NOTE  Internal Medicine

Simple Ectopic Kidney in Three Dogs

Jiyoung CHOI1), Heechun LEE2), Youngwon LEE1) and Hojung CHOI1)*

1)College of Veterinary Medicine and Research Institute of Veterinary Medicine, Chungnam National University, Daejeon 305–764,
Korea
2)College of Veterinary Medicine, Gyungsang National University, Jinju 660–701, Korea

(Received 10 February 2012/Accepted 22 May 2012/Published online in J-STAGE 5 June 2012)

Abstract. Simple ectopic kidney was diagnosed in three dogs by means of radiography and ultrasonography. A 2-year-old castrated male
Schnauzer, a 13-year-old female Schnauzer and a 9-year-old male Jindo were referred with vomiting, hematuria and ocular discharge,
respectively. In all three dogs, oval-shaped masses with soft tissue density were observed in the mid to caudal abdomen bilaterally or uni-
laterally, and kidney silhouettes were not identified at the proper anatomic places on abdominal radiographs. Ultrasonography confirmed
the masses were malpositioned kidney. The ectopic kidneys had relatively small size, irregular shape and short ureter but showed normal
function on excretory urography.
KEY WORDS: canine, ectopic kidney, radiography, ultrasonography.

doi: 10.1292/jvms.12-0060; J. Vet. Med. Sci. 74(10): 1373–1375, 2012

Normal position of dog’s right kidney is at the level of
T12-13 to L2-3, and the left kidney is slightly more cau-
dally [10]. The term ectopic kidney is used to describe the
congenital malposition of one or both kidneys [8]. Ectopic
kidneys have been reported in humans [12], swine [11], calf
[5], cats [1, 4, 6, 8, 13] and dogs [7, 15]. Simple ectopic
kidney is usually asymptomatic clinically and rare congeni-
tal malformation [4]. Diagnosis of a simple ectopic kidney
is usually confirmed by radiography, ultrasonography and
excretory urography [4, 8]. Diagnostic imaging features of
ectopic kidneys include abnormal location, rotation, small
size, unusual shape, short ureteral length and anomalous
renal vasculature [6]. In contrast to ectopic ureter, there are
few reports of ectopic kidney in small animals. All dogs dis-
cussed in this report was diagnosed with simple abdominal
ectopic kidney based on the results of the imaging findings.
A 2-year-old castrated male Schnauzer (Dog 1) was
presented with vomiting. On physical examinations, right
testis was not palpated. No significant abnormalities were
observed on the CBC. Serum chemistry revealed increase
of alanine aminotransferase (ALT, 960 U/l; reference range
4–125 U/l) and aspartate aminotransferase (AST, 877 U/l;
reference range 7–84 U/l). On abdominal radiography, two
oval-shaped soft tissue masses in the caudal abdomen were
found displacing descending colon ventrally. These masses
were confirmed to be the kidneys by ultrasonographic ex-
amination. Right testis appeared small, hypoechoic and of
normal architecture in the caudal region of the right kidney.
Excretory urography was performed to estimate kidneys
and ureters. The right kidney of this dog had a normal size
(3.1 times the length of the 2nd lumbar vertebra), and the
contour of the cranial pole was smooth but flattened. The
size of left kidney was also within normal range (2.8 times
the length of the 2nd lumbar vertebra) and had a discoid
shape with a smooth contour (Fig. 1). The dog was diag-
nosed with bilateral simple ectopic kidney with unilateral
cryptorchidism.
A 13-year-old female Schnauzer (Dog 2) was presented
with a 15-day history of hematuria. No significant complete
blood cell count or serum chemistry abnormalities were
found. Urinalysis revealed the presence of + blood and ++
protein on a dipstick. Granular cast was also observed in
the urine sediment. One oval-shaped mass with soft tis-
sue opacity was observed in the left caudal abdomen on
abdominal radiography. Small bone opacity materials were
in this mass. Two smooth large calculi were found in the
urinary bladder. The left kidney silhouette was not found
in the proper anatomic region. Abdominal ultrasonography
confirmed that the mass was the left kidney. Left renal cal-
culi and cystic calculi were confirmed on ultrasonographic
examination. On excretory urography, the size of left ecto-

