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Perineal Urethrostomy: PU Surgery for Cats

Perineal Urethrostomy: PU Surgery for Cats

Our feline friends can experience a urinary blockage without warning, and if standard treatments are ineffective then a perineal urethrostomy (PU) might be the answer. Today, join Brighton vets as they share more about PU surgeries for cats.

How do urinary blockages happen in cats?

Urinary blockages occur when 'plugs' of protein-rich sludge, crystals, or small stones get stuck in your cat's urethra (the tube through which your cat urinates). Neutered male cats have a much higher occurrence of urinary blockages due to them having a much narrower urethra, which allows less material to get through.

What are the signs of a urinary blockage in a cat?

When a cat has an obstruction in their urethra, they will squat to pee more often than usual, but expel little to no actual urine. The most urgent problem with this condition is that liquid will continue to enter the bladder without being able to be expelled. This causes serious discomfort and pain from the pressure, in addition to the danger posed by the buildup of toxic waste that cannot be expelled as usual through urine. Your cat can experience symptoms of lethargy, disorientation, and vomiting. If this issue isn't treated promptly, the bladder will rupture.

How can PU surgery help my cat?

If your cat's condition can't be addressed using standard treatment options such as removing the blockage with a catheter, or if your cat is prone to recurring bouts of urinary blockages, a surgical procedure called perineal urethrostomy (PU) might be recommended by your veterinarian.

This procedure is designed to widen the cat's urethra, allowing potential blockages to pass through. This surgery reduces the risk of future blockages but does not guarantee that your cat will never get an obstruction again.

What to expect after surgery

Your cat will be required to wear an Elizabethan collar (e-collar) to prevent licking or biting at the surgical site. Excessive licking can interfere with healing and if your cat licks or gets to the incision, there may not be any tissue left to repair since the skin is very thin. This collar must not be removed until your vet gives you the go-ahead, which is typically in about 2 weeks.

Your cat will also need to be kept calm and have their activity restricted. Your veterinarian may recommend confining your cat to a small area, away from other pets, where his activity can be limited and he can be closely monitored.

Immediately after the surgery, it is normal for your pet to have bloody urine for a few days and may have accidents as they get used to the new function of their urethra. This is temporary and we recommend you keep your pet in a room with tile during your cat's recovery from PU surgery so any accidents can be cleaned up easily. If blood or urine stains their back legs or belly, you can use a wet washcloth to clean them. Do not wipe the incision area directly.

Your cat will require a special litter for his recovery so it won't stick to the incision. You can use shredded newspaper or if your cat prefers a pelleted litter, you can purchase pelleted paper litter. Be prepared and have an appropriate paper litter ready for your cat when he gets home. You can return to your regular litter after they have healed.

What is my cat's long-term prognosis after surgery?

The general outcome of PU surgery is positive. It can help your cat live a more comfortable life without frequent bladder obstructions.

Studies have shown that cats tend to live around three to five years after PU surgery. That being said, this surgery won't negatively harm their life expectancy. With proper preventive care, your cat can live a happy, healthy, blockage-free life.

What is the cost of PU surgery in cats?

The cost of surgery can be on the pricey side, and costs vary depending on the diagnostic tests needed and the severity of your pet's case. However, when compared to the potential cost of frequent treatments for recurring blockages, PU surgery may actually save you money in the long run. Contact our Horizon Veterinary Clinic vets to get more information about pricing, or for a good-faith estimate.

    How can I prevent my cat from developing a urinary obstruction?

    Preventive care is the key to reducing your cat's risk of developing urinary blockages. Routine visits for a routine exam allow your vet to monitor your cat's overall health and ensure they are receiving the right care at home to prevent blockages, especially if they are more prone to them. In the meantime, here are some other things you can do between appointments:

    • Increase your cat's water intake by providing clean, fresh water, or adding some cat-safe flavors.
    • Change your cat's diet to one that has limited minerals, like magnesium, phosphorus, and calcium.
    • Reduce your cat's stress by keeping their litter clean, and try to avoid changing their schedule too much.
    • Offer an enriched environment with perches, moving toys, or food puzzles.

    Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. For an accurate diagnosis of your pet's condition, please make an appointment with your vet.

    If your cat has frequent bladder obstructions, PU surgery might be the right option for their needs. Contact our Brighton vets to discuss your options.

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