# Cystocentesis, shouldnt the vet ask for permission first?



## daddysgirl (Feb 27, 2007)

Took Roxy to the vet on Fri for her annual exam and Rabies shot. the vet tech took her to the back to draw blood for heartworm. i asked, since they were drawing blood anyways and she is getting older, if they could also do a CBC and Chemistry. she was is the back for so long, i couldnt understand why. the tech brought her back in and said we got the blood and a urine sample. i kept thinking to myself, i didnt ask for a UA to be run and how did they get a sample. our Vet came in and said they had done a cystocentesis to get her urine and thats why she was in the back for so long. i couldnt believe it. if they had asked me first, i would have never agreed to it as Roxy has never had any urinary problems. Poor Roxy, she had a needle in her Jugular, one thru the abd into her bladder and one for her Rabies shot. my sweet girl took it all in stride, but made sure to get treats on the way out, her momma didnt raise no fool on a good note, she has lost 2 lbs


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## Traz (Jan 19, 2009)

Yes, I would have been a bit upset, because I am sure they charged you also. Especially of you didn't go in with any complaints related to urinary symptoms. And why did they use a jugular for lab? They can use veins in the legs. I have never let a vet take my dog out of my site for tests.


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## BeauShel (May 20, 2007)

I would really be letting the vet know about not requesting the urinalysis on Roxy and dont appreciate them doing that test on her. Especially since it was with a needle. I could understand if she peed for them but darn that is just wrong. Dont blame you for being mad. Way to go Roxy for being such a brave girl with all the needles. You deserve an extra treat and toy for that. 

I remember when I took Beau to the Emergency Vet and explained his history to the vet tech and she passed it on to the vet that all the seizures happened that night instead of months, so they put a cath in him and gave him valuim even though he didnt have a seizure there. I raised hell with the vet when she came in and explained what they had done. I told her the real story and they didnt charge me for any of the tests. They didnt tell her also about his recent stomach surgery or his heart problem. So now I am really scared if I ever have to take one of the dogs there after hours.


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## daddysgirl (Feb 27, 2007)

Traz said:


> Yes, I would have been a bit upset, because I am sure they charged you also. Especially of you didn't go in with any complaints related to urinary symptoms. And why did they use a jugular for lab? They can use veins in the legs. I have never let a vet take my dog out of my site for tests.


i still cant believe they did that. i am a pediatric nurse and would never take someones child into our treatment room without telling the parents exactly what i am doing before i did it. as for the jugular, i dont know why, i question that myself, as many times as i have had to draw blood on babies, i wish they had a vein like Roxy's on her leg. who knows, just hope my girl wasnt the pin cushion for a new tech.


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## daddysgirl (Feb 27, 2007)

BeauShel said:


> I would really be letting the vet know about not requesting the urinalysis on Roxy and dont appreciate them doing that test on her. Especially since it was with a needle. I could understand if she peed for them but darn that is just wrong. Dont blame you for being mad. Way to go Roxy for being such a brave girl with all the needles. You deserve an extra treat and toy for that.
> 
> I remember when I took Beau to the Emergency Vet and explained his history to the vet tech and she passed it on to the vet that all the seizures happened that night instead of months, so they put a cath in him and gave him valuim even though he didnt have a seizure there. I raised hell with the vet when she came in and explained what they had done. I told her the real story and they didnt charge me for any of the tests. They didnt tell her also about his recent stomach surgery or his heart problem. So now I am really scared if I ever have to take one of the dogs there after hours.


Carol, this trip to the vet was a cluster you know what. Roxy isnt the least bit scared from it, you know her. she did get alot of treats and a new rawhide from me. i keep telling her i'm sorry. it gets better, the tech also said, we sent her blood to check her thyroid levels. i told him why? she had it last at 0730 and its almost 1800.


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## Susan6953 (Jun 9, 2008)

I can't believe they didn't ask you first before running tests. My vet always asks if only because they want to be sure I can/am willing to pay for the test. I would definitly let the vet know you are unhappy.


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## CarolinaCasey (Jun 1, 2007)

I would definitely have told the vet and tech straight away that you didn't request the U/A and won't be paying for it. I know that where I work, we charge for the cysto and also for the U/A. That in total would be about $45 or so. Why should you have to pay for that, especially since it wasn't asked for? Grr!  It would definitely be different if you had consented or had been asked prior. Not to mention, a lot of dogs hate to be put on their back and have their abdomen palpitated and stuck w/ a needle. 

