My cat keeps blocking due to stress. Is PU surgery the best option?

Hi, thanks fir using Petco Pet Education Center, formerly Petcoach! Poor Jose! The most common causes for urinary obstruction are: crystals in the urine (struvite or Calcium oxalate), bladder stones, stress causing inflammation or a urinary tract infection (not common). The goals of therapy are to relieve the obstruction, test the urine for crystals and infection, do blood work to make sure he isn't sick (high potassium, increased kidney values) take an X-ray to look fro bladder stones. We treat with antibiotics for 2-3 weeks, a urethral relaxant (Prazocin) for a week, and pain medications for a few days. If he has bladder stones surgery is require to remove them. Long-term management is a life long diet change to a prescription urinary diet (royal canin s/o, Hill's c/d, Purina UR) and increase water intake. You can buy a water fountain and change him to an all canned food diet (more water in canned food) from one of the above company's. Jose will also be at risk to reblock and should always be monitored and on a prescription diet. Other wise there are no life long medications. I hope this helps and I wish Jose a speedy recovery!

Hello. Yes, unfortunately. Grunting and straining indicate that he is having difficulty passing urine. There may still be significant inflammation or he could reblock. In this situation, it may be time to consider surgery. If he blocks repeatedly, a surgery called a perineal urethrostomy can be performed. If your veterinarian does not perform this procedure, they may have to refer you to another surgeon that does. Make sure he is able to pass urine every time he tries, but if he continues to grunt, he should be rechecked.

The life expectancy is the same for a cat that has undergone a PU surgery versus a cat that has not. No difference as long as there is not any underlying kidney damage. PU surgery is a permanent fix but it will not stop bladder stones from forming so a urinary blockage is still possible. Keeping him on a prescription diet ONLY is the best option to prevent recurrence of the problem.

This is only done in very severe cases that do not resolve or in cases that tend to reoccur too often, is this the first time it happened? if so you should first explore traditional treatment, and by the way in cats UTI is actually not very common, urinary blockage is usually caused by a condition called FLUTD which is related to stress and causes bladder inflammation.

The good news is he is passing urine well. When he was blocked the bladder got enlarged and now he doesn't have the bladder tone and control to hold the urine inside and urinate under control. This should improve with time. There is also medication that can help so please talk with your veterinarian about trying some medication. Acupuncture may also help with the neurological control of the bladder. Thanks for using Petco Pet Education Center, formerly Petcoach to help you care for Newton.

Sounds like you all are doing quite a bit already. If you feel that pain is not well controlled the addition of something like buprenorphine may be beneficial. Also, there is a surgical procedure that is commonly performed on cats that get urinary blockages. Essentially the urinary tract is changed from a male to a female shape, thereby widening the urethra and making it much less likely to allow for obstruction in the future. Whether or not your vet is comfortable performing this procedure is another thing altogether. I know many vets that can perform it perfectly well while I know others that have never had to perform it a single time. It is a delicate procedure because the urethra of the cat is so small so finding a doctor that is comfortable with it is of utmost importance. If your cat is not a repeat offender or has not yet blocked completely, surgical change may not be the best option at this time. Continue following the directions of the doctor and be patient with waiting for dissolution. You can also consider lithotripsy to break apart stones if there are any instead of bladder surgery. Hope this helps.

Hello. Thank you for using Petco Pet Education Center, formerly Petcoach. I have never heard of this as a post-operative behavior from a perineal urethrostomy. I don't know if I would be concerned but I would say this needs to be monitored. You didn't mention how long ago the surgery was but if this behavior persists longer than 6 months then I would say you should consult a veterinary behaviorist. Hope this helps. Best wishes.