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PU Surgery in Cats

Occasionally, cats may experience the symptoms of a urinary blockage. These blockages can be life-threatening if not treated immediately, and a perineal urethrostomy may be necessary. In today's post, our Yucaipa vets talk about what perineal urethrostomy surgery is and what to expect from it.

What is perineal urethrostomy (PU) surgery?

A perineal urethrostomy (PU) is a surgical reconstruction of the urethra (the tube your cat urinates through). The purpose is to create a larger opening to make it easier for your cat to urinate. Typically, PU surgery is only considered once it has been determined that urinary obstructions either cannot be corrected by catheterization or if the cat has been experiencing repeated obstructions.

Urinary blockages can very quickly become life-threatening for your cat. While this surgery is used to greatly decrease the likelihood of repeat blockages, it's not guaranteed that obstructions will not happen again. The care taken after surgery will help to ensure that the procedure was a success, and lower the risk of future blockages.

While possible in both, it’s much more likely for a male cat to experience urinary blockages than female cats. This is because the female urethra is much shorter and wider than the male’s. As the male urethra extends along the length of the penis, it becomes more narrow. This increases the likelihood of an obstruction occurring.

When is PU surgery recommended?

PU surgery is most commonly recommended in the following situations.

  • A urethral obstruction in the penis that cannot be removed. The most common treatment for urethral obstructions is to use a catheter. Your vet would pass the catheter through the external opening of the urethra and force any stones or mucus in the urethra into the bladder. This should allow them to be managed using medication or surgery. If this method can’t clear the blockage, then PU surgery may be required to help the cat urinate.
  • Recurrent urethral obstructions. Obstructions can be common and recurring in some male cats. Although it’s possible to continually remove the blockages, the cat may also benefit from PU surgery to try to avoid or lower the risk of future obstructions.

How much does PU surgery for cats cost?

This can vary depending on the diagnostic tests needed, and the extent of the condition. It's always a good idea to contact your veterinarian directly if you are concerned about cost. They should be able to give you a more accurate estimate.

What is the recovery like for cats after PU surgery?

Your cat will need to wear an Elizabethan collar (e-collar) to prevent licking or biting at the surgical site. Excessive licking can interfere with healing. 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’s normal for your pet to have bloody urine for a few days and they may have accidents as they get used to the new function of their urethra. This is temporary, and we recommend, if possible, that you keep your pet in a room with tile during 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 their recovery that doesn’t stick to the incision. You can use shredded newspaper or, if your cat prefers a pelleted litter, you can purchase pelleted paper. You can return to your regular litter after they have healed.

What can I expect after my cat has had PU surgery?

If your cat has undergone successful PU surgery, and the recovery process was without complications, then there should be no further concerns. There may be a rare case where a cat experiences another obstruction after having PU surgery, but this is highly unlikely.

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 a healthy urinary tract, here are a few things you can do at home:

  • Increase your cat's water intake by providing clean, fresh water.
  • 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.

If you have any questions or concerns about your cat's surgery or recovery, or suspect that your cat might have a urinary obstruction, contact our Yucaipa vets today.

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