*Correspondence to: Choi, H., College of Veterinary Medicine,

Chungnam National University, 220 Gungdong, Yuseong-gu,
Daejeon 305–764, South Korea.
e-mail: hjchoi@cnu.ac.kr
©2012 The Japanese Society of Veterinary Science
Fig. 1. Right lateral (A) and ventrodorsal (B) radiographs after
excretory urography of Dog 1. The left kidney was smaller than
the right one. The cranial region of the right kidney contour was
flattened. The left kidney had a discoid shape and smooth contour.
1374 J. CHOI, H. LEE, Y. LEE AND H. CHOI
Fig. 2. Right lateral (A) and ventrodorsal (B) radiographs after
excretory urography of Dog 2. The left kidney was smaller than
the right kidney and had an oval shape. Hilum of the left kidney
showed cranial rotation. Left ureter extended craniodorsally about
1.5 cm distance and turned caudally to the trigone of the urinary
bladder (B).
Fig. 3. Right lateral (A) and ventrodorsal (B) radiographs after
excretory urography of Dog 3. Right kidney was located more
caudally than the left kidney. The cranial region of the right kidney
had a defect of cortical volume.
pic kidney was within normal range (2.6 times the length of
the 2nd lumbar vertebra), but smaller than the right kidney
(3.4 times the length of the 2nd lumbar vertebra). The left
ectopic kidney was a discoid shape and functioned normally.
The pelvis of left ectopic kidney was cranially-facing, so
ureter extends craniodorsally about 1.5 cm distance and
turned caudally to trigone of the urinary bladder (Fig. 2).
The dog was diagnosed with unilateral (left) simple ectopic
kidney and cystic calculi.
A 9-year-old male Jindo dog (Dog 3) was presented with
ocular discharge. On physical examination, severe facial
asymmetry, abnormal gait and dysuria were observed.
The neurological findings were compatible with brainstem
region. No significant abnormalities were identified by the
blood examination. On a urine dipstick test, +++ blood was
presented. A mass with soft tissue opacity was found in the
right middle abdominal region and stippled bone opacity ma-
terials in the urinary bladder and cystic calculi on abdominal
radiography. This mass was identified as the right kidney on
ultrasonography. Excretory urography revealed that the right
kidney was normal (3.1 times the length of the 2nd lumbar
vertebra) with a loss of cortical volume at the cranial pole,
Fig. 4. Postmortem examination of Dog 3. The right kidney
(B) had a defect of cortical volume in the cranial pole, and
right ureteral length was shorter than left ureter.
and the size of left kidney was 3.0 times the length of the 2nd
lumbar vertebra (Fig. 3).
Intraabdominal testis of Dog 1 was surgically removed.
Since ectopic kidney did not cause any clinical signs, treat-
ment for this condition was not performed. Dog 2 underwent
surgical removal of uroliths by cystotomy. Cystic calculi
were removed and submitted for quantitative analysis. The
results of analysis indicated that calculi consisted of struvite
(magnesium ammonium phosphate). The dog uneventfully
recovered from surgery. Dog 3 was diagnosed with other
neurological disease based on the results of MRI examina-
tion. The clinical signs of the patient were not improved, and
this dog was euthanatized one month after the first admission.
Necropsy was performed on this dog. Similar to the imaging
results, the ectopic kidney had a cortical defect of cranial
pole region and a short right ureter (Fig. 4). Unfortunately,
histological examination for kidneys was not performed.
Ectopic kidneys can be classified as simple or crossed ac-
cording to the human literature [4, 8]. If the kidney, ureter
and vesicoureteral junction are all on the same side of the
abdomen, it was called simple ectopic kidney while crossed
ectopic kidney is related to the transposition of the kidney
with the associated ureter crossing the midline [4, 8]. Ac-
cording to their anatomic position, these are also classified as
pelvic, iliac or abdominal ectopic kidney [4, 8].
During ascent, both normal embryonic kidneys also un-
dergo a 90 degree rotation about their long axis so that the
ventrally-directed renal pelvis becomes medially oriented
[1, 8]. If there is less rotation, the renal pelvis will be cra-
nially or craniomedially positioned. Over-rotation can also
occur with the renal pelvis oriented laterally or caudally
