Ripley’s Believe It or Not / Ectopic Ureters

 

Believing that popular tourist attractions must have something compelling to continue to draw crowds, I happily pay to see the giant pig or the enormous snake at the County Fair. Never mind that I have some pretty big snake patients, I am always curious about the possibilities of extremes, from the biggest to the smallest. So it was a given that at some point I would cave and take my family through Ripley’s “Believe It or Not” Museum of artifacts collected around the world on his many trips. More than one museum is required to store his treasure trove, but this one is located right on the Wharf in San Francisco. I saw a mermaid created from the upper body of a monkey and the lower half of a large fish. I saw a stuffed two headed weasel and a real-life video of “Lizard Man” (a man who has tattooed his body with green scales and had his tongue surgically forked). Many of the animals and people were born unique due to congenital anomalies we commonly label as a “defect”, but they were celebrated in their time. I would like to think they found some enjoyment in being different.

 

Seeing these displays made me ponder the varieties of pathology and medical mysteries that I have observed and or heard about from other veterinarians over the years. How much more is out there? It’s mind boggling. I don’t recall any “Siamese twins” or animals conjoined together at birth. I have had a dog born with three kidneys. Pets born with three legs or half a tail are common. Some pet mutations become new breeds. This kind of genetic mutation must be odd enough to stand out (beauty is in the eye of the beholder) but not be deadly. Think of the Manx cat (no tail) or the Munchkin (short, crooked or chondrodystrophic legs like a Bassett Hound) or the hairless Sphynx cat.

 

“Cracker” was a great case. Found on Craig’s List, he came in for a puppy check-up just two days after he was purchased. Cracker was a beautiful silver and black Husky with thick fur and blue eyes. During this initial examination we noted that only one of his testicles had descended into the scrotal sac. This meant he would need to be neutered, both to prevent passing this undesirable trait on and for his health, as retained testes tend to become cancerous with age. Cracker’s owner stopped by the next day to pick up some deworming medicine and commented that he seemed to dribble urine constantly. I frowned and pulled them from the lobby into an open exam room. His coat did seem unduly wet. Wiping him down with paper towels I waited and watched. Drip after slow drip rolled onto the table. Uh-oh. There were several possibilities, none good, but I was most worried about an ectopic ureter. “Ectopic” means displaced and the ureter is the tube that runs urine from the kidney down to the bladder, where it’s stored until the animal chooses to urinate.  This ureter tube is supposed to empty directly into the bladder. Unless, of course, it loses its way and attaches someplace else, outside of the bladder, in which case the urine just rolls on out, drip, drip, drip as it is made by the kidney.

 

Cracker’s owner and I discussed this possibility. We ran some tests to look for bladder infections and check basic kidney function (normal). I asked her to monitor his leaking. On Crackers’ next visit for vaccinations she confirmed that he dripped regularly, without apparent control. By this time he had nearly doubled his weight (normal) and now I could feel a large lump in his belly. We turned to some special x-ray studies. A contrast dye was injected into his foreleg vein. As the dye is processed by the kidneys the normal kidney, ureters and bladder light up like a Christmas tree on x-ray film. If a kidney isn’t working it won’t light up. If a ureter is misplaced you may be able to see that also (tracing tiny ureters can be tricky). In Cracker’s case, his left kidney lit up – it was almost the same size as his head! Sent on to the veterinary teaching hospital at UC Davis, Cracker was ultimately diagnosed with hydronephrosis of the left kidney, which they removed. He had an ectopic ureter on the right kidney, which they fixed by re-attaching it into the bladder. And they removed the stray testis while they were in there. Phew! Believe It or Not, Cracker is 100% normal today!

 

Christine B. McFadden, DVM

Drmc@mcmenagerie.com

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