Gee whiz!: an atypical unilateral ectopic ureter in a mixed breed dog

Abstract

An adult female spayed mixed breed dog was referred to the Cornell University Hospital for Animal’s Soft Tissue Surgery Service after being diagnosed with a unilateral ectopic ureter using Computed Tomography (CT) with contrast. The dog had been unresponsive to a low dose of phenylpropanalamine (PPA) prior to presentation. Previous urine cultures and urinalyses as well as repeat diagnostics were negative for urinary tract infections or other significant abnormalities indicating kidney dysfunction or systemic illness. The patient presented with severe urinary incontinence and muscle atrophy of the hind end due to bilateral hip osteoarthritis. Cystoscopy revealed an atypical urinary tract including a short and wide urethra, a paramesonephric band, and a right intramural ectopic ureter inserting into the urethra just distal to the neck of the bladder. A laser introduced through the cystoscope was used to ablate the ureteral wall until urine was visualized draining directly into the bladder. The urinary incontinence persisted and was not fully responsive to the maximum dose of PPA. The patient returned for the surgical insertion of an artificial ureteral sphincter known as an Hydraulic Occluder (HO). Her urinary incontinence resolved after inflation of the HO. Prognosis for this patient is fair as dogs with urinary incontinence and structural abnormalities of their urinary tract have increased incidence of recurrent urinary tract infections causing an increased morbidity. This paper will discuss the diagnosis, medical management and surgical options for ectopic ureter as well as the anatomy of the female canine urinary tract.