Perineal Urethrostomy: description and costs

Recently, I posted a story on Tallulah, the grey tabby male cat who had a urinary blockage. In the story, Marcy J (Tallulah’s owner) mentions a perineal urethrostomy (aka a "PU"), a surgical procedure that all too many pet parents of male cats have heard of.

What is a Perineal Urethrostomy and When are they Performed?

A perineal urethrostomy is a surgical procedure that widens the opening of the urethra (the tube that carries urine from the bladder to outside of the body) and it is performed on both cats and dogs.

In male cats, the urethral canal becomes narrow and can be prone to blockages from mucous plugs, stones or sediment in the urine. Your veterinarian may recommend the surgery if your cat becomes frequently blocked, which is a very dangerous situation and deadly if left untreated, or if the blockage has caused a lot of trauma to the urethra, which sounds like happened to poor Tallulah.

In male dogs, the urethra may become blocked with stones or has received trauma (such as being hit by a car).

Perineal Urethrostomy Surgery

(this might make you feel all ouchy - you are warned!)

The surgery involves separating the urethra from the surrounding tissues and then cutting it open and attaching it to the perineal skin (the perineum is the space between the anus and the urinary tract opening). This positioning allows for a wider urethral opening that is more like that of female anatomy, which has a wider urethral canal than in males.

After surgery, your pet will need to stay in the hospital a couple of days for healing. Once at home, cats will need a shredded paper or pellet litter until the surgery site is fully healed and to wear an Elizabethan collar (more lovingly known as a lampshade) to prevent your cat from licking the wound and disturbing its healing. Your veterinarian also may send your cat home on a pain management and possibly antibiotics.

Potential complications for this procedure are anesthetic risk (as with all surgeries), stricture (scarring that creates a new blockage), and frequent bladder infections.

How Much Does a Perineal Urethrostomy Cost?

(this too might make you feel ouchy)

It can be a very costly procedure. Marcy mentions that the total for everything was $6,000, with $2,900 spent on the emergency care, leaving a total of $3,100 for the cost of the surgery and hospitalization. Marcy did bemoan the fact that she did not have pet insurance to help cover these costs, as you can imagine.

Perineal Urethrostomy Trends

(the good news)

The most frequent cause of perineal urethrostomies is blockages in male cats. The good news is that even though this condition is still relatively common, studies in the United States and Canada show a decline in the number of perineal urethrostomy’s performed and a decrease in the number of blocked cats seen. The decrease coincides with the increased use of feline diets that are low in magnesium so take note: diet is very important in preventing blockages, particularly in male cats.

Thank you to the follow sources for help with this summary: The Veterinary Information Network, Inc.; ThePetCenter.com; the American Veterinary Medical Association; and Wipikedia.

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