If the terminal part of the ureter opens in any location other than in the bladder it is called an ectopic ureter.

The result of the ectopic ureter is persistent dribbling of urine.

CT scan is the best diagnostic tool used to diagnose ectopic ureters.

Surgery is recommended for this condition.

What is it?

• Ectopic ureter is an abnormally located terminal portion of the ureter.  Instead of the ureter opening in   the bladder, it opens in the urethra, vagina, or uterus.  The result is constant dribbling of urine. The sphincter or valve helps to keep the urine within the bladder. The ectopic ureter opens beyond the region of the sphincter.
• Urinary incontinence (leakage of urine) and ectopic ureters
• In a dog that has an ectopic ureter, urine flows down the ureter directly into the urethra instead of the bladder (see illustration below). As a result, these pets typically drip urine constantly. Because this condition is congenital, most of these dogs are incontinent when they are born. The problem may be first noticed after the puppy has been weaned from its mother, because she may constantly clean the puppy.
• Urinary continence is also maintained by a valve at the neck of the bladder called the urinary sphincter. About 50% of the dogs that have an ectopic ureter have an abnormally weak urinary sphincter, and are also incontinent due to this (urinary sphincter mechanism incontinence).

Anatomy

• The kidney is has many filters which drain urine down the tube to the bladder called the ureter.
• The urethra is a tube that passes urine out of the body from the bladder.

Clinical signs

• This condition is most commonly found in
  • females
  • Labrador retrievers
• Leakage of urine - the hind end will be moist all or most of the time; in the heat of the summer maggot infestation may occur
• If bladder infection is present, frequent urination and bloody urine may be noted.
• More common in large breed dogs such as Labrador Retrievers; very rare condition in cats
• Almost exclusively diagnosed in females

Diagnosis

• Blood tests such as a complete blood cell count and biochemical profile should be completed to make sure that the kidneys and other internal organs are healthy
• The urine should be analyzed for signs of infection
• Imagining studies:
  • Abdominal ultrasound allows visualization of the structure of the kidney
  • An excretory urogram is a dye test that outlines the path of the ureters.
  • CT scan is the best diagnostic tool used to diagnose ectopic ureters.
  • The CT scan below shows a dilated ectopic ureter (labeled E) located within the urethral wall.

Treatment

• Three procedures are done to correct the urinary incontinence
  1. Surgical re routing the ureter back into its normal location (the bladder)
  2. Surgical tightening the valve at the level of the bladder (sphincteroplasty)
  3. Surgical creation of a sling around the urethra using the vagina to help pull the bladder into a more normal position and to tighten the urethra (colposuspension)

Complications

• The most common complication is difficulty urinating after surgery as a result of swelling of the tissues; in such cases a urinary catheter may be left in place for a few days.
• Recurrence of urinary incontinence is seen in dogs that have no functional urethral sphincter.

Prognosis

• About 75% of the dogs will regain urinary continence with surgery. Some dogs will respond to the addition of a medication called phenylpropanolamine.

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