Case Study

Bilateral ectopic ureters and bilateral renal dysplasia in a 8 month old Labradoodle

This 8 month old F Labradoodle dog hs a history of urinary incontinence

Urinalysis: USPG 1.017, pH 5.5, WBCs 11-20/hpf

This 8 month old F Labradoodle dog hs a history of urinary incontinence

Urinalysis: USPG 1.017, pH 5.5, WBCs 11-20/hpf

DX

Bilateral ectopic ureters likely entering into the pelvic urethra. Left renal dysplasia – severe. Right renal dysplasia – mild.

Image Interpretation

The left kidney is severely dysplastic, subnormal in size 2.38 cm with severely disrupted architecture and disrupted pelvis. The right kidney presented pyelectasia 0.5 cm and subnormal in size at 4 cm with loss of corticomedullary detail and minor disrupted architecture strongly consistent with primary renal dysplasia.

Urinary bladder was structurally unremarkable; however, both ureters were dilated and appeared to enter into the pelvic urethra and bypass the trigone.

Outcome

Endoscopy guided laser ablation of the ureters would be the least invasive method of approaching this case. Renal values should be monitored carefully. The left kidney is likely minimally metabolically present; however, the right kidney may be adequate to sustain quality of life for some time in this patient depending upon renal values. Urine culture and sensitivity and treatment for chronic UTI is warranted as well. Chronic UTI Protocol: I recommend Enrofloxacin (5 mg/kg SID PO) in late pm after urination to maximize urinary concentrations overnight. This assumes that culture supports this use. Repeat culture at 3-4 weeks and continue treatment at least 7-10 days post negative urinary sediment and negative culture. Note: Negative culture does not necessarily mean lack of UTI. Other favorite antibiotics for chronic UTI include third generation Cefa (Ceftiafur or similar sid injectable) or Clavamox. If suspicion of occult urinary incontinence is present then phenylpropanolamine (PPA) (1-2 mg/kg BID) can be employed long term to enhance urethral tone.
This exam qualifies as an unfit for sale for breeding purposes. This line should be investigated for further evidence of renal dysplasia and ectopic ureters prior to any breeding.