Suspected ectopic ureter

RE: Suspected ectopic ureter

Chris Milligan — Tue, 22 Jun 2021 21:35:10 GMT

Just saw Andrew's answer - I defer to specialist input; maybe we just got lucky with the ones we've done over the years!

RE: Suspected ectopic ureter

Chris Milligan — Tue, 22 Jun 2021 21:33:55 GMT

IVU is a really useful technique for these, and usually gives a very clear answer (literally lit up on the radiograph) if the rad sequence is performed at the correct intervals and you use enough contrast medium (use the maximum of the dose range - huge volume and scary to give quickly but will give you a good answer).

RE: Suspected ectopic ureter

Andrew Kent — Mon, 21 Jun 2021 08:34:13 GMT

Hi Charlotte,

Personally I am not a fan of contrast studies in this setting as they are rarely definitive so require other modalities to confirm and make decisions around treatment. In female dogs the best test for EU is urethrocystoscopy and that provides all the information we need to plan any procedures - I tend to offer ultrasound as well on the basis of some of these dogs also having renal dysplasia etc.

Most of these can also be treated cystoscopically using laser ablation - much less invasive and with results that are at least as good (if not better) than conventional surgery - so speak to a centre that can offer this if you can.

Not sure where you are but if they would be keen on referral then do send them my way - I perform all the laser cases here at Willows.

Happy to chat further if helpful,

Andy

RE: Suspected ectopic ureter

bob lehner — Sat, 12 Jun 2021 10:07:53 GMT

[quote userid="11308" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29880/suspected-ectopic-ureter/230755#230755"]I found IVU to be much more useful than retrograde - get some lovely clear images and the contrast going retrograde may obscure things, like how far the ureter tunnels through the bladder wall[/quote]

Can be satisfying when they work - but frustrating if you don't get it all timed right - not so easy if you are not very familiar with the process. Helped by good prep - enemas etc.

I think skilled urethroscopy, as Dinu says, would likely be gold standard these days?

RE: Suspected ectopic ureter

Dinu Catilina — Fri, 11 Jun 2021 18:43:25 GMT

Any chances for an urethroscopy? Most should be clearly visible on one.

RE: Suspected ectopic ureter

Clive Ansell — Fri, 11 Jun 2021 18:13:12 GMT

I think I would speak to the referral centre and see what they suggest or prefer in the way of imaging. It may be more sensible for them to do it all under one anaesthetic. Give the client the options, with costs, and see what they want to do.

RE: Suspected ectopic ureter

Anthony Dennison — Fri, 11 Jun 2021 16:21:34 GMT

I found IVU to be much more useful than retrograde - get some lovely clear images and the contrast going retrograde may obscure things, like how far the ureter tunnels through the bladder wall