Ectopic Ureters in Dogs & Cats
What are ectopic ureters?
The ureters are the small tubes that carry urine from the kidney to the bladder. Normally they enter the bladder around the neck area, allowing it to fill with urine which is subsequently excreted. In some dogs and cats the ureters enter in the wrong place, hence the term "ectopic."
This means that the urine may not go directly into the bladder and may enter into the urethra (the tube from the bladder to the outside world) or into another part of the urinary or reproductive system.
Most (95%) ectopic ureters are 'intramural' which means that the tube connects to the bladder at a relatively normal location but travels within the wall of the bladder or urethra and opens at the wrong point. Some ectopic ureters will be 'extramural' meaning they attach and open at the wrong point. The (badly drawn) diagrams demonstrate both of these types.
Many dogs with ectopic ureters will also have other concurrent urinary tract abnormalities, including a short urethra or persistent membranes. This means that fixing the ureter may only be one part of controlling incontinence.
What clinical signs do ectopic ureters cause?
Ectopic ureters are the most common cause of urinary incontinence in young, female dogs, and this is the most common presenting sign. It can also be identified in older dogs.
However it can also be associated with recurrent urinary tract infections, kidney abnormalities and the formation of bladder or kidney stones.
How are ectopic ureters diagnosed?
Ectopic ureters are often strongly suspected based on the presentation (young, female dog with incontinence) although not all cases are so obvious.
Certain breeds are also predisposed, including Golden Retrievers, Labrador Retrievers, West Highland White Terriers, Miniature Poodle & Siberian Huskies.
Various diagnostic tests can be used to confirm ectopic ureters, which may include a combination of:
Do ectopic ureters need to be treated?
Most people do elect to treat this condition if identified as these dogs are often very incontinent.
There is also a risk of long-term complication if left untreated, including permanent kidney damage.
How are ectopic ureters treated?
Traditionally this disease was managed surgically, requiring opening of the abdomen, however complication rates are not insignificant. For that reason we now manage appropriate cases with an alternative interventional procedure called cystoscopic laser ablation.
This is a much less invasive option than traditional surgery with excellent success rates. However it is only appropriate for intramural ectopic ureters and so traditional surgery is still required in some cases.
If you have any further questions about ectopic ureters, feel free to contact me through the site.