Objective—To determine incidence of and possible risk
factors for catheter-associated urinary tract infection
(UTI) among dogs hospitalized in an intensive care unit
and compare results of bacterial culture of urine samples
with results of bacterial culture of catheter tips.
Procedure—A standard protocol for aseptic catheter
placement and maintenance was used. Urine samples
were obtained daily and submitted for bacterial
culture. When possible, the urinary catheter tip was
collected aseptically at the time of catheter removal
and submitted for bacterial culture. Bacteria that were
obtained were identified and tested for antimicrobial
Results—4 of the 39 (10.3%) dogs developed a UTI.
The probability of remaining free from UTI after 1 day
in the intensive care unit was 94.9%, and the probability
of remaining free from UTI after 4 days was
63.3%. Bacteria isolates were generally common urinary
tract pathogens and were susceptible to most
antimicrobials. Specific risk factors for catheter-associated
UTI, beyond a lack of antimicrobial administration,
were not identified. Positive predictive value of bacterial
culture of urinary catheter tips was only 25%.
Conclusions and Clinical Relevance—Results suggest
that placement of an indwelling urinary catheter in
dogs is associated with a low risk of catheter-associated
UTI during the first 3 days after catheter placement,
provided that adequate precautions are taken for aseptic
catheter placement and maintenance. Results of
bacterial culture of urinary catheter tips should not be
used to predict whether dogs developed catheter-associated
UTI. (J Am Vet Med Assoc 2004;224:1936–1940)
Case Description—A 9-year-old dog was evaluated for traumatic cervical myelopathy after a surgical attempt to realign and stabilize the C2 and C3 vertebrae.
Clinical Findings—The dog could not ventilate spontaneously and was tetraplegic; positive-pressure ventilation (PPV) was maintained. Myelography and computed tomography revealed spinal cord compression with subluxation of the C2 and C3 vertebrae and extrusion of the C2-3 intervertebral disk.
Treatment and Outcome—Surgically, the protruding disk material was removed and the vertebrae were realigned with screws and wire. For PPV, assist control ventilation in volume control mode and then in pressure control mode was used in the first 6 days; this was followed by synchronized intermittent mandatory ventilation until 33 days after the injury; then only continuous positive airway pressure was provided until the dog could breathe unassisted, 37 days after the injury. Physical therapy that included passive range of motion exercises, neuromuscular electrical stimulation, and functional weight-bearing positions was administered until the dog was discharged 46 days after injury; the dog was severely ataxic and tetraparetic but could walk. Therapy was continued at home, and 1 year later, the dog could run and had moderate ataxia and tetraparesis.
Clinical Relevance—Hypoventilation with tetraparesis in traumatic spinal cord injury can be successfully treated with PPV exceeding 30 days, surgery, and physical therapy.