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Urethral Shaft Abnormality in Dogs

Ectopic Ureter in Dogs

In dogs, an ectopic (displaced) ureter is a congenital anomaly where one or both ureters open into the urethra or vagina. Bilateral ectopia involves both ureters, while unilateral ectopia involves only one ureter. Dogs with ectopic ureters have their tubular shaft bypass the bladder floor (trigone) and enter through the bladder wall. In less common cases, the ureter opens into the bladder floor and extends as a trough into the urethra.

Certain dog breeds may have a predisposition to displaced ureters, including Labrador Retrievers, Golden Retrievers, Siberian Huskies, Newfoundlands, Bulldogs, West Highland White Terriers, Fox Terriers, and Miniature and Toy Poodles.

Symptoms

While this condition is rare, especially among male dogs, occasional cases may be asymptomatic, showing no evident urination issues. However, common symptoms to observe include intermittent or persistent incontinence, as well as vaginal inflammation (vaginitis) due to urine scalding the vaginal tissue.

Causes

The mode of inheritance for ectopic ureter remains unknown, though there seems to be a breed predisposition component associated with it.

Diagnosis

Your veterinarian will employ a diagnostic procedure called urethrocystoscopy, utilizing an insertable tube equipped with a camera. Through this method, the veterinarian can internally examine the dog’s bladder and visualize the opening into the urethra or vagina. Additionally, your veterinarian will inspect for perforations, depressions, striping, and tenting in the bladder, which may indicate urethral fenestrations.

When conducted with expertise, urethrocystoscopy allows for a more precise diagnosis compared to external imaging techniques like X-rays. Another method, urethral pressure profilometry, assesses surface variations to detect possible urethral muscle (sphincter) incompetence. However, it’s important to note that a displaced ureter could potentially complicate the interpretation of test results.

Treatment

Addressing an ectopic ureter typically involves surgical intervention, which may entail creating a new ureteral opening into the bladder or removing a blocked or severely infected kidney. If feasible, a portion of the displaced ureter will be excised, and the ureter opening (ureterocele) into the bladder repaired.

In cases where urethral muscle incompetence is present, incontinence may persist, and the muscles may be weakened to some extent during the recovery period following surgery. Some puppies with urethral muscle incompetence may gain control over urination after their first heat cycle. Additionally, it’s advisable not to spay incontinent dogs before their first heat cycle.

Living and Management

After surgery, your veterinarian will conduct follow-up assessments to evaluate its effectiveness. Internal imaging of the dog’s urinary organs and bladder, achieved by dye injection through the vaginal canal in females, will track the fluid and allow visual inspection of the surgical site’s healing. The colposuspension technique, involving the surgical elevation of the vagina to support the bladder neck where the urethra and bladder join, may be utilized to address incontinence.

If incontinence persists, medications such as phenylpropanolamine, an alpha-blocker, may be prescribed to improve urinary flow. Alternatively, tricyclic antidepressants like imipramine may be given to alleviate tension and pain. Reproductive hormone therapy may increase the sensitivity of urethral stress response receptors. Diethylstilbestrol, a nonsteroidal estrogen, may be orally administered to spayed bitches for urethral muscle control. In some cases, a combination of estrogen therapy and phenylpropanolamine may prove more effective for controlling incontinence.

In incontinent male dogs, steroid therapy may be recommended. Initially, testosterone propionate may be administered to assess the effectiveness of replacement therapy. For sustained action, testosterone cypionate can be used. However, reproductive hormone therapy is not advised for immature animals.

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