DIM × treatment interaction. Despite increased AA supply and increased demand for lactose secretion with AA-CN, net hepatic release of glucose remained unchanged, but WB-Ra of glucose tended to increase with AA-CN. Portal true flux of glucose increased with AA-CN and represented, on average, 17% of WB-Ra. Splanchnic true flux of glucose was unaltered by treatments and was numerically equivalent to WB-Ra, averaging 729 and 741 mmol/h, respectively. Mammary glucose utilization increased with AA-CN infusion, averaging 78% of WB-Ra, and increased gradually as lactation advanced. Net portal, hepatic, splanchnic, and mammary fluxes of lactate, glycerol, and BHBA were not affected by AA infusion. Increasing the supply of AA in postpartum dairy cows elevated the WB-Ra of glucose without affecting the true liver glucose release. The greater WB-Ra of glucose with abomasal AA infusion seemed to originate mainly from greater true portal-drained viscera release of glucose. Glucose utilization by the portal-drained viscera was unaffected by abomasal AA infusion, but the exact mechanism behind the greater true portal glucose release could not be assessed in the current study. The increased mammary glucose uptake was in line with the increased milk lactose yield. In early postpartum lactation, the demand for AA seems to be so high that even with increased AA supply, cows have metabolic priorities for AA other than hepatic gluconeogenesis., (Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Nine Holstein cows with rumen cannulas and indwelling catheters in splanchnic blood vessels were used in a generalized randomized incomplete block design with repeated measures to study the effect of increased early postpartum AA supply on splanchnic and mammary AA metabolism. At calving, cows were blocked according to parity (second and third or greater) and allocated to 2 treatments: abomasal infusion of water (CTRL; n=4) or free AA with casein profile (AA-CN; n=5) in addition to a basal diet. The AA-CN infusion started with half of the maximal dose at the calving day (1 d in milk; DIM) and then steadily decreased from 791 to 226 g/d until 29 DIM. On 5, 15, and 29 DIM, 6 sample sets of arterial, portal, hepatic, and mammary blood were taken at 45-min intervals. Over the whole period, increasing AA supply increased milk (+7.8 ± 1.3 kg/d) and milk protein yields (+220 ± 65 g/d) substantially. The increased milk yield was not supported by greater dry matter intake (DMI) as, overall, DMI decreased with AA-CN (-1.6 ± 0.6 kg/d). Arterial concentrations of essential AA were greater for AA-CN compared with CTRL. The net portal-drained viscera (PDV) release of His, Met, and Phe was greater for AA-CN compared with CTRL, and the net PDV recovery of these infused AA ranged from 72 to 102% once changes in DMI were accounted for. The hepatic removal of these AA was increased equivalently to the increased net PDV release, resulting in an unaltered net splanchnic release. The net PDV release of Ile, Leu, Val, and Lys tended to be greater for AA-CN, and the net PDV recovery of these infused AA ranged from 69 to 73%, indicating increased PDV metabolism with AA-CN. The fractional hepatic removal of these AA did not differ from zero and was unaffected by the increased supply. Consequently, the splanchnic release of these AA was approximately equivalent to their net PDV release for both CTRL and AA-CN. Overall, greater early postpartum AA supply increased milk and milk protein yields substantially based on increased mammary AA uptake. The PDV metabolism of branched-chain AA and Lys were increased, whereas it seemed to be unaffected for other essential AA when the intestinal AA supply was increased. On a net basis, the liver removed more group 1 AA (His, Met, Phe, and Trp) for anabolism and catabolism when the early postpartum AA supply was increased. Thus, increasing the postpartum AA supply increased splanchnic and mammary consumption of AA; hence, the protein deficiency persisted., (Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

This article provides a general overview of nursing care principles including an approach to developing a nursing care plan using the nursing process as its foundation. The nursing process is a problem-solving approach used in planning patient care. This article also focuses on nursing care as it pertains to the respiratory, cardiovascular, and renal systems (fluid balance) as well as care of the recumbent patient. Knowledge of nursing care techniques and risk factors for complications puts the care provider in a position of being proactive rather than reactive to patient care needs., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Pigs are used for long-term biomedical experiments requiring repeated injections, infusions and collections of blood samples. Thus, it is necessary for vascular catheters to be indwelling to avoid undue stress to the animals and the use of restraints. We propose a refined model of percutaneous insertion of long-term central venous catheters to minimize the surgical trauma and postoperative complications associated with catheter insertion. Different sizes of needles (18 Ga versus 21 Ga) for initial puncture of the veins were compared. In conventional pigs weighing less than 30 kg, catheter insertion may be facilitated by using a microintroducer set with a 21 Ga needle. In pigs weighing 50 kg, a standard 18 Ga needle may be preferable., (© The Author(s) 2015.)

