At this point, it should be no surprise that we had to go forward with Beau getting a PU Surgery. This decision, at first, was a difficult decision to make. We had battled previous urinary tract infections (UTIs), switching to all different types of food, and even tried reducing his stress by building him safe spaces.
Unfortunately, even with all of this, we had a devastating experience where Beau got blocked 3-times within 2 days, resulting in a: we may have to euthanize him, talk from the vet (which I still find unacceptable.)
PU surgeries, while life-saving, may not always be recommended to pet owners. We actually didn’t know they existed even though we had been to the vet 4 times within the 2 days. It wasn’t even a topic they brought up. On the 3rd visit, my partner and I did research on the car ride to see if there was another alternative to putting a catheter in Beau since that wasn’t working, and we discovered the surgery. When we brought it up to the vet, they kept saying, “Oh, we don’t need to do that, it’s also super expensive, let’s keep trying this…” while the results hadn’t been positive and Beau wasn’t getting any better.
My partner and I scrambled to do all the research we could, while also asking lots of questions to the vet, making sure we had all the information we needed to go forward with such a serious, but important operation. So, here’s a little info for you who are interested in getting more knowledge or may be going through a similar circumstance to what we were in.
What kind of cats generally need this surgery?
Well, the majority of cats that have recurring UTIs tend to be neutered male cats. If neutered too early, a cat’s urinary tract may not develop properly, leading to a smaller urethra. Unfortunately, this has been the case for both of our cats and both times we weren’t involved in the decision making or we would have waited a bit longer before getting the procedure done.
What are some factors for blockages?
A lot of times blockages come hand in hand with urinary tract infections, crystals, stones, or “sludge”, while other times blockages happen due to muscle spasms which can actually close off the urethra.
I’ve tried medications and they’ve worked in the past, why would you suggest this surgery?
Well, I wouldn’t recommend this surgery for “first-time offenders.” In the 2 years we had Beau, he has gotten about 3 blockages before the final few leading to the surgery (around the age of 3). The medications worked in the past, and Beau had a good stream of urine coming out of him for months, but even with all the advice we got from the vet and the precautions we took, it still wasn’t good enough for him. While we can’t necessarily pinpoint why Beau got blocked that often (whether it was him not drinking enough, that his urine wasn’t acidic enough, he was too stressed out, or because his urethra spasmed too much) we knew it was time to put the pills down and try something different.
What the medications do…
Sometimes we don’t ask all the questions we need to, so you may not actually know that the medications don’t actually solve the problem. The medications given to you for urinary tract infections and crystals are commonly painkillers, anti-inflammatories and muscle relaxants. It’s still your cat’s responsibility to pee out all the gunk that’s left in their bladder, and dependant on how acidic their urine gets, they may not be able to pee it all out.
So are you saying the food doesn’t work?
Absolutely not. The food works the majority of the time, but like everything, there are some cats that it doesn’t work on. When feeding a urinary specific food it’s extremely important to make it at least 90% of their regular diet, including treats. We made the mistake of switching off of urinary specific food with our cats. Now, again, this isn’t true for all cats, but some cats will have to remain on this food for the rest of their lives.
Why is this important? Well, the urinary food raises the acidity in their stomachs to make sure that crystals do not develop. A lot of pet store food is made for the general/average cat and doesn’t take into consideration cats with special needs. Even Royal Canin, Science Diet & Purina (pet store level) urinary care won’t help regulate your little one’s urinary health. (This may not be true of places outside of Canada as all “vet prescription food” is only sold at the vet and not in regular stores, and I know some places like Europe allow for “prescription food” to be sold in regular pet stores.)
I’ll delve deeper into the topic of urinary food in the future and will link the article here, but back to the main topic!
When may it be a good choice to get the PU Surgery done?
If your kitty is getting blockages commonly or hasn’t been seeing drastic signs of improvements after medication/food treatments, I highly recommend talking to your vet about the PU Surgery. It’s a better choice to get the surgery done while your cat is younger since your cat will be able to recover faster and with fewer chances of complications. This surgery is also quite a large surgery that will require your little one to be under for an extended amount of time, which can be unsafe for cats with heart problems (which sometimes comes with age.) Always, always, always talk to a vet about your cat’s medical history, especially if they are not your regular vet and take time to decide.
So what exactly happens?
Well, the PU surgery will require the vet to remove your cat’s penis and create an artificial permanent opening instead. They shorten the distance from the bladder to this hole and make sure that the tubing is wide enough to pass any crystals or sludge.
