Laser treatment for blocked ureter and bladder cyst in female dog

Abstract

CASE DESCRIPTION A 4-year-old spayed female Beagle was evaluated because of a 2-month history of intermittent pollakiuria, stranguria, dysuria, and abdominal pain. A diagnosis of bacterial cystitis was initially made, but clinical signs persisted despite appropriate antimicrobial treatment, so the dog was referred for further evaluation and treatment. CLINICAL FINDINGS Abdominal ultrasonography revealed a large, thin-walled, cystic structure in the urinary bladder at the level of the expected right ureterovesicular junction that communicated with the uniformly dilated right ureter. Severe right-sided pyelectasia was also detected. A presumptive diagnosis was made of a right-sided orthotopic ureterocele with secondary hydroureter and pyelectasia. TREATMENT AND OUTCOME Cystoscopy revealed a large cystic structure in the region of the right ureterovesicular junction without obvious communication between the ureter and urinary bladder. Portable C-arm fluoroscopy was used to confirm the presence of an intramural orthotopic tract and to measure the diameter of the ureter and renal pelvis via retrograde contrast ureteropyelography. Complete laser ablation of the ureterocele was performed by incising it circumferentially near its base. Clinical signs resolved immediately following the procedure. Six weeks later, the dog remained free of clinical signs and abdominal ultrasonography revealed resolution of hydroureter with persistence of mild right-sided pyelectasia. CLINICAL RELEVANCE Cystoscopic-guided laser ablation of an orthotopic ureterocele secondary to ureterovesicular stenosis was a safe and effective minimally invasive treatment for the dog of this report, resulting in immediate and continued improvement of clinical signs and ultrasonographic changes. Laser ablation should be considered as an alternative to surgery for the treatment of orthotopic ureteroceles in dogs.