Aims: The objective of this study was to describe the use of indwelling epidural catheters post-operatively in dogs in a home environment, and to report associated complications., Methods: Dogs undergoing surgical procedures of the hind limb (n=83) were included in the study and were administered 0.05 or 0.10 mg/kg epidural morphine via an indwelling epidural catheter every 6 hours. Data compiled relating to catheter placement included time of placement, ease of placement and problems encountered, number of attempts of placement, and individual placing the catheter. A client questionnaire was provided to evaluate side effects, complications, pain, and ease of use of the epidural catheter system after discharge from the hospital and catheter removal at home. Side effects were compared between the dogs receiving 0.05 or 0.1 mg/kg epidural morphine., Results: The most common patient complication was abnormal urination patterns (32/82, 39%); specifically dribbling urine where laying, emptying the entire bladder where laying, not urinating for extended periods of time, and taking a longer time to pass urine were reported. There were no significant differences in the number or types of side effects reported in either dosing group. The most common technical issues reported by owners were difficulty getting the needle into the injection port (10/81, 12%) and removing the adhesive covering keeping the epidural catheter system in place (19/78, 24%). There were no reports of inflammation or discharge at the catheter site in any of the dogs. Of the respondents surveyed, 76/79 (97%) found the epidural catheter system easy to use at home in the post-operative period., Conclusions: Indwelling epidural catheters are a feasible method of administration of post-operative analgesia in the immediate post-operative period in the home environment and were associated with only a few minor complications in this population.

Intravenous drug administration in adult swine is difficult to perform due to inaccessible superficial veins and thick subcutaneous fat layers. However, successful intravenous drug administration is critical for many biomedical applications including pharmacokinetic studies as extravascular drug administration can influence the drug's absorption and elimination rate. The purpose of this study was to develop and refine an effective technique for indwelling auricular vein catheter placement in the conscious mature sow. We developed a protocol using a topical anesthetic cream and minimal physical restraint to place indwelling catheters in the auricular vein of six multiparous sows. This method was quick (3 min 20 s ± 8 s [mean ± SE per catheter]), effective (11/12 catheters successfully placed) and reliable, allowing a large drug volume (20-22 mL) to be administrated successfully during the trial without relying on prolonged restraint or general anesthesia of the sow.

Long-term, frequent venous access for diagnostic, therapeutic, or research purposes in cats is problematic. Frequent blood sampling over extended periods is necessary for some therapeutic regimes and often required for clinical research in veterinary science. In this paper, we describe the implantation of vascular access ports (VAPs) and assess their use for repeated blood sampling over 16 weeks and 38 weeks, as well as the use of jugular catheters for one week. The VAP placement procedure was well-tolerated with few minor complications (minor swelling, contusion, or superficial dermatitis from self-trauma), which were not observed when neck bandages were applied immediately after surgery. Thromboembolism occurred in two cats, but did not occur after switching to a smaller catheter with a rounded tip and taurolidine-citrate locking solution. Although duration of access was much longer with VAPs compared to jugular catheters, patency rates were similar (89% (n=28) to 92% (n=12) after 16 weeks and 75% (n=12) after 38 weeks for VAPs; 88% (n=49) after one week for jugular catheters). Behavioural reactions to blood collection from 30 cats-assessed over 16 weeks and comprising 378 collections-were absent or minor in 99% of collections. These findings indicate that VAPs offer a viable alternative to jugular catheters for studies requiring frequent blood sampling and lasting more than 2 weeks., (Copyright © 2013. Published by Elsevier India Pvt Ltd.)

A 20-year-old male castrated domestic longhair cat was evaluated for assessment of its chronic kidney disease (CKD) and a non-healing ulcerated mass at the site of a previously placed and subsequently removed GIF tube. The cat had been diagnosed with CKD 10 years prior and two GIF tubes had been placed over a 5-year period, the second of which was associated with secondary infection. Biopsy of the non-healing ulcerated mass was consistent with grade 2 soft tissue sarcoma. At necropsy there was a discrete, serpentine, subcutaneous mass measuring approximately 8 mm in diameter that extended approximately 20 cm along the dorsum to the caudal thorax, following the path of the GIF tube, from the main intrascapular, ulcerated mass where the fluid port injection site was located. This is the first report of a fibrosarcoma arising at the site of a subcutaneous fluid port in a cat. Although the cat's owners were pleased with the 4 years of quality of life provided by this device, this complication should be considered when a decision to place ports for long-term management of disease is made.

