Bilateral hydronephrosis and hydroureter was diagnosed in a 5-year-old pug presented for chronic hematuria and recurrent urinary tract infections. Diagnosis was confirmed by excretory urography, ultrasonography, and excretory CT urography after treatment for pyelonephritis failed to resolve clinical signs. The stenosis, present at the ureteropelvic junction of each ureter, was believed to be a congenital abnormality. Bilateral ureteral stents were placed via fluoroscopic guidance using a rigid cystoscope. Over the next 45 weeks, there was continuing improvement in clinical signs. Twelve months following the procedure clinical signs (dysuria, hematuria) had resolved.

Diagnosis and treatment of obstructive diseases of the urinary tract are a frequent and arduous challenge for practitioners and surgeons. Traditional surgical techniques can yield inconsistent results and have been associated with high patient morbidity and mortality. Ureteral stenting has revolutionized the management of obstructive ureteral disorders caused by calculi, strictures, or tumors in dogs and cats.1 This case report described a novel interventional endo-urologic treatment approach to ameliorate a rare case of bilateral ureteral stenosis, presumed to be congenital. Minimally invasive interventional diagnostic and therapeutic approaches for urinary tract disease hold promise for improved patient management. Main limitations include limited availability restricted to isolated referral surgical centers and objective assessment of the long-term outcome.—Jason Bleedorn, DVM, DACVS

Endoscopic placement of ureteral stents for treatment of congenital bilateral ureteral stenosis in a dog. Lam NK, Berent AC, Weisse CW, et al. JAVMA 240:983-990, 2012.

1. Ureteral obstructions in dogs and cats: A review of traditional and new interventional diagnostic and therapeutic options. Berent AC. JVECC 21:86-103, 2011.