Well, a year and a half after I wrote Help, My Cat Can't Pee on BlogHer, my sweet little black cat, Kizzy, almost died again from a total urinary blockage. Thankfully, before he blocked completely, we'd already decided to take the rather dramatic step of perineal urethrostomy surgery.
Cats become candidates for this crazy surgery after they've been blocked three or more times, according to my vet. A year ago, we thought we'd never do it. The surgery is drastic: The vet cuts off the cat's penis and tacks the sides of the urethra open wider with sutures. After those sutures dissolve, your cat has a nice wide urine highway right underneath his anus. (He's still a "he," technically, albeit a "he" with no penis.) (Genitals don't equal gender, anyway. Kizzy would like you all to know he is indeed, still a mancat.)
Kizzy went in for his third catheterization several weeks ago, and I talked to my husband before I took him about the threshold for surgery. Primarily we wanted to weigh how likely Kizzy was to face problems later in life, like incontinence or pain. Secondarily, we wanted to know how much the surgery would cost. We were already shelling out hundreds of dollars every time he was hospitalized for a blockage, so our tolerance for vet bills is high, but we weren't going to bankrupt my daughter's college fund or anything. Finally, we wanted to know if it would actually work.
I, of course, asked Dr. Google, and that's why I decided to write this post. I did see a lot of message boards, but I didn't find many blog posts that detailed someone's personal experience from beginning to end, and that's really what I wished for when I went looking.
After we agreed to the surgery (which in the Kansas City area cost around $1,200), Kizzy was scheduled for the next day. (He was already catheterized and they needed to let that flush out and make sure he was okay before they proceeded.)
The surgery itself was done by a vet who had done them before and had no real complications from any of her patients. She told me after the surgery that Kizzy had developed scar tissue again immediately after his catheter was removed for surgery prep, and she actually had to amputate the tip of his penis in order to insert the surgery catheter. So, in other words, he was 100% blocked and would've definitely died if we hadn't had the surgery. This removed any doubt I had about whether or not the risk was too great in retrospect.