Veterinary SurgeryRefer a case
Soft-tissue surgery · Kentucky & Southern Indiana
Perineal urethrostomy (PU) in Louisville and Lexington, Kentucky
Dr. Joshua A. Bruce, DVM, DACVS-SA provides board-certified perineal urethrostomy (PU) surgery through KVS partner veterinary clinics.
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What is a perineal urethrostomy?
A perineal urethrostomy (PU) is surgery that creates a wider urinary opening in male cats. The narrowest part of a male cat's urethra is near the tip of the penis, where crystals, mucus plugs, or small stones can get stuck. A PU removes that narrow section so urine can flow through a wider opening.
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When is PU recommended?
PU is usually recommended for male cats with repeated urinary blockages despite medical management and diet changes, or when the urethra is damaged or narrowed after a blockage. There isn't a set number of blockages required before surgery. Repeated blockages and emergency visits can also make it harder for families to afford surgery later, so Dr. Bruce has performed PU after a cat's first blockage. In dogs, a scrotal urethrostomy is more often performed, most often as part of cancer treatment, since urinary stones in dogs can usually be flushed back into the bladder or removed through a urethrotomy.
If your pet is in distress right now, contact your primary veterinarian or the nearest emergency hospital first. KVS does not provide emergency care and is not a walk-in hospital. Once your pet is stable, your veterinarian can contact KVS about surgical options. A cat straining in the litter box with little or no urine, crying, or vomiting may be blocked. A urinary blockage is life-threatening and needs emergency care right away.
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What surgery involves
Once the cat is stable and unblocked, surgery is done under general anesthesia. The penis and the narrow part of the urethra are removed, and the wider part of the urethra is carefully sutured to the skin to create a new opening. Intact cats are always neutered at the same time.
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How the KVS referral model works
Your veterinarian evaluates your pet and submits a referral.
KVS reviews the records and plans the case.
Surgery stays with the local team at the participating clinic, followed by a coordinated recovery and recheck plan.
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Recovery
Some bleeding and dripping of blood or clots is expected at first, so cats should be confined to a small area that's easy to clean. An e-collar is worn until the site heals, usually about 2 weeks. A dust-free litter such as pelleted newspaper is preferred, though some cats refuse it, and regular litter may have to be used. Absorbable sutures are usually used, but a 2-week recheck is still scheduled to make sure the site is healing well. Most cats go home the same day unless there is an issue. PU makes blockages much less likely, but cats can still have bladder inflammation or infections, so diet and stress management usually continue.
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Service area
Louisville Metro and surrounding Kentucky communities; Lexington and Central Kentucky partner practices; Southern Indiana. KVS is not a walk-in hospital. Availability is coordinated with participating veterinary clinics.
Common questions
Common questions about perineal urethrostomy
Who performs this surgery for KVS?
Dr. Joshua A. Bruce, DVM, DACVS-SA, an ACVS board-certified small-animal surgeon and the owner of Kentucky Veterinary Surgery.
Where is surgery done?
At participating veterinary clinics in Louisville, Lexington, surrounding Kentucky communities, and Southern Indiana.
Will my cat still be able to use the litter box normally?
Yes. After healing, cats urinate normally through the new opening and use the litter box as usual.
Can my cat still have urinary problems after PU?
PU greatly lowers the risk of blockage, but some cats can still have bladder inflammation or urinary infections, so ongoing care with your veterinarian remains important.
How do I get started?
Begin with your primary veterinarian, who can review your cat's urinary history and submit a referral to KVS.
Sources
References
- American College of Veterinary Surgeons (ACVS). Urinary Obstruction in Male Cats. https://www.acvs.org/small-animal/urinary-obstruction-in-male-cats/
Next step
Start with the veterinary team who knows your pet.
Pet owners: ask your primary veterinarian to submit the referral.
Find a partner clinic