Initially cats may show signs of inflammation in the bladder and urethra (tube from the bladder to the tip of the penis) that may include blood in the urine, frequent urinations, straining to urinate or urinating outside of the litter box. These signs may resolve on their own in 5-7 days or may progress to complete obstruction (blockage) of the urethra.
With a complete obstruction you are likely to notice your cat in the litter box straining to urinate and not producing any urine. This situation can be life threatening and the cat will need to be taken to a veterinarian immediately to pass a urinary catheter to relieve the obstruction. Urinary obstruction may be caused by small stones, crystals, mucous, or severe inflammation.
If the blockage can not be relieved, or if the cat has repeat episodes of urinary obstruction, then surgery should be considered to alleviate the problem.
Perineal urethrostomy (“PU”) is a surgical procedure to permanently widen the opening of the urethra to help prevent obstruction from recurring. It is important to note that this surgery will not prevent stone formation, inflammation or infection in the bladder from recurring, however it should minimize or eliminate the chance of re-obstruction.
The surgical procedure involves suturing the lining (mucosa) of the urethra directly to the skin to create a new, larger opening to allow urination. The urethral mucosa is very delicate tissue and the surgical site needs to be protected afterwards by keeping an Elizabethan collar on the cat at all times until the sutures are removed in 12-14 days.
If the cat is allowed to lick or groom at the surgical site there is a high chance of having complications including urine leaking underneath the skin or scar tissue formation causing the new opening to become strictured (narrowed).
In the hands of an experienced veterinary surgeon, complications are rare and this procedure can literally be a lifesaver.