[15]. These malrotations frequently accompany ectopic and
fusion anomalies [12]. Dog 2 described here showed malro-
tation of renal axis, and renal pelvis directed cranioventrally.
However, Dogs 1 and 3 had normal direction of renal pelvis.
In human medicine, the maximum number of fourteen
lobules is present by the 28 weeks of intra-uterine life [14].
Lobulation usually disappears as the kidney matures, but
can persist in children or even adults [14, 16]. Persistent
fetal lobulation is usually incidental findings on imaging
 SIMPLE ECTOPIC KIDNEY
[16], and these can be mistaken for pathology. Especially,
anterior lobulations are more persistent than posterior [14].
Other remnants of fusion may be seen as small triangular
echogenic notches in the cortex of normal kidneys on ultra-
sound. Usually found in the upper pole of the kidney, these
are known as junctional parenchymal defects [16]. Both are
more common on the right, and have no clinical significance
at all. Unfortunately, these normal variants of kidney shape
have not been studied in small animals. Canine kidneys seem
to be unilobar kidney due to complete fusion of the cortical
areas of adjacent lobes. However, the multilobar structure
of kidneys of carnivores is confirmed by the presence of
cortical columns and the position of the interlobar arteries,
which delineate individual lobes [9]. Therefore, flattened or
notched shape of cranial pole on the right kidney in Dogs 1
and 3 could be considered as the similar variants to the per-
sistent lobule or junctional parenchymal defects in humans.
Since more studies and investigations should be required in
veterinary medicine, we described this lesion as a focal loss
of cortical volume in this study.
Although two dogs are male (Dogs 1 and 3) and two
are Schnauzer (Dogs 1 and 2) in this report, sex and breed
predilections of ectopic kidney have not been identified in
the veterinary medicine [4, 7, 8, 15]. However, feline ec-
topic kidney has been reported more often in males than in
females [8]. Ectopic kidney usually does not show specific
clinical signs [4]. Most of these kidneys are incidentally di-
agnosed during examination for other medical or urological
problems [1]. Human and veterinary reports described that
ectopic kidneys are more disease-prone than normal kid-
neys. The ectopic kidney can cause poor outflow and is more
susceptible to calculi, hydronephrosis and infection [4, 15].
Hydronephrosis is the most common finding in humans with
ectopic kidney [4, 6]. There is also an increased incidence of
other extrarenal malformations in humans, including skeletal
anomalies (particularly vertebral), imperforate anus, crypt-
orchidism, other genitourinary and cardiovascular anomalies
and chromosomal defects [1]. The dogs in this report did not
show any evidence of ureteral obstruction. However, chrypt-
orchidism was present in Dog 1, and urologic abnormalities
in Dogs 2 and 3.
A diagnosis of ectopic kidney is usually confirmed by
radiography, ultrasonography and excretory urography [4].
In human medicine, retrograde cystourethrography is an-
other diagnostic procedure that is performed [2]. Computed
tomography now allows accurate evaluation of abdominal
organs without having to perform exploratory laparotomy.
In particular, this modality can evaluate renal vasculature
without any superimposition. Since CT angiogram was not
performed in this study, we could not observe any vascular
anomalies related to malposition of kidneys. However, there
is a report of ectopic kidneys with vascular anomalies in a
cat [8]. Rotation anomalies are often caused by or related to
aberrant renal vessels [3], and therefore CT could be useful
method for detecting of abnormal vessels in ectopic kidney
1375
showing malrotation.
Differential diagnosis of ectopic kidneys in humans and
animals includes neoplasia, foreign bodies, solitary kidney
and pregnancy [8]. Ectopic kidney could be included in the
differential diagnoses of abdominal or retroperitoneal mass-
es. This is of particular importance, since ectopic kidneys are
more susceptible to the diseases than normal ones. Although
clinically silent ectopic kidney is identified, careful monitor-
ing of the patient should be needed for urologic problems.
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