Bilateral ectopic ureters in a male dog with unilateral renal agenesis

A 1-year-old neutered male mixed-breed dog was evaluated because of signs of urinary incontinence. Retrograde positive contrast urethrocystography and excretory urography with pneumocystography revealed bilateral intramural ectopic ureters and absence of the right kidney. During abdominal exploratory surgery, only the left kidney was located. The left intramural ectopic ureter was repaired by neoureterostomy (creation of a new opening for the ureter to enable urine to empty into the bladder). The right ectopic ureter was ligated at its entrance into the urinary bladder serosa. Results of excretory urography (performed immediately after surgery and repeated 8 weeks later) revealed successful correction of the left intramural ectopic ureter. Twelve weeks after surgery, the dog remained continent. To the authors' knowledge, there are few reports of ectopic ureters in male dogs; furthermore, the urinary tract abnormalities detected concurrently in this dog are also unusual.     

PERCUTANEOUS ULTRASOUND-GUIDED PYELOGRAPHY AIDED DIAGNOSIS OF ECTOPIC URETER AND HYDRONEPHROSIS IN A 3-WEEK-OLD FILLY

Ultrasound-guided percutaneous pyelography has previously been used in dogs to diagnose ectopic ureter. To the authors' knowledge its use has never been reported in the horse. This paper reports the technique used in a three-week-old filly with a suspected ectopic ureter. Pyelography can be performed under sedation and is a relatively simple, safe procedure. The technique enables assessment of individual renal function through collection and analysis of urine from each renal pelvis.     

EXCRETORY UROGRAPHY AND ULTRASONOGRAPHY IN THE DIAGNOSIS OF BILATERAL ECTOPIC URETERS IN A FOAL

A 7-week-old Appaloosa filly was admitted for persistent urinary incontinence since birth. Vaginal speculum examination revealed urine flowing from an opening in the right vaginal wall. Cystoscopy demonstrated that the ureters did not terminate at the bladder. The endoscope passed easily from the vagina directly into a dilated right ureter. An excretory urogram confirmed the vaginal termination of at least one ureter, based upon extensive filling of the vagina with contrast media in the absence of bladder filling. Bilateral hydroureter and dilated renal pelves were demonstrated both by excretory urography and by ultrasonography. Euthanasia was requested by the owner in lieu of attempted surgical correction. At necropsy, it was confirmed that the right ureter entered the vagina and the left ureter terminated at the urethra. The diagnosis of bilateral ectopic ureter in this foal was suggested by the history and clinical signs, supported by endoscopy and ultrasonography, and confirmed by excretory urography and necropsy. This case establishes the value of diagnostic imaging techniques in the antemortem diagnosis of ectopic ureter.     

Extramural Ectopic Ureter in a Domestic Ferret (Mustela putorius furo)

Ectopic ureter is the most common cause of congenital urinary incontinence in the dog and cat. The occurrence of ectopic ureter in the dog has been estimated to be 0.016%. A 6-month-old ferret was evaluated for urinary incontinence and urine scalding around the perineal and inguinal areas. Ultrasonography showed a nondistended urinary bladder that contained a possible intraluminal blood clot. Excretory urography revealed a left ectopic ureter. The ferret was initially treated with oral amoxicillin-clavulanate and topical silver sulfadiazine ointment for the perineal and inguinal dermatitis associated with the incontinence. Because of the potential for complications and additional surgery with ureteral transplantation, a left nephroureterectomy was performed. Surgical recovery was uneventful and the incontinence improved, although a small amount of incontinence-associated dermatitis was still present 24 days after discharge. Phenylpropanolamine therapy was initiated to address a suspected dysfunction of the urethral sphincter. Urinary incontinence improved with the phenylpropanolamine therapy; however, a small amount of incontinence persisted throughout the 3 months in which the ferret was evaluated. To the authors' knowledge, this is the first report of an ectopic ureter in a domestic ferret.     

Delayed-onset urinary incontinence in five female dogs with ectopic ureters

This case series describes five female dogs with congenital ectopic ureter presenting with delayed-onset urinary incontinence out of 22 female dogs diagnosed with ectopic ureter over a 102-month period at a veterinary teaching hospital. All five dogs improved following surgical treatment of ectopic ureter, but only three remained continent long-term without further intervention. Delayed-onset urinary incontinence in female dogs with ectopic ureters may be more common than the current literature suggests. Congenital ectopic ureter should be considered and investigated as a possible contributing factor in female dogs presenting with delayed-onset urinary incontinence.     

Ultrasonographic diagnosis of unilateral ectopic ureter in a Labrador dog

A 3-month-old, Labrador bitch presented with urinary incontinence. A unilateral, ectopic ureter was diagnosed with ultrasound without the aid of additional contrast radiographic techniques. Ipsilateral hydroureter and mild hydronephrosis were also present. At the level of the bladder trigone the ectopic ureter became intramural and this was clearly demonstrable with ultrasound. The opening of the ectopic ureter into the proximal urethra was, however, not visualised owing to its intrapelvic location.     

