Urinary blockages are one of the most urgent and dangerous medical emergencies in male cats. Without immediate care, a blocked urethra can lead to kidney failure or bladder rupture within just 24 to 48 hours. In cats with recurring obstructions, Perineal Urethrostomy (PU) surgery can be a life-saving procedure that provides long-term relief and restores comfort.

At the Veterinary Emergency and Specialty Center of Northern Arizona in Flagstaff, AZ, we specialize in advanced surgical care for cats facing urinary emergencies—including PU surgery. Here’s what every cat owner needs to know.

Why Are Male Cats at Higher Risk for Urinary Blockages?

Male cats have a longer, narrower urethra than females, making them more prone to obstructions. A small amount of crystals, mucus, or inflammation can completely block urine flow—turning a painful issue into a life-threatening one.

Learn more from International Cat Care: Urethral Obstruction in Cats

Common Causes of Urinary Blockage in Cats

Urinary obstruction is usually multifactorial, but these are the most common culprits:

  • Urinary Crystals or Stones – Struvite or calcium oxalate crystals can combine into stones that obstruct the urethra.
    Learn more: ACVS Guide to Urinary Stones
  • Mucous Plugs – A sticky mix of mucus and inflammatory cells can block the urethral passage.
  • Urethral Inflammation or Spasms – Often related to feline lower urinary tract disease (FLUTD) and exacerbated by stress.
  • Urinary Tract Infections – Can lead to inflammation and debris buildup.
    Cornell Guide to UTIs in Pets

Recognizing Signs of a Urinary Emergency

Prompt recognition can save your cat’s life. Call your vet or seek emergency care if your cat shows:

  • Frequent, unproductive attempts to urinate
  • Straining or vocalizing in the litter box
  • Blood in the urine
  • Vomiting, lethargy, or loss of appetite
  • A painful, firm abdomen
  • Hiding or aggression from discomfort

What Is Perineal Urethrostomy (PU) Surgery?

PU surgery involves removing the narrow penile portion of the urethra and creating a wider opening in the perineal region. This helps prevent future blockages and allows the cat to urinate more freely.

It is typically recommended when:

  • A cat has multiple urinary obstructions
  • The urethra becomes permanently damaged or scarred
  • A blockage cannot be resolved with catheterization

For more, read Hill’s Pet Guide to PU Surgery

What to Expect: PU Surgery & Hospitalization

Pre-Surgical Stabilization

Before surgery, we stabilize your cat with:

  • IV fluids to support kidney function
  • Pain relief and antibiotics to manage infection and inflammation
  • Diagnostics like bloodwork, urinalysis, and imaging

The Procedure

Performed under general anesthesia:

  • The penile urethra is removed
  • A new, wider urethral opening is created in the perineum
  • The surgical site is sutured carefully to ensure proper healing

ACVS Overview: Urinary Obstruction & PU

Immediate Post-Op Care

  • Hospitalization for 24–48 hours for monitoring
  • Urinary catheter may be used to prevent strain
  • Continued pain control and IV fluids

Home Care After PU Surgery

Your Post-Op Checklist

  • Use paper or non-clumping litter to prevent wound contamination
  • Limit activity to prevent pulling stitches—confinement is often needed
  • Monitor the incision daily for redness, swelling, or discharge
  • Watch for urination issues like straining, blood, or licking

Nutrition & Hydration

Prevent recurrence with diet changes:

  • Prescription urinary diets that reduce mineral content
  • Canned food and water fountains to boost hydration
  • Avoid fish-based or high-magnesium diets

Signs of a Complication

Call your vet if you notice:

  • No urination within 24 hours of returning home
  • Persistent bleeding
  • Excessive licking at the surgical site
  • Signs of pain or fever

Long-Term Management: Preventing Future Blockages

Even after surgery, urinary health requires lifelong care:

  • Encourage hydration through wet diets and multiple water sources
  • Reduce stress, which can trigger FLUTD—Feliway diffusers and routine help
  • Maintain regular checkups for urinalysis and weight management
  • Treat UTIs promptly, if they occur. Learn more: UTI Prevention & Care – Embrace

Why Choose Veterinary Emergency and Specialty Center of Northern Arizona?

Located in Flagstaff, AZ, we offer:

Know the Signs. Act Quickly. Prevent the Next Blockage.

Urinary obstructions are a painful and potentially fatal condition, but they are also highly treatable—especially when caught early. For cats with repeated blockages, Perineal Urethrostomy surgery offers long-term relief and a significantly reduced risk of recurrence.

If your cat is straining in the litter box, don’t wait. Call us or visit Veterinary Emergency and Specialty Center of Northern Arizona for expert evaluation and compassionate care.

Schedule a Visit or Emergency Consult Now