How do you differentiate between a urinary tract infection or an ectopic ureter in an 8 week old puppy. What tests

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Customer: how do you differentiate between a urinary tract infection or an ectopic ureter in an 8 week old puppy. What tests should I expect my veterinarian to run
Answered by Dr.Fiona in 2 mins 14 years ago
26+ years of experience

8,206 satisfied customers

Specialities include: Dog Veterinary, Dog Medicine, Dog Diseases, Small Animal Veterinary

Hi thereCustomer

Welcome to Just Answer! I would like to try to help you and your puppy with this question, but need a bit more information in order to better assist you.

Is the pup dripping urine, or leaking urine while sleeping?

When did the pup start showing symptoms?


Your "optional information" just came through - that helps me understand much better what you are asking.

So, you don't have the pup yet, right? She is still with the breeder?

Has a urine sample been taken directly from the bladder for culture and sensitivity testing?


According to the breeder there is no bacteria in the urine which makes me wonder why they're treating her with antibiotics.


Yes - a good question!

What symptoms was she showing that made them think she had a UTI in the first place?

Is she urinating more often than the other pups?

Or licking at her vulva a lot?

apparently she's had random dribbling and it didn't clear up so they took her back in for another check up and thats when they told the breeder she might have the ectopic ureter problem



Ok... off to write up a detailed answer, back in about 20min

Thank You.

Hi again Pat,

So, there are a number of possibilities for what may be going on with this pup.

Let me explain a bit more about infection, incontinence and about ectopic ureters and then explain how we differentiate between them.

1. Infection -

A urinary tract infection is quite a common thing in a puppy.

They are more prone to infections of all sorts because their immune systems are immature.

She should have a urine sample taken directly from the bladder with a small needle by her veterinarian to check for infection. This is the place I would start with a puppy.

Most infections clear up very quickly with a course of antibiotics.

Unless a sample of urine is sent to a lab for a culture and sensitivity test, then antibiotic choices are simply a guess. MOST dogs get better if they are treated with Clavamox (which is very safe in pups). However, it is possible that she has something that is resistant to whatever antibiotic she is on.

When we get a urine sample, we usually check it in the clinic for bacteria. AND THEN we send it out. Although we may not see any under a microscope there can still be bacteria present but just at a low level. So, perhaps she does have a simple UTI but it is just at a low level and that is why no bacteria were seen.

A culture and sensitivity would answer this question! (Obtaining the sample and sending out for culture and sensitivity would cost about $120 where I work).

2. Urinary incontinence

With this, dogs urinate in their sleep or when lying down. It is something we see fairly commonly - but generally in middle aged to older, spayed female dogs. In those animals, it can be because the sphincter to the bladder is not strong enough. There are a number of medications that can help to improve the tone of the sphincter.

3. Ectopic ureters

Unfortunately, in a dog this age with urinary incontinence, we do have to wonder if there could be congenital defects such as a ureter in the wrong place.

I'll include links:

And more about the congenital (born with it) problem where the ureter is not in the right place (which may be fixable with surgery):

So, your dog may have a urinary tract infection, or she may have urinary incontinence, or a combination of the two. If she has urinary incontinence, it may be due to a weak sphincter muscle or it may be due to ectopic ureters.

Now, if this pup were my patient, I would start with a urine culture. If that was negative, I would refer her to a specialist for further testing. When ectopic ureters are suspected, the test options are:
1. cystoscopy

With this, an endoscope it passed up into the bladder. A camera is used to look for the TWO entrances into the bladder from the 2 ureters. If only one is seen, then we can diagnose ectopic ureters.

2. IVP

IVP double contrast urethrocystogram, but to do this test, the pup needs to be 14 - 16 weeks of age at least. With this, x-rays are taken of the bladder area. A dye is injected into the bladder by passing a catheter up the urethra and into the bladder. The bladder is FILLED with dye and more x-rays taken. The dye shows up on x-rays and we look to see 2 ureters filled with dye. This is not quite such a good test, but a good option if you don't have access to cystoscopy.

Given your location, UCDAvis would be a great choice to have further testing done. It has been a while since I sent a pup for these tests, so it's hard for me to remember how much it would cost. I'd guess about $1500 for either one.

Now, in terms of treatment....I will quote here from a specialist who deals with ectopic ureters. Her name isXXXXX and she is an Internal Medicine veterinary specialist at MJR-Veterinary Hosptial of the University of Pennsylvania. Here is what she says:

Either surgery or laser ablation is the suggest treatment of choice. We prefer laser ablation since it is a lot less invasive (done via cystoscopy), and the continence rate is a little better than surgery, it seems, but hard to say with only 30-40 dogs done so far to be about 65% without meds, 75% with meds and about 85-90% if we place a hydraulic occluder on when all else fails (new device placed surgically).

Laser is great and quick. There are only a few places doing it though.


I hope that this has been helpful?

If it has, please "accept" my answer and leave feedback. I will still be here to provide more information if you need it!

The above is given for information only. Although I am a licensed veterinarian, I cannot legally prescribe medicines or diagnose your pet's condition without performing a physical exam. If you have concerns about your pet I would strongly advise contacting your regular veterinarian.

Best wishes to you and to this puppy!


Thank you so much for your very helpful answer. I really appreciate your quick response. It's always so hard to know where to start when trying to make a decision about a pet's health. Or in this case, a potential pet! I feel I now have enough information to at least get some tests run to help this pup and I have a better idea what we're up against! Thanks again.
You are so very welcome!

Good luck with this pup!
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