Title: Pilot comparison of computed tomographic excretory urography, urogenital ultrasonography, and ureteropyelography for diagnosing ectopic ureters in dogs

Investigator:

Amber Harris, DVM, DACVIM
Joseph Bartges, DVM, PhD, DACVIM, DACVN
Veronica Chiu, DVM

If interested, please have your primary veterinarian request additional information from our Clinical Trials office at 706-296-7818 or through the University of Georgia (UGA) Internal Medicine service by calling the small animal referral coordinator at 706-542-5362.

Study description:

Ectopic ureters are a congenital abnormality in dogs resulting in one or both ureters bypassing the urinary bladder and emptying into abnormal locations typically within the urethra, leading to urinary incontinence and predisposing to urinary tract infections. There is currently no “gold standard” diagnostic method for the determination of type of ectopic ureter present (i.e. intramural vs. extramural). Currently, the standard of care is using computed tomography followed by cystoscopy for the evaluation of urinary incontinence in dogs. The ability to determine the presence of ureteral ectopia and type with the highest sensitivity and specificity is paramount in being able to provide the most appropriate treatment recommendation in the most efficient and fiscally responsible way, while minimizing anesthetic events for patients. This pilot study is designed to compare sensitivity and specificity of computed tomographic excretory urography (CTEU), ureteropyelography, and urogenital ultrasound for determining the presence and type of ectopic ureters in dogs.

Inclusion criteria:

• Clinical signs of urinary incontinence for at least 1 week’s duration
• Non-CT based diagnostic confirmation of the cause of urinary incontinence
• Diagnostic quality CTEU, ureteropyelography, and abdominal ultrasonography

Dogs presenting to the Internal Medicine service with urinary incontinence due to suspected ectopic ureters may be eligible for the study. If enrolled, dogs will have a focused urogenital ultrasound performed on the day of presentation. Abdominal CTEU, ureteropyelography, and cystoscopy will be performed the following day under general anesthesia. Cystoscopy will determine the presence or absence of ureteral ectopia, and each patient will be treated accordingly depending on their ureteral ectopia (laser ablation or surgery). The costs of the focused urogenital ultrasound, CTEU, ureteropyelography imaging, and associated anesthesia costs for the imaging event will be paid for by the study. Dog owners are responsible for all other costs pertaining to their dog’s diagnosis and treatment.

Duration of study:

The study is currently OPEN.

Potential benefits to veterinary medicine:

By directly comparing the most commonly used and recommended imaging modalities for the evaluation of ectopic ureters, this research aims to improve animal health and welfare by determining which diagnostic modality is most sensitive and specific for determining the presence and type of ectopic ureters.