TITLE: SPARC Cat acute UroMOCA implantation
AUTHORS: Anna Rietsch, Brett Hanzlicek, Margot Damaser, Dennis Bourbeau

[DESCRIPTION]
<div class = "text-blocks"><div class = "text-block">This is a procedure for an acute wired UroMOCA implant cat experiment.  A cystotomy is performed and an active, wired  (for power) UroMOCA is placed in the bladder.  The bladder is sutured closed, and urodynamics is performed to collect wireless data from the UroMOCA.  This protocol includes basic surgery, UroMOCA implantation, urodynamics and imaging.  </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 removedConductivity of urine was recorded before sending for urinalysis        40.78 mS/cm        41.54 mS/cm        41.52 mS/cm
7 mL
?. [Cystogram - DYNA CT]
Use 1:10 dilution of contrast to saline to visualize bladder.Fill the bladder with contrast and take a 3D CT imageAdd    more to bladder  take 3D CT image
10 mL
?. [Cystogram - DYNA CT]
Empty Bladder    ~13.5ml
?. [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
15 mL
?. Empty BladderRemove 17 ml of saline + urine
?. [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, with the wires for power remaining outside the bladder.  Suture the bladder closed, check for leaks and place bladder back into body.
?. [Surgery]
Close the abdomen, with the wires for power remaing outside of the animal
?. [Urodynamics/cystometry 3]
Fill bladder with saline at 2ml/minand record pressure using pressure transducer connected to  LabViewFill to  ; No spontaneous  contractions seenFill to  ; Pressure response from UroMOCA is seen
12 mL
15 mL
?. [Urodynamics/cystometry 3]
Empty Bladder
?. [Euthanasia]
Cleveland Clinic animal team euthanizes the animal
?. [Urodynamics/Cystometry 2]
Fill bladder with saline and record pressure using pressure transducer connected to  LabViewFill to  ; Non-voiding contraction seenFill to  ; Non-voiding contraction seenFill to  ; Non-voiding contraction seen
12 mL
13 mL
16 mL
?. [Surgery]
Test for device function.  Data is being sent wirelessly from the UroMOCA to the receiving radio
?. [Cystogram - DYNA CT]
Infuse 10mL of contrast (1:10 dilution) – Single CT imageInfuse an additional 5mL of contrast (1:10 dilution) – Single CT image
?. [Cystogram - DYNA CT]
Empty Bladder
?. [Urodynamics/cystometry 4]
Fill bladder with saline at 2ml/minand record pressure using pressure transducer connected to  LabViewFill to  ; Tug on catheter - large contraction
15 mL
?. [Urodynamics/cystometry 4]
Empty bladder15ml removed
?. [0.9% saline Bolus infusion 1]
Infuse 0.9% saline in boluses of 3mL, 6mL, 9mL, 12mL, 15mL at a rate of 10mL / minutes. UroMOCA transmitting data
?. [0.9% saline Bolus infusion 1]
Empty bladder
?. [1.5% saline Bolus infusion 1]
Infuse 1.5% saline in boluses of 3mL, 6mL, 9mL, 12mL, 15mL at a rate of 10mL / minutes. UroMOCA transmitting data
?. [1.5% saline Bolus infusion 1]
Empty Bladder
?. [3.0% saline Bolus infusion 1]
Infuse 3.0% saline in boluses of 3mL, 6mL, 9mL, 12mL, 15mL at a rate of 10mL / minutes. UroMOCA transmitting data
?. [3.0% saline Bolus infusion 1]
Empty Bladder
?. [1.5% saline Bolus infusion 2]
Infuse 1.5% saline in boluses of 3mL, 6mL, 9mL, 12mL, 15mL at a rate of 10mL / minutes. UroMOCA transmitting data
?. [1.5% saline Bolus infusion 2]
Empty bladder
?. [1.5% saline Bolus infusion 3]
Infuse 1.5% saline in boluses of 3mL, 6mL, 9mL, 12mL, 15mL at a rate of 10mL / minutes. UroMOCA transmitting data
?. [1.5% saline Bolus infusion 3]
Empty bladder
?. [3.0% saline Bolus infusion 2]
Infuse 3.0% saline in boluses of 3mL, 6mL, 9mL, 12mL, 15mL at a rate of 10mL / minutes. UroMOCA transmitting data
?. [3.0% saline Bolus infusion 2]
Empty Bladder
?. [0.9% saline Bolus infusion 2]
Infuse 0.9% saline in boluses of 3mL, 6mL, 9mL, 12mL, 15mL at a rate of 10mL / minutes. UroMOCA transmitting data
?. [0.9% saline Bolus infusion 2]
Empty Bladder
?. [3.0% saline Bolus infusion 3]
Infuse 3.0% saline in boluses of 3mL, 6mL, 9mL, 12mL, 15mL at a rate of 10mL / minutes. UroMOCA transmitting data
?. [3.0% saline Bolus infusion 3]
Empty Bladder
?. [0.9% saline Bolus infusion 3]
Rotate animal on right sideInfuse 0.9% saline in boluses of 3mL, 6mL, 9mL, 12mL, 15mL at a rate of 10mL / minutes. UroMOCA transmitting data
?. [Dissection/Histology]
Bladder is removed and placed in formalin for histological analysis