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Perineal Urethrostomy (PU) Surgery in Cats

Cats undergo PU (perineal urethrostomy) surgery when they experience urinary blockages that can't be treated effectively through standard means. Here, our Argyle vets discuss why urinary blockages happen and how PU surgery for cats can be an effective way to stop them from occurring. 

How do urinary blockages happen in cats?

Urinary blockages are caused by 'plugs' made of protein-rich sludge, crystals, or small stones that can get stuck in your cat's urethra - the tube that allows your cat to urinate. Neutered male cats are more likely to have urinary blockages because they have a narrower urethra, meaning less material can get through.

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

When a cat has an obstruction in their urethra, they will squat to pee more frequently than normal but little to no urine will actually be expelled. You may notice them frequently going to the litter box, trying to urinate in other spots outside the litter box, or meowing while in the litter box. They may also lick 

As the bladder fills up but is unable to be expelled it will cause your cat serious and noticeable discomfort and pain. If the issue isn't treated promptly it can lead to a bladder rupture.

Another concern with urinary blockages is that the toxic waste that is typically released through urination will begin to back up into the bloodstream resulting in lethargy, disorientation, and vomiting. 

How can PU surgery help my cat?

The first treatment option a vet will usually try to resolve a urinary blockage is using a catheter to clear it. If they are unable to, or if your cat experiences frequent urinary blockages, they may recommend a procedure called perineal urethrostomy (PU). 

This procedure is designed to make the urethra wider, thus allowing potential blockages to pass through rather than getting stuck. This surgery reduced the risk of future blockages but does not guarantee that they will never get an obstruction again.

What is cat PU surgery recovery like?

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 is typically worn for two weeks, but your vet must give the okay before it can be removed. 

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 their activity can be limited and they 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 prognosis for PU surgery is good. There is a slight risk that cats will form a stone that is too large to fit through even the wider urethra, but generally cats do not reobstruct after the surgery. 

What does PU surgery for a cat cost?

PU surgery cab be expensive and prices will vary depending on the diagnostic tests needed, and the extent of the condition. It typically ranges between $3, 000 - $4, 500 Alternatively, if you compare the cost of surgery to the cost of frequent treatment for blockages, it may actually save you money in the long run. Please contact our Argyle vets to get an estimate for the procedure. 

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

    Proper preventive care is the key to reducing your cat's risk of developing urinary blockages. To help your cat maintain their urinary tract health, here are a few things you can do at home:

    • Increase your cat's water intake by providing clean, fresh water, or adding some flavor.
    • Change their diet to a urinary health diet that has limited minerals, such as magnesium, phosphorus, and calcium.
    • Reduce your cat's stress by keeping their litter clean, and reducing changes to their schedule.
    • 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.

    Does your cat experience frequent bladder obstruction? PU surgery might be the right option for their needs. Contact our Argyle vets to discuss your options.

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