It is pretty common to use the jugular to draw blood for bloodwork since you need more blood. We usually draw blood for a HWT right in the room with the client, but use hind leg. I hate when vet offices take the animal "to the back" for routine blood draws. What exactly is going on back there? Yes, some clients can't stand to watch their dog be poked or the sight of blood, but other that that, why go to the "back?" Sometimes, I must agree, that the animal is better behaved, or better restrained in another room, especially those of the feline variety!


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## Bender (Dec 30, 2008)

I wouldn't pay for anything I didn't agree to, and that the dog didn't need in the first place. Silly! It's like taking your car in for an oil change and having them repaint it and charge you for the paint....

Lana


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## Penny & Maggie's Mom (Oct 4, 2007)

Our vet many times draws Cody's blood from the jugular ( in the room with us). For a draw that needs a fair amount of blood, it's easier to get a clean, quick draw ( no clots, that can effect results).


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## Noey (Feb 26, 2009)

i would be sooo annoyed. Let them know it.


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## mylissyk (Feb 25, 2007)

The only thing my vet does in the back exam area is express anal glands! It's a larger area so the whole small exam room doesn't get fumigated, lol. Everything else, blood draw, shots, etc., they do in the room with me there. 

I agree with everyone, I would have told them you didn't ask for those tests, and were not told they were doing them, so you are not paying. 

I hope the bill wasn't too high.


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## IowaGold (Nov 3, 2009)

A jugular stick is the stick of choice for enough blood for Chemistry Panel. We're not talking about 3 drops of blood for heartworm test, we're talking 3-6cc of blood to have the appropriate amount for a full chem panel and CBC. While this amount of blood *can* be drawn out of a leg, it is not recommended because the vein in the leg is much smaller than the jugular and the resultant increased turbulence can easily cause hemolysis of the sample (which interfers with the tests being run).

A senior screening SHOULD include a urinalysis whether or not the pet has had urinary problems or not. Kidney disease does not become apparent on bloodwork until 75% of kidney function is lost. One will see a low specific gravity and protein in the urine long before the kidney disease is apparent in the blood. I have also personally got clues to look for bladder cancer (more than once) because of a UA. In addition, a cystocentesis sample is the gold standard urine sample. It is extremely unlikely that you have contamination (like you will with free catch sample simply because the vulva and prepuce are typically populated by white blood cells, bacteria, and sometimes red blood cells) and you will get a much more accurate testing of what is actually going on in the bladder itself.

As to the thyroid level at that timing, the vet is testing the "trough" level (or the lowest the med should be in the body). It it actually not a bad idea to know both your dog's peak (highest-approx. 4-6 hours post pill) and trough levels on thyroid meds. This way you know that the dose is high enough but not too high. I might question the timing of this test if you were running a full panel, but if it's just a T4 as part of the senior screening bloodwork (which is commonly included), there is no reason not to do a T4.

Granted, I always ask permission before performing any test or procedure, but in reality, a cysto really isn't any worse than drawing blood (it just sounds bad and we are already conditioned to except drawing blood). I'll bet most patients would prefer a cysto to a catheter! Of course I always ask permission before taking a dog to the _Treatment_ Area. Most owners don't want to believe this, but many, many dogs are better behaved away from their owners. I routinely _ask_ to _borrow_ small adult dogs for their treatments, especially if that treatment included a blood sample. I also _always_ take cats to the treatment area for blood draws. With big dogs, I will almost always draw a heartworm sample in the room but ask to borrow them for larger samples. A cysto would also be done in the treatment area.

I hope you were able to let your vet know about your concerns and that you were able to come to an understanding. Hopefully all the testing came back normal too!


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## AmbikaGR (Dec 31, 2007)

I would have been upset also and raised a stink. I would have told the vet I did not ask for nor did I authorized the cystocentesis and had no intention to pay for it. I would also explain that I would likely be looking for a new vet. 
I had a similar occurrence with a vet years ago with Keeper. I took her in for her distemper, parvo, andro shot booster when she was a year old. When I went to pay the bill there was a charge for her rabies shot also. When I stated that she had not gotten a rabies shot the vet chimed in yes she did. When I stated she was not due for it the vet said you were here for her shots and should have been more clear. I told him I was not paying for it nor was I ever returning to his practice. And I kept true to my word. I shouls add that this vet was real piece of work. Prior to this I had an incident where when lifting my Brandi onto the exam table she pushed off the side of the table and twisted me. I went to the floor and could not get up, I had thrown out my back. They had to call an ambulence and took me to the ER where they gave me a muscle relaxer injection and eventually I was able to hobble out of the hospital. I was unable to even drive for about 2 -3 weeks as I would spasm up. On my next visit to the vet he instructs me to lift my dog onto the table. I asked him if he remembered the last time I did that and he says "Yes, that is why I don't lift them onto the table". He eventually had the vet tech lift Brandi onto the table.


