Canine Female Urinary Catheters

How to Place a Female Urinary Catheter in a Canine


Preparation:

Can be placed with or without sedation.

Positioning:

Patient can be place in either lateral or DV with legs hanging over the end of the exam table with a rolled towel under the patient’s caudal ventrum.

Supplies:

  • Exam gloves- one pair non-sterile, one pair sterile
  • Chlorhexidine scrub
  • Sterile lube
  • Sterile Saline
  • 6 ml syringe
  • Sterile urinary catheter-Foley.  5 fr small dogs, 8 fr medium, 10-12 fr large dogs
  • CCS- if indwelling
  • Tape and +/- suture

Procedure:

  1. Clip and clean the perivulvar area. Wearing exam gloves, cleanse vulva with chlorhexidine scrub.  Allow for good contact time (1-2 min)
  2. Rinse vulva with sterile saline.  Place a sterile drape.
  3. Don sterile gloves and lubricate distal tip of sterile urinary catheter with sterile lubricating jelly.
  4. Inspect the catheter, estimate the length of the catheter required to reach the bladder, and verify the patency of the balloon (have someone instill 5mls of sterile saline into the catheter port).
    inflate.jpg
  5. Insert a lubricated finger of the right hand between the labia of the vulva, direct the finger dorsally to avoid the clitoral fossa, then craniallly to enter the vestibule. Slide the finger along the floor of the vestibule, on midline, and palpate the urethral opening at the junction of the vestibule with the vagina.  The urethral opening is covered by a mound of tissue (papilla) that may be obvious or subtle. This landmark is helpful because the urethral opening is located just caudal to this junction. 
  6. Position urinary catheter underneath your finger and gently insert it between the labia of the vulva and into the vestibule.  Place your right finger on the tip of the catheter and gently push it forward to guide it into the urethral opening.  Do not expect the catheter to advance just by pushing the catheter with your left hand.  Use your left hand to help keep the catheter aligned. You may use an otoscope or speculum to aid in visualization.  Otoscopes cannot be used with Foley catheters.
    palpation.jpg
  7. Slowly advance the catheter forward ventrally and into the urethra until drops of urine are obtained.  Verify placement by palpating the tissue of the urethral papilla over the catheter.  If the catheter has slipped over the papilla, it will continue to advance into the vagina.  
  8. If indwelling, you must check placement with a lateral radiograph.
  9. If using a foley catheter, inflate the balloon (typically 5 cc’s) and gently pull the catheter snug to the patient’s trigone.
  10. Mark the urinary catheter at the entrance into the vulva, with a sharpie pen.
  11. Place a tabbed butterfly white tape at the entrance to the vulva and suture in place. However, if the patient is recumbant, it is also okay to simply secure the catheter to the patient's leg or tail (the balloon inflated will hold the catheter in place, therefore suture at the vulva is not necessary).  
  12. Attach a closed collection system and tape (tabbed) all junctions.
  13. Remove all flow clamps from CCS.
  14. With tabbed white tape, secure urinary catheter to one of the patient’s rear legs or tail, to prevent dragging or accidentally stepping on the catheter line.
    ucath.jpg

Instrument Technique:

  1. A speculum may be uysed to separate the urethral tissue so that the opening can be seen with the aid of a light source.
  2. An assistant should hold the speculum in an open position to allow the otoscope cone to be inserted through it.
    speculum.jpg
  3. The catheter is then inserted through the cone into the urethral opening and then into the bladder.  A stylet through the catheter is required. The otoscope cone will not allow the distal portion of the Foley catheter ti pass through, so the cone is removed from the otoscope but left in place on the catheter. 

ucathcone.jpg