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Computertomografische und sonografische Befunde bei einem Hund mit Doppelniere, Ureter duplex und ektoper Ureterozele
Eine 5 Monate alte, männliche Französische Bulldogge wurde aufgrund von Harninkontinenz vorgestellt. Bei der Ultraschalluntersuchung des Abdomens zeigte sich eine Ureterozele sowie eine bilobulierte rechte Niere. Durch exkretorische computertomografische Urografie ließen sich rechtsseitig eine Doppelniere, ein Doppelureter sowie eine ektopische Ureterozele nachweisen. Nach Wissen des Autors ist dies die erste Beschreibung einer Doppelniere im Zusammenhang mit einer ektopischen Ureterozele beim Hund, die durch Sonografie und Computertomografie nachgewiesen wurde. Die ektopische Ureterozele wurde im Anschluss an die bildgebende Diagnostik mittels Neoureterozystostomie chirurgisch versorgt. In der Kontrolluntersuchung zeigte der Patient noch eine geringgradige Inkontinenz, die mit Phenylpropanolamin weiter behandelt wurde.
Computed tomographic and sonographic findings in a dog with duplex kidney, ureter duplex and ectopic ureterocele
A 5-month-old, male French bulldog was presented with a history of urinary incontinence. Abdominal ultrasound showed changes compatible with a ureterocele and a bilobed right kidney. Excretory computed tomographic urography was consistent with right-sided duplex kidney, ureter duplex and ectopic ureterocele. To the authors’ knowledge, this is the first description of a duplex kidney with an ectopic ureterocele diagnosed with ultrasound and contrast enhanced computed tomography in a dog. After the imaging diagnosis, a neoureterocystostomy was performed. In the follow-up examination the dog presented with mild incontinence which was treated medically using phenylpropanolamine.
Ureteral ectopia is a common finding in young dogs with urinary incontinence. A predisposition for certain breeds such as Siberian Husky, Newfoundland and Bulldog is described. Whereas in human medicine, ectopic ureters often exist in combination with double ureters and a duplex kidney, this combination is a rare finding in domestic mammals. In dogs, this anatomic abnormality has only been reported in a male Labrador Retriever and a female Bull Mastiff to date.
Signalment, history, and clinical findings
A 5-month-old, male French bulldog was presented with a history of urinary incontinence since 12 weeks of age. The dog showed unconscious urine dripping that had worsened since onset. The dog was empirically treated by the referring veterinarian with unknown antimicrobial drugs, however the clinical signs did not improve.
The physical examination revealed a tense abdomen and a mild degree of discomfort by abdominal palpation; the urinary bladder was mild to moderately filled. During the physical exam, the dog showed dripping of small amounts of urine. The neurological examination was within normal limits. The complete blood count and the blood chemistry were unremarkable. The microbiological culture of the cystocentesis urine was negative and analysis of the urine sediment did not reveal pathological findings.
Imaging and diagnosis
Two-view abdominal radiographs were unremarkable. Abdominal ultrasound was performed with a linear probe using a frequency of 8.4 MHz (GE Logiq E9, GE Healthcare, Germany). In the dorsal region of the bladder-neck a thin walled cyst-like structure was seen consistent with a ureterocele. The ureterocele extended approximately 3 cm caudally into the bladder neck and the prostatic part of the urethra . A Doppler examination for the assessment of the ureteral openings was not possible due to panting of the patient.
The right kidney showed a bilobed structure with a smaller cranial and a larger caudal pole. The normal echotexture of the cortex and the medulla was preserved in all aspects of the right kidney. An incomplete parenchymal bridging between the two renal poles was noted with an incomplete parenchymal indentation at the same level. The renal pelvis was moderately dilated (0.4 cm, normal range < 0.2 cm). Additionally, the proximal aspect of the right ureter was moderately dilated with a cross-sectional diameter of 0.4 cm. The right ureter tapered towards the caudal aspect of the abdomen. The size of the right kidney was considered as physiological. No abnormalities of the left kidney were seen, and the remaining abdominal organs were within normal limits.
The ultrasound findings were consistent with an ectopic right ureter and ureterocele. The presumptive diagnosis for the right kidney was congenital malformation of the right kidney with an incomplete supernumerary kidney or fused double kidney.
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Aus der Zeitschrift Tierärztliche Praxis K 01/2020
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