🐾 Long-Term Success: 100% Resolution of Incontinence in Cats After Ectopic Ureter Treatment

Long-term outcome of ectopic ureter treatment in four female cats

Elisabeth A. Lemmon, Dana L. Clarke, Lillian R. Aronson

Background

Ectopic ureters, though uncommon in cats compared with dogs, can cause urinary incontinence and renal dysfunction if untreated. Most data on this condition originate from canine studies, with limited feline-focused research. Previous case reports have demonstrated favorable short-term outcomes following surgical or cystoscopic correction, but long-term data are lacking. This study aimed to describe the clinical presentation, diagnostic evaluation, treatments, and long-term outcomes of cats treated for ectopic ureters.

Methods

A retrospective case series reviewed medical records from 2016–2021 at the University of Pennsylvania’s Ryan Veterinary Hospital. Four female cats with confirmed unilateral ectopic ureters—three extramural and one intramural—were included. Diagnostic evaluation included blood work, urine culture, abdominal imaging (ultrasound, CT, cystoscopy), and classification of ureteral type. Treatment comprised intravesicular end-to-side neoureterocystostomy for extramural cases and cystoscopic laser ablation for the intramural case. Postoperative care, complications, and follow-up outcomes were recorded, with a median follow-up period of 1705 days.

Results

All four cats presented with urinary incontinence, and two had recurrent urinary tract infections. Following treatment, all cats achieved resolution of urinary incontinence and lower urinary tract signs within 14 days. One cat with a solitary kidney developed transient postoperative azotemia, which resolved within 72 hours. No other significant complications occurred. During the 3.5–8.7-year follow-up, none of the cats experienced recurrence of incontinence or urinary signs, and all remained non-azotemic. Only one cat developed a recurrent E. coli urinary infection 1.5 years postoperatively, which resolved with antibiotic therapy. Imaging follow-ups revealed improvement in prior renal pelvic and ureteral dilations.

Limitations

The study’s main limitations include the small sample size (n=4) and its retrospective design, which limit statistical generalizability. Additionally, all cases were female and unilateral, precluding evaluation of bilateral or male presentations.

Conclusions

Both intravesicular end-to-side neoureterocystostomy and cystoscopic laser ablation demonstrated excellent long-term outcomes for cats with ectopic ureters. All treated cats achieved sustained continence and maintained normal renal function over several years. These findings support early diagnosis and intervention as effective and safe approaches for managing ectopic ureters in feline patients.

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