How to place a percutaneous pigtail catheter | VETgirl Veterinary CE Videos

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In this VETgirl online veterinary CE video, we demonstrate how to place a percutaneous pigtail catheter into the bladder. This is a drainage catheter with a curl (which looks like a pig’s tail) at the end of the catheter (to prevent the catheter from slipping out). The pigtail catheter has several side holes at the distal end to enhance draining. Our patient in this video is a young, male neutered cat who presented as a referral for a severe urethral obstruction with a urethral tear. Unfortunately, multiple attempts to catheterize him had failed, and he was severely azotemic and unstable.

Percutaneous pigtail catheter (Cook)

As the patient was too unstable for surgery (an immediate perineal urethrostomy due to the urethral tear and initial inability to place a urinary catheter), a temporary indwelling, sterile pigtail catheter was placed percutaneously through the skin and directly into the bladder to help evacuate the bladder for 24-48 hours (or until the patient as stable enough for a perineal urethrostomy). The patient was anesthetized with a controlled airway, and appropriately monitored with an ECG and Doppler. After scrubbing to maintain aseptic technique, an incision is made through the skin with a scalpel directly over the region of the bladder. The bladder is then localized with the non-dominant hand, and the pigtail catheter is inserted percutaneously into the bladder and gently “popped in.” Once in place, the pigtail catheter is directly fed into the bladder and seated. The stylet is then removed and the pigtail catheter further advanced and fed off the stylet directly into the bladder. A tab and string are attached to the catheter, and are designed to be pulled to create the “curl” at the distal end of the catheter. This is then secured around the end of the catheter.

Example of a pigtail catheter (Biometrix)

You can see urine starting to flow directly out of the pigtail catheter. A sterile syringe is then attached to the catheter and the bladder is manually evacuated. Placement of the urinary pigtail catheter into the bladder is confirmed by FAST ultrasound; a small amount of saline is flushed directly into the bladder and you can see swirling of urine contents on the ultrasound.

A piece of white tape is tightly adhered to the outside of the pigtail catheter where it exits the body. A Chinese finger trap is used to secure the pigtail catheter in place to the exterior of the body wall over the white tape. A light bandage including cling and Vet Wrap is then placed around the pigtail catheter to secure it and the site as sterile as possible. In this patient, once the pigtail catheter was placed and the bladder decompressed, it was then possible to place an additional 5 French red rubber catheter directly into the penis to bypass the urethral tear until surgical correction occurred. While a simple decompressive cystocentesis was considered, since this patient would eventually require surgery and it was reported that had been attempted and was unsuccessful, the percutaneous pigtail catheter as a live saving procedure.

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How to place a percutaneous pigtail catheter | VETgirl Veterinary CE Videos

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