What Is Your Diagnosis?

Abstract

HistoryA 4-year-old 31-kg (68.2-lb) sexually intact female German Shepherd Dog was evaluated for acute lethargy and anorexia. The dog was laterally recumbent and stuporous. Abnormalities detected on physical examination included pale mucous membranes, increased capillary refill time, dehydration, tachycardia, and tachypnea with increased respiratory effort. Marked hypotension was detected during evaluation of blood pressure. The abdomen was distended and tense, and palpation elicited signs of discomfort. Results of serum biochemical analyses indicated hyperphosphotemia (15.9 mg/dL; reference range, 2.5 to 6.8 mg/dL) and increased concentrations of BUN (130.0 mg/dL; reference range, 7.0 to 27.0 mg/dL) and creatinine (8.65 mg/dL; reference range, 0.50 to 1.80 mg/dL). Abnormalities detected on CBC included normocytic anemia (Hct, 11.5%; reference range, 37.0% to 55.0%) and neutrophilic leukocytosis (26.3 X 10 9 neutrophils/L [reference range, 3.3 to 12.0 X 10 9 neutrophils/L]; WBCs, 28.6 X 10 9 cells/L [reference range, 6.0 to 16.9 X 10 9 cells/L]). Treatment for shock, hypotension, and anemia was initiated by means of a whole blood transfusion and a 6% hetastarch solution. a A lateral survey radiograph of the abdomen was obtained (Figure 1).Determine whether additional imaging studies are required, or make your diagnosis from Figure 1-then turn the page * * Figure 1-Lateral radiographic view of the abdomen of a 4-year-old sexually intact female German Shepherd Dog evaluated for acute lethargy and anorexia.

Omental torsion associated with splenic torsion in a dog

“…Ultrasonographic abdominal examination is very helpful for the diagnosis of splenic torsion in dogs 13–15 17 31 32. The spleen is usually enlarged and diffusely hypoechoic, although the parenchyma may include patchy hypoechoic or anechoic areas 15 17–19 31–34. Colour Doppler evaluation of a twisted spleen may reveal decreased or absence of venous flow, and together with B‐mode imaging, may show venous thrombi 31 35.…”

Primary Splenic Torsion in Dog as a Cause of Atypical Acute Abdomen

“…Este é um achado inespecífico que pode sugerir torção esplênica, neoplasia esplênica, ou anemia hemolítica imunomediada [9]. Evidência ultrassonográfica de esplenomegalia também é considerada não-específica, no entanto, hipoecogenicidade difusa do baço com ecodensidades lineares que separam grandes áreas anecoicas dando ao baço aspecto de textura "rendada" é altamente sugestivo de torção esplênica [7,8]. No presente caso, os achados ultrassonográficos foram consistentes com a torção do baço.…”

Abstracts From the Journals

“…Splenic torsion is a surgical emergency and the patient can easily die unless proper measures are undertaken. Jaeger and Simmons (2006) describe the condition in a 4‐year‐old German shepherd bitch with acute lethargy and anorexia. The bitch was laterally recumbent and stuporous.…”