ULTRASONOGRAPHIC FINDINGS IN 14 DOGS WITH ECTOPIC URETER

To evaluate ultrasonography as an alternative to contrast radiography for diagnosis of ectopic ureter in dogs, ultrasonography of the urinary tract was performed prospectively in a series of urinary incontinent dogs anesthetized for contrast radiography. Fourteen dogs had ectopic ureter based on surgical, necropsy or unequivocal contrast radiographic findings. There were eight females and six males of a variety of breeds; five were Labrador retrievers. Mean (range) age at the time of diagnosis was 1.2 (0.2–4) years for females and 3.5 (0.3–5) for males (p < 0.05). Ectopic ureters were unilateral in five dogs (2 left; 3 right) and bilateral in nine dogs. Both ultrasound images and contrast radiographs were positive for 21 (91%) ectopic ureters; the same two ectopic ureters were not detected using either modality. The termination of each of the five normal ureters was visible on ultrasound images; two (40%) were visible on radiographs. Other ultrasonographic findings included dilatation of the ectopic ureter and/or ipsilateral renal pelvis in ten (43%) instances, evidence of pyelonephritis in two dogs (with enlargement of the contralateral kidney in one dog), and urethral diverticuli in one dog. Ultrasonography is a practical diagnostic test for ectopic ureter in dogs. In this series there was close correlation between the ultrasonographic and contrast radiographic findings for each ectopic ureter, but ultrasonography enabled more accurate determination of normal ureteral anatomy.     

Ectopic ureter in a dog: extension from the kidney to the urinary bladder and to the urethra

An ectopic ureter extending to the urinary bladder and to the proximal portion of the urethra was diagnosed in a 6-month-old dog with urinary incontinence. The diagnosis was made by use of excretory urography. The kidney and ureter were removed. When urinary incontinence continued, positive-contrast cystography was performed. The ectopic ureter was found to bypass the bladder via a submucosal extension that emptied into the urethra.     

Four cases of lowered urethral pressure in canine ectopic ureter

To evaluate the function of the constrictor urethrae of dogs that had urinary incontinence and were diagnosed as having ectopic ureter, the urethral pressure profile (UPP) was measured by means of a microchip catheter transducer. The UPPs (14.5 +/- 3.3 mmHg) of the four dogs suffering from ectopic ureter were much lower (p<0.001) than the UPPs of clinically healthy female dogs (35.3 +/- 5.7 mmHg). In the cases of ectopic ureter, it was shown that the UPP was lowered, and it was suggested that this would lead to the expression of urinary incontinence.     

Unilateral Nephrectomy in a Juvenile Llama

Objective —The purpose of this study was to decribe the clinical presentation, diagnostic evaluation, and surgical management of a llama with an ectopic ureter.
Animals or Sample Population —Nine-month-old female llama.
Results —The diagnostic evaluation included the use of computed tomography and an excretory ureterogram to confirm and identify the location of the ectopic ureter. Surgical management involved a unilateral nephrectomy.
Conclusions and Clinical Relevance —Computed tomography is a valuable asset to diagnose the presence and terminal location of an ectopic ureter in llamas, and nephrectomy appears to be a viable procedure to resolve the subsequent urinary incontinence.     

Surgical treatment of a duplicated and ectopic ureter in a dog

An eight‐month old female bull mastiff was referred for evaluation of urinary incontinence. Contrast‐enhanced computed tomography identified complete duplication of the left ureter with ectopic insertion of the duplicate ureter into the proximal urethra. Ureteroneocystostomy was performed, which improved but did not resolve urinary continence. To the authors’ knowledge, this report details only the second reported case of duplicated ectopic ureter in the dog and the first documenting surgical reimplantation; thus, double‐system ureteral ectopia should be considered as a possible differential diagnosis for urinary incontinence.     

Ectopic ureter in the horse: Three cases and a review of the literature

Ureterovesicular anastomosis resulted in resolution of the clinical signs of urinary incontinence in three horses with unilateral ectopic ureter. Follow-up of two of the horses ten months and three years later indicated no further urinary tract problems; the third horse died four days after surgery from intestinal infarction.

Diagnosis can be readily confirmed by antegrade or retrograde ureterography, or endoscopic visualization of the ectopic ureteral openings. Nephrectomy appears indicated in cases of unilateral ectopic ureter with associated ipsilateral urinary tract infection or hydronephrosis, providing the contralateral kidney has normal function. Ureterovesicular anastomosis appears to be indicated in the management of unilateral ectopic ureters in the absence of ascending urinary tract infection or hydronephrosis, and in cases of bilateral ectopic ureters.

