How to Care for Your Dog After a Urethrostomy
What Is a Urethrostomy?
A urethrostomy is an invasive but often life-saving procedure that is performed to relieve a urethral stricture—which leads to the inability to pass urine. This procedure is performed in humans, cats and dogs.
The procedure is typically performed in dogs that have reoccurring kidney stones or urethral blockages that cannot be catheterized. Depending on the reason for the procedure, a urethrostomy can be temporary or permanent.
The end result of a urethrostomy is that your dog will urinate from an alternative urethral opening made by the vet. The good news is that stones can no longer cause an obstruction or urethral stricture. The bad news is your pet is going to need extra care as they will be more susceptible to conditions such as urinary tract infections.
How Is a Urethrostomy Performed?
In intact male dogs, the scrotal urethrostomy procedure will begin with neutering. Once the male is neutered, the vet will make an incision site at either the penile body or perineum. This is called a perineal urethrostomy. The difference between these two will be the location of the urethral opening.
An incision is made over the penile body through subcutaneous fat tissues to recover the urethra. The urethra is incised, brought to the surface and sutured to the surrounding muscle tissue. In a tidy scrotal urethrostomy, sutures are placed starting in the corners and then the sides making a neat oval opening. In a perineal urethrostomy, the end result is not as tidy but works the same.
Typically, your pet will be hospitalized and kept sedated for a day or two after the surgery. They will be prescribed pain and anti-inflammatory medication as well as antibiotics.
Bringing Your Pet Home After Surgery
As mentioned, most dogs will be kept in hospital for a day or more after surgery. Sadly, this doesn't always happen. My experience was that my dog was released to me less than three hours after his emergency surgery because the clinic was closed the next day.
If you have your pet housed for a few days at the vet, they often keep them sedated. Your pet will have time to start healing and will be much better off for the trip home. You will want to have a towel or two down in your back seat as your dog may be lightly bleeding from his op. site. If you do not usually allow your pet in your car, please do so on this occasion! Your pooch needs to be kept calm, comfortable and warm.
You will want to have tissues on hand! If your pet urinates between the vet and the car, you will have to dab the surgical site because urine will scald the raw flesh and will not only be painful but may also cause infection. Be prepared to keep this practice up long term.
If you have the same unfortunate circumstances as I did, you are likely not yet mentally prepared for the state your beloved pet will be in. Your pet won't stand or walk properly, and he or she will likely very sore, confused and scared. If this happens to you, it's nice to be told what to expect. I know I wasn't expecting it—and I found the whole ordeal to be very traumatic for both of us!
In the case of an early release, pack the car with towels and old blankets—I cannot emphasize this enough. My back seat still has a big, dry blood stain on it from the day I brought my dog home only hours after his surgery. Also, ensure it's warm for your pet! The anesthetic makes it difficult for the dog to regulate their own body temperature naturally. So bringing a blanket for them is a must (if you live in a cold region).
If you have a smaller pooch, I'd recommend using a doggy carrier for this journey. However, If your dog is too big for such a thing, consider picking him up and carrying him if he has trouble or pain walking.
Because your dog needs to be kept calm and their movement restricted, it is best to make the trip home a team effort. Have someone drive and have someone hold the dog! Be careful not to overexcite or stimulate them with too much of a fuss.
Post-Operative Care at Home
It takes as many as six to eight weeks for the urethrostomy site to properly and completely heal. This time frame depends on the level of care you provide and how well your dog copes. The following tips will help you through this difficult time.
Expect bleeding: It is normal after a urethrostomy but can be alarming for owners. The incision itself and the urethral opening will bleed. Bleeding will increase with excitement, urination and pooling (if the dog has been asleep for a few hours, blood can build up and release all at once when the dog rises). Managing this bleeding in your home is difficult! Be preemptive and have old towels, blankets and 'puppy training pads' lining the areas where your dog will be to avoid stains. If stains do happen, I found dishwashing detergent helped bring the blood back out.
In the interest of keeping your dog still, food and water can be hand fed to your pup within the first 48 hours. Water can be given in the form of ice chips. Food should be bland. My vet recommended chicken breast without the skins. After the first two days, your pet should be able to eat from a bowl on their own. But there is no harm in prolonging hand-feeds.
Keeping your pet still while they heal is a mission in itself! Some dogs are prescribed sedatives to help with this. If you have not received these, you can request them or try to manage activity in other ways. Make an area where the dog is restricted and has everything he needs. Treats can be given to preoccupy your pooch, but select things that will last a long time and avoid overindulging them.
It's important you keep a close eye on your pet and make sure they aren't scratching or licking their wounds. A 'no lick' or bitterant may be used to help deter your dog from licking, or an Elizabethan-style collar or 'cone' may be worn. If your vet didn't give you these, you can buy them at any pet store.
During post-op healing, you should supervise your dog's bathroom outings. Make note of any difficulty or discomfort they have and relay this to your vet at checkups. Blood may be seen with urination, and urinating can sting. Take a generous amount of tissues or toilet paper with you to pat dry the surgical site and surrounding area. And don't forget a torch if it's nighttime!
Urine on or near the surgical site can cause infection and irritate the skin. Even after patting your pet dry, a saltwater rinse of the area is advisable after bathroom outings. Large syringes can be bought at pharmacies and make helpful tools for this purpose. It's also just plain kinder if you use warm water!
Permanent Extra Care
Now that your pooch's urethra has been re-routed and has an alternative, man-made exit, bladder stones should pass without causing future issues. Unfortunately, though, he or she will be more susceptible to urinary tract infections (UTIs). The skin on and around the opening can also be very sensitive and, therefore, vulnerable to irritation and future skin complications. So it is important that you take extra care and precautions on a full time, permanent basis.
As much as my dog's veterinarian said he would learn to squat instead of lifting his leg, I've found two years later he still hasn't. Because he had a perineal urethrostomy, his urine can come out more like a sprinkler than a stream. Unfortunate, I know. Because of this, I use gentle baby wipes to clean him after he goes. Bathing him more frequently also is a good way to help take care of his skin. These simple practices will help prevent skin irritation and assist in avoiding UTIs.
Even with good care, it is important to keep an eye on things. Look carefully at your dog's post-op site to observe for any skin inflammation or other problems. It's also necessary to monitor your dog's urination occasionally. Checking for colour and unfortunately, smell too. If you think your dog's urine seems concentrated or off, grab a sample and make an appointment with your vet. If that's not doable, make regular checkups to be on the safe side. UTI's can easily be treated with antibiotics and having a sample ready will be more convenient for both you and your vet. Of course, the vet staff will be happy to do this for you but may charge more money.
These practices seemed overwhelming to me, especially in the beginning. But the routine becomes easier as time goes on so stick with it. Your dog will heal and get used to the new situation. This maintenance and good care will ensure your dog lives a happy and comfortable life regardless of their unfortunate experience with a urethrostomy.
This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.