ANSWERS

1. List 4 ways in which the bladder may be emptied.
   • Natural micturition (urination).
   • Manual expression.
   • Catheterisation.
   • Cystocentesis.
2. A tomcat is presented with a suspected blocked bladder due to urolithiasis; which technique would be safest to provide immediate relief and why?
   Cystocentesis; the quickest method with minimal preparation or equipment required. Sedation or anaesthesia are not normally necessary.
3. Describe how cystocentesis is performed.
   • An assistant restrains the patient in lateral or dorsal recumbency.
   • A sterile 23G needle, with a 5 or 10ml syringe attached, is inserted through the abdominal wall at a 45 degree angle entering the bladder near its junction with the urethra. The urine is then withdrawn.
   • The bladder must be reasonably full for cystocentesis to be performed.
4. How is a Jackson cat catheter different to a regular cat catheter?
   A Jackson cat catheter is specially designed to be indwelling; it is therefore shorter than a regular cat catheter with a plastic phlange for suturing it into place. A metal stylet aids insertion.
5. How does the stylet of a Foley bitch catheter differ to that of a dog catheter?
   The stylet of a Foley catheter is not guided through the bore like that of a dog catheter, but placed directly at the opening of its distal end, and therefore lies along the side of the catheter.
6. What sterilisation technique is generally considered most suitable for urinary catheters and why?
   Most urinary catheters are designed for single use only and are pre-packed and sterilised by gamma irradiation by the manufacturer. Catheters are not suited to heat sterilisation, and therefore if they are to be re-used ethylene oxide is the technique of choice. Foley catheters should only ever be used once, since they are made of soft latex which is easily perishable. The new silicon catheters are autoclaveable.
7. What is the maximum length of time an indwelling urinary catheter should be left in place?
   There is no absolute maximum time that an indwelling urinary catheter may be left in place, but they should always be removed as soon as possible to avoid bladder infections and cystitis.
8. List possible reasons for performing urinary catheterisation.
   • To empty the bladder prior to surgery.
   • To relieve a patient suffering a urinary tract blockage.
   • Hydroprepulsion to dislodge crystals.
   • To affix a urine collection bag.
   • For accurate assessment of urine output.
   • Introduction of contrast media.
   • Collection of a sample for urinalysis.

Note: Two practical tasks accompany this module: a) Preparation of equipment for urinary catheterisation and b) Demonstration of manual bladder expression.