The kidneys produce urine continuously and the tiny pipelines through which the urine is transported from the kidneys to the bladder are the ureters (one for the left kidney and one for the right kidney). The bladder stores the urine until it can be voluntarily unloaded.

Ectopic ureters are a congenital error in the development of the ureters. Instead of connecting to the bladder, the ureters connect directly to the urethra. The ureters are then bringing urine to an area that is unable to store urine and leaking ensues. One or both ureters can be affected.

Ectopic ureters are commonly diagnosed in puppies and mostly female dogs (female to male ratio: 20:1). Often clinical signs include urine leaking/dribbling almost constantly or intermittently, discolored fur around the vulva. Licking of the genital area (irritation from urine) and recurrent urinary tract infections.

Several diagnostic tools can be used to diagnosed ectopic ureter in dogs.

1. Abdominal ultrasound: The normal ureter is too small to be seen with ultrasound. If the ureter is distended, it provides some clues that one may be dealing with an ectopic ureter. In female dogs, about 50% of the dogs will have dilated ureter(s); in male dogs up to 80%. However, a lack of ureteral dilation does not exclude the possibility of an ectopic ureter.

2. Cystoscopy: Cystoscopy is the diagnostic method of choice for the diagnosis of ectopic ureter in females dogs (less so in male). Cystoscopy employs a tiny camera on the end of a probe which can be used inside the urethra, vagina, or bladder to locate the ureteral openings. An advantage of cystoscopy is that laser ablation (see below) can often be performed during the same anesthesia thus confirming and correcting the problem all in one procedure.

3. CT scan: CT scanning is an excellent diagnostic method for the diagnosis of ectopic ureters especially in male dogs. It is highly accurate and reveals the exact location of the ureter attachment. This form of imaging also requires general anesthesia.

Several treatments are available for the correction of ectopic ureter(s).

1. Cystoscopy-assisted laser ablation: Cystoscopy-assisted laser ablation is a less invasive approach with less incidence of post-operative incontinence when compared to surgery. Laser ablation is best used for “intramural” ectopic ureters (most common type). These are ureters that start to enter the bladder where they are supposed to but do not actually penetrate all the way in. Instead, they continue inside the bladder wall and open up in the urethra. The laser will be used to cut/ablate the ectopic ureter (s) back into the bladder. Most patients are able to leave the hospital within 12-24 hours after the procedure. Males typically become urinary continent (80%) but some 40% of females ultimately require additional treatment to remain continent.

2. Surgery: Surgery is recommended in cases where the ectopic ureter is considered “extramural” i.e. directly attach to the urethra (i.e. no tunneling). Extramural ectopic ureters are rare (1%) and their path is often determined at the time of the cystoscopy or CT scan.