What is the success rate?
There is no definitive answer to this, as this highly depends on your vet. It’s true that the perineal urethrostomy is a difficult surgery to perform, but in our case, our vet never had a cat left on the table and only one cat with any long-term complications.
What are some of the long-term complications?
The chance of future UTIs
Well, since PU surgeries don’t cure the underlying issues, (ie. don’t cure stones/crystals), your cat is still prone to future UTIs (and actually more prone). The only difference is… they shouldn’t have any difficulty passing these stones or crystals, improving their long-term health and making sure you don’t have blockages in the future.
Not Using the Litter Box/Leakage
Sometimes cats have been known to disregard litter boxes because of the negative association they have towards it, they have also been known to dribble because they can’t feel when they are done peeing. This was true of Beau until he had his stitches removed. We thought it was going to be a longterm issue, but it went away immediately.
Scar tissue closing/resealing
Though rare, scar tissue may close and actually block the new urethra. The good part of this is, it’s super reversible and most vets will insert a catheter to reopen the hole. This should not be a worry after the healing process is complete, however again if it does happen, your cat will be fine!
What is the healing time?
For us, the full-healing time was around 3 weeks (because Beau had a double cystotomy as well). You can read a day by day account of the first week here. After the first week, you should be in the clear, but again this depends on the age and health of your cat. You can also check out that article for post-operation care and extra information. I’m also here if you want to chat and make sure to ask your vet if you can e-mail them any of your questions!
We are so grateful that we found your post (God bless you) because our cat is lying in hospital right now and we getting so so worried and stressed out. Long story short, we are in the exactly same situation as you were and vet is suggesting PU surgery which is life saving but cost a fortune. We love our cat and want him to get the best vet and care we could afford. Could you let me know where did you get Beau’s surgery done and roughly cost for everything? (One comment said that you are in Toronto, we happened to be in the same city)
Best,
CZ
Hey Chris, the surgery cost a minimum of $3000, but will vary based on how much medication & anesthetics your cat needs. Please shoot me an e-mail if you’d like to know what vet we went for privacy reasons 🙂
Hi. I’m after advice on food for our George who is 13days post op from PU surgery. George was fully blocked and a catheter couldn’t be inserted so his life was in the balance for 24 hours. The vet we chose to go to on that day had successfully done a number of these ops so we were confident of success.
George was unwell for a number of days afterwards with a catheter inserted for 2 days. A long weekend was coming so we asked to take him home with us and return each day for a check up. He came home on antibiotics, anti inflammatory and pain meds.
He is our darling rescue cat with a very short tale due to an injury. He’s definitely been though the wars but we love him and he’s slowly recovering.
My question is food: I’m sceptical about the Royal Canin and Hills food the vets are pushing on us. We are now adding additional water to the wet food, a few drops of apple cider vinegar to his drinking water which he doesn’t mind.
What dry food do I get for him? He didn’t like Hills, we did buy Purina Pro Urinary as the water content was higher, the magnesium level was lower.
Is this a good food for George or do I need to purchase the Canin or Hills Vet prescribed food?
Any advice will be gratefully received.
I’m in Australia so maybe some of the products you are able to purchase, I can’t.
Hey Julie, I wouldn’t be skeptical about RC and Hills. I’ll admit that nutritionally, they aren’t the greatest food, but in terms of making sure that your cat’s pH is regulated, they do a great job. The major difference between pet store food and SD & RC is that SD & RC have been thoroughly tested to regulate acidity in your cat’s stomach. While some other foods have been “tested” they haven’t been tested as rigorously and most of the time they are only tested by the manufacturing company in small batches.
Now, that isn’t to say that there isn’t food out there that is just as ideal, I just haven’t come across it myself. I’ve tried a number of foods that claimed to be pH balanced (from Natural Holistic lines), but unfortunately, that’s what lead Beau to getting his final blockage and ultimately his need for a PU Surgery.
Since the surgery, we’ve had him on Science Diet full-time, and my only complaint is that he’s gained some weight (which we are keeping managed by making him exercise more.)
As for Purina, I know that there is one that works really well and one that’s basically “a scam.” I’m not sure how Australian pet foods work, I just know that the one you HAVE to get from the vet in Canada is the Purina one that works. The one I’ve heard many complaints about is PURINA PRO PLAN Focus Urinary Tract Health Chicken Formula which I believe even states it’s not a substitute for vet food, but I’ve heard much better things of the actual vet line UR Urinary St/Ox.
