I'm the proud owner of two dogs: a Chihuahua-Papillon cross and an American Staffordshire. I am an animal lover and advocate in general.
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 providing the procedure was successful.
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.
Questions & Answers
Question: We had that surgery two years ago. We have experienced all those situations normally and everything was normal. But yesterday I noticed a little blood on his new hole. The pee is coming normally but after that, there is a little blood in it. I'm observing him. It's the second day, and this morning he has blood there again. What has caused bleeding after my dog's urethrostomy?
Answer: If you know of any trauma your dog could have caused to the site, such as scratching or can see breaks in the skin where blood is coming from, then I would hope it's from superficial abrasions. However it sounds more like the blood is following through with the stream of urine. Which is cause for concern! Since stones should pass easily after a urethrostomy, blood could be a sign of a urinary tract or bladder infection. You'll need to make an appointment with your vet as soon as possible and take with you a sample of freely-caught urine for analysis. A vet can give appropriate antibiotics to treat the infection.
Question: My 2 year old American Staffordshire just had a urethrostomy done. Total penile amputation and stoma created. How old was your dog when he had surgery? I see this article was in June of 2019 I was going to ask if he returned to normal dog activities after. I’m also curious about how long dogs had a normal life after, if years. That may not apply if your dog just had the surgery.
Answer: This article was last updated June of 2019 but was originally written in 2016, which was when my dog had his surgery. He is now 6 years old and definitely returned to normal activities. He eats his typical diet, still goes for walks and runs, still plays the same as always.
Caring for him has gotten easier however, I still wipe him with baby wipes after he does a wee and bathe him more frequently. We also do a routine vet visit and urine analysis every six months.
I hope your pup is back to his normal self soon! It takes time, patience and above all love. I hope this answers your question and wish you and your pup the best of wishes on your journey.
Question: Your article was so helpful. My dog, 10 yr. just had a PU 2 days ago. I am so alarmed at the amount of blood! I read this is normal and you seem to also express this in describing your experience. I have noticed that his gums are quite pale as well. I am hoping that I am worrying about something that is completely normal. Is this amount of blood normal for a dog after a urethrostomy?
Answer: I am sorry you are having to experience this but assure you, you'll both get through it. An unbelievable amount of bleeding is unfortunately quite normal for several weeks into recovery. Scary, I know. However pale or white gums are always due cause for making an appointment with your vet. Post-surgery follow-ups are usually free or at least cheaper than a normal consult. And it's better to be safe than sorry. Good luck with your journey and be sure to check out my later articles concerning life after Canine Urethrostomy and future care.
Stephanie Purser (author) from Australia on July 26, 2020:
I'm unable to answer your question with any medical knowledge or certainty. But am able to tell you you're vet's taking the appropriate action, as are you by seeing your vet.
My dog (who is a few years post urethrostomy now) still gets a little bit bloody from time to time but I usually treat as though from grinding and am able to see raw skin it may be coming from. But also I feel like the skin there's not biologically designed for its new purpose and may just be particularly weak/sensitive.
I'm sorry I cannot provide any better information. I wish you all the best for your doggy!
Salomé Meyer on July 23, 2020:
My dog had his urethrostomy 2 years ago. There is regularly signs of blood from the opening - sometimes even fresh blood. I’ve had him at the vet - no sign of trauma or infection, but we treat precautionary for UTI. Where is it coming from and what causes it? He now has a rash in the groin area as well!
Stephanie Purser (author) from Australia on May 05, 2020:
Thank you. Three weeks is early to expect any major improvement with toileting. Your dogs likely still sore and urinating/defecating can both be uncomfortable. Give it more time. Once healed (in another 3-4 weeks), I'd expect you to begin seeing some improvement.
However in the case of urinating in an unfortunate manner, typically on themselves like a sprinkler instead of a stream, I'm afraid depending on the vet's handy work it could be possibly permanent. Several years on from his procedure, my dog still requires a clean down with baby wipes. Time will tell.
Best wishes for you and your pooch.
Oana on May 05, 2020:
Hi. Did you noticed any changes on your dog related to his routines after the surgery? I mean it's 3 weeks now and he still pees uncontrollably and also with the poop..i am worried now..
Very useful article by the way.
Have a good week!
Stephanie Purser (author) from Australia on October 28, 2019:
Heavy bleeding in the first six weeks from the operative site is generally normal. It's also very normal for bleeding to increase when your pooch poops. Providing the blood comes from the operative site. If the blood is coming from the dogs rectum at all or has persisted longer than six weeks, I would advise to contact the vet straight away.
It's absolutely normal to be frightened by the bleeding. I know I was. The recovery from a urethrostomy is very confronting for both you and your pet. So give your pooch lots of reassurance and love.
Be sure to see your vet for post operative check ups. And express your concerns of course.
Rajath on October 28, 2019:
Hi I had my dog a perineal urothostomy. We area lot of bleeding when he pass stools. Or if some one he likes he gets excited and it bleeds too much... Can you please tell is it normal?? And how will it take for the blood to stop completely and never appears again? Please inform me .. I'm scared.
Check the mother regularly for signs of infection or other health concerns for a few weeks after birth. Vaginal discharge should taper off and stop by about three or four weeks after birth. Contact your veterinarian immediately if her discharge appears red and smells foul, her nipples appear red and swollen or if she appears shaky and drools excessively.
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- Speak with your veterinarian when your dog delivers all of her puppies to know what behavior is normal and what's not after birth. That way you'll know when to call in case of emergency.
- You can also use clean newspapers or old sheets in place of towels in the whelping box.
- Bring everything your dog likes or needs near or into the whelping box so she doesn't have to leave her puppies during the early weeks.
- Some mother dogs will be very protective of their litters, so always be careful when interacting with mother and babies in the first few weeks after birth.
- Do not expose the mother and puppies to the possibility of infection or illness by inviting everyone you know to see the cute little family. Every visitor carries any number of bacteria and viruses, which could pass to the puppies and mother and make them sick. Wait until the puppies are at least a month old before exposing them to visitors.
Jane Williams began her writing career in 2000 as the writer and editor of a nationwide marketing company. Her articles have appeared on various websites. Williams briefly attended college for a degree in administration before embarking on her writing career.
Perineal Urethrostomy Prevention in Dogs
There is currently no known method of prevention for urinary stones. Some veterinarians have found limited success in reducing the amount of protein in the diet. In most cases, the cause of stone formation is unknown. Affected animals should be eliminated from the breeding pool to prevent passing on of any genetic conditions.
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Identifying the Need for Perineal Urethrostomy (PU) Surgery
Mucus, crystals, and urinary bladder stones in your pet’s urine can easily clump together to form a plug in the urethra. Sometimes a blockage in the urethra can be relieved by using a catheter to push the plug back into the urinary bladder. If this cannot be successfully done, then a perineal urethrostomy must be performed in order to save your pet’s life. If catheterization has been needed on multiple occasions to remove a plug, your vet may suggest PU surgery as a preventative strategy. In any case where a plug is caused by a stone and the stone is pushed back into the urinary bladder, a different surgery, called a cystotomy must be performed to remove the stone from the urinary bladder. That way the stone will not roll back into the urethra causing another blockage.
We will need a copy of your vet’s medical notes and x-rays before getting you on our schedule. So please have your vet e-mail or fax those notes and x-rays to us.
An x-ray must be provided to be sure no stones are in the urinary bladder before performing a PU. We do not offer x-rays at Helping Hands, so they must be provided by your regular veterinarian.