Perineal Urethrostomy (PU)
Feline Lower Urinary Tract Disease
Have you ever hear of a 'blocked cat'? This procedure is intended to provide a permanent opening in the urethra that will help avoid blockages in cats.
What is the goal of a PU, or Perineal Urethrostomy?
The goal of perineal urethrostomy, or 'PU surgery', is to remove the narrowest part of the urethra and create a new opening for urine to exit where the urethra is wider in size.
How is a Perineal Urethrostomy procedure done?
In essence, the surgical procedure reroutes the urinary plumbing to remove the part that keeps getting clogged and divert the urine out from a wider area of pipe. The penis is amputated and the remaining urethra is sutured to the skin to create a new opening. The urethral tissue is very delicate, and must be protected for 2 weeks after surgery in order for appropriate healing to occur. If a cat is able to groom the surgical site before it is completely healed, the surgical site could break down and require additional surgery to fix.
What are the risks of a Perineal Urethrostomy?
Possible complications of Perineal Urethrostomy include dehiscence (breakdown of suture closure), stricture (scar tissue narrowing the new opening over time), and infection. Because the urethra is shorter, cats are at a higher risk of developing a urinary tract infection after PU surgery.
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POST OPERATIVE CARE PLANNING
FOR A PERINEAL URETHROSTOMY PROCEDURE:
Your cat MUST wear its e-collar AT ALL TIMES for at least 14 days after surgery. The e-collar should not be removed, until the surgical site is evaluated for appropriate healing by a veterinarian. This cannot be stressed enough for this particular surgery.
Keep your cat isolated from all other animals and at a lower activity level for 2 weeks after surgery. This is best achieved by keeping them confined to a large dog kennel or small room with no furniture to jump up or down on. Other animals may attempt to sniff or groom the surgical site and cause damage.
Do not touch the surgical site, any blood clots on the surgical site should be left in place to avoid trauma to the surgical site with cleaning.
Blood may be in the urine for 5-7 days after surgery.
Remove all clay-based litter and use paper based litter (Yesterday’s News, shredded paper) for 2 weeks until the surgical site heals.
Sutures are absorbable and do not need to be removed
Pain medication will be prescribed
Sedative medication will be prescribed
Prescription urinary diet will be prescribed for life-long use
Monitor the urethrostomy site twice daily for excessive swelling, discharge, bleeding, pain, or bruising around the incision as these may indicate urine leakage under the skin or other complications. Your veterinary team should be contacted with any concerns. Photos of concern can be emailed to your veterinary care team for review before coming in for a recheck examination.