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