Clinical Exposures: A retained testis and spermatic cord torsion in a boxer


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 one-day 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.


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).
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.

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.


2. An enlarged, dark-red, right testis with an enlarged spermatic cord caused by torsion was identified intraoperatively.
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 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.