Giving more water is a great start for good urinary health, however, it’s unfortunately not the be all end all. When I mentioned that Beau was eating a “pH safe” food, it was a wet food we mixed with lots of water. He still, unfortunately, blocked even with loads of water.
This is going to be very different for each cat (as some cats can live their whole life eating kibble, having minimal water and never get a UTI), but in my opinion, if you’re really worried go with what we know works until another better food comes up that has the studies behind it.
It’s the answer I wish I didn’t have to give (because I too hate the monopoly vets have on urinary cat foods) but it’s been what’s kept both Walker & Beau alive for the past few years. (Walker also had urinary issues and ever since he’s been on RC he’s never had them again, he’s been UTI free for 2 years now.)
Hope that helps 🙂
I’ve been obsessively reading your blog this past week. I feel like my partner and I ARE your partner and you – lol. And I think we’re both in Toronto! Can I ask where Beau had his PU surgery?
Our wonderful boy Ezra blocked last Friday so we took him to the emergency vet where he stayed for 48 hours, catheterized. The catheter was removed and the vet said he was peeing! We took him home with pain meds, antibiotics for a minor UTI, and anti-spasmodics …and he immediately reblocked. We took him to his regular vet on Monday and they gave us the options of either re-catheterizing or cystotomy. We chose to go the cystotomy route because there was a lot of sludge in his bladder as well as some crystals, which have been sent out for testing. The two options were basically the same price, so we thought it would make the most sense to go for the surgery, which we were told would fix the issue. That was on Monday and we picked him up Tuesday night. Again the vet told us everything went really well and that he was peeing on his own. We brought him home and he was pretty lethargic, but was eating and peeing small but frequent amounts which we were elated about. Thursday came around and we noticed drops of bright red blood on the floor and more frequent trips to the litter box. He was also obsessively licking his genital area; his cone wasn’t long enough -_- Concerned, we called our vet and they told us to bring Ezra in. The vet told us his bladder was quite full again, which we were surprised about because he really was peeing well in (and out) of his litter box, so they emptied his bladder with a syringe instead of a catheter and basically told us there was maybe the option of another surgery or we would have to put him down. That was obviously really jarring to hear and we were extremely upset by what seemed like kind of crappy bedside manner. They sent us home with an anti-inflammatory, more pain meds, and more anti-spasmodics.
At this point we were pretty distraught and took turns crying/consoling each other and lying on the floor next to our favourite kitty. He still wasn’t producing any urine, so back to the emergency vet we went today (Sunday, so this has all been going on for 9 days). The vet today was really awesome and told us that his bladder wasn’t full, but he was concerned that he was trying to pee unsuccessfully. He did a quick ultrasound (and didn’t charge us bless his soul) and saw that his uretehra looked pretty inflamed. He thoroughly went through our options with a lot more empathy and said they could keep him in emerg for 4-7 days with a catheter in, which would maybe let his urethra heal and be less inflamed and if that didn’t work he would consider PU surgery. He mentioned he really does not like PU surgery as much as other vets do because of the possibility of so many complications, but your post makes it seem a lot less scary. The third option is the option of which we do not like to speak, but this vet said that we’re not even close to considering that. We’re back home and reading so many articles and talking to everyone we can about what we should do.
We just called the emerg vet again to let him know Ezra had not peed and he said we can bring him in tonight but the fact that Ezra is eating and cuddling and playing with his toys is a good sign and he said we could wait until the morning to see his usual vet. We’re currently trying to make a decision about what the frig to do.
We are SO decision and financially exhausted and so stressed, but we’re willing to do anything for Ezra. I’m in a constant state of anxiety and I feel like I could cry at the drop of a hat at all minutes of the day. Neither of us are sleeping well or eating much. We’re not sure if we’re being selfish by going back and forth to the vet with Ezra and having him poked and prodded but we also can’t imagine putting him down. We’re aware that stress is a major trigger for uretheral spasms, so we feel like every time we stuff him in his carrier, we’re just making it worse.
I’m so glad Beau is doing well and it gives me hope for our sweet EZ. I’m not sure what the point of this post is except that it feels good to get this off my chest every couple of days. I suppose also my questions above are still relevant. If we have to go the PU route, which is what it’s looking like, we want the best care possible.
Thanks for your posts!!! Seriously very helpful and comforting during a really unpleasant time for everyone.
