Effect of vein characteristics and operator experience on intravenous catheter insertion success in cats in an emergency room.

ObjectivesThe aim of the present study was to identify patient, vein and operator factors associated with first-attempt success of peripheral intravenous catheter (PIVC) insertion in cats presenting to an emergency room.MethodsA prospective study was conducted in the emergency room of a university small animal hospital between February and April 2024. Cats requiring PIVC insertion were enrolled. Data collected included patient signalment, vein visibility and palpability, catheter size, indication for catheterization and operator characteristics (role, years of experience and estimated number of previous PIVC insertions). First-attempt success was defined as catheterization with visible blood flashback and successful flushing without extravasation or discomfort. Univariable and multivariable logistic regression analyses were performed to assess associations with first-attempt success.ResultsA total of 97 PIVC insertions in 95 cats were analyzed. Overall, first-attempt success was 85.6% (n = 83/97). Most insertions involved the cephalic vein (96.9%) and 22 G catheters (57.7%). Neither catheter size, target vein nor indication for insertion was significantly associated with success. Operators with 8-15 years of experience had significantly higher odds of success compared with those with 2 years or less (P = 0.03). Operators who had inserted more than 500 intravenous catheters had greater odds of success than those with fewer than 100 insertions (odds ratio [OR] 8.63, 95% confidence interval [CI] 1.48-50.12; P = 0.02). Vein visibility was strongly associated with first-attempt success (OR 7.78, 95% CI 2.29-26.42; P = 0.001), while palpability was not. In the final multivariable model, both vein visibility (OR 8.0, 95% CI 2.16-30) and more than 500 prior insertions (OR 13.24, 95% CI 1.54-144) remained independently associated with success.Conclusions and relevanceFirst-attempt intravenous catheter insertion success in cats was strongly influenced by operator experience and vein visibility. These findings highlight the clinical importance of operator training and vein assessment during catheter insertion in feline emergency patients.