What are Ureteral Anastomosis?

Ureteral anastomosis in dogs is a surgical procedure commonly used in cases of trauma and scarring to the ureter. Ureteral anastomosis is also common in situations where a previous abdominal or pelvic surgery was performed. 

The ureter allows urine to pass urine to the bladder from the kidneys. The goal of a ureteral anastomosis is to remove any ureter damage or remove any damaged parts of the ureter.

Ureteral anastomosis is a recommended procedure when it comes to dogs who have previously undergone other abdominal or pelvic surgery. In fact, the need for a ureteral anastomosis is quite common in dogs who have undergone these procedures. This is even true for dogs who have undergone simple surgical procedures such as an ovariohysterectomy (spay). 

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Ureteral Anastomosis Procedure in Dogs

Prior to performing a ureteral anastomosis, a veterinarian must examine the dog. In addition to a physical examination, the dog will also undergo several imaging procedures. Imaging may include radiography and ultrasonography. 

On the day of the ureteral anastomosis procedure, the dog is put under anesthesia. In most cases, pain medications are also delivered via an IV. After being placed under anesthesia, the dog is laid on his or her back. During an ureteral anastomosis, the knees are usually slightly bent. 

Once the dog is in place, before the first incision, a catheter is inserted into the dog’s urethra. The bladder is then filled with an antibiotic of some sort. In order to retain the antibiotic in the bladder, the catheter is used to clamp the bladder closed. 

An incision that is about 7cm is then made near the bladder. This incision will expose the thin outer layer of the bladder walls. Another incision is then made near the bladder walls, causing the antibiotic to suction into the bladder. The bladder will then be emptied. 

After the bladder is empty, the ureter will be brought up to the incision of the bladder walls. Any part of the ureter that is not healthy is removed. Sutures are then placed through each end of the remaining healthy ureter. The sutures are then passed through the outer, thin layer of the bladder walls. 

Now that the ureteral anastomosis is complete, a catheter is placed. A suture is then used to stitch the ureter to where the incision began. The area over the ureter is then sutured closed, followed by the suturing of the original surgical incision. 

Efficacy of Ureteral Anastomosis in Dogs

Ureteral anastomosis in dogs is quite effective. There is rarely a case in which a dog has any type of urological complications following the procedure. The effect of this surgery is quite permanent in dogs. Especially since damaged ureter is removed during the ureteral anastomosis. 

Ureteral Anastomosis Recovery in Dogs

It is recommended that the catheter remain in the dog for at least two days following an ureteral anastomosis. Since this is the case, veterinarians require most dogs to stay at the clinic for at least 48 hours. Depending on the severity of the dog’s case, it may be longer.

During the dog’s stay at the veterinary clinic he or she may receive different treatments. These treatments may range from pain management to IV fluids. In some cases, antibiotics may be required after an ureteral anastomosis. 

After the procedure, it may take some dogs a few weeks to show signs of improvement. That’s why it’s important to follow all aftercare instructions the veterinarian provides you with. Usual aftercare following an ureteral anastomosis consists of the dog wearing an Elizabethan collar and crate rest. Some dogs may require a special diet following the procedure. 

Many times following this surgery veterinarians will prescribe antibiotics and/or pain management to be given at home. They also usually require the dog to return for a follow-up exam about two weeks after the ureteral anastomosis. 

Cost of Ureteral Anastomosis in Dogs

Ureteral anastomosis in dogs may cost anywhere from $900 to $3,000 or more for the procedure itself. The cost of the procedure will vary depending on the cost of living where the surgery is being completed. 

In most cases, the final surgery cost includes the procedure, IV administration, hospital stays, medications during the stay, and vital sign monitoring. 

Other costs should be considered when pricing an ureteral anastomosis. These costs may include veterinarian visits before and after the surgery as well as any treatment needed prior to or following the ureteral anastomosis. 

Dog Ureteral Anastomosis Considerations

Generally, an ureteral anastomosis is a safe surgery. As a result, there aren’t many complications reported following the procedure. Depending on the cause of needed the surgery, it may be a life saving procedure for a dog. Especially if the parts of the ureter that are removed are found to be cancerous. 

There are not many risks associated with an ureteral anastomosis aside from typical general surgery risks. These risks may include, but are not limited to sensitivity to anesthesia and infection. The most common risk following the surgery is ureterovesical reflux. But, thanks to advancements in the ureteral anastomosis surgery, this is rarely seen. 

The potential to need further treatment following the procedure depends on different factors. These factors may include how severe the case was/is and how the dog is recovering. 

Ureteral Anastomosis Prevention in Dogs

In most cases, ureteral anastomosis is recommended when the ureter is damaged and/or there is an obstruction of the ureter. 

Obstructions of the ureter range from stones to tumors. These can cause damage to a dog quickly if not treated right away. In some cases, there may be some changes that can be made for the dog to avoid these obstructions. 

Dogs who often have urinary tract system problems may require a special diet. Finding the right food for your dog may reduce the chance of needing an ureteral anastomosis later on. 

Dog owners should also monitor their dog’s behavior and well being on a regular basis. If any changes are noticed, a veterinarian should be contacted right away. Changes that you definetly be considered include straining to urinate, blood in urine, inappropriate urination, change in appetite, and/or vomiting and diarrhea.