Goals of Treating Ectopic Ureters
The primary goal of treating ectopic ureters is to mechanically create a new ureteral opening so that urine can collect in the bladder and then exit the body through the urethra as normally as possible. Of course, other goals are to relieve the dog’s discomfort and to eliminate or at least reduce the owner’s frustration caused by the accompanying incontinence. Ectopoic ureters typically can be treated surgically. This involves rerouting the ureter into the urinary bladder and then tacking (suturing) it in the proper place. Obviously, it is important to have the pathways from the kidneys to the bladder actually end in the bladder, if incontinence and chronic urine dripping are to be corrected.
Many veterinarians recommend that incontinent female puppies not be spayed before their first heat cycle; sometimes, their condition resolves on its own under that hormonal influence. There are no realistic medical (drug) therapies for ectopic ureters. Even with surgery, affected animals may remain incontinent, depending in large part upon the status of their urethral sphincter mechanism which plays a huge role in the voluntary withholding or passage of urine. There are a few medications that may help to reduce incontinence, depending on its cause. For example, antibiotics can help to clear up a urinary tract infection (UTI) which can contribute to incontinence. It is very important to treat UTIs before any surgical correction is contemplated. However, this will not “treat” or “cure” the ectopic ureter itself.
If there are severe secondary complications from an ectopic ureter, such as an infected or otherwise damaged kidney, the affected ureter and kidney may need to be removed. Depending upon the location of the particular abnormality, techniques to surgically correct ectopic ureters are delicate, at best. Most general veterinary practitioners will not see a large number of these cases during their careers and therefore will refer the owners and their pets to skilled soft tissue surgical specialists.
Surgical correction of ectopic ureters is successful in roughly 50% of the cases. Incontinence continues in about 50% of animals, but tends to be reduced. Only a few dogs show no improvement after surgery.