Ectopic Ureters

n ectopic ureter is when the ureter (the tube that connects the kidney to the bladder) does not enter the bladder in the correct anatomic position. In normal anatomy the ureters leave the kidney and attach to the bladder at the rear third of the bladder.  Both cats and dogs can be born with this condition, however it appears to be more common in female dogs with some breeds such as Golden Retrievers, Skye Terriers and Labrador Retrievers.

The ectopic ureter may pass within the bladder wall tissue before entering the bladder in an abnormal location or the ureter may enter the bladder in an abnormal area without tunneling in the bladder wall.  Congenital abnormalities of the kidneys and urinary tract can also be observed in patients with ectopic ureters

Signs of ectopic ureters may include:

  • Continuous or intermittent urinary incontinence (leakage) or urinary accidents
  • Difficulty potty training
  • Urine leakage when lying down and/or sleeping
  • Urine leaking or dribbling at times but normal urination at other times
  • Excessive grooming of the genital area (urine leakage may have caused a rash in this area)
  • Bladder infection 

Ectopic Ureters may be diagnosed in several ways. 

  • Bloodwork: including a  complete blood count, chemistry panel, urinalysis and possible urine culture too look for bacterial growth
  • X-rays with a special dye called contrast. The contrast is given intravenously to help highlight the kidneys and urinary tract.  
  • Ultrasound to look for anatomic abnormalities
  • CT scan with contrast to evaluate the urinary tract 
  • Vaginourethrograpy with cystoscopy: a small camera is introduced into the vagina, urethra and urinary bladder to evaluate the distal ureteral openings, abnormal urine flow may be noted with this procedure as well. 

Depending on where the ureters are located treatment options can vary.  Surgical options for ectopic ureters that tunnel through the bladder wall may include surgical removal of abnormal tissue or cutting the ureter off of the exterior of the bladder and creating a new attachment and opening into the bladder at a more correct location. For ectopic ureters that attach in an abnormal location but are not contained within the bladder wall, treatment involves cutting the end of the ureter that attaches to the outside of the bladder and re-suturing it in a more proper location into the urinary bladder. Patients will often be hospitalized for several days postoperatively for pain control as well as to keep a urinary catheter in place to ensure the bladder stays empty during the first few days of healing. 

It should be noted that ectopic ureters are not common and that a urinary tract infection, submissive urination in puppies and difficulties with house-braking should always be ruled out as a cause for symptoms.