Case Study

Ectopic ureter, hydronephrosis, hydroureter, and ureterocele in a 3 year old MN Labrador Retriever

A 3-year-old neutered male Labrador Retriever dog was presented for evaluation of decreased appetite, possible polyuria and polydypsia, taking longer to urinate than normal, and hematuria. On urinalysis, isosthenuria (1.016), 3+ protein, white blood cells, and red blood cells were present. Stress leukogram was evident on CBC, but serum chemistry was within normal limits.

Sonographic Differential Diagnosis

Right ectopic ureter. Concurrent ureterocele at trigone. Complete hydronephrosis right kidney.
The changes are consistent with primary ectopic ureter.

Image Interpretation

Moderate right hydroureter was noted and traveled caudally. It appeared to start to enter into the trigone and then deviated cranially. A concurrent ureterocele was present, and there was an abnormal entrance of the right ureter. The right kidney had severe dilation of the renal pelvis and disruption of architecture with renomegaly, measuring 16.5 x 5.0 cm. Near complete cortical thinning was noted. Viability of the right kidney is in question. Echogenic debris was noted in the right kidney, which is suggestive of concurrent infection. The left kidney appeared fairly normal and measured 6.14 cm with normal cortex. Residual prostate was uniform.

DX

Hydronephrosis, hydroureter, and ureterocele

Outcome

None

Comments

Surgical transposition is possible; however, the viability of the right kidney is in question. Therefore, full right nephrectomy and right ureterectomy would likely be necessary in this patient. IVP or CT evaluation could be considered prior to surgical consultation.

Clinical Differential Diagnosis

Bladder pathology (bacterial cystitis, urolith), ectopic ureter, prostatic disease (abscess), renal pathology (pyelonephritis, renolith, hydronephrosis).