Hepatic lobe torsion in 3 dogs and a cat

OBJECTIVE: To describe the clinical features of hepatic lobe torsions in 3 dogs and 1 cat. STUDY DESIGN: Retrospective clinical study. ANIMALS: Three client-owned dogs and 1 client-owned cat. METHODS: Medical records were reviewed, and information regarding signalment, clinical signs, physical-exam findings, diagnostic tests performed, treatment, outcome, and follow-up was retrieved. RESULTS: Clinical signs existed for 4 hours to 1 week before examination. Signs were nonspecific in 2 animals that did not have an obvious cause for the hepatic torsion. These signs consisted of lethargy (2), polyuria/polydypsia (2), and anorexia (1). In the other 2 animals, signs were suggestive of the underlying cause of the hepatic lobe torsion. In 1 dog, the torsion was associated with a traumatic diaphragmatic hernia. The cat had a concurrent hemoabdomen secondary to a ruptured hepatocellular carcinoma. Bloodwork abnormalities were nonspecific. Twisted liver lobes included the left lateral lobe (2), the caudate lobe (1), and the right medial lobe (1). Surgical resection (2) or repositioning (1) of the affected liver lobe was attempted in the 3 dogs, and was successful in 2. CONCLUSION: Hepatic lobe torsion is a rare problem but has been reported in humans, rabbits, dogs, pigs, a cat, and a horse. The left lateral liver lobe is most frequently affected. This condition may be idiopathic or associated with neoplasia or absence of ligamentous support (congenital or traumatic) to the liver. CLINICAL RELEVANCE: Prompt surgical resection or repositioning of the involved liver lobe can lead to a successful outcome, avoiding the deleterious effects of venous obstruction such as thrombosis and subsequent necrosis.     

Liver Lobe Torsion in Rabbits: 16 Cases (2007 to 2012)

The objective of this retrospective case series was to determine the clinical signs, diagnostic test results, treatment protocols, and outcomes of rabbits treated for liver lobe torsion during a 5-year period at a large referral institution. A total of 16 rabbits diagnosed with liver lobe torsion at Angell Animal Medical Center (Boston, MA USA) during January 2007 to March 2012 were included in the study. The diagnosis of liver lobe torsion was made at surgery, during abdominal ultrasound, or on postmortem examination. Medical records of the subject animals were reviewed for signalment, history, clinical signs, results of clinical pathology testing, diagnostic imaging findings, treatment, surgical and histopathology findings, hospitalization time, and outcome. The most common clinical signs of rabbits diagnosed with liver lobe torsion in this study included anorexia, lethargy, and decreased fecal production lasting 1 day. Lop breeds, particularly mini lops, were overrepresented. Anemia was the most common hematologic abnormality, while elevated levels of alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, blood urea nitrogen, and creatinine were the most common serum biochemical abnormalities. Abdominal ultrasonography with Doppler assessment was used in 14 rabbits and provided a diagnosis of liver lobe torsion in all cases. The caudate lobe was involved in 10 rabbits (62.5%, 95% CI: 38.8 to 86.2), followed by the right lateral lobe (n = 5; 31.25%, 95% CI: 8.6 to 53.9), the left lateral lobe (n = 2; 12.5%, 95% CI: 3.7 to 28.7), and the right medial lobe (n = 1; 6.25%, 95% CI: 5.6 to 18.1). Two rabbits had more than 1 torsed liver lobe. Exploratory laparotomy and liver lobectomy were performed in 9 rabbits, and all of them survived. Supportive care alone was provided for 7 rabbits, 3 of which survived. The results suggest that nonspecific clinical signs of anorexia, lethargy, and decreased fecal production, in conjunction with anemia and high serum hepatic enzyme activities, should increase the index of suspicion for liver lobe torsion in rabbits. Abdominal ultrasonography with Doppler assessment is useful to confirm the diagnosis. The long-term prognosis for rabbits undergoing liver lobectomy and surviving the hospitalization period is excellent.     

Torsion of the caudate lobe of the liver in the domestic rabbit (Oryctolagus).

Torsion of the caudate lobe was an incidental necropsy finding in three livers of 984 rabbits. The affected rabbits were mature (18-24 months), without a common background, and did not have clinical signs related to hepatic torsion. No lesions secondary to lobar torsion were seen.     

