Veterinary Medicine - November 2007 - (Page 710)

Clinical Exposures PEER-REVIEWED cord was double-ligated with 2-0 polydioxanone, and the testis was removed. Abdominal exploration revealed no other abnormalities, and the celiotomy incision was closed routinely. The left testis, measuring 3 x 1.5 cm, was also removed by using a standard midline skin incision cranial to the scrotum. The dog recovered well and was discharged from the hospital two days after surgery. Two years after surgery, the dog was reported to be in good health. HISTOLOGIC EXAMINATION Histologic examination of the abdominal testis showed widespread hemorrhages, multifocal coagulative necrosis, and interstitial fibrosis of the tubular structures in the testis and epididymis (Figure 3). An increase in Leydig cell population was present throughout the epididymis, and the tubular epithelium was composed primarily of Sertoli cells. Spermatogonia were sparsely evident in several seminiferous tubules. No signs of neoplasia were found. The histologic findings were compatible with spermatic cord torsion. Histology was not performed on the scrotal testis. 3. A photomicrograph of the right testis showing extensive hemorrhages as well as vascular and fibrous connective tissue proliferation in the interstitial area (F). Note the presence of several degenerated testicular tubules (arrows) showing either edema or coagulative necrosis of the lining epithelium (hematoxylin-eosin stain; bar = 100 µm) Ultrasonographic examination of the abdomen combined with color flow Doppler may detect a uniform hypoechoic testis and absence of blood flow to and from the affected testis.5,6 Surgical exploration of the abdomen is required to confirm the diagnosis. In this case, ultrasonographic and color flow Doppler findings correlated well with gross and histologic findings. DISCUSSION In this report, an intra-abdominal-retained testis and spermatic cord torsion were identified in a young boxer. Spermatic cord torsion is relatively uncommon in dogs. Boxers are overrepresented among dogs with spermatic cord torsion, which may reflect the incidence of cryptorchidism in this particular breed.1 Causes As in this case, spermatic cord torsion is more frequently reported with intra-abdominal-retained testes than inguinalretained or scrotal testes.1,2 It has been hypothesized that the intra-abdominal location of a nonneoplastic or neoplastic testis allows for greater mobility of the testis within the abdominal cavity and may result in spermatic cord torsion.3 After torsion, the nonneoplastic testis enlarges, resulting in venous occlusion, edema, and inflammation.2 Ischemic necrosis, hemorrhage, and edema may be seen histologically in torsion of a nonneoplastic testis.2 However, testicular enlargement may occur before torsion in cases of testicular neoplasia.3 Most reported cases of torsion have occurred in neoplastic testes in which seminoma and Sertoli cell tumors were identified histologically in most of the dogs.1,2 CONCLUSION In dogs, spermatic cord torsion is usually an acute situation and should be considered in cases of acute abdomen in cryptorchid dogs.7,8 Differential diagnoses may include intestinal obstruction, an intra-abdominal neoplastic testis, and intra-abdominal spermatic cord torsion. Since cryptorchidism is a heritable defect, treatment includes surgically removing both testes. In a retrospective study of 13 dogs with spermatic cord torsion, 77% survived surgery.1 O REFERENCES 1. Pearson H, Kelly DF. Testicular torsion in the dog: a review of 13 cases. Vet Rec 1975;97:200-204. 2. Naylor RW, Thompson SMR. Intra-abdominal testicular torsion—a report of two cases. J Am Anim Hosp Assoc 1979;15:763-766. 3. Johnston SD, Kustritz MV, Olson PNS. Disorders of the canine testis. In: Johnston SD, Kustritz MV, Olson PNS, eds. Canine and feline theriogenology. Philadelphia, Pa: WB Saunders Co, 2001;312-332. 4. Jarløv N, Blixenkrone-Møller M. Two cases of torsio testis in dogs. Nord Vet Med 1986;38:244-245. 5. Johnston GR, Feeney DA, Rivers B, et al. Diagnostic imaging of the male canine reproductive organs. Methods and limitations. Vet Clin North Am Small Anim Pract 1991;21:553-589. 6. Hecht S, King R, Tidwell AS, et al. Ultrasound diagnosis: intra-abdominal torsion of a nonneoplastic testicle in a cryptorchid dog. Vet Radiol Ultrasound 2004;45:58-61. 7. Flanders JA, Schlafer DH, Yeager AE. Diseases of the canine testes. In: Bonagura JD, ed. Kirk’s current veterinary therapy XIII small animal practice. Philadelphia, Pa: WB Saunders Co, 2000;941-947. 8. Bartlett GR. What is your diagnosis? Testicular torsion. J Small Anim Pract 2002;43:521, 551-552. Clinical signs and diagnosis Affected animals may present with clinical signs of acute abdomen including a sudden onset of abdominal pain, vomiting, abdominal distention, anorexia, depression, pyrexia, a stiff gait, and abnormalities in urination.1-4 Abdominal palpation may reveal an enlarged mass. 710 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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