Perineal urethrostomy (P.U. surgery) for cats (male, weight, feline) - - City-Data Forum

Tracysherm · 05-15-2009, 03:51 PM

Okay, my male cat just had his 3rd urinary blockage, and following the "three strikes" recommendation, we just got him the P.U. surgery. If you don't know what it is, you probably don't want to, but it can be life-saving (google it, and if you're a guy, grit your teeth).

He's still in the hospital, and will hopefully come home in a few days. He'll need to be confined for about 2 weeks and wear a rigid collar (so he doesn't bother the incision).

Has anyone else gone through this? Was your cat able to eat and drink with the collar on? Was the surgery successful? Did yours end up with any complications or chronic leakage? Did your cat still need the prescription diet for crystals? I'm hoping he'll now have a good quality of life without needing to be rushed to the vet for blockages every few months.

Everything I've read says that there's a success rate of over 90%, and our surgeon is a board-certified U Penn vet with a success rate higher than that.

Please share your experiences. Thanks.

Tracysherm · 06-01-2009, 03:57 PM

Wow, no one else has gone through this!

Anyway, I thought I'd post a follow-up for anyone considering this surgery for their kitty. In this surgery, they basically remove the penis, and create a new opening for the urethra to open directly outside the body. Your boy cat will look kind of like a girl cat, but a cat's "equipment" is pretty small normally, and his friends shouldn't notice when the hair grows back.

Fletcher is doing well. The recovery period is very long though. He had to be locked in one room for two weeks, wearing a rigid collar and using special litter. Tomorrow he has to get the stitches out, and it's a whole procedure requiring sedation and a half-day stay. Two days after coming home from the surgery, he got blocked again by a clot (scab) and had to go back to get unblocked (fortunately he was "under waranty" and that visit was free!)

But all in all, this saved his life. If you have a male cat who has had repeated urinary blockages from crystals or stones, this surgery can almost eliminate the problem. As you know, a blockage can kill them in about a day. Our guy is only about 6 years old, so it was worth it to give him plenty of more years. He still needs the prescription diet to prevent crystals, but even if he does develop crystals, he'll be able to pass them.

If you do have a vet recommending PU surgery, make sure it's a board certified veterinary surgeon doing it, and not a "regular" vet. Regular vets do the "regular" surgeries like spays, neuters, removing benign lumps, etc. But this is a very delicate and involved surgery. The surgeon said that while at Penn he had to fix a bunch of botched attempts at PU surgery done by doctors who didn't really know what they were doing.

It was like $3500 all together, but if you have the money or some catastrophic pet insurance, you'll be fine. And it's much better that micro-managing your cat's peeing for the rest of his life, and rushing him to the emergency vet every few weeks or months.

Hope this helps someone else!

tigafan · 06-01-2009, 04:05 PM

Sorry that I didn't see your post before. I personally never had a cat go through the surgery, but many of our patients did and lived nice long pain-free lives after the surgery. We did the surgery at our hospital. In the 15 years that I worked, i never saw a complication. All of the cats remained on prescription diets.

The poor,poor cats that don't get the surgery.....unblocking a male is difficult. I'm glad your baby got the surgery!!

Vanessa780 · 06-02-2009, 08:20 PM

My cat blocked back in November for the first time ... i knew he was having uti issues and was trying to treat him naturally - which worked for while , until he blocked . He was unblocked and kept for 3 days . Two weeks ago he partially again and was unblocked and sent home the next day . Three days later was totally blocked and very sick - despite the fact that I was monitering him closely . I had to rush him to the hospital where he was unblocked and catherterized again - spending three days there . I brought him home and he partially blocked the next day . Back to the hospital ... they expressed him manually for two days until he totally blocked again . PU surgery was highly recomended and I felt I had no other choise at that point (especially seeing the pain he was in) . He had the surgery four days ago and came home last night . He has the e-collar and is shaved down the belly , but seems to be doing well . He also had bladder surgery to remove the stones . He is urinating , but i noticed that he hasnt quite gotten it down , as he is getting out of the litter box prematurely . It was a laser surgery so it isnt TOO ugly - and I had asked the doctor to please keep everything as neat and pretty as possible in such an invasive surgery . Hes going for his post op in 3 days ... he also has taken up residence on my lap

... he seems much happier than he has been for 2 weeks . So far so good ... and my doctor was wonderful . She said she has never had any complications and has done ALOT of these surgeries . Good luck ... i just decided it was the more humane thing to do

Vanessa

Quote:

Originally Posted by TracySam

Okay, my male cat just had his 3rd urinary blockage, and following the "three strikes" recommendation, we just got him the P.U. surgery. If you don't know what it is, you probably don't want to, but it can be life-saving (google it, and if you're a guy, grit your teeth).

He's still in the hospital, and will hopefully come home in a few days. He'll need to be confined for about 2 weeks and wear a rigid collar (so he doesn't bother the incision).

