Feline lower urinary tract disease or interstitial cystitis is common in cats. The complete etiology or cause of this syndrome is unknown, but some causative factors include stress, diet, environment, infection, and genetics. Some of these cats may become unable to urinate which is a medical emergency. Signs that your cat may exhibit if he is unable to pass urine are multiple trips to the litter pan, crying in the litter pan, inappropriate location of urinations, passing small amounts of blood in the litter pan, vomiting, and lethargy. Some owners will interpret the straining as constipation, so if your cat is straining in the litter pan it is important to make sure they do not have a urinary tract obstruction. Most cats are initially treated medically to relieve the obstruction (urinary catheterization) and fluid support. However, some cats will continue to have difficulty urinating or relapse days or weeks later and will need a perineal urethrostomy.

A perineal urethrostomy (PU) is the surgical formation of a permanent opening of the urethra at the perineal surface. The goal of this procedure is to widen and shorten the urethra which will decrease the likelihood of another obstructive episode. This procedure requires adequate exposure of the pelvic urethra, proper development of a drain board, and meticulous attention to suturing of the mucosa of the urethra to the skin and should be performed by a surgeon who performs the procedure regularly.

The most serious complication is stricture formation which requires a revision to the surgery site if it occurs. Stricture formation can be caused by making the stoma too small. There are other reasons for stricture formation such as self induced trauma from the cat licking at the suture line or urine leakage. Cats may have recurrent episodes of cystitis following a PU, however, they should not face a life threatening obstructive episode. Continued medical and dietary management are necessary is often necessary.

After your cat has a PU, he will be wearing an Elizabethan collar (E-collar) until the sutures are removed. This is to prevent him from licking to the incision line which can create excessive scarring at the site. Paper litter instead of clay or clumping litter should be used until the sutures are removed. It is common for a small amount of bleeding after surgery, however, this should not be excessive.

	Elizabethan collar