Any medical or surgical procedure carries a risk of a complication such as an infection. Infections in human patients occur in about 4% of hospitalized patients. The number of infections in hospitalized dogs and cats is not well studied. However, studies of hospital-related infections help physicians and veterinarians improve the quality of care they provide to their patients. Today’s blogpost will talk about infections associated with intravenous (IV) catheters and how AMC is working to make them less common.

Uses of Intravenous Catheters in Animal Patients

At AMC, the most common location for IV catheter placement is in the leg. The catheter is wrapped with tape and some bandage material to secure it in place and prevent the pet patient from removing it. The catheter can be used to give medications, anesthetic agents, fluids and blood transfusions. We can also take blood samples from the catheter for analysis in the laboratory. Patients undergoing surgery in the operating room (OR) and most patients seen in AMC’s animal ER have an IV catheter placed because of the need to administer many IV treatments.

How Catheters Become Infected

If you have ever had a catheter, you are likely familiar with the safety precautions involved in its placement. Your skin is cleaned with antiseptic, the nurse wears gloves and all the equipment packaged in sterile containers. These precautions decrease the risk of a catheter infection. How, then, does a catheter infection occur?

One issue specific to pets is their fur. Veterinarians clip it prior to catheter placement, but even after the antiseptic scrub, the stubble can harbor normal skin bacteria which can set off a catheter infection. Hindleg catheters are always at risk for infection because they are in the litterbox or are dangerously close to bad diarrhea. Front leg catheters are not much better, since they are easily licked or chewed.

AMC Studies Catheter Infections

To better understand what causes catheter infections in our AMC patients and help veterinarians everywhere prevent this catheter complication, AMC clinician scientists, Drs. Mastrocco, Prittie, Weltman, Keyserling studied catheter placement following a very specific protocol for placing and removing each catheter. This study analyzed bacteria identified when the catheter was tested after removal. The bacteria was compared between IV catheters placed in the ER to those placed in the more controlled situation in the OR. The study’s hypothesis was that ER catheters would have more infections since they were placed in emergency situations in critically ill patients.

Surprising and Not So Surprising Results

Overall, about one in ten catheters showed bacterial growth. The bacteria were common skin and intestinal bacteria, confirming our concerns about placing catheters in furry pets and those that use litterboxes.

What was surprising was that there was no difference in infection rate between catheters placed in ER and the OR. How long the catheter was in place did not affect the infection rate and neither did the experience level of the veterinarian or licensed veterinary technician placing the catheter. For reference, the infection rate at AMC was similar to other veterinary studies.

The most important finding may be the antibiotic resistance identified in some of the bacteria isolated from the catheters. Antibiotic resistance is one of the top global public health threats identified by the World Health Organization.

Preventing Antibiotic Resistance

While the goal of the AMC catheter study was to identify things veterinarians could do to prevent infections, it identified something we all can do and that is be good antibiotic stewards. To prevent antibiotic resistance, good antibiotic stewards:

Complete the entire prescribed course of antibiotics for yourself or your pet.

Don’t ask for antibiotics if your physician or veterinarian says the infection is viral. Antibiotics don’t work against viruses.

Don’t share leftover antibiotics between people or pets.

Use vaccines to prevent disease in your pet and yourself rather than count on antibiotic to treat an infection.