Left medial liver lobe torsion with secondary bicavitary effusion and septic peritonitis in a dog with an acute kidney injury following ovariohysterectomy

Abstract

A 7‐month‐old, spayed, female, mixed breed dog was referred for a 3‐day duration of elevated liver enzymes, azotaemia, anorexia and lethargy following ovariohysterectomy. Bloodwork showed non‐regenerative anaemia, inflammatory leukogram, moderate thrombocytopenia, severe azotaemia, severe mixed hepatopathy, hyperbilirubinemia and hypoalbuminemia. Point‐of‐care ultrasound identified free fluid and a heterogeneous mass in the mid‐ventral abdomen. Septic peritonitis was confirmed on cytology, and abdominal exploratory with left medial liver lobectomy was performed. Histopathology identified submassive hepatic necrosis and bridging fibrosis with biliary reaction, confirming a liver lobe torsion. The dog recovered perioperatively, but remained hospitalised to receive dialysis for severe renal dysfunction. The dog was transitioned to outpatient dialysis for several treatments. Unfortunately, kidney function continued to decline after dialysis was discontinued, and humane euthanasia was performed approximately 2 months postoperatively. To the authors’ knowledge, this is the first reported case of liver lobe torsion following routine ovariohysterectomy in a dog.