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Peanut

• Patient:
  Peanut, 8 month old spayed female Australian shepherd.



• Presenting complaint:
  Leaking urine inappropriately since purchase. Peanut has had urinary tract infections. Peanut did not respond to medical treatment of her dribbling. Severe perivulvar dermatitis due to continual urine soilage.



• Diagnostic studies before endoscopy:
  The referring veterinarian had performed an excretory urogram and diagnosed bilateral ectopic ureter. Urodynamic studies (urethral pressure profile and leak point pressure) were attempted, but Peanut was so painful that she could not be catheterized while awake. The complete blood count and chemistry profile were within normal limits, and urine could not be obtained for analysis and culture.



• Endoscopic procedure:
  Cystoscopy was performed and the bilateral ectopic ureters were confirmed. In addition the urethra appeared to be short and there was a persistent membrane at the vestibular-vaginal junction. A diode laser was used through the operating channel of a 2.7 mm cystoscope to cut the membrane between the urethra and the intramural ectopic ureter. Collagen was also injected beneath the mucosa.



• Benefits of using endoscopy:
  Cystoscopic treatment of ectopic ureters avoids a traditional laparotomy and cystotomy. This novel technique was developed by Dr. Tim McCarthy and we have had the same success with four other patients.



• Clinical result:
  Peanut has markedly improved urinary control and the dermatitis rapidly resolved. Peanut was dry while in the hospital and dribbles very infrequently if not being treated medically. She is dry as long as she continues on phenylpropanolamine.

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