Ureteric ectopia

The ureter ectopia or ureter ectopia is a congenital malformation of the ureter that occurs mainly in dogs and appears to be hereditary in some breeds . Bitches are affected much more often than males.

Pathophysiology

In a healthy dog, the ureters flow into the bladder within the trigonum vesicae (urinary bladder triangle) , where the urine is retained by the urethralis muscle until micturition . In ectopic ureter is the mouth of one or both ureter below this sphincter , and takes opens into the urinary bladder into the urethra , the vagina or the uterus . Because the urine cannot be retained, urinary incontinence occurs , which manifests itself in constant light dripping of urine. Local skin irritation and ascending urinary tract infections can occur as complications .

clinic

Signal element

The disease is more common in Norwegian elk dogs , Siberian huskies , Newfoundland dogs , golden and Labrador retrievers , West Highland white terriers , fox terriers and miniature poodles , but can occur sporadically in all breeds. Bitches are affected eight times as often as males. Most cases are presented between the ages of three and six months.

Symptoms

The main symptom of ureter ectopia is urinary incontinence with constant urine dripping. Animals with one normal and one ectopic ureter also show normal urination behavior, while animals with bilateral ectopic ureters cannot urinate normally. The constant dripping of urine can cause skin irritation and infections in the vagina and vulva in bitches , which can rise up to the kidneys.

Males are less likely to develop symptoms because they can usually compensate for bypassing the urethralis muscle with the internal urethral sphincter , which runs the length of the urethra .

diagnosis

Diagnosis is made by injecting a contrast medium into the bloodstream , which is eliminated through the kidneys. The path of the contrast agent through the kidney and ureter to the urinary bladder can be traced by means of X-rays . If there is an ectopic ureter, the x-rays show its course past the bladder to its mouth. At the same time, this diagnostic method also allows the presentation of any additional anomalies in the urinary tract, such as hydronephrosis .

Therapy and prognosis

Curative treatment is carried out surgically . If the ureter is unilateral, a nephrectomy of the affected kidney can be performed, especially if complications such as hydronephrosis or pyelonephritis are present. In the case of bilateral ectopia of the ureter, the treatment of choice is a transplantation of the ectopic ureter openings into the urinary bladder, whereby a functionally normal situation can be achieved in the urinary tract. Transplantation is also possible with unilateral ectopia if the kidney on the affected side is normal.

Nephrectomy is contraindicated in the case of bilateral ectopia of the ureter and unilateral ectopia with a contralateral kidney that is not completely healthy . In such cases, treatment consists of transplanting the ectopic ureter orifice into the urinary bladder.

In mild cases, urinary incontinence can also be treated symptomatically, for example by giving phenylpropanolamine or ephedrine .

With successful surgical treatment, the prognosis is good. Occasionally, complications such as persistent urinary incontinence or dysuria and hydronephrosis occur.

Genetics and Breeding Hygiene

The inheritance of ureteral ectopia in dogs is not known; it is believed to be a polygenic disease. Affected dogs should not be used for breeding; Matings that resulted in pups with ureteral ectopic should not be repeated.

literature

• Ureteral anomalies. In: The Merck Veterinary Manual , 9th Edition, Whitehouse Station, NJ, USA, 2005, ISBN 0-911910-50-6 , p. 1254
• Ectopic ureter in the dog. In: Pareys Lexicon of Syndromes - Hereditary and breeding diseases of domestic and farm animals . Parey Buchverlag, Berlin, ISBN 3-8263-3237-7 , p. 179

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !