Ectopic Ureter Repair in Dogs

The ureters naturally drain liquid waste from the kidneys to the bladder. Some dogs are born with a genetic deformity that leaves their ureters draining to an improper place. It affects young, female dogs most commonly. Large breeds are more susceptible to this issue than small breeds. It is often noticed from birth or from when the dog is weaned and manifests as a constant drip of urine. Some dogs only experience incontinence when in certain positions.

Many owners seek treatment for this issue as the dog generally begins to smell of urine and is unable to stop urinating in the home. To repair this problem, surgery is often the only option. There are various invasive or non-invasive procedures that address ectopic ureters. As this is a rare condition, using an ACVS board-certified veterinary surgeon that specializes in urinary tract surgery is advised.

Ultrasounds, x-rays or, more often, CT scans are used to confirm the presence of ectopic ureters. This will help differentiate the issue from incontinence caused by USMI (a disorder or the urethra). All treatments of this deformity involve the use of general anesthesia. Full blood work will need to be run prior to the surgery to ensure that the dog is healthy enough to receive anesthesia. Urinalysis is also done to assess if there is blood passing into the urine. 

The dog will need to fast for several hours preceding the operation. A drug will be administered to sedate the animal, and an IV will be inserted. General anesthesia will then be applied to render the dog unconscious. If a laser ablation with cystoscopy is being performed, the ureters will be detached from the incorrect location and reattached to the bladder using a laser. This eliminates the need for an incision. If traditional surgery is being used, an incision will be made down the middle of the abdomen. The ureters will be sectioned from the urethra and sutured onto an incision to the bladder. Standard closure using sutures will end the procedure.

If the operation is performed correctly, an ectopic ureter repair can permanently correct incontinence in affected dogs. The ureters, once moved to their correct position, may operate properly for the remainder of the dog's life. During recovery, it is not uncommon for the dog to spot urine, however this can often be addressed using medication for a short period of time. The dog should be checked for USMI whenever ectopic ureters are present, as this disorder often occurs simultaneously and can also cause incontinence.

The dog should be monitored as it wakes from general anesthesia. The first urination will be watched to see if any straining or difficulty is present. Sometimes swelling may prevent normal urination, in which case a catheter will be placed until swelling goes down. A prescription for antibiotics may be given for the weeks that follow the surgery. To prevent the dog from licking at its incision, an Elizabethan collar can be used during the healing process. If any signs of infection develop, such as redness, swelling or pus, take the dog back to the surgeon immediately.

The cost of an ectopic ureter repair can vary greatly depending on who performs the operation and what procedure is chosen. For example, cystoscopy requires specialized equipment and training but may prevent the need for further surgeries or complications that lead to higher overall cost. CT scans tend to cost more than other forms of diagnostic imaging. Therapy medications are often prescribed after this procedure. The total cost of the repair may cost anywhere from $2,000 to $10,000 with average treatments costing $5,000.

Whenever general anesthesia is used, certain serious risks exist. With surgeries involving the urinary tract, urinary tract infections may develop. Complications arise in approximately 14% of dogs who receive this treatment. If the dog suffered from dilated ureters, this problem may worsen after surgery. Dysuria can be present in some instances. A small number of dogs experience kidney failure following an ectopic ureter repair. Success rates for this surgery range from 58%-75%. Surgery using laser ablation is associated with far less complications than traditional, incision-based surgery. 

As ectopic ureters are a hereditary condition, the only way to prevent their occurrence is to not breed dogs who suffer from this ailment. Inquire about the family health history when purchasing a puppy. Females suffer from this issue far more than males. All larger breeds can be affected by ectopic ureters, however Newfoundlands, Labrador and Golden Retrievers, Poodles and Siberian Huskies are especially susceptible.