Ectopic Ureter in Cats

A normal urinary system starts with the kidneys which filter toxins from the blood and create urine. Urine then travels from the kidneys to the bladder via the ureter. The bladder stores urine until the bladder is emptied via the urethra. Normal cats are born with 2 kidneys and 2 ureters.

An ectopic ureter is when the ureter connection is displaced. Often, the ectopic ureter attaches to the urethra, after the bladder sphincter, which prevents voluntary control over emptying the bladder. In females, the ureter may empty into the uterus or vagina. Ectopic ureters can occur in one or both ureters.

Urinary incontinence is an inconvenience for the pet owner, but is not an emergency. Secondary complications from the condition, like repeated urinary tract infections and urine scald can become serious if left untreated. Prognosis in surgically treated animals is good, although some animals continue to have urinary incontinence after recovery.

Ectopic ureters are very rare in cats. In dogs, females are more likely to be affected than males, but in cats, both sexes are affected equally. It is believed that there is a genetic component to the disease that has yet to be discovered.

Urinary tract infections (UTI) are common with ectopic ureters, especially in females.

Symptoms of a UTI include:

• Frequent, small quantities of urination
• Abdominal pain.

Untreated UTIs can spread to the kidneys which can be fatal.

Ectopic ureters are caused when the urinary tract does not form properly during development in the womb. There appears to be a genetic component, but the pattern of inheritance has not been identified.

Incontinence may be characterized as occasional or continuous, urine leakage, and difficulty house training. Continuous dribbling of urine can also cause discoloration and constant licking around the genitals. Females may experience inflammation of the vagina and vulva due to continued scalding from the urine.

Some animals may have skin irritation due to urine scald, and are predisposed to urinary tract infections.

Depending on the location of the abnormality along the urinary tract, incontinence may only occur while the animal is active, or when in a particular position, like laying down on one side. Male cats may not show incontinence until adulthood. Some cats with ectopic ureter(s) are asymptomatic.

Diagnosis of an ectopic ureter requires elimination of other causes of incontinence, including bladder stones or urinary tract infections. This is done by physical examination, urinalysis, urine culture, and bloodwork. A specialist may be required.

Diagnostic imaging is required for confirmation of diagnosis and can include:

• Ultrasound
• Radiographs
• Urethrocystoscopy
• CT Scan

Ectopic ureters can only be corrected with surgery, where the ureter is moved to the correct attachment point on the bladder. Less invasive laser surgery is an option for some cats.

Animals that still experience incontinence after surgery may be prescribed medications to help them achieve better bladder control.

In rare circumstances a corrective surgery may block the urethra, causing urine to back up into the kidney, a condition known as hydronephrosis. Surgery is required to correct this, with severe cases requiring full removal of the kidney and ureter.

Without surgical intervention the condition is permanent. Prognosis is positive with treatment, although some animals may still experience incontinence even after successful surgery. The reason for this is unknown, but prescribed medications can help.

Ectopic ureters are congenital (meaning an animal is born with that defect). Affected animals should not be bred.

Ectopic ureters are not contagious.

Ectopic ureter(s) are very rare in cats.

• Surgery
• Medications for incontinence