TECHNIQUE

Urethral Catheterisation 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.
Caution:
  • Heavy sedation or anaesthesia required. (B601.2.w2, J213.9.w1)
    • It is useful to include a benzodiazepine in the premedication or in the sedation protocol because this will reduce the likelihood of urethral spasm. (B601.2.w2)
      • Midazolam 1.5 - 2.0 mg/kg intravenously provides appropriate relaxation. (V.w122)
Technique:
  • Gently wash the prepuce or the vulva 
    • Use warm, dilute antiseptic solution and then rinse with warm water or saline. (B601.2.w2)
  • Select a suitable urinary catheter 
    • The selection is based on the sex and the size of the rabbit, usually 4 to 9 F (most urinary catheters that are suitable for for cats or small dogs are appropriate). (B601.2.w2)
      • In most rabbits, a well lubricated 9 French sterile catheter can be used. (B604.3.w3, J213.9.w1)
      • In male rabbits a 3-4 gauge Jackson's cat catheter is appropriate; larger catheters can be used in females. (V.w122)
  • Open the sterile urinary catheter's packaging to expose the distal three centimetres of the catheter and apply sterile, water soluble lubricant to this tip. (B601.2.w2)
  • Maintain an aseptic technique by ensuring that the catheter stays wrapped in its packaging and sterile gloves are worn. (B601.2.w2)
  • Restrain and position the rabbit
    • Males: 
      • Place in a dorsal or lateral recumbency. (B601.2.w2)
      • Restrain in a sitting position. (B604.3.w3, J213.9.w1)
    • Females:
      • Place in sternal recumbency. (B601.2.w2, J213.2.w3, J213.9.w1)
  • Introduce the catheter
    • Males: retract the prepuce to expose the penis and then introduce the catheter. (B601.2.w2)
      • Pass the catheter about 2.5 cm (one inch) into the urethra. (J213.2.w3)
    • Females: 
      • The procedure is a bit more challenging than in males. (B601.2.w2)
      • Gently pull the vulva caudally. Introduce the catheter into the vagina and advance it along the floor. The opening of the urethra lies ventrally and the catheter should hopefully slide in without resistance. (B601.2.w2, J213.2.w3, J213.9.w1)
    • If resistance is met then retract the catheter a little and slightly rotate it before re-advancing. If obstruction of the urethra is suspected, introduce a small volume of sterile water or saline to try to flush any obstructing material back into the bladder. (B601.2.w2)
      • Sterile isotonic saline is preferred. (V.w122)
      • The fluid used should be warmed to body temperature. (V.w122)
  • Attach a syringe to the end of the catheter
  • Retract the syringe plunger and slowly collect the urine.
  • 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

  • Urethral catheterisation is appropriate for:
    • Collection of an uncontaminated urine sample (B601.2.w2)
    • Therapeutic flushing of the bladder in patients with urinary sludging. (J213.9.w1)
    • Treatment of urinary obstruction (B601.2.w2)
    • Contrast radiography of the urinary tract (B601.2.w2)
    • Catheterisation should be performed as an alternative to cystocentesis if the bladder is overdistended. (B601.2.w2)
Notes
  • Sterile equipment
    • Urinary catheters 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.
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)

Urethral catheterisation:

  • Heavy sedation or anaesthesia required. (B601.2.w2, J213.9.w1)
    • It is useful to include a benzodiazepine in the premedication or in the sedation protocol because this will reduce the likelihood of urethral spasm. (B601.2.w2)
  • Can be challenging in female rabbits
    • This procedure is a bit more challenging in female rabbits than in males because locating the urethral opening in the ventral vagina can be a bit difficult. (B601.2.w2)
  • Resistance or obstruction to the introduction of the urinary catheter
    • If resistance is met then retract the catheter a little and slightly rotate it before re-advancing. If obstruction of the urethra is suspected, introduce a small volume of sterile water or saline to try to flush any obstructing material back into the bladder. (B601.2.w2)
Equipment / Chemicals required and Suppliers
  • Sterile water-soluble lubrication.
  • An appropriately sized sterile urinary catheter .
    • Usually 4 to 9 French (B601.2.w2).
    • A 9 French sterile catheter. (B604.3.w3, J213.9.w1)
  • A 10 mL syringe.
  • Sterile gloves.
  • Sterile water or saline.
  • A sterile universal container for the urine sample.
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 Debra Bourne MA VetMB PhD MRCVS (V.w5); Aidan Raftery MVB CertZooMed CBiol MIBiol MRCVS (V.w122)
References B600.3.w3, B601.2.w2, B602.14.w14, B604.3.w3, J213.1.w1 J213.2.w3, J213.9.w1

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