July 06, 2018

Complications Associated With Arterial Catheterization in Cats

In a retrospective study of 35 cats, most complications were minor, and none led to death.
By By Natalie Stilwell, DVM, MS, PhD
Cat Arterial CatheterizationPeripheral arterial catheterization is useful in critically ill patients for monitoring arterial blood, blood pressure, and blood gas values. However, catheterization in patients with small blood vessel size, such as human neonates and small animals, is considered technically difficult. The most common complications associated with arterial catheterization in human neonates are vascular spasm and thromboembolism.

As relatively few studies have explored complications of this method in veterinary medicine, researchers in Pennsylvania recently performed a retrospective study examining this topic.

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Study Design
Records were retrospectively identified for feline patients that had an arterial catheter placed at the Pittsburgh Veterinary Specialty and Emergency Center. Patient signalment, reason for hospitalization, survival, and arterial catheterization details were recorded, and cases with incomplete medical records were excluded.

The researchers categorized the following as minor complications:
  • Catheter occlusion
  • Hematoma formation
  • Bleeding at the puncture site
  • Loss of a palpable peripheral pulse

Major complications included serious systemic issues secondary to arterial catheterization, such as ischemic damage and infection.

The authors performed statistical analyses to examine potential correlations among the patients’ reason for hospitalization, purpose of catheterization, duration of catheter use, complications, and survival. 

Results
Between 2010 and 2014, complete records were available for 35 cats that underwent arterial catheterization. Patients had a median age of 10 years (range, 8 months to 16 years) and included 11 spayed females, 23 neutered males, and 1 intact male. Median weight of patients was 4.3 kg (range, 2.4-8.6 kg). Three cats required placement of more than 1 arterial catheter.

Most catheters (79%) were placed for surgical procedures, with the remainder placed in cats that were admitted to the ICU for medical reasons. The most common sites for arterial catheter placement were the coccygeal artery (66%) and dorsal pedal artery (24%). Most catheters were 24 gauge, ¾ inch (79%), and the median duration of use was 3 hours (range, 1-117 hours). The majority of catheters (95%) were flushed using a continuous infusion of 0.9% sodium chloride solution.

Minor and major complications were noted in 27% and 0% of surgery-related catheters, respectively. Major and minor complications were each noted in 1 ICU case, with the major complication consisting of ischemic injury from a coccygeal catheter that necessitated amputation of the tail. The reason for hospitalization (medical vs surgical) did not influence the incidence of complications. Of the 35 catheterized cats, 74% recovered and were discharged, 20% were euthanized, and 6% died. All cats that experienced catheter-associated complications were discharged successfully.

There were significant correlations between duration of catheter use and incidence of complications. Also, a higher complication rate was observed in catheters placed for ICU monitoring, compared with those placed for surgical monitoring.

Conclusion
The overall incidence of minor complications associated with arterial catheterization in the study was 24%, while a single, major, nonfatal complication was noted out of 35 cats. The most commonly noted complication was catheter occlusion.

 
Dr. Stilwell received her DVM from Auburn University, followed by a MS in fisheries and aquatic sciences and a PhD in veterinary medical sciences from the University of Florida. She provides freelance medical writing and aquatic veterinary consulting services through her business, Seastar Communications and Consulting.
 

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