Veterinary Medicine - November 2007 - (Page 708)

Clinical Exposures illuminating images from patient files OP E E R - R E V I E W E D A retained testis and spermatic cord torsion in a boxer Lysimachos G. Papazoglou, DVM, PhD, MRCVS; Michail N. Patsikas, DVM, PhD, DECVDI; Georgia Brellou, DVM, PhD; Nectarios Soubasis, DVM, PhD; and Vasileia Kouti, DVM A 13-month-old intact male boxer weighing 57.2 lb (26 kg) was presented to the Aristotle University of Thessaloniki Companion Animal Clinic for evaluation of a oneday history of vomiting. The dog’s vaccination status was current. PHYSICAL EXAMINATION AND DIAGNOSTIC TESTING On physical examination, the dog was bright, alert, and in good body condition. The dog exhibited signs of pain on abdominal palpation, and a firm mass was detected in the caudal abdomen. The scrotum contained only one testis, which was small. Thoracic auscultation revealed a sinus rhythm and a grade III/VI murmur heard best over the pulmonic valve area. The results of a complete blood count, serum chemistry profile, and urinalysis were within reference ranges. Abdominal radiographs suggested the presence of gas-filled small intestinal loops in the caudal abdomen. An ultrasonographic examination of the caudal abdomen revealed a 5-x-3-cm, oval, coarse, hypoechoic mass surrounded by an echogenic line consistent with an enlarged testis. An elongated structure of the same echogenicity located along the lateral aspect of the mass, consistent with epididymis, was also seen (Figure 1). Color flow Doppler ultrasound revealed an absence of blood flow in the mass. Mild hypomotility of the intestinal loops adjacent to the mass was evident. Based on clinical and diagnostic imaging findings, we tentatively diagnosed intestinal obstruction or intra-abdominal spermatic cord torsion. Thoracic radiographic and echocardiographic examinations were done to further evaluate the murmur and revealed no abnormalities. A physiologic murmur with no clinical significance was diagnosed. 1. An abdominal ultrasonogram showing a hypoechoic mass surrounded by an echogenic line consistent with an enlarged testis (T). An elongated structure of the same echogenicity located along the lateral aspect of the mass, consistent with epididymis, is also visualized (E). TREATMENT AND FOLLOW-UP Surgical exploration of the abdomen was performed on the same day as admission to confirm the diagnosis. The patient received isoflurane anesthesia, and a ventral midline celiotomy was performed. An enlarged, 5-x-3-cm, dark-red testis was found in the caudal abdomen on the right side with an enlarged spermatic cord; this enlargement was due to 360-degree torsion (Figure 2). The 2. An enlarged, dark-red, right testis with an enlarged spermatic cord caused by torsion was identified intraoperatively. This case report was provided by Lysimachos G. Papazoglou, DVM, PhD, MRCVS; Michail N. Patsikas, DVM, PhD, DECVDI; Nectarios Soubasis, DVM, PhD; and Vasileia Kouti, DVM, from the Department of Clinical Sciences and Georgia Brellou, DVM, PhD, from the Laboratory of Pathology at the Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, 11 S. Voutyra St., 54627, Thessaloniki, Greece. 708 November 2007 VETERINARY MEDICINE

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Veterinary Medicine - November 2007 Contents Leading Off The Veterinary Medicine Interview: Dr. Lila Miller Clinical Exposures Idea Exchange A Challenging Case: Uveitis and Secondary Glaucoma in a Cat Is it Immune-Mediated Neutropenia? Pimobendan Treatment in Dogs with Congestive Heart Failure CE Form Product Preview Advertiser Index Marketplace/Classifieds Mind Over Miller Special Supplement by Lilly: Flea Bite Facts Q&A

Veterinary Medicine - November 2007

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