TITLE: SPARC Cat - Sham Control Chronic Implant Cat 4, Day 0
AUTHORS: Brett         Hanzlicek, Margot Damaser

[DESCRIPTION]
<div class = "text-blocks"><div class = "text-block">This is a procedure for a sham control chronic implant cat experiment (Day 0) for cystotomy (bladder surgery).  The cystotomy is performed and an inactive UroMOCA is placed in the bladder.  The cat is observed daily and imaged on day 0, 14 and 30 to track changes to the bladder and overall cat health in response to the cystotomy and device implantation.  This protocol includes basic surgery, urodynamics and imaging for Day 0 in the chronic experiments.</div></div>

[STEPS]
?. [Transport Cat]
Transport cat from housing site to surgery site.
?. [Animal Prep and catheter placement]
Animal is anesthetized and abdomen is shaved by the vet team.  The cat is then moved into the surgery room and attached to monitors by the vet team.
?. [Animal Prep and catheter placement]
Drape animal and perform betadine scrub on abdomen and genitals.
?. [Animal Prep and catheter placement]
Put surgilube on 3.5Fr catheter and insert into bladder through the urethra.  Advance the catheter until resistance is met, then pull back 2-3cm.
?. [Animal Prep and catheter placement]
Use gentle suction with syringe to withdraw urine from bladder through the catheter.  Measure the volume and save the urine for urinalysis.  urine removed
15 mL
?. [Cystogram - DYNA CT]
Use 1:5 dilution of contrast to saline to visualize bladder.Fill the bladder with   contrast and take a single CT imageAdd    more to bladder (total of 20 ml) and take single CT imageAdd    more to bladder (total of 25 ml) and take single CT imageAdd    more to bladder (total of 30 ml) and take single CT imageTake a 3D CT image with 30ml contrast:saline in the bladderCT of empty bladder 1 (timestamp 9:12:51)CT of empty bladder 2 (timestamp 9:17:38)
10 mL
10 mL
5 mL
5 mL
?. [Cystogram - DYNA CT]
Empty Bladder
?. [Urodynamics/Cystometry ]
Performed after cat is transferred from Isoflurane to propofol anesthetic.
Fill rate is 2ml saline/minute using syringe pump.
Data is recorded using Labview software.
Pressure is recorded using an external pressure transducer connected to syringe pump on one end and tubing that leads to the catheter on the other end.
?. [Urodynamics/Cystometry ]
Fill bladder with saline and record pressure using pressure transducer connected to  LabViewFill to
30 mL
Pressure graph plateaued around 25ml – possible leak pointFinished cystometry: animal held at 30ml saline, tugging on catheter produced reflex contractions
?. [Urodynamics/Cystometry ]
Empty BladderCat transitioned back to isoflurane
?. [Surgery]
See protocol titled "SPARC Cat surgery Day 0" for details on accessing and opening the bladder for device insertion.
?. [Surgery]
1 cm incision made in bladder.  Place device in bladder,  suture the bladder closed, check for leaks and place bladder back into body.
4-0 Vicryl Polysorb = Bladder Mucosal Layer 4-0 Vicryl Polysorb = Bladder Muscle 3-0 Prolene = Fascia/muscle 4-0 Vicryl Polysorb = Fat layer 3-0 Monosof Nylon = Skin = 11 non-continuous sutures
?. [Surgery]
Take a picture with DYNA-CT and a 3D CT11:28:33 Picture of device in empty bladder 11:29:41 Contrast in bladder with device 11:30:16 10 ml contrast in bladder with device – some leakage around catheter 11:31:16 20 ml contrast in bladder with device 11:35:37  3D CT Scan
?. [Urodynamics/cystometry 2]
Fill bladder with saline at 2ml/min
?. [Urodynamics/cystometry 2]
Fill to 19 ml;  saline began to leak around catheter
?. [Wake and return cat]
Wait for cat to wake up and return to housing site.