There are no reported studies evaluating the use of erythromycin for regional limb perfusion (RLP) in horses. Our hypothesis was that using the cephalic and saphenous veins for RLP will enable delivery of therapeutic concentrations of erythromycin to the distal limb. Nineteen healthy horses participated in the study. The cephalic, saphenous or palmar digital (PD) vein was used to perfuse the limb with erythromycin. Synovial samples were collected from the metacarpo/metatarso-phalangeal (MCP/MTP) joint and blood samples were collected from the jugular vein. Maximum concentration (C(max)) of erythromycin in the MCP joint using the cephalic vein was 113 mg/L. The Cmax of erythromycin in the MTP joint using the saphenous vein was 38 mg/L. Erythromycin administered using the PD vein was not detectable in the MCP/MTP joint of four of six horses. Concentrations of erythromycin achieved in the synovial fluid of the MCP/MTP joint were between 152 and 452 times the minimal inhibitory concentration (MIC) for Rhodococcus equi (R. equi). In conclusion, the results indicate that when using the saphenous or cephalic veins for RLP, therapeutic concentrations of erythromycin in the MCP/MTP joint can be consistently reached [corrected]., (© 2012 John Wiley & Sons Ltd.)

Objective: To determine whether heparinized saline would be more effective in maintaining the patency of peripheral IV catheters in dogs compared to 0.9% sodium chloride., Design: Prospective blinded randomized study., Setting: University Veterinary Teaching Hospital., Animals: Thirty healthy purpose bred dogs, intended for use in the junior surgery laboratory, were utilized. The dogs were randomized into 1 of 3 groups, 2 treatment groups and a control group., Interventions: An 18-Ga cephalic catheter was placed in the cephalic vein of each dog. Each dog in the treatment group had their catheter flushed with either 10 IU/mL heparinized saline or 0.9% sodium chloride every 6 hours for 42 hours. The dogs in the control group did not have their catheters flushed until the end of the study period. Immediately prior to flushing catheters, each catheter was evaluated for patency by aspiration of blood and the catheter site was evaluated for phlebitis., Measurements and Main Results: All dogs in the heparinized saline and 0.9% sodium chloride group had catheters that flushed easily at each evaluation point. More dogs in the saline group had catheters from which blood could not be aspirated, but there was no significant difference between these groups. All dogs in the control group had catheters that flushed easily at the end of the assigned 6 hour interval except in 1 dog. Phlebitis was not detected in any dog., Conclusions: Flushes of 0.9% sodium chloride were found to be as effective as 10 IU/mL heparinized saline flushes in maintaining patency of 18-Ga peripheral venous catheters in dogs for up to 42 hours. For peripheral catheters placed with the intention of performing serial blood draws, heparinized flushes may be warranted., (© Veterinary Emergency and Critical Care Society 2013.)

When used in veterinary medicine, central venous catheters are typically inserted through the external jugular vein, with their caudal extension within the cranial vena cava. Radiographic or fluoroscopic guidance is recommended to assist in correctly placing these catheters. This article provides radiologic examples of common central venous catheter malpositions and complications.

