Ectopic Ureter in Dogs: Veterinary Insights & Treatment Guide 2025 🩺🐾

By Dr. Duncan Houston BVSc

Hi, I’m Dr Duncan Houston BVSc, veterinarian and founder of Ask A Vet. In today’s 2025 veterinary series, we’re discussing ectopic ureters—a congenital anomaly where urine bypasses the bladder, causing incontinence and infections. I'll explain what it is, how it’s diagnosed, treatment options including innovative laser removal, and how Ask A Vet, Let’s dive in! 💙🐶

1. What is an Ectopic Ureter? 🤔

An ectopic ureter occurs when one or both ureters—normally connected to the bladder—connect abnormally to the urethra, vagina, or reproductive tract. Urine bypasses the bladder sphincter → continuous or intermittent urinary incontinence . This congenital defect does not resolve naturally.

2. Who is at Risk? 🐾

• Usually identified in young dogs under one year, but milder cases may surface in adults .
• Females are affected 4–20× more often than males .
• Breed predispositions include Siberian Huskies, Golden & Labrador Retrievers, Poodles, West Highland Terriers, Newfoundlands, and other terriers .
• Genetic basis suspected, but the mode of inheritance remains unclear .

3. What You’ll See & Feel 🕵️♂️

Look out for:

• Continuous or intermittent urine leakage, especially during resting or sleeping .
• Repeated urinary tract infections (UTIs) due to bypassed sphincter barrier .
• Excessive licking of genital area and urine staining .
• Behavior signs of discomfort or pain during urination .

4. How Vets Confirm Diagnosis 🔬

Suspect an ectopic ureter? A vet will:

4.1 Baseline Tests

• Physical exam and dog’s history .
• Urinalysis & culture to identify UTIs .
• Bloodwork to rule out metabolic conditions contributing to incontinence .

4.2 Imaging & Advanced Diagnostics

• Abdominal ultrasound or X-rays to screen for stones or structural anomalies .
• Cystoscopy (gold standard in females): camera-assisted scope reveals ureteral opening and may allow laser correction .
• Contrast-enhanced CT (most accurate in males) to trace ureter pathway .

5. Treatment Options 🛠️

Treatment focuses on repositioning the ureter into the bladder, plus managing infections:

5.1 Minimally Invasive Laser Ablation

• Intramural ectopic ureters: corrected via cystoscopy + laser ablation in the same session .
• Pros: less invasive, faster recovery, no external incision .
• Popular success: many regain continence, though ~50% may need post-op medication .

5.2 Traditional Surgery

• Extramural ureters: require open surgery—the ureter is transected and reimplanted into the bladder .
• Intramural cases sometimes use neoureterostomy or tissue resection with comparable outcomes .
• Invasive, with longer recovery and incision care .

5.3 Post-Treatment Medication

• Phenylpropanolamine (PPA): improves urethral tone—used in dogs with lingering incontinence .
• Estrogens like estriol benefit some cases, especially spayed females .

6. Prognosis & Recovery 📊

The long-term outlook depends on intervention type, concurrent urinary conditions, and individual healing:

• Laparoscopic laser success → curing incontinence in ~50–75% of dogs .
• Surgical correction success ~47–72%, with complication rates up to 26% .
• Persistent incontinence post-op often managed effectively with PPA or estriol (~50% may need it) .
• Males and bilateral hydronephrosis cases often have better surgical outcomes .

Laser cases usually resume normal activity quickly; open surgery needs about 2 weeks of activity restriction .

7. Aftercare & Monitoring ✅

• Urinalysis & culture every 4–6 weeks to monitor UTIs .
• Follow-up imaging: check ureteral placement and hydronephrosis resolution .
• Medications: continue if needed for incontinence control .
• Skin care: prevent urine scald with topical barriers and frequent cleaning .

8. Prevention & Breeding Best Practices 🌱

Ectopic ureters can’t be prevented after birth, but breeders should:

• Avoid breeding affected dogs or carriers .
• Encourage genetic screening for predisposed breeds—even though specific mutations aren’t fully identified .

9. Support from Ask A Vet💡

• Ask A Vet: Telehealth follow-ups, UTI prevention guidance, post-op check-ins.

10. When to Contact the Vet 🚨

• Persistent urinary leakage despite surgery or meds
• Recurrent UTIs or pyelonephritis
• Signs of kidney issues: pain, decreased appetite, vomiting, more thirst
• Discolored urine, symptoms of incisional issues

11. Final Thoughts 📝

Ectopic ureters are not emergencies but do impact quality of life through incontinence and recurrent infections. With early diagnosis and the right treatment—especially minimally invasive options like laser ablation—many dogs regain good urinary control. Where needed, post-op medications, long-term management, and support from Ask A 🐾💙

If your dog shows urinary dribbling or repeated UTIs, book a telehealth consult via AskAVet.com and download our app for ongoing care guidance. 🌟