diagnostic sampling and therapeutic technique

What factors determine the route of medication administration in small animals?

Patient condition or temperament, type of medication, urgency, cost/ease of administration, and desired effect.

What forms can orally administered medications come in?

Liquids, capsules, or tablets.

How should small volumes of oral liquid medication be given?

Place syringe tip between cheek and gums with the head neutral or slightly elevated.

How should large volumes of oral liquid medication be given?

Place syringe between the teeth behind the tongue hump and hold the head slightly elevated.

Why should you avoid hyperextending the neck during oral liquid administration?

It may cause fluid aspiration.

Why might cats hypersalivate during oral liquid administration?

Due to taste; flavored liquids can help.

What is important when hiding tablets or capsules in food?

Ensure the animal eats the medication with the vehicle.

What is the best restraint position for pilling if food baiting fails?

Sitting position.

Where should a pill be placed when manually pilling?

Over the hump of the tongue.

Why should dry pills be followed with liquid?

They may stick and irritate the esophagus.

What is a pilling syringe used for?

To secure and deliver a tablet over the tongue hump into the esophagus.

What is orogastric intubation used for?

Administering meds/food/fluids directly to the stomach, feeding neonates, or decompressing bloat.

How do you measure an orogastric tube for placement?

From the tip of the nose to the 13th rib.

What type of lubricant is used for OGT placement?

Water‑soluble gel or liquid.

How do you prevent backflow when removing an OGT after fluid administration?

Bend the tube to occlude contents before withdrawing.

What is a common systemic transdermal medication?

Fentanyl patch.

Why should gloves be worn when applying systemic transdermal meds?

To avoid absorbing the medication yourself.

How are transdermal sprays or liquids applied?

Sprayed onto hair or skin; avoid touching area for the specified time.

What is important when applying transdermal patches?

Apply to dry skin and cover the area after treatment.

What is the most important rule when administering ophthalmic meds?

Never touch the bottle/tube tip to the eye or any surface.

How long should you wait between multiple ophthalmic medications?

3-5 minutes.

Which ophthalmic form should be applied last—liquid or ointment?

Ointment.

What must be done before applying aural medications?

Clean the ear so medication contacts the epithelium.

How is aural medication distributed after application?

Massage the base of the ear.

Why is the colon being free of fecal material important for intrarectal meds?

It improves absorption.

What intrarectal meds can be used for vomiting patients?

Antiemetic tablets or suppositories.

How far should a tablet be inserted intrarectally?

At least 5 cm.

How far can a red rubber or urinary catheter be inserted for intrarectal administration?

8-10 cm.

What is the purpose of flushing warm water through a catheter during intrarectal administration?

To help distribute medication or assist enema flow.

What is the most common intranasal vaccine?

Bordetella bronchiseptica (kennel cough).

How should the patient be restrained for intranasal meds?

With the head elevated.

What is the most common route for vaccinations in small animals?

Subcutaneous (SC/SQ).

Why is SC administration not recommended in severely dehydrated or critical patients?

Absorption is poor.

What is the max typical SC fluid volume for a cat?

100 mL or less.

How is the skin prepared for SC injection?

Tent the skin and insert needle at the base, bevel up and parallel to the fold.

Why must you aspirate before SC or IM injection?

To ensure no blood is present.

What are common IM injection sites in small animals?

Epaxial muscles, semimembranosus, semitendinosus.

What IM site is avoided in small animals?

The neck.

What gauge needle is used for IM injections?

22-25 gauge.

What veins are commonly used for IV injections in dogs?

Cephalic and lateral saphenous.

What veins are commonly used for IV injections in cats?

Cephalic, medial saphenous, femoral.

What indicates correct IV needle placement?

Blood flash in the hub.

What are IV catheters used for?

Medications, fluids, electrolytes, blood transfusions/donations.

How often should IV catheters be inspected?

Every 48 hours or as needed.

When should an IV catheter be removed and replaced?

Phlebitis, infection, thrombosis, leaking, pain, or exposed catheter.

How often should unused IV catheters be flushed?

Every 4 hours with saline.

What is the max recommended time an IV catheter should remain in place?

No more than 72 hours.

What are the four categories of IV access devices?

Winged needle (butterfly), over‑the‑needle, through‑the‑needle, multilumen catheter.

What is a butterfly catheter used for?

Short‑term use, blood collection, medication administration.

Where are through‑the‑needle catheters primarily used?

Jugular vein.

What is the advantage of a multilumen catheter?

Allows simultaneous infusions at one site.

What protective measures are required for IV chemotherapy?

Protective clothing, oncology hood, needle protection system, hazardous waste disposal.

What needle sizes are used for blood sampling in cats and small dogs?

22 gauge.

What needle sizes are used for large dogs or large animals?

