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Perineal Urethrostomy (PU) Surgery: An Overview

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What is Perineal Urethrostomy (PU)?

A Perineal Urethrostomy (PU) is a surgical procedure that reconstructs the urethra in cats, creating a wider opening for urine to pass from the bladder to the outside. This surgery is considered when a cat has had recurrent urethral obstructions.

The Purpose of PU Surgery

The primary aim of PU surgery is to lower the risk of future urethral obstructions, which are life-threatening and usually require urgent care including urinary catheter placement. It’s important to understand that while PU surgery helps prevent blockages, it doesn’t cure the root causes of obstructions.

Causes of Urinary Blockages

Common causes of urethral obstructions, which may need ongoing management after surgery, include:

  • Feline Lower Urinary Tract Disease (FLUTD)

  • Mucus plugs

  • Urinary stones

  • Tumors

  • Trauma

  • Regular veterinary supervision is vital for your cat's urinary health post-surgery

Indications for PU Surgery

PU surgery is usually suggested when repeated catheterizations have been necessary and other medical interventions have failed.

Procedure for Perineal Urethrostomy (PU) Surgery

Before performing a PU, it's necessary to first clear any urethral blockages. If urethral stones are present, they need to be pushed back into the bladder for removal via cystotomy. X-rays or ultrasounds of the urinary tract are required to plan the surgery. Once cleared for surgery, the procedure involves removing the penis, neutering (if not already done), and creating a larger urethral opening near the bladder.

Post-Surgery Care for Your Cat

Post-surgery, immediate transfer to a 24/7 emergency facility for monitoring and care is highly recommended. At home, it’s crucial to keep the E-collar on your cat to protect the surgical site. Expect some bloody urine and accidental urination initially. Keep your cat on a hard-surfaced floor for easy cleaning and use a soft, paper-based litter like shredded newspaper or pelleted paper litter to avoid irritation at the incision site.

Long-Term Care After PU Surgery

Continuous monitoring of your cat’s urinary health is essential. Follow-up visits are necessary within two weeks of the surgery. Cats that have had a PU surgery are at increased risk of urinary tract infections. Although rare post-PU surgery, urinary blockages can recur. A comprehensive preventative plan including a prescription urinary diet, encouraging water intake, and reducing environmental stress should be developed with your veterinarian.

Scheduling a PU Surgery

PU surgeries require prior stabilization of the cat and scheduling. Bloodwork will be conducted before the surgery to ensure safety during anesthesia. Islandside Surgical Center is an outpatient facility, and while pets can go home the same day, overnight monitoring at an emergency hospital is advised.

*We reserve the right to decline or postpone any surgical procedure if deemed not in the best interest of the pet.

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