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## moverking (Feb 26, 2007)

I don't even like the *idea* of a cystocentesis....it may be the only way to _try_ to get a sterile specimen, but the risk of bladder wall damage (never mind the rest of the tissue and muscle gone through) and infection seem pretty high to me.


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## IowaGold (Nov 3, 2009)

moverking said:


> I don't even like the *idea* of a cystocentesis....it may be the only way to _try_ to get a sterile specimen, but the risk of bladder wall damage (never mind the rest of the tissue and muscle gone through) and infection seem pretty high to me.


No there is very, very little risk to a cystocentesis. We never worry about infection or damage with blood draws, do we? It's the same needle and syringe.


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## moverking (Feb 26, 2007)

IowaGold said:


> No there is very, very little risk to a cystocentesis. We never worry about infection or damage with blood draws, do we? It's the same needle and syringe.


I guess that's true, thinking twice about it. I don't think I've ever heard of the procedure in humans, though. Probably because we're easier to cath?

Still bothers me.


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## Susan6953 (Jun 9, 2008)

They do it in people too, especially babies who, like dogs, won't pee on cue. It is less likely than catheterization to cause a bladder infection.


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## vixen (Jul 26, 2008)

i'd be so angry if my vet did anything with out conculting me first. When Max had his senior health check last year, the include full bloods, full body and joint check and ECG, I went out the back with him and was with him through out.

On the taking the blood from the jugular vain, my vet has to with Max and even then it takes 5 mins to locate his vain, we tryed his leg once as I was showing him and the fur grows back quicker there, and it took 15 mins and 3 attempts to find his vain. The vets a good one it just Max is a pain to get blood from.


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## Goldnbear (Dec 28, 2009)

I have another thought on this...there could have been a miscommunication between you, the tech, and the vet. They may have thought you wanted a complete screen or sometimes, like at my hospital, we have a "package" that includes an ERD test. It screens for early kidney damage (before it shows up on bloodwork). Are you sure it was a UA that they were doing with the urine? And I agree that if they needed more blood, that alot of times jugular draws are done. We NEVER do jugulars in the room, EVER. It actually seems easier on the pet, but clients do not usually want to see it. For a routine hwt, yes, we would use a leg in the room, but not for a jugular.
Ok, that being said, I would definately tell them if they ran tests that you didn't want...you shouldn't have to pay for them. If this happens at our clinic, we don't make the client pay. It happens very rarely. If however, the test finds something, the vet usually charges half for it since it revealed a problem. I wouldn't worry too much about the cysto, it is not usually traumatic. The worst part about it, as already said, is the laying on their back part. If they have good techs, they should have been able to stabilize well and talk sweetly to your baby.


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## Hershey (Oct 31, 2009)

IowaGold said:


> A jugular stick is the stick of choice for enough blood for Chemistry Panel. We're not talking about 3 drops of blood for heartworm test, we're talking 3-6cc of blood to have the appropriate amount for a full chem panel and CBC. While this amount of blood *can* be drawn out of a leg, it is not recommended because the vein in the leg is much smaller than the jugular and the resultant increased turbulence can easily cause hemolysis of the sample (which interfers with the tests being run).
> 
> A senior screening SHOULD include a urinalysis whether or not the pet has had urinary problems or not. Kidney disease does not become apparent on bloodwork until 75% of kidney function is lost. One will see a low specific gravity and protein in the urine long before the kidney disease is apparent in the blood. I have also personally got clues to look for bladder cancer (more than once) because of a UA. In addition, a cystocentesis sample is the gold standard urine sample. It is extremely unlikely that you have contamination (like you will with free catch sample simply because the vulva and prepuce are typically populated by white blood cells, bacteria, and sometimes red blood cells) and you will get a much more accurate testing of what is actually going on in the bladder itself.
> 
> ...



Ditto to that post. Better to run the tests than not


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