20-18 gauge.

How is the cephalic vein occluded for venipuncture?

Thumb or tourniquet at the elbow.

Where is pressure applied to occlude the jugular vein?

Thoracic inlet, without compressing the trachea.

How is the lateral saphenous vein occluded in dogs?

Circumferential pressure at or above the stifle.

How is the medial saphenous vein exposed in cats?

Abduct upper leg and flex to expose medial area of bottom leg.

What is thoracocentesis used to diagnose or treat?

Pleural filling defects.

What is pleural effusion?

A buildup of fluid between the pleura and the lungs ("water on the lungs").

What can thoracocentesis remove?

Air or fluid from the pleural space.

What clinical signs suggest pleural filling defects?

Tachypnea, respiratory distress, diminished or absent lung sounds, muffled heart sounds.

What are common causes of pleural effusion?

CHF, trauma, cancer, severe infections.

What equipment is needed for thoracocentesis?

Sterile gloves, OTN catheter, 2-5 inch needle, IV extension tubing, 3‑way stopcock, syringe, #15 blade, lidocaine, clippers, antiseptic scrub, EDTA and red‑top tubes, culture media.

Where is the thorax prepped for thoracocentesis when collecting air?

Dorsally.

Where is the thorax prepped for thoracocentesis when collecting fluid?

Ventrally.

What is used to desensitize the thoracocentesis insertion site?

Lidocaine.

How is the catheter inserted during thoracocentesis?

Perpendicular to the chest wall until a flash/pop is felt, then advanced a few millimeters.

After entering the pleural space, how is the catheter directed?

Direct the needle and catheter ventrally, then advance only the catheter.

What are complications of thoracocentesis?

Pneumothorax, lung laceration, blood vessel laceration leading to hypovolemia.

What post‑procedure monitoring is required after thoracocentesis?

Respiratory rate, lung sounds, oxygen saturation via pulse ox.

What is abdominocentesis used for?

Aspiration of abdominal fluid to diagnose hemoabdomen, uroabdomen, ascites, or other disease.

What are contraindications for abdominocentesis?

Penetrating abdominal injury, suspected pyometra.

What is the most common complication of abdominocentesis?

Failure to obtain a sample and skin hemorrhage or omental protrusion.

What serious complications can occur during abdominocentesis?

Penetration of bowel or spleen, damage to xiphoid, introduction of bacteria.

What equipment is needed for abdominocentesis?

Sterile gloves, 20-22 gauge needles, syringe, clippers, antiseptic scrub, lab tubes.

Where is the abdominocentesis site located?

Right mid‑abdominal region.

Is local anesthesia usually required for abdominocentesis?

No.

What patient positions are acceptable for abdominocentesis?

Standing, sternal, or lateral recumbency.

How is fluid obtained during abdominocentesis?

Gently aspirate or allow fluid to flow.

What can stimulate fluid flow if none is obtained?

Rotating the needle or placing a second needle.

What is done if no fluid is retrieved?

Repeat the procedure in other locations.

What post‑procedure monitoring is required after abdominocentesis?

Vital signs, pain, abdominal distention, bleeding or bruising at site.

What is the purpose of a transtracheal wash?

To obtain tracheobronchial material while bypassing the mouth and oropharynx.

What are indications for a transtracheal wash?

Diagnosing lower airway/lung disease, acute bronchopneumonia, inflammation, microorganisms, parasite eggs/larvae, infectious agents, neoplastic cells.

What is a contraindication for transtracheal wash?

Severe respiratory stress.

What complications can occur during a transtracheal wash?

Hemorrhage, pneumomediastinum, pneumothorax, subcutaneous emphysema, acute dyspnea.

What caution must be taken during a transtracheal wash?

Keep the patient awake with an intact cough reflex.

What is the purpose of fine‑needle aspiration (FNA)?

To acquire tissue cells from a mass, lymph node, or gland and differentiate inflammation from hyperplasia.

What are complications of FNA?

Minor hemorrhage, tissue damage, infection.

What equipment is needed for FNA?

25-22 gauge needles, 3-6 mL syringes, clean slides, surgical scrub or alcohol.

How is the area prepared for FNA?

Surgically prep or wipe with alcohol.

How is the mass stabilized during FNA?

Secure it with the free hand.

How is the needle manipulated during FNA?

Introduce needle, redirect once or twice, then remove.

When is suction applied during FNA?

Optional; may or may not apply pressure to syringe plunger.

Why must the syringe contain at least 1 mL of air before expelling onto a slide?

To push the sample out cleanly.

How is liquid FNA material smeared?

Push smear.

How is viscous FNA material smeared?

Pull smear.

What is the difference between push vs. pull smears?

Push for liquid samples; pull for thicker, more viscous samples.