Evaluation of the ureteral jet in dogs by using color Doppler ultrasonography

Abstract

Ureteral jets are the result of a forceful ejection of urine from the vesicoureteral junction into the urinary bladder. By using color Doppler ultrasonography (US), we aimed to identify distinct ureteral jets in dogs, provide insight into ureteral obstruction, and facilitate study of urodynamics and vesicoureteric sphincter function via pulsed Doppler US. Color Doppler US was applied to detect urinary flow from the right ureteral orifices in eight healthy beagles. Under anesthesia, 0.9% saline (2.5 mL/kg/h) and furosemide (0.5 mg/kg) were administered intravenously to assist in detection of distinct ureteral jets and examine their frequency, velocity, duration, and waveform. In all dogs, ureteral jets were visualized under diuresis and anesthesia within 2 to 5 min (mean 3.57 ± 0.90 min) of the furosemide injection. Mean frequency, peak velocity, and duration of right ureteral jets in seven dogs in whom six ureteral jet waveform patterns were identified were 9.86 ± 3.09 jets/min, 34.07 ± 10.02 cm/sec, and 2.82 ± 1.08 sec, respectively. During the 10 min period starting 10 min after the initial jet appeared, only three waveforms were identified. Color Doppler US of ureteral jets may aid in assessing vesicoureteric sphincter function and ureteral abnormalities, such as ureteral obstruction, in dogs.

Ultrasonography as a sensitive and specific diagnostic modality for the detection of ectopic ureters in urinary incontinent dogs

“… 14 Intravenous administration of furosemide (0.5 mg/kg) has been reported to aid the location of the ureteral orifice in “normal” dogs. 20 Medical records indicate that at least 1 dog in this study received intravenous furosemide, although the number of dogs that received diuretic is difficult to ascertain as it was inconsistently documented. It may be useful for future studies to assess whether the administration of intravenous furosemide affects the diagnostic accuracy of AUS for identification of EUs.…”

“…Ultrasound diagnosis of EUs involves the identification of a ureteral jet by doppler, the identification of the tubular ureteral structure distal to the bladder neck, and the presence of secondary hydroureter 14 . Intravenous administration of furosemide (0.5 mg/kg) has been reported to aid the location of the ureteral orifice in “normal” dogs 20 . Medical records indicate that at least 1 dog in this study received intravenous furosemide, although the number of dogs that received diuretic is difficult to ascertain as it was inconsistently documented.…”

ACVIM consensus statement on diagnosis and management of urinary incontinence in dogs

“…76,77 Confidence in the diagnosis of EU can be increased by administration of furosemide because it will increase the likelihood of identifying ureterovesicular junctions by increasing ureteral diameter, ureteral peristalsis, and urine jet production (Figure 7). 76,78,79 Ultrasonography also is excellent for Many dogs with EU have an abnormality of the vaginal vestibule called a VVSR which is a broad tissue band dividing the vaginal opening into 2 parts and lifting the urethral opening dorsally (Figure 8). 86 The VVSR should be corrected by laser or electrocautery ablation at the time of ectopic ureter correction.…”

“… 76 , 77 Confidence in the diagnosis of EU can be increased by administration of furosemide because it will increase the likelihood of identifying ureterovesicular junctions by increasing ureteral diameter, ureteral peristalsis, and urine jet production (Figure 7 ). 76 , 78 , 79 Ultrasonography also is excellent for assessing the remainder of the urogenital tract such as the kidneys (eg, renal dysplasia that can occur with EU), excluding those components obscured by the pelvis. Because the sensitivity of US is lower than cystoscopy, cystoscopy still should be pursued if pattern recognition is consistent with EU because it cannot be entirely ruled out based on US, and the possibility of misdiagnosis of intra vs extramural EU exists.…”