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Perineal Urethrostomy in the feline

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by

Christine Pengra

on 17 March 2015

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Transcript of Perineal Urethrostomy in the feline

Thank You!
What is Perineal Urethrostomy?
It is a surgical procedure that creates an opening in the urethra.
Is there any other options?
Some times diet and medication will help break down the uroliths however, that isn't always the case.

Other felines experience recurrent episodes and surgery is generally the best option.
Who does it effect?
Most affected cats are within 1-10 years of age.

Mostly male
Preoperative Tests
Why would perineal urethrostomy be performed?
By: Christine Pengra
Perineal Urethrostomy
in the feline

It is performed because the urethral opening is to narrow and or chronically obstructed.
Perineal Urethrostomy
What will be needed for the surgery?
Iris or tenotomy scissors
Small needle holders (Derf or Castroviejo)
Fine thumb forceps
8-french red rubber catheter or kelly hemostat forceps
4-0 or 5-0 rapidly absorbable monofilament sutures
sterile cotton swabs
magnification
Derf
8-French Rubber Catheter
Castroviejo
Suture
Kelly (straight)
Iris
tenotomy
How is the surgery started?
The cat is given a pre-anesthetic sedative-analgesic drug to help relax
IV anesthetic to to allow placement of ET tube.
CBC
Chemistry
to assess kidney function and blood potassium
radiographs
urinalysis
EKG (not always)
How long does the surgery take ?
It can take about 45 minutes to an hour depending on the case.
It can take longer depending on the severity or if there is trauma to the area.
May require an additional surgeon.
Perineal Urethrostomy
Position in dorsal recumbency
hindlimbs tied cranially until pelvis is slightly elevated
place towel under pelvis to support patient
place purse string suture in the anus
clip and aseptically prepair perineal region.
Possible complications of surgery :
bleeding or swelling in surgical site
Stricture (scarring or narrowing) of surgical site
can occur if cat traumatizes site
incomplete dissection or urine leakage under skin
UTI can occur within the first year of PU surgery
does not prevent uroliths or urolith formation
dysuria
pollakiuria *perineal urine extravasation
dehiscence * rectal prolapse
dermatitis
Aftercare:
paper litter would be used for about 7 days
if there is leakage under the skin, urinary catheter may be placed for 2-3 days
E-collar for about 7-10 days
Cats should be rechecked 1,3,6 and 12 months after surgery for UTI.
Frequently asked questions
How much does it cost?
between $1500.00 to $3000.00
What are the risks ?
risks are very low, the major risk is the general anesthesia, bleeding, and postoperative infections
What is the post operative care?
reduced activity until sutures are removed (10-14 days)
inspect area
E-collar
How long is the hospital stay?
about 2-3 days in most cases, in some extreme cases can be longer (1 week).
Will this stop uroliths from forming?
no, this will only help them pass the uroliths without becoming blocked.
S. Goh, BVSc, MS, Diplomate ACVS, C. S., & Seim III, DVM, Diplomate ACVS Colorado State University, H. B. (2014, July/August). Feline Perineal Urethrostomy Ventral Approach. TPV journal, 43-49.
PetPlace Veterinarians. (n.d.). What is a Perineal Urethrosotmy. Retrieved from http://petplace.com/cats/what-is-a-perineal-urethrostomy/page1.aspx
References:

Tobias, DVM,MS, Diplomate ACVS, University of Tennessee, K. M. (2007, March). Perineal Urethrostomy in the Cat. NAVC clinician's brief, 19-22.
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