Tanwen – Ectopic ureter

Meet Tanwen – A 6 year old Welsh Springer Spaniel presented to the surgical referral team for investigation of vaginal discharge.

Tanwen is a 6 year old Welsh Springer Spaniel who was referred to our soft tissue surgeon Samantha Lane at Bath Vet Referrals for investigation of vaginal discharge which was initially thought to be prolonged oestrus but continued following neutering.

Clinical examination was normal but urine staining was present on the feathers of Tanwen’s hindlimbs. Routine blood tests and urinalysis showed no significant findings. Vaginal cytology was consistent with significant neutrophilic inflammation and oropharyngeal contamination. Tanwen’s blood progesterone was slightly elevated which is unusual in neutered bitches so a GnRH stimulation test was performed to rule out an ovarian remnant or other progesterone producing tissue. This was normal.

A CT IVU and retrograde vaginourethrogram was performed. This showed an intrapelvic bladder. The right ureter was opening normally but the left ureter was slightly dilated and the termination was unclear.

A trial treatment with Propalin (phenylpropanolamine hydrochloride) was initiated and Tanwen’s vaginal discharge improved for two years before Tanwen began leaking urine when asleep. Her usual vets added Incurin (estriol) but the urinary incontinence continued.

Tanwen was re-examined at Bath Vet Referrals and there were no significant findings on blood or urine samples. Abdominal ultrasound and abdominal radiographs were within normal limits (other than a caudally positioned bladder). Cystoscopy was performed and this showed a left sided ectopic ureter with associated urethritis. A paramesonephric septal defect was also diagnosed.

Surgical treatment of the ectopic ureter was discussed with the owner and Samantha Lane performed an exploratory coeliotomy and a left sided side-to-side neoureterocystotomy to create a new, normal urethral entry into the bladder.

The urethra beyond this was ligated to prevent ongoing flow of urine beyond the new urethral opening. The vaginal septum was not surgically treated as this is often an incidental finding during cystoscopy.

Tanwen recovered well from surgery and has not had any signs of urinary incontinence following surgery.

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