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Perineal Urethrostomy in Cats with FLUTD
Feline Lower Urinary Tract Disease (or FLUTD for short) is a very serious condition that is on the rise. It is especially common in obese, neutered male cats.
There is an increase in the number of cases of FLUTD, but the reasons for this is unknown, however, there may be a link to ingredients found in commercial cat food. Urinary problems in both cats and dogs need to be treated immediately as it is extremely dangerous, especially if there is a blockage or bleeding. Cats showing signs of a urinary tract infection need to be taken to the vet immediately.
If a male cat has a history of urinary problems, a perineal urethrostomy (surgical removal of the urethra) may need to be performed in order to treat the condition. In Chip's case, the surgery was needed in order to save his life.
Chip's First Urinary Tract Infection
Chip, my male cat, was one year old when he had his first urinary tract infection. I was in the shower when I heard him screaming and found him in the litter box trying to go to the bathroom. I thought maybe he'd eaten something and it was hurting his stomach. When I took him to the vet, the veterinarian said he probably had an infection and that I watch for when he urinates and save a sample to bring in.
Later that night, Chip still hadn't urinated and he was still distressed. I took him to the emergency pet clinic. They found immediately that Chip had a blockage due to struvite crystals. They said that his urethra was very small, so catheterizing may not be possible. Luckily, they were able to catheterize him and drain and flush his bladder. They then put him on an anti-biotic and Chip was to eat special food from then on: Hills Prescription CD.
Another Urinary Blockage
After the first infection, I had changed Chip's regular veterinarian as she had missed his blockage. The next time Chip had an infection, he'd had the same symptoms as the first, he couldn't pass any urine and was in pain.
When I took him to the vet I'd thought they'd just catheterize him like last time. However, because of the small size of his urethra and the nature of this new blockage, he could not be catheterized. This time they injected his bladder with a needle, pulling urine out through the syringe and flushing his bladder.
The vet said that in order to help Chip, a Perineal Urethrostomy would be needed. The veterinarian said that she did not feel qualified to perform this surgery as she'd not had much success and that I should have Purdue University do the surgery. She also told me that it would be very expensive (it was $4000), but that Purdue could do the surgery within the next few days and that I could take Chip down to West Lafayette the next day. We agreed that this would be the best course.
Chip's Perineal Urethrostomy
The day after Chip's second urinary blockage, I picked him up from the vet and took him to Purdue University. He already had an IV in and his leg was wrapped in a bright pink elastic bandaging to keep the IV in place. He meowed the whole trip down. Once there, they said that depending on Chip's condition they may not perform the surgery that day. In the examination room, Chip seemed tense but curious about the room he was in, so he seemed okay. The vet examined him and said he would call me later about when they would perform the surgery to remove Chip's urethra.
On the road home I got a call saying that they had already started the surgery as Chip needed it immediately. I was very nervous, but later the same evening they called and said it was successful. Over the course of the next few days, they would call each morning giving me an update on Chip's condition and I was happy to hear he was doing better. I picked him up a few days after his surgery. He was wearing a cone, but was happy to be home and seemed much more comfortable.
Perineal Urethrostomy Aftercare
Chip was put in his own separate room, which I slept in, away from his sister, Nilla, who had apparently rejected him (she attacked him, a common thing for cats to do to other cats that are sick.) Moving Chip to a private room also served as a great way to prevent him from jumping and being overly active while recuperating.
Several times each day, Chip received liquid medicine through a syringe (as he would refuse pills.) He also received canned food in order to keep him urinating. Chip had always had problems drinking water -- the whole concept of water had always been confusing to him (he's a really dumb, but lovable cat.) Because of this, he always has to eat canned or ground up food.
After a week, Chip got to have to cone removed and over time he healed up and had been doing well since. Nilla eventually forgave him for being sick and now they live together again. About once each year, Chip will get a urinary tract infection, but treatment for his is much easier as he now has a wide, short urethra. On these days he gets a supplement as well as extra water in his food and then he's fine.