Hey Amanda, just read this and sounds like… yes, you were in a very similar situation as us and for that, I am extremely sorry. I also got your PM and have responded to it with some information about my vet, but I’m still going to answer your comment publically just in case other readers find my response helpful.
I completely understand your vet feeling like the risks and complications are too high for this surgery because they definitely can be. The thing is, most of the time complications land on the shoulders of the person who operates. We were even in a very uncomfortable situation recently where a vet gave us a bit of flax (is that the phrase?) because we put Beau through the surgery. Which we think is crazy.
Oddly enough, have a post queued for tomorrow (which will be found here) where I really break down what each of the complications are and what they mean for your cat in the long term. It also lets you know which ones Beau has experienced and what we had to do for that, although I will still state Beau is an extremely lucky cat who hasn’t experienced anywhere near the worst complications. The thing about the majority of the complications is that they are reversible/manageable, however, it’s a question of whether or not your cat will have a good quality of life experiencing these complications.
I’m very surprised to hear that your vet didn’t encourage you to get both operations done at the same time. From the research I’ve done and from the conversations I’ve had with my vet colleagues, it seems like the majority of cats have to undergo both surgeries (or more commonly the PU Surgery). The issue with the cystotomy is that even though they scrape out the sludge, a great amount of it can still be left (or the opposite where so little can be left, that still blocks your cat’s urethra. Now, this isn’t to say that your vet is wrong or bad for not encouraging you to do both at once, but they may not have as much experience with PU Surgeries as my vet did.
Like I mentioned in my post about the complications, my vet has only experienced one cat get complications from the many PU surgeries he’s done. This really eased us, and while it was still scary to put Beau under the knife, our vet called us every day (even a few times) to let us know what happened/was happening with Beau.
I’m glad I found this site. I’ve been through the ringer since Dec 29. That Friday, I noticed Moses was straining and quietly crying. I didnt know what was wrong with him, but I knew I had to get him in. I took him to my regular vet, who isn’t a cat lover, and Moses was expressed manually. My vet said he had crystals, but had a good stream of urine, so sent him home with antibiotics and different food. The next morning I noticed his litter box was dry, and that he straining again. He was eating and drinking, but I knew I had to call the vet right away. When I called, I was transferred over to a different clinic that was taking call. The vet had me bring him in and cathaterized him, leaving it in for 48hrs. He had a lot of crystals. After the 48hrs, she removed it, and by that afternoon, he still could not pee. She talked to me about the surgery, but was willing to try cathing him again for another 48 hrs. This time, he had a lot of mucous that came out. Both times, she irrigated his bladder and always had IV fluid running. So today, after another 48 hr round, she removed the catheter, said his urine look good and clear, but by early afternoon, he was full and straining again. My options were – put him down, (which she couldn’t see doing because he is a young, healthy cat), or the PU surgery. Problem is, she doesn’t do the surgery and no one in my city does either. We located a vet about 70 miles from where I live, who does the surgeries. So, she catheterized him again to empty his bladder, and sent me on my way to the other clinic. I’m tired, wore out from crying and worrying. His surgery is tomorrow afternoon. The tech said the surgery has good success rate, but I’m still concerned. Poor Moses has been going through this for 5 days and has not been home with us. He is wore out and stressed out. I’m just looking for some positive feedback and just someone to talk to, who has been through this. He is a healthy cat, but has been sedated now 4 times. and still has to go through the surgery. I just want him home.
Paula, I am so incredibly sorry that you’re going through this and know that I can completely understand your fatigue. I don’t know if you’ve found my other posts about the surgery and how positive it has been on Beau’s life. It’s been over a year now since Beau got his surgery and we’ve only seen one complication (which is another urinary tract infection), this was brought on due to stress when we were introducing him to his new sister. That was completely flushed away with a round of antibiotics and he’s been perfect since! I firmly stand behind this operation and do truly believe it has saved my cats life and has improved his quality of living.
I’m always here if you have any questions or just need some extra support. You can find my e-mail through the contact page if there’s something private you need to share or you’re more than welcome to post here as many others have so others can learn from your experience.
