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Perineal Urethrostomy Surgery for Cats

A guide to perineal urethrostomy surgery, its indications, and post-operative care for cats.

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Feline Lower Urinary Tract Disease

Male cats are prone to urinary obstruction (blockage), which may be caused by urinary stones (calculi) or tumours. More commonly, urinary obstruction is caused by a condition called “Feline Lower Urinary Tract Disease” (FLUTD) or “Feline Idiopathic Cystitis”. The causes of FLUTD are multifactorial, but all result in failure of urine to exit the body via the urethra.

This causes urine to build up in the bladder which causes a build-up of toxic substances in the blood, including potassium and creatinine. This can cause pain and cause the cat to become quite sick and develop heart problems. Male cats are predisposed to obstruction due to their narrow, long urethra. These obstructions can occur due to urinary stones, urethral plug, or by spasm of the urethral sphincters.

How is this condition managed?

Initial treatment for this condition in cats includes intravenous fluids, urinary catheterisation to empty the bladder, and medications to alleviate the harmful effects of changes in the blood, to relieve the blockage, and help prevent re-obstruction. Changes in diet and lifestyle can also help decrease the chance of recurrence.

What happens if medical management is not successful?

In many cases, despite appropriate medical management and home changes, the problem continues to occur. This may be shortly after the first episode, or sometime later, and in many cats urinary blockage can occur multiple times. When blockages continue to occur, a surgical procedure called a perineal urethrostomy is indicated to help prevent blockages from occurring.

What does a Perineal Urethrostomy involve?

This is a surgical procedure done under general anaesthetic which aims to widen the male cat’s urethra. This procedure aims to prevent calculi or plugs from blocking the exit to the urethra and allows urine to pass out of the body easier. This is accomplished by opening the urethra and using the larger part which is further in the body as the new opening to the outside.

The skin around the penis is incised and dissected to access the wider portion of the urethra. This is then sutured to the surrounding skin to enable it to heal and create a new, wider opening.

What happens after surgery?

After surgery your cat may have a urinary catheter placed whilst the inflammation from the surgery subsides. They will be kept in hospital until they are urinating by themselves, and we are confident that there have been no complications from the surgery. This is usually only 1 or 2 days after surgery.

This surgery has a good prognosis for full recovery. It is possible for blockages to recur but it is less likely with this surgery. Other complications can include recu

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