Has anyone else gone through this? Was your cat able to eat and drink with the collar on? Was the surgery successful? Did yours end up with any complications or chronic leakage? Did your cat still need the prescription diet for crystals? I'm hoping he'll now have a good quality of life without needing to be rushed to the vet for blockages every few months.

Everything I've read says that there's a success rate of over 90%, and our surgeon is a board-certified U Penn vet with a success rate higher than that.

Please share your experiences. Thanks.

STT Resident · 06-03-2009, 07:10 AM

That brings back memories. My experience goes back THIRTY YEARS! I had a male cat with the same problems and nothing worked for him. The situation was getting out of control and then I decided to go and see a vet who had recently moved into the area (rural Connecticut) and was gaining a very good reputation in just a short while. To cut a long story short, he performed the surgery (by the way, you're right, I don't think most people REALLY want to know what it entails, especially males!) and the cat went on to live a very long and perfectly normal, happy life,

This vet was quite exceptional - I believe he was originally from Yugoslavia - and he was way before his time where many surgical procedures were concerned. When nobody else wanted to even consider anything but euthanasia on a dog I had which was hit by a car, he took her in and painstakingly put her back together again at minimal charge and one would never have afterwards known the extent of her injuries.

I'd guess in over 30 years this procedure has been honed to perfection so I'd guess you have nothing to worry about. Good luck!

Tracysherm · 06-03-2009, 10:05 AM

Wow Vanessa, your guy had both surgeries at the same time!

Our other male cat a few years back got blocked twice, and he had the surgery where they open the bladder and scrape out all the stones & crystals. After that he had the Rx diet and some herbal pills and he never blocked again. He recovered pretty quickly from that surgery, but I remember he was a little "sloppy" for a while afterward, like missing the box, and peeing on the bathroom floor near the toilet. The doc explained that they sometimes get traumatized by how painful it was to urinate with the crystals, and it could change their habits as a result.

Our guy who just had the PU is using the box pretty well, but he's been pretty mopey the past few days (maybe mourning the loss of his "equipment"?) He has to wear the e-collar a few more days. When they take out the stitches from the PU surgery, it can get extremely itchy and they will try to lick excessively. So after two weeks of wearing the collar while he had the stitches, he still has 4 more days of wearing it after the stitches are out. So be prepared for that. It'll be so good to get that thing off him. I don't know if they used laser, but the whole area looks pretty good. Once his hair grows back, we won't see anything.

Good luck with recovery.

STT, I had no idea the PU surgery was around 30 years ago!

Tinmouse · 06-05-2009, 09:15 AM

Hi - About 3 years ago my cat ButterBean had to have this surgery. He has been doing great. He is still over weight but has lost a few pounds. Im sorry to hear that you paid so much for your surgery, that is 3 times the amount I was charged.

SXMGirl · 06-05-2009, 10:48 AM

Grady had the surgery about 30 years ago at UPenn and he lived a very long life. I don't think you have anything to worry about.

Merryn · 08-02-2009, 06:30 PM

Hi...

Our Norwegian Forest cat had the Perineal urethrostomy at the beginning of April. He did very well during his post-op and recuperated with no problems. When we first brought him home, e-collar and all, we were advised that he would likely exhibit some blood for a week or so when he urinated and it should clear up within 10 days. It cleared up within a week. Before Shylocke received this surgery, however, he would have bllod in his urine from time to time but the vet determined that Shylocke is a very sensitive cat (he is) and gets stressed very easily. (he does) When that happens or any change occurs, he seems to develop diarrhea and/or bloody urine but never for long...maybe a day or two.
That being said, it is now just about 4 months since his surgery and in this past week, I have wiped blood off his fur where he urinates a couple of times. Yesterday and today, I have wiped the blood off every time he urinates. Depending on how much he goes determines how much blood I get on the wipe. On top of this, he has diarrhea as well. So, I'm wondering if it's time to see the ER about this...I have kind of lost faith in my regular vet through all of this (another story) so I would prob'ly like to take him back to the hospital where he recieved the surgery. BUT...is this happening because of the hot and humid weather, or irregular mealtimes since my husband is on vacation and we are not following as strict a schedule? Is it because he is annoyed with our senior cat for bellowing all the time and then he goes in search of him and herds him to us to get us to make him keep quiet? Yes, he does this. There are no great changes except for this confounded weather. I'm just not understanding any of why he has bllod after urinating. If someone could tell me if they have experienced this or have any other advise to offer, I would appreciate it. This cat is my baby and I'm too emotional when it comes to decisions about him. I hate to see him suffer and I don't want to lose him. I'm also not made of money nor is my husband and it has cost us in excess of 5000.00 in 7 months, which included the 2 previous blockages, medications, hospital stays, etc.
Thanks for all of your help. Hope to hear from someone soon.
Merryn

tigafan · 08-02-2009, 07:36 PM

If he is urinating well just wait and get him to a regular vet in the morning. If you are looking for another vet, consider a feline vet. Most cat owners really prefer them and they will be completely on top of urinary tract issues. This isn't going to be related to weather or mealtimes.