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The Exam RoomBy The VeterinaryPracticeNow Desk3 min readAugust 11, 2026
The PU complication rate every practice should benchmark against
140 cats, four teaching hospitals, and the finding that changes how you counsel owners before the surgery.
A multi-institutional retrospective of 140 cats undergoing perineal urethrostomy found that 37.8% experienced a complication within 90 days, but none of the variables tested predicted which cats would have problems.
What the study found
Fifty-three of 140 cats (37.8%) experienced a complication perioperatively, immediately postoperative, or within 90 days of discharge. The most common complications were hypotension (15 cats), urinary tract infection (11 cats), and urethral stricture (five cats). Two cats were euthanized and one died during hospitalization. No risk factors were identified that were statistically related to the development of complications or survival to hospital discharge.
How the study was built
Retrospective, multi-institutional study across four university teaching hospitals, January 2009 through December 2019. The researchers collected signalment, history, clinical signs, catheter duration, reason for the PU, initial bloodwork, surgery and anesthesia times, postoperative catheter placement, and complications up to 90 days. This is observational evidence, it can show association, not causation, and it cannot tell you what would have happened to these cats under a different protocol.
The number, and its error bars
The abstract reports the 37.8% complication rate and the breakdown by complication type, but does not provide confidence intervals, p-values, or odds ratios for the tested risk factors. The finding that no risk factors reached statistical significance means the study could not distinguish cats at higher risk from those at lower risk using the variables it measured.
What the authors say it cannot tell you
The authors conclude that cats undergoing PU most commonly developed minor complications, and that no risk factors were identified that were associated with the development of those complications. The abstract does not state additional limitations, which is itself a limitation, a reader of the abstract alone cannot assess selection bias, loss to follow-up, or whether the study was powered to detect clinically meaningful differences.
Who paid for it
The abstract does not state funding source or conflicts of interest.
What this means for your practice
VeterinaryPracticeNow's read, not the study's. Everything in this section is our editorial interpretation for practice owners. The study does not claim any of it.
The complication rate reported here is the number to use when you're counseling an owner before a PU. It's a teaching-hospital figure, so your practice's rate may run lower, but it's the most recent multi-institutional benchmark we have, and it's honest about minor complications that resolve. The fact that no tested variable predicted complications means you can't stratify risk in the exam room, the study found no way to separate higher-risk from lower-risk cats using the data it collected.
For the associate DVM, this is useful when an owner asks whether waiting another day on the catheter changes the surgery's risk profile, this dataset found no association. For the owner-DVM, the hypotension cases are the reason your anesthesia-monitoring protocol matters, and the UTI cases are the reason a post-op recheck belongs in your protocol. The deaths and euthanasias reported are the outcome range that belongs in your consent form.
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