TECHNIQUE

Cystocentesis of Rabbits (Disease Investigation & Management - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords See also:
Description Note: Techniques used in wild lagomorphs
  • While most veterinary procedures described for use in domestic rabbits can also be used in wild lagomorphs, it is much more likely that sedation or anaesthesia will be required to carry out such procedures in these animals.
Cystocentesis
  • Caution:
    • In most domestic rabbits there is no need for sedation. (B602.14.w14, J213.1.w1, J213.9.w1) However, sedation or anaesthesia will prevent the rabbit from struggling and reduce the risk of damage to internal structures. (J213.9.w1)
    • Repetitive puncture of the bladder can result in inflammation and subsequent stone formation. (B600.3.w3)
  • Technique:
    • Restrain and position the animal
      • Excellent restraint is critical if the rabbit is conscious. (J213.1.w1)
      • Have the rabbit restrained in dorsal recumbency:
        • The assistant should place the rabbit in dorsal recumbency and stretch the animal by holding the scruff in one hand and the hindlimbs in another. (B602.14.w14, J213.9.w1)
        • Or the handler holds the rabbit in dorsal recumbency with both forearms against the rabbit's body and a towel or hand over the rabbit's eyes. (J213.1.w1)
        • Or wrap the rabbit in a towel and hold securely in dorsal recumbency with the eyes covered. (J213.2.w3, J213.9.w1)
      • Make sure the rabbit cannot move suddenly. (J213.2.w3)
      • Lateral recumbency can also be used. (B601.2.w2)
    • Locate the bladder 
      • The bladder can be palpated just cranial to the pelvic brim on the ventral midline. (J213.2.w3, J213.9.w1)
      • Take care to differentiate the bladder from other structures (e.g. an abdominal abscess, a gravid or neoplastic uterus). (B600.3.w3)
      • Ultrasound can be useful for visualising the bladder and also for detecting any abnormalities. (B600.3.w3, J213.9.w1)
      • Note, the bladder may be difficult to palpate, particularly if flaccid. (J213.2.w3)
    • Assess the bladder volume 
      • Delay the procedure if the bladder is empty or attempt catheterisation if the bladder is overdistended. (B601.2.w2)
    • Clip the fur
      • Clip a small window immediately cranial to the pubis and in the ventral midline. (B601.2.w2)
      • Or visualise the midline by placing a little alcohol in front of the pubis. (J213.1.w1)
    • Disinfect the skin using 70% alcohol. (B601.2.w2, B602.14.w14, J213.9.w1)
    • Isolate the bladder using one hand. (B601.2.w2)
    • Direct a small needle attached to a syringe into the bladder with the other hand.
      • Direct a 25 mm (1 inch) needle (22 to 25 gauge) attached to a sterile 5 to 10 mL syringe through the midline abdominal wall and into the bladder. (B601.2.w2, B602.14.w14, J213.1.w1, J213.2.w3, J213.9.w1)
    • Retract the syringe plunger slowly and collect the urine. (B601.2.w2)
      • If blood enters the needle then withdraw the needle from the abdominal cavity and make a second attempt with a fresh needle and syringe. Do not redirect the needle once it is within the abdomen because accidental laceration of the viscera may occur. (B601.2.w2)
    • Transfer the urine sample to an appropriate container
      • e.g. a sterile universal container.
Appropriate Use (?)
  • Collection of urine for urinalysis. (J213.9.w1)
    • Urinalysis is a useful diagnostic tool in the investigation of many rabbit illnesses. (B601.2.w2, B602.14.w14)

Different urine collection techniques are appropriate for different individuals and purposes

  • Cystocentesis
    • Collection of an uncontaminated urine sample.
    • This is the preferred method of urine collection for bacterial culture. (J29.16.w6)
    • Can be performed in the conscious animal although sedation or anaesthesia advised in rabbits that are likely to struggle. (B602.14.w14, J213.9.w1)
Notes
  • Sterile equipment
    • Needles, urinary catheters etc. must remain sterile during the procedure. (B601.2.w2)
  • Disposal of used equipment
    • Used disposable equipment needs to be put into the appropriate clinical waste container and needles should be disposed of in a sharps container.
Complications/ Limitations / Risk
  • In wild lagomorphs
    • While most veterinary procedures described for use in domestic rabbits can also be used in wild lagomorphs, it is much more likely that sedation will be required to carry out such procedures in wild lagomorphs.
  • Urinalysis
    • This can sometimes be difficult in the rabbit because there may be a heavy but normal pigment or mineral content of the urine. (B602.14.w14)

Note: Different urine collection techniques have different limitations and risks to their use.

Cystocentesis
  • Sedation or anaesthesia required in animals likely to struggle. (J213.9.w1)
  • Bladder damage
    • Repetitive puncture of the bladder from cystocentesis can result in inflammation and subsequent formation of calculi. (B600.3.w3)
    • Bladder wall microtrauma can lead to local calculus formation. (J29.16.w6)
  • Damage to other internal abdominal structures
    • There is a risk of damage to internal abdominal structures if cystocentesis is performed on a conscious rabbit that struggles. (J213.9.w1)
      • In particular, the thin-walled caecum may be lacerated. (J29.16.w6, J213.2.w3)
      • An enlarged uterus or an abscess could be punctured. (J29.16.w6)
    • Take care to differentiate the bladder from other structures (e.g. an abdominal abscess, a gravid or neoplastic uterus). (B600.3.w3)
    • If blood enters the needle then withdraw the needle from the abdominal cavity and make a second attempt with a fresh needle and syringe. Do not redirect the needle once it is within the abdomen because accidental laceration of the viscera may occur. (B601.2.w2)
  • Note: Catheterisation should be performed as an alternative to cystocentesis if the bladder is overdistended. (B601.2.w2)
    • See: 
Equipment / Chemicals required and Suppliers
  • Clippers
  • 70% alcohol for disinfecting the skin. 
  • A small needle (25 mm, 22 to 25 gauge)
  • A 5 mL or 10 mL syringe. 
  • A sterile universal container for the urine sample.

(B601.2.w2, B602.14.w14, J213.1.w1, J213.9.w1)

Expertise level / Ease of Use This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
Cost / Availability
  • Equipment is relatively inexpensive.
  • Cost of equipment for in-house testing
  • Cost of external laboratory fees.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (see: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).
Author Nikki Fox BVSc MRCVS (V.w103)
Referee Frances Harcourt-Brown BVSc FRCVS (V.w140)
References B600.3.w3, B601.2.w2, B602.14.w14, B604.3.w3, J29.16.w6, J213.1.w1 J213.2.w3, J213.9.w1

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