Intraosseous (IO) access and catheterization in companion animals is a safe and effective method for drug and fluid administration in cases of vascular collapse. However, IO devices are sometimes associated with clinical complications, including pain, bone trauma/fractures, or infection. Cat bones are small and delicate, and evaluation of IO devices in this species is warranted. In this study, IO access devices (N = 3) were evaluated in feline patients to compare success rates, rapidity of insertion, and bony complications/trauma. Devices included an automatic impact penetration device (device A), an automatic rotary insertion device (device B), and a manual IO needle (device C). Bony damage and trauma at each insertion site was assessed by computed tomography (CT). A total of 18 cat cadavers were used, and IO insertion sites (N = 72) from various random locations (both humeri and tibiae) were evaluated. Cannulation was attempted in 12 tibial and 12 humeral locations. Successful insertion times, ease of insertion, and success rates were documented. There were no significant differences in CT-confirmed success rates. Device B demonstrated a significantly lower time of insertion (P < 0.01) and ease of insertion (P < 0.01) than devices A and C, with a trend toward decreased bone fragment numbers with device B insertions. There were no identified differences by insertion site. All 3 tested devices in the present study were successful, and device B was significantly faster and easier to place in cat cadavers compared with the other devices.
Commentary: This article describes the use of 3 different types of intraosseous access techniques to assess success of placement, speed of insertion, and amount of bone trauma in cats. The results showed that the EZ-IO device had a lower time of insertion and was easier to place. Gaining vascular access quickly in emergent situations can be quite the challenge, especially in neonates and cats. This is the first study performed that evaluated intraosseous access in cats. It showed that all 3 methods were successful and should encourage veterinarians to invest in at least 1 of these devices to allow for rapid venous access.—April Paul, DVM, Diplomate ACVECC
Comparison of three intraosseous access techniques in cats. Bukoski A, Winter M, Bandt C, et al. J VET EMERG CRIT CAR 20:393-397, 2010.