Bilateral Ectopic Ureters in a 6-month-old Labrador Retriever
Jennifer Lach
April 9th, 2014
Advisors: Dr. Marina McConkey and Dr. Antonia Jameson Jordan
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.
References:
1. Berent AC, Weisse C, Mayhew PD, et al. Evaluation of cystoscopic-guided laser ablation
of intramural ectopic ureters in female dogs. J Am Vet Med Assoc 2012;240(6):716-725.
2. Reichler IM, Specker CE, Hubler M, Boos A, et al. Ectopic Ureters in Dogs: Clinical
Features, Surgical Techniques and Outcome. Vet Surg 2012;41:515-522.
3. Smith AL, Radlinsky MG, Rawlings CA. Cystoscopic diagnosis and treatment of ectopic
ureters in female dogs: 16 cases (2005-2008). J Am Vet Med Assoc 2010;237(2):191-195.