PERINEAL URETHROSTOMY (PU) SURGERY

WHAT IS PERINEAL URETHROSTOMY?

Perineal urethrostomy or PU is a surgical procedure that entails creating a permanent opening of the urethra (pipe that connects the urinary bladder to the outside) to prevent stones, crystals, mucous plugs to obstruct the urethra.

WHY DO CATS DEVELOP URINARY BLOCKAGE?

Urinary blockage is a very common condition in adult cats usually overweight / obese that are fed dry food. The cause of the obstruction of the urethra is multifactorial and associated with a syndrome named Feline Urologic Syndrome. Cats develop urinary bladder inflammation and mucus plugs, sediment and small stones that eventually plug the urethra.

HOW DO I KNOW THAT MY CAT HAS URINARY BLOCKAGE?

Cats that experience urinary blockage strain to urinate and often urinate outside the litter box. Immediate medical attention should be considered if the patient is straining and no urine is produced. This condition is life threatening and cat that completely obstruct could die within days from kidney failure.

WHAT ARE THE TESTS NECESSARY TO DIAGNSOSE URINARY BLOCKAGE?

Cats that experience urinary blockage, should have blood work and urine test done to determine if their kidneys are failing. X rays of the belly are also necessary to determine the urinary bladder size, and presence of stones.

WHAT ARE THE TREATMENTS FOR URINARY BLOCKAGE?

The management of cats with urinary blockage can be addressed in two ways: medical and or surgery. The medical treatment entails placing a catheter into the urinary bladder to ensure urination and keep it in place for 2 to 3 days. Additionally, pain medication and special diet (wet) should be prescribed by the veterinarian. If the conservative management fails at the second or third time, surgery is indicated. 

Regarding surgery, the two common procedures performed for cats with urinary blockage are cystotomy (open the urinary bladder) to remove and flush any stones, crystals and sediments and perineal uretrostomy (PU).

WHAT IS THE AFTERCARE AFTER PU SURGERY?

After surgery, few things have to change in the household to ensure that the healing of the PU is going well. The litter box should have shredded paper instead of litter to prevent the clay contacting the incision, multiple water bowels should be available to increase water intake (add tuna juice) and the diet should be wet only and always.

The patient will need to wear an E- collar to prevent self-trauma to the incision and the incision should not be touched. 

WHAT THE COMPLICATIONS OF PU SURGERY?

The success of PU surgery is very good if performed correctly, however complications could always arise. The most common problems associated with PU surgery include scar tissue formation at the incision site that will lead to recurrence of the urinary blockage. Additional complications are urinary tract infections and opening of the incision by the patient.  These complications can be fixed with a revision surgery.