🩺 Vet Guide 2025: Ectopic Ureters in Dogs – Causes, Diagnosis & Surgical Solutions 🐶💧

By Dr Duncan Houston, BVSc

🔍 What Are Ectopic Ureters?

An ectopic ureter is a birth defect in which one or both ureters—tiny tubes that normally carry urine from the kidneys to the bladder—connect to the wrong location. Instead of attaching to the bladder, these ureters may empty into the urethra, vagina, or elsewhere, causing urine leakage. 💦

📋 Common Symptoms

• 🚺 Incontinence in young female puppies
• 💧 Constant dribbling of urine
• 🩸 Recurrent bladder infections (in 64% of cases)
• 🧼 Licking of the vulva or penis due to irritation

Normal urination is often still observed, making the condition tricky to distinguish from house-training issues or UTIs.

🔬 Diagnosing Ectopic Ureters

1. Initial Testing

• 🔬 Urinalysis and urine culture to rule out infections
• 🩺 Bloodwork to assess kidney function

2. Imaging

• 🩻 Radiographs: For structural assessment and contrast studies
• 💉 Intravenous Pyelogram (IVP): Highlights ureters with contrast dye (60–70% accurate)
• 🔊 Ultrasound: Useful if ureters are dilated but less definitive
• 🧠 CT Scan: Most accurate but more expensive and less widely available
• 🔎 Cystoscopy: Camera inserted into the bladder and urethra, allows for direct visualization and laser treatment

⚠️ Why It Matters

Without proper treatment, ectopic ureters often cause lifelong incontinence, chronic infection, and discomfort. While surgery or laser ablation doesn’t always guarantee full continence, it significantly improves quality of life and reduces complications. 🛡️

💡 Treatment Options

1. 🔬 Laser Ablation (Minimally Invasive)

Best for intramural ectopic ureters (tunnel inside the bladder wall but exit incorrectly). A cystoscope with laser cuts the ureter opening to the correct location.

• ✅ Outpatient procedure in many cases
• 💧 ~60% of females may still need additional incontinence therapy
• ♂️ Males typically regain full continence

2. 🔪 Neoureterostomy

Used when the ureter connects incorrectly to the bladder wall but hasn’t fully entered. A new opening is created and the malformed portion is removed.

• ⚠️ Sphincter damage is possible
• 🩺 May require follow-up treatment for incontinence

3. 🩻 Neoureterocystostomy

When the ureter bypasses the bladder entirely, this surgery redirects it properly into the bladder. Both kidneys may be impacted, increasing the risk of renal damage if healing is poor.

4. ❌ Nephroureterectomy

If the kidney is damaged beyond function, it and the ureter are removed—only performed if the other kidney is healthy.

🏥 Post-Surgical Recovery & Outcomes

• 🛏️ Hospitalization for several days after surgery
• 🧴 Urinary catheter for 1–2 days
• 💊 Pain relief and antibiotics at home
• 🕐 Healing period: 2–3 weeks for bladder; ~6 weeks for ureteral swelling

👉 55% of dogs show improved continence after surgery. Total resolution rates vary (33–58%), but medications post-surgery are often more effective than before correction.

🔁 When Surgery Isn’t Enough

• 📈 Reassess with IVP or imaging if incontinence persists
• 💊 Medications (e.g., phenylpropanolamine, estrogen supplements)
• 🔧 Additional surgery if needed to support the bladder neck or urethra

🧪 Why Early Detection Matters

Correcting ectopic ureters early helps prevent kidney damage, infections, and emotional distress for both pet and owner. Puppies with signs of persistent incontinence should not be dismissed as “difficult to house-train.”

📲 Final Thoughts from Dr Duncan Houston

Ectopic ureters are a rare but important cause of incontinence in young dogs—especially females. While not every case ends with full continence, today’s laser and surgical options offer real hope for both dogs and their families. Don't wait—early diagnosis means better outcomes. 🐶💙

📲 Need Help Deciding Next Steps? Ask A Vet

Concerned your puppy may have ectopic ureters? Chat now with Dr Duncan Houston and our team of licensed professionals on the Ask A Vet app. We're here to guide you through diagnostics, referrals, and treatment options. 🐶💬