Skeletal modifications after transpelvic urethrostomy as treatment for urethral stricture in a three-month-old cat

To describe the occurrence, management, and long-term outcome of bilateral lateral displacement of the ischial tuberosities following transpelvic urethrostomy (TPU) performed to treat intrapelvic urethral rupture and obstruction in a skeletally immature cat.

One 3-month-old male domestic short-haired cat.

Case report.

A young cat with intrapelvic urethral rupture secondary to repeated unsuccessful urethral catheterizations was initially managed conservatively and subsequently underwent perineal urethrostomy, which failed due to recurrent intrapelvic urethral stenosis. Transpelvic urethrostomy was then performed as a salvage procedure. Clinical follow-up included serial physical examinations, radiography, computed tomography (CT), orthopedic assessment, and owner-completed functional questionnaires over a three-year period.

The cat regained voluntary urination within 12 h postoperatively and remained continent. Follow-up radiographs at 2 months revealed bilateral lateral displacement of the ischial tuberosities, with pelvic width measuring 46.2 mm at the iliac wings and 55.7 mm at the ischial tuberosities, compared with a pelvic length of 79.6 mm. At 3 years, CT measurements showed dorsal acetabular rim angles of 16.9°-18.1° and an acetabular angle of 45°. Functional assessment demonstrated minimal musculoskeletal pain (feline musculoskeletal pain index [FMPI] = 2/72) and negligible disability (average disability score [ADS] = 0.75/16), with preserved locomotor function.

Transpelvic urethrostomy can be a feasible and effective surgical option for managing intrapelvic urethral rupture in skeletally immature cats. Although pelvic morphological alterations may occur following caudal pelvic symphyseal release, these changes were not associated with functional impairment in this case, highlighting the potential role of TPU as a salvage procedure in selected juvenile feline patients.