Vascular access ports (VPAs) are totally implantable devices designed to provide repeated access to the vascular system. Port access is performed by percutaneous needle insertion using a noncoring needle. VAPs have been placed in 12 dogs affected by different tumors and needing long lasting chemotherapy. Using the non-invasive Seldinger technique a silicone catheter was inserted from the jugular vein up to the junction of the cranial vena cava and the right atrium. The catheter then was connected to the port previously placed in a subcutaneous pocket over the scapula. 7/12 dogs showed no clinical complications. Port was removed in 4/12 dogs for post-operative complications as fistula formation (n.2) and infection/mal-position (n.2). One patient had mild complications shortly after implantation. VPAs were left in site until the death in the rest of patients. VAPs are useful for dogs undergoing long-lasting chemotherapy protocols as these devices allow peripheral veins to be spared and not seriously damaged for repeated infusion of vesicant drugs. In most cases VPAs are well tolerated and may be left in site for several months., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: To describe the clinical use of regional limb perfusion with antimicrobials (A-RLP), complications, and outcome in a large series of patients., Design: Retrospective case series., Animals: 174 horses., Procedures: Medical records of horses treated with A-RLP between 1999 and 2009 were reviewed. Signalment, primary complaint, horse use, etiology, duration of clinical signs, previous treatment, structures involved, concurrent conditions, A-RLP characteristics, additional treatments, complications, and outcome were recorded. At long-term follow-up, 2 outcomes were investigated: survival rate and return to previous use at the same or higher level. Univariate and multivariate logistic regression analyses were conducted., Results: Group 1 (96 horses) included septic synovitis. Group 2 (50 horses) included extrasynovial lacerations (23 horses) and fresh, minimally contaminated intrasynovial lacerations without evidence of established synovial infection (27 horses). Group 3 (28 horses) included miscellaneous other conditions. Only minor complications were reported in 12.26% of horses that received IV (n = 155) and 33% of horses that received intraosseous (27) A-RLP. Horses with septic synovitis had a lower survival rate (53.43%) than did horses with lacerations (91.89%). Within group 2, no significant differences in short- or long-term outcomes were found between horses with extrasynovial and fresh, minimally contaminated intrasynovial lacerations. For the horses returning to previous use, 80% of horses with septic synovitis and 72.72% of horses with lacerations were performing at the same or higher level at the time of follow-up., Conclusions and Clinical Relevance: The results of the present study indicated that A-RLP is a safe technique with minimal adverse effects. The IV route presented fewer complications than intraosseous injection. Horses with infection of synovial structures had a lower survival rate than did those with acute, minimally contaminated intrasynovial lacerations. The latter had a similar prognosis for horses with extrasynovial lacerations treated with A-RLP.

Objective: To describe the procedure and clinical usefulness of locking-loop pigtail nephrostomy catheter (PNC) placement in dogs and cats., Design: Retrospective case series., Animals: 16 cats (18 kidneys) and 4 dogs (4 kidneys) that underwent PNC placement., Procedures: Medical records of patients that underwent PNC placement were reviewed. The PNCs were placed percutaneously with ultrasonographic and fluoroscopic guidance or via a ventral midline laparotomy with fluoroscopic guidance. Either a modified Seldinger technique or a 1-stab trocar introduction technique was used for PNC placement. Preoperative renal pelvic size, postoperative renal pelvic decompression, catheter patency, serum biochemical changes, and results of microbial culture of urine samples were reviewed. Length of time the catheter was in place, reason and method for catheter removal, complications, and clinical outcomes were noted., Results: Reasons for PNC placement were ureterolithiasis (15 kidneys), ureteral stricture (3), malignant obstruction (2), and percutaneous nephrolithotomy (2). Seven of 22 catheters were placed percutaneously, and 15 were placed via a ventral midline laparotomy. Catheters were either size 5F (n = 17) or 6F (5). The PNCs remained indwelling for a median of 7 days (range, 1 to 28 days). Catheter-associated complications included urine leakage (n = 1) and accidental dislodgement by the patient at home (1). All catheters performed successfully by providing temporary urine diversion and drainage for successful renal pelvis decompression., Conclusions and Clinical Relevance: Placement of locking-loop PNCs was safe, effective, and well tolerated in dogs and cats for temporary urine diversion to achieve renal pelvis decompression.

The regional intravenous antibiotic administration has been used to achieve high local concentrations of antibiotics into the extremities. The goal of this case report was to describe a known, but not often used technique of local administration of antibiotics for treatment of acute soft tissue, joint or bone infection in a dog, which suffered from chronic renal failure. In a seven years old Great Dane tarso-metatarsal arthrodesis was performed and three days after surgery infection was obvious. Gentamicin-sensitive E. co i was found by antibiogram. A tourniquet was tightened on the affected limb and gentamicin was administered in a dosage of 0,5 mg/kg every twelve hours via an intravenous catheter placed in the saphenous vein. The therapy lasted for ten days and wound healing was progressive. Regional intravenous gentamicin administration was very effective in treating distal extremity infection.

Researchers may place a catheter in the ear vessel of a rabbit for a short period of time in order to collect repeated blood samples without extensive restraint of the animal. Maintaining such a catheter in a healthy rabbit can be challenging, as the animal may scratch at the ear, removing the catheter or forming a large hematoma that might impede blood sampling. The authors developed a technique for protecting the indwelling catheter by cutting a section of moleskin to the same shape as the ear and gluing it to the surface of the ear and the catheter. They applied this technique to collect multiple blood samples during 12-h periods from nine rabbits in a pharmacokinetics study. Catheters remained patent in five rabbits for 12 h, in two rabbits for 8 h, in one rabbit for 6 h and in one rabbit for 4 h. This technique allowed for collection of repeated blood samples and prevented the rabbits from interfering with the catheter while allowing them to move freely during the sampling period.