1. Urine Collection Techniques

2. Anatomy Review
Urine accumulates in the bladder: we need to understand anatomy, to understand how to get to our goal.
Where is the bladder is located?
What else is contained within the abdomen around this location?
What is the bladder made of?

3. Indications for Urine Collection
Why would a veterinarian request a urinalysis?
Concern with bladder or kidneys
Urolithiasis, infection, dehydration, disease (FLUTD, FIC, blocked tom, pyelonephritis)
What exactly are we testing for?
Color, specific gravity, ketones, protein, glucose, hematuria, crystals, microorganisms, etc.
*Note: samples tested for bacteria/fungi are typically sent out referred to as “culture and sensitivity”

4. Collection techniques
Voided/Free catch
Manual expression
Urinary catheter
Cystocentesis

5. Voided/Free Catch Gather your supplies Dog: Cat: Advantages:
Disadvantages:

6. Manual Expression
Technique:
Indications:
Contraindications:

7. Manual Expression Advantages: Disadvantages:
Complications that could happen:

8. Urinary Catheterization
Define:
Indications:
Contraindications:

9. Types of Urinary Catheters
Red Rubber
Polypropylene
Foley
Tom Cat

10. Urinary Catheterization
Male Dog: technically the easiest patient
1. Aseptic Technique
2. Wear gloves
3. Handle catheter aseptically at all times
4. Apply lubrication

11. Male dog continued 5. Restrainer pull back prepuce to expose penis
6. Advance catheter through tip of penis into urethra, continue until urine is seen
7. Aspirate urine, or secure catheter in place
Note: If collecting urine for testing, discard the first 2 ml aspirated

12. Urinary Catheterization
Female dog: more challenging
Prep is same
Speculum and light source required
Find urethral opening 2-4 cm inside the vagina
Secured by taping catheter to the tail

13. Urinary Catheterization
Male cat:
Most commonly for urethral obstruction
Sedation or anesthesia possible
Prep site as normal
Pull hind limbs cranially
Check for mucus plug: if cannot be removed advance tomcat or polypropylene catheter
use sterile saline to push blockage
secure with stay sutures

14. Urinary Catheterization
Monitoring Output:
Closed system is created by attaching the catheter to an IV line and then a collection bag
Normal patients should produce 1-2 ml/kg/hr of urine
Maintenance:
Urinary catheters must be removed every 4-5 days
Daily cleaning/maintenance q 24h

15. Cystocentesis
Define:
Indications:
Contraindications:

16. Cystocentesis Disadvantages: Advantages:
Sample is free from all contaminations/disease in lower urinary tract
Considered the most sterile form of urine collection
Quick, minimal supplies
Minimizes iatrogenic UTI or trauma
Disadvantages:
Possible laceration of bladder
Trauma/laceration of other anatomy
Iatrogenic hematuria

17. Cystocentesis
Gather your supplies:
Positioning:

18. Cystocentesis Locating the bladder : Palpation Landmarks Canine Feline
Tools:

19. Cystocentesis Procedure
Wet injection site with alcohol
Hold syringe so you can aspirate without changing position
Place needle directly into bladder, with intent, at a degree angle
Use aspiration to withdraw desired amount of urine
Stop aspirating
Bring needle straight out

20. Cystocentesis Troubleshooting
Blood in needle?
Abort mission, come straight out
Change needle AND syringe and try again
Negative pressure?
May go deeper, but release pressure from aspiration FIRST
Aspirate again
If no urine: stop aspirating and bring needle straight out
*NEVER REDIRECT NEEDLE IN THE BLADDER!!!!!

21. Urine Storage
Non-sterile urine is transferred into a specimen cup or RTT
Should be tightly sealed to prevent contamination or evaporation
Sterile urine is transferred to a Red Top Tube
Must be transferred directly through the rubber top – Change needle first!
Urine must be analyzed within 30 minutes of collection
If cannot be analyzed within 1 hour, must be refrigerated

22. Urine Storage Up to 24 hours – 12 hours is ideal Why refrigerator?
Slow the deterioration of components
Maintain current bacterial population
*Note: refrigeration may cause crystal formation
Why do we keep out of sunlight?
UV light breaks down components like Glucose and Bilirubin