A 6 month old female intact Labrador retriever was referred to Cornell University Hospital for Animals (CUHA) Soft Tissue Surgery Service for evaluation of persistent urinary incontinence. The patient had been leaking urine consistently since she was acquired from a breeder at two months of age. Soon afterwards, she was treated by the referring veterinarian for a documented urinary tract infection with a six week course of cefpodoxime, followed by ciprofloxacin. Her infection resolved but there was no change in her clinical signs. She continued to leak urine throughout the day and night. The patient had otherwise been healthy, was up-to-date on vaccines, and her only medication on presentation was Advantage flea preventative.

On presentation, the patient was bright, alert and responsive, with vital parameters all within normal limits. On presentation, the only physical exam abnormalities noted were the urinary incontinence, urine soaked hind quarters, and pink wart-like nodules covering her vulvar and caudal abdominal skin. A problem list was formed and consisted of urinary incontinence and cutaneous plaques. Differential diagnoses for urinary incontinence in an intact female puppy include congenital abnormalities such as ectopic ureters, ureteroceles, or urethral sphincter mechanism incompetence. Other differentials include urinary tract infection, behavioral, or paradoxical incontinence.

Ancillary bloodwork was normal aside from a mild lymphocytosis. A urinalysis demonstrated dilute urine, and a urine culture was negative. A focal urinary tract ultrasound revealed bilateral ectopic ureters and moderate-to-severe ureteromegaly, bilateral, mild renal pyelectasia, and bilateral, questionable nephropathy. The patient was hospitalized for cystoscopy and definitive therapy. This presentation will discuss ectopic ureters, including the cause, prognosis, treatment options, and outcome of the case.