A vile sexual act in the same vein as the Cleveland Steamer or the Alabama Hot Pocket. To properly perform a Puget Sound Sausage, the male must excrete a good deal of liquid diarrhea into the toilet while his partner is unaware. Once the water is good and brown, the male dips his phallus into the diarrhea/toilet water mixture, then runs outside and sticks his member into his partner's mouth before he/she realizes the penis is covered in diarrhea.
"I straight up gave that slut a Puget Sound Sausage last night, son!"
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