I’m sending you the biggest hugs and hand squeezes. You’re not alone <3
I just went through this with my boy Ziggy. He blocked about a month ago and then reblocked within a week after his 1st blockage. It was a difficult decision since you are not given a guarantee that he will be fine after and it was very expensive. It will be a month this Thursday since his surgery and he is doing great! I have 2 cats 1 female and Ziggy. I have fed them grain free dry as well as grain free canned food since they were kittens. I thought I was doing all the right things…
He will not eat the prescription food at all. I tried everything and after reading several blogs, I found that people said that their cats enjoyed Purina pro V focus so I tried that and he is eating that so far. I am trying to transition my finicky female cat to only canned food but so far she is not having it. I will not give up! However, I cannot get any vet to tell me what I should do if my Ziggy will not eat prescription food. I’m hoping that the pro v will be ok since his surgery. The prescription food has a lot of grains and not very good ingredients. I also read that what they need is water and a high quality wet food is better than the prescription food…that the key is water..
BTW, thank you for posting your story, I also did a lot of research in 1 week after Ziggy was blocked and read some horror stories and did not know what to do when I had to make the decision to go ahead with the surgery because again, there were no guarantees that it would work. Your post gave me hope and I took the chance and so happy I did!
Hey Sharda, so glad that Ziggy is doing well. Trying to get your cat to transition to a different food can be very difficult. These may be things you haven’t tried before: try microwaving the food for a short period of time (wet food), try mixing a bit of their old kibble into the new food, try putting on some parmesan cheese on top, or try broth.
Unfortunately, feeding a good quality food isn’t always the most important (especially if your cat battles with urinary problems.) We learned this the hard way. A lot of high-quality foods are great from the general pet, however, with cats like ours, the pH in their urine is much more important. Large high-quality brands aren’t aiming for a balanced pH. Their focus is getting as many good ingredients into your pet as possible, which oftentimes does more harm (again for cats like ours.)
I’m still in search of a high-quality cat food that was developed to make sure that the pH in our cat’s urine is well-maintained, but to this day the only ones that I’ve found are the vet recommended ones (which have the fillers.) Although not the greatest food, I’m just happy they’ve made my kitty able to pee!
Let me know if you ever have any questions or concerns or if you need any other tips on how to get Ziggy to eat. Kalista was a very hard cat to try to transition. She was happier starving herself rather than trying a new food… *sigh*
Hello. Our kitty Miluea (me-lou) had this surgery at the ripe age of 18. It was trying for sure, but after a few post OP UTIs, he seems to have recovered very well. We are about 2 months away from the surgery itself and he just turned 19. I have one question for you, ever since the surgery, he doesn’t want to sit flat on his bottom like normal, he holds his backside off the ground slightly. Does your kitty do this? Thanks for sharing!
Hey Alicia, Beau did that for a while until he wasn’t sore anymore. He now sits on his backside like he used to (it probably took a month or two). He may associate pain with sitting down on his backside (even if he’s not feeling pain) and may take a bit of time to readjust
Glad that you and Beau got through that scary time. What a relief its all behind you now.
Hope he doesn’t get any UTI’s.
I hope he doesn’t either! He’s been in the clear so far, and I hope to keep it that way! *knocks on wood*
We’re very happy that it all worked out fine for Beau. It must be very painful for a Kitty or other animal to have PU 🙁 Pawkisses for a Happy sunny Sunday 🙂 <3
Definitely was a painful process for him, but I’m 100% sure he’s happier this way! He’s had 0 struggles since and has been better than ever!
I am glad it all worked out. It breaks my heart when owners can’t afford this and have to euthanize.
Absolutely agree. I feel so privileged to have been able to pay for it this time around.
We’re glad this surgery helped Beau. We know a couple of other cats that have had it and have done well as well.
I hope they all had a great recovery and long healthy lives!
Beau will come through this with flying colors and be around for a long time with you.
My Cubby had PU surgery when he was 5 yrs old – the blockage was pretty extensive and the surgery was pretty dramatic in scope. He healed well, but still insisted on eating kibble as his favorite. He had been the runt of his litter; at under 8 lbs, we let him eat whatever he wanted just to make sure he had plenty of calories to maintain what little weight he had. We always gave him and his brother wet food, but Cubby preferred kibble anyway.
He lived another 13 years and passed away at the ripe old age of 18. So, the PU surgery saved his life, keeping him with us for many. many loving years. I’m confident that your Beau will give you the same full lifetime of love. You are loving “parents” to give Beau this chance to live a full life.
Best to you and Beau,
dc
Thanks so much DC! So happy to hear that Cubby did so well after having the surgery! It also seems a lot more common than I originally thought 🙂
I hope things go good for Beau’s surgery. You and Beau will be in our thoughts and prayers. Hope Beau gets well soon and has a full recovery.
Oh Beau had his surgery! 🙂 He had it late last year and has been doing AMAZING ! 🙂