     

Ectopic ureterocele in a cat

A 9-month-old, castrated male domestic shorthair cat with urinary incontinence was referred for surgical correction of an ectopic ureter. Excretory urography revealed hydronephrosis of the right kidney, right hydroureter, and ureterocele. A partial ureterocelectomy and neoureterocystostomy were performed. This report describes the surgical modification of the ureterocele and ectopic ureter to correct ipsilateral hydronephrosis, hydroureter, and urinary incontinence.     

Urinary incontinence due to ectopic ureter in a male dog.

Urinary incontinence was associated with an ectopic ureter in a 5-month-old, male Wire Fox Terrier. The dog regained urinary continence after transplantation of the ureter from the urethra into the urinary bladder. Of the 3 reported cases of extopic ureters in male dogs, 2 have been associated with urinary incontinence. These observations do not support the hypothesis that ectopic ureters are more frequently recognized in female than in male dogs because urinary incontinence is more commonly associated with the disorder in female dogs.     

Ectopic ureter in a male cat

A male cat with persistent urinary incontinence is described. Definitive diagnosis of unilateral ectopic ureter was obtained by intravenous urography, after which surgical re-implantation of the ureter into the bladder was performed. The literature on ureteral ectopia in cats is discussed.     

Ectopic ureter in a male cat

A male cat with persistent urinary incontinence is described. Definitive diagnosis of unilateral ectopic ureter was obtained by intravenous urography, after which surgical re-implantation of the ureter into the bladder was performed. The literature on ureteral ectopia in cats is discussed.     

Evaluation of transurethral cystoscopy and excretory urography for diagnosis of ectopic ureters in female dogs: 25 cases (1992-2000)

OBJECTIVE: To evaluate transurethral cystoscopy and excretory urography for diagnosis of ectopic ureter in female dogs and identify concurrent urogenital abnormalities. DESIGN: Retrospective study. ANIMALS: 25 female dogs. PROCEDURE: Medical records of female dogs that underwent transurethral cystoscopy, excretory urography, and ventral cystotomy were reviewed for signalment, history, physical examination findings, results of bacteriologic culture of urine, and surgical findings. Videotapes of transurethral cystoscopy and radiographic studies were reviewed systematically without knowledge of surgical findings. RESULTS: Ectopic ureters were diagnosed in 24 of 25 (96%) of the dogs, bilaterally in 22 of 24 (91.6%) dogs. Cystoscopic evaluation yielded a correct diagnosis in all dogs when results of ventral cystotomy were used as the diagnostic standard. Cystoscopic evaluation identified a terminal ureteral opening for all ureters. Urethral fenestrations, troughs, striping, and tenting were identified. Abnormalities of the vestibule were identified in all examinations available for review (24/25). The paramesonephric septal remnant and its association with ectopic ureters were identified and characterized by cystoscopy. Radiographic findings were discordant with surgical findings and correctly identified 36 of 46 (78.2%) ectopic ureters and 2 of 4 normal ureters. Hydroureter and renal abnormalities were associated with distal urethral ectopic ureters on radiographic evaluations. CONCLUSIONS AND CLINICAL RELEVANCE: Transurethral cystoscopy was accurate and minimally invasive for identification and classification of ectopic ureters in dogs. Contrast radiography had limitations in diagnosis of ectopic ureters. Cystoscopic findings and associated vaginal and vestibular abnormalities support abnormal embryologic development in the pathogenesis of ectopic ureters.     

Unilateral renal agenesis associated with additional congenital abnormalities of the urinary tract in a Pekingese bitch

An eight-month-old Pekingese bitch with urinary incontinence was found to have three congenital anomalies of the urinary tract: left renal agenesis, bilateral ectopic ureters with a left cranial blind-ending ureter, and urinary bladder hypoplasia. The diagnoses were made by retrograde vaginourethrography, excretory urography, ultrasonography and duplex Doppler ultrasonography. Although urological anomalies associated with renal agenesis have been frequently observed, a cranial blind-end ectopic ureter has not, to the authors' knowledge, been described in the bitch. The dog was managed medically with a restricted protein diet because of a compromised unilateral kidney with hydronephrosis and hydroureter.     

The use of computed tomography in the diagnosis of an ectopic ureter in a Quarter Horse filly

This report describes a 4‐month‐old Quarter Horse filly with an ectopic ureter. The filly presented with signs of urinary incontinence, which had been present since birth. Computed tomography (CT) examination and cystoscopy confirmed a diagnosis of a unilateral ectopic ureter. A nephrectomy of the left kidney was performed and renal function was closely monitored post operatively. The filly was treated for abdominal chylous effusion as a post operative complication. The filly survived to discharge from the hospital, and maintained normal urinary function at 12 months post operatively.