Background: Computed tomography excretory urography (CTEU) for diagnosing ureteral ectopia in dogs is typically performed under general anesthesia to minimize motion artifact. Sedation offers an attractive alternative, but its diagnostic performance compared to general anesthesia remains unestablished.
Objectives: To compare the diagnostic indices of CTEU performed under sedation versus general anesthesia to identify ureteral ectopia, using cystoscopy or exploratory laparotomy as the reference standard. Animals: Fifty-three client-owned dogs with urinary incontinence evaluated via CTEU with subsequent cystoscopic or surgical confirmation of ureteral conformation.
Methods: Retrospective cohort study. Dogs were grouped by restraint method used during CTEU (general anesthesia versus sedation). Ninety-two ureters (general anesthesia, n = 47; sedation, n = 45) were reviewed by two blinded observers to reach a consensus on the presence or absence of ureteral ectopia. Overall accuracy, sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were calculated.
Results: Accuracy for ureteral ectopia under general anesthesia was 98% (46/47; 95% CI: 89-100) and under sedation was 91% (41/45; 95% CI: 79-96). For general anesthesia, sensitivity was 96% (95% CI: 82-99), specificity 100% (95% CI: 84-100), PPV 100% (95% CI: 87-100), and NPV 95% (77-99%). For sedation, sensitivity was 95% (95% CI: 75-99), specificity 88% (95% CI: 71-96), PPV 86% (65-95%), and NPV 96% (80-99%).
Conclusions: The lower point estimates for specificity and PPV for sedation suggest a potential for increased false positives. While sedation remains a viable alternative, general anesthesia may offer superior specificity for the diagnosis of ureteral ectopia using CTEU in dogs.
