Ectopic Ureters in Dogs

Because the side effects of ectopic ureters are so similar to other illnesses, the veterinarian will probably go ahead and treat your puppy for one of these, such as a urinary tract infection. However, your pet will not respond well to the medication if it is ectopic ureters, so the veterinarian will likely decide to do more extensive testing to determine the problem.

Ectopic ureters are a physical defect in one or both of the ureters, which are the small tubes that travel from the kidneys to the bladder. Urine flows from the kidney into the bladder through these ureters, but sometimes one or both do not lead all the way to the bladder, so they bring urine wherever they do lead, which may be the uterus, vagina, or urethra. Because these other organs are unable to handle the storage of urine, this causes leakage, infection, and irritation of the urinary and reproductive system.

The signs of ectopic ureters are the same as many other conditions, such as urinary tract infection. These common signs include:

• Frequent urination
• Blood in the urine
• Urinary incontinence (dripping or leaking urine at times)
• Constant licking of the genitals
• Redness and rash in the genital area
• Repeated bladder infections

Types

There are two types of ectopic ureters:

• Bilateral includes both ureters
• Unilateral only includes one ureter

• Young dogs 3-6 months of age
• Females are 8 times more susceptible 
• West Highland White Terriers
• Fox Terriers
• Miniature and Toy Poodles
• Siberian Huskies
• Labrador Retrievers

Diagnosing ectopic ureters is usually a multi-step process because the symptoms are so similar to other conditions, such as urinary tract infections and vaginal infections. The veterinarian will likely talk to you at length about your pet’s health history even though it is probably not very long since this usually affects puppies under six months old. Next, a thorough physical examination will be performed including temperature, weight, reflexes, pupil reaction time, blood pressure, heart rate, respirations, breath sounds, and abdominal palpation. Also, a urinalysis, complete blood count, biochemistry profile, and glucose level will be done. The most important steps in diagnosing this condition are the imaging, which include:

Intravenous Pyelogram (IVP)

This procedure is done after clearing the intestinal tract by fasting and performing an enema. The veterinarian will inject dye through an intravenous (IV) tube and watch it travel through the kidneys and ureters to see where it ends up.

Ultrasound

This test looks at the echoes of sound waves to see if the urine is entering the bladder as it should be.

CT Scan (contrast enhances computed tomography)

This is similar to the IVP, but it is more detailed and can show exactly where the ureters are attached. This test is very accurate, but also more expensive than the other two tests, so this is usually done if the other tests are inconclusive.

Cystoscopy

If the other tests are inconclusive, the veterinarian may decide to do a cystoscopy. This is done by inserting a small camera on the end of a probe to look inside the bladder, vagina, and uterus to find where the ureters are attached.

Treating the ectopic ureters usually includes an operation to attach them to the bladder as they are meant to be. This may be done with laser ablation, laparoscopically, or open surgery.

Neo Ureterostomy

This procedure is only done if the ureters are attached to the bladder but do not penetrate. The veterinarian will create an opening for the ureter to empty into the bladder the way it should. This procedure is not always successful because of the invasiveness and the incontinence will continue, leading to another treatment.

Neoureterocystostomy

When the ureters are attached somewhere else, this procedure is done to remove them and connect them to the bladder the way they should be.

Nephroureterectomy

This procedure is only done as a last resort if the kidney is damaged or infected beyond repair. The kidney and ureter will be removed completely, but only if the other one is normal.

Laser ablation

This procedure is not offered in many veterinary practices because of the special equipment needed. This is only done if the ureters enter the bladder but do not penetrate and continue inside the bladder wall, opening up in the vagina or urethra. Another alternative to the laser ablation uses both the laser and the cystoscope to help guide the laser.

Your puppy will probably remain in the hospital for at least 24 hours for observation and pain medication. Once your pet is ready to go home, be sure you understand all the directions given by the veterinarian. You will likely be sent home with medications and you need to follow the instructions completely. A follow up examination will be scheduled for 7-10 days later, but call the veterinarian if you have any questions or concerns.