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.
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.
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.
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
As in this case, spermatic cord torsion is more frequently reported with intra-abdominal-retained testes than inguinal-retained 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
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.
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.
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
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.
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