What Is PU Surgery?
Perineal urethrostomy (PU) is a surgical procedure designed to help cats suffering from severe urinary blockages. It involves creating a new, wider opening in the urethra to allow urine to pass more easily, reducing the risk of life-threatening obstructions. This procedure is typically performed as a last resort when other treatments have failed, providing a long-term solution for cats that are prone to blockages.
While the surgery is invasive, it significantly improves a cat’s ability to urinate normally and reduces the risk of life-threatening emergencies in the future. With proper post-operative care, many cats go on to live comfortable and healthy lives.
Why Do Cats Experience Urinary Blockages?
Urinary blockages, often caused by urethral plugs, bladder stones, or inflammation, are common in male cats due to their naturally narrow urethras. These blockages can quickly become fatal if untreated. A combination of dietary factors, stress, and inadequate water intake can contribute to the formation of crystals or mucus plugs that obstruct the urinary tract.
Over time, repeated blockages can cause inflammation and scarring, making it even harder for the cat to urinate. Certain breeds, such as Persians and Siamese cats, may also be genetically predisposed to urinary tract issues, increasing their risk of developing severe blockages.
Symptoms of Urinary Blockage
- Straining to urinate with little or no output: Cats may frequently squat in the litter box, appearing to struggle to pass urine with no success.
- Frequent attempts to urinate outside the litter box: A blocked cat may become restless, attempting to relieve itself in unusual places due to discomfort.
- Vocalizing due to pain: Cats in distress often meow loudly or cry out when trying to urinate.
- Lethargy and loss of appetite: A urinary blockage can cause systemic illness, leading to fatigue and a refusal to eat.
- Vomiting: As toxins build up in the body due to urine retention, cats may experience nausea and vomiting.
- A swollen, firm abdomen: The bladder can become dangerously distended, causing severe pain and discomfort.
If you notice these signs, seek emergency veterinary care immediately. If left untreated, urinary blockages can become fatal within 24-48 hours.
When Is PU Surgery Necessary?
PU surgery is recommended when:
A cat has recurrent urinary blockages that do not respond well to medical treatment.
These blockages can cause extreme discomfort and distress for both the cat and the owner. Frequent vet visits and catheterizations can become both financially and emotionally taxing, making surgery a more permanent solution.
A urethral blockage cannot be cleared through catheterization.
In some cases, even the most skilled veterinarians may not be able to remove the obstruction with standard methods. When this happens, the inability to urinate can lead to kidney failure and dangerous toxin buildup in the body, making PU surgery an urgent necessity.
Scarring has caused severe urethral narrowing.
Scar tissue can develop due to repeated blockages or previous catheterization, further restricting urine flow. As the scarring worsens, cats may experience chronic pain, inflammation, and a progressively worsening ability to urinate, making surgery the best option for long-term relief.
How the Procedure Works
During PU surgery, a veterinary surgeon removes the narrow portion of the urethra near the penis and reconstructs a wider opening, preventing future blockages. The surgery is performed under general anesthesia, and post-operative care is crucial for healing.
What to Expect After PU Surgery
Immediate Recovery
Cats usually stay in the hospital for several days after surgery for monitoring and pain management. During this period, veterinarians will closely observe the cat’s urine output, hydration levels, and any signs of infection or complications.
Some may require a temporary urinary catheter to keep urine flowing smoothly while the surgical site heals. Pain relief medications and antibiotics are often administered to ensure comfort and prevent infections. Owners will receive instructions on what to expect in the coming weeks and how to manage their cat’s recovery at home.
Home Care and Healing
Litter Box Management
Use dust-free, non-clumping litter to prevent irritation. Clumping litter can stick to the surgical site, increasing the risk of infection and discomfort. Keeping the litter box clean is essential, so scoop it frequently and change the litter as needed to ensure a hygienic environment. Providing an easily accessible and low-sided litter box can help reduce strain on your recovering cat.
Restricted Activity
Avoid jumping and rough play for at least two weeks. Cats recovering from PU surgery need time to heal, and excessive movement can put stress on the surgical site. Consider setting up a confined, comfortable space with soft bedding to encourage rest. Using baby gates or placing the cat in a room without high surfaces can help prevent accidental jumping or climbing.
Medication & Follow-ups
Administer pain relievers and antibiotics as prescribed. Pain management is crucial to keeping your cat comfortable; missing doses may cause unnecessary distress. Follow-up visits allow the veterinarian to check for infections, ensure the surgical site is healing correctly, and remove any necessary sutures. If you notice signs of infection, such as swelling, redness, or excessive licking, consult your vet immediately.
Dietary Adjustments
A special urinary diet may help prevent stone formation and future complications. These diets are formulated to maintain an optimal urinary pH and reduce the formation of crystals or stones. Wet food can be beneficial as it increases hydration, which supports urinary health. Always discuss dietary changes with your veterinarian to ensure the best nutritional plan for your cat’s needs.
Potential Risks and Long-Term Outlook
Most cats recover well after PU surgery, but complications such as infections, stricture formation (narrowing of the new opening), or occasional incontinence may occur. However, the majority of cats regain normal urinary function and quality of life post-surgery.
How to Prevent Urinary Blockages
While PU surgery is a lifesaving option, prevention is always better. Consider these measures to reduce the risk of urinary issues:
- Encourage Hydration: Provide fresh water at all times and consider adding wet food to your cat’s diet. Many cats do not drink enough water, which can lead to concentrated urine and increase the risk of stone formation. You can also try using a pet water fountain to encourage them to drink more frequently.
- Maintain a Balanced Diet: Special urinary health diets can help prevent stone formation. These diets are formulated to maintain the right pH balance in the urine and reduce the risk of crystal formation. Always consult your veterinarian before making any dietary changes to ensure your cat is getting the right nutrients.
- Minimize Stress: Stress can contribute to urinary issues. Ensure a calm environment and provide plenty of enrichment. Cats are sensitive to changes in their surroundings, and stress can trigger episodes of feline lower urinary tract disease (FLUTD). Consider using pheromone diffusers, providing hiding spots, and keeping a consistent routine to help reduce anxiety.
- Regular Vet Checkups: Routine exams and urine testing can catch early signs of urinary problems before they become severe. Regular visits allow your vet to monitor your cat’s urinary health and make dietary or lifestyle recommendations as needed. Early intervention can prevent small issues from developing into life-threatening blockages.
Wrapping It Up
PU surgery can be a lifesaving procedure for cats suffering from chronic or severe urinary blockages. If your cat has experienced repeated blockages, consulting with your veterinarian about PU surgery may be the best path forward to ensure a healthy and comfortable life.
If your pets are in an emergency or if you have general inquiries, please do not hesitate to contact Veterinary Emergency Centre.
General Hotline: 2334-2334
24-Hour Emergency Hotline: 6828-6620