Spontaneous lung lobe torsion in two pugs

Two, young adult, male pugs presented for spontaneous left-cranial lung lobe torsions. Clinical signs associated with these two cases included increased weakness, increased respiratory effort, tachypnea, acute collapse, lethargy, anorexia, and cyanosis. The torsed lung lobes were excised using a thoracoabdominal stapling device without detorsing the lobes. Both dogs recovered uneventfully, and at least one year postoperatively, no clinical abnormalities were noted by their owners. Results of this report suggest that spontaneous lung lobe torsion in pugs occurs and should be a differential diagnosis for pugs with increased respiratory effort, tachypnea, nonproductive cough, acute collapse, cyanosis, and lethargy. Surgical excision may be curative.     

Liver lobe torsion in a dog

Abdominal radiographs of a dog presented for anorexia and vomiting revealed an ill-defined increase in opacity caudal to the stomach and caudal displacement of the small intestines. Ultrasonographs revealed an enlarged liver lobe with vascular thrombosis. Left medial liver lobe torsion was confirmed at postmortem.     

Prevalence of Surra among camels and horses in Jordan

The prevalence of Trypanosoma evansi infection among camels and horses in Jordan was studied using thick blood smears and inoculation techniques with mice and rats. A total of 437 camels and 83 horses from four climatic zones were surveyed. In addition, 40 donkeys, 32 cattle and 35 goats in contact with infected camels and horses were also tested in the same way. Clinical disease was evident in 8.2% of the camels (36 out of 437) and in 9.6% of the horses (8 out of 83). Infection was limited only to the Sweama area on the Dead Sea (within the warm desert-climatic zone), with prevalence of 30.5% and 33.3%, respectively, for camels and horses. Donkeys, cattle and goats examined were all free from T. evansi. Clinically affected camels were positive by both, thick blood smear and mouse and rat inoculations. Rat and mouse inoculations revealed (X²=3.2, df=1, exact p=0.07) greater number of positive cases in horses than those revealed by thick blood smears. T. evansi-infected camels and horses showed all the clinical signs known for Surra. In addition, it was observed that 100% of infected camels stared at the sun.     

Liver lobe torsion in dogs: 13 cases (1995-2004)

OBJECTIVE: To determine history, results of diagnostic testing, surgical findings, complications, and outcome for dogs with liver lobe torsion (LLT). DESIGN: Retrospective case series. ANIMALS: 12 dogs (1 with 2 episodes). PROCEDURE: Signalment, clinical signs, clinicopathologic findings, radiographic and ultrasonographic findings, surgical and histologic findings, complications, and hospitalization time were evaluated. RESULTS: The most common clinical signs were nonspecific abnormalities (eg, vomiting, lethargy, and anorexia) of acute or chronic duration. All dogs were large-breed dogs (median body weight, 37.2 kg [82 lb]). Biochemical abnormalities included high alanine amino-transferase (n = 12) and aspartate aminotransferase (11) activities. Results of abdominal ultrasonography were supportive of the diagnosis in 5 of 8 cases. Affected lobes included the left medial lobe (n = 4), left lateral lobe (3), papillary process of the caudate lobe (2), caudate lobe (1), and right lateral lobe (1). Exploratory celiotomy and liver lobectomy were performed in 12 of 13 cases, and in 11 of those 12 cases, the dog survived. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that development of nonspecific clinical signs of vomiting, lethargy, and anorexia in conjunction with high serum hepatic enzyme activities and mature neutrophilia in a medium-sized or large-breed dog should increase the index of suspicion for LLT. Abdominal ultrasonography with Doppler assessment may be useful in establishing the diagnosis. The long-term outcome for dogs that survive the hospitalization period is excellent.     

RADIOGRAPHIC DIAGNOSIS OF LUNG LOBE TORSION

Clinical data, thoracic radiographs, ultrasonographic exams, and histopathologic reports in 13 dogs and two cats with confirmed lung lobe torsion were reviewed. Age of dogs ranged from 4 months to 11.5 years, (mean of 6.4 years) and several breeds of large and small dogs were represented. Right middle lobe torsion was predominant in large dogs (five of eight large breed dogs) and left cranial lobe torsion was more commonly seen in small dogs (three of five small-breed dogs). Two domestic short-hair cats, 10 and 14 years of age, had right cranial and right middle lobe torsion, respectively. Underlying thoracic disease was found in only five of 15 patients. On thoracic radiographs, increased lobar opacity and pleural effusion were found in all patients (100%). Small dispersed air bubbles were found within the affected lobe of 13 patients (87%). This pattern, which was the result of vesicular emphysema, was variably extensive, and became more evident on follow-up radiographs in five of six dogs. The lobar bronchi could be seen in only eight of 15 patients (54%), and appeared irregular, focally narrowed or blunted in six of the eight patients, and displaced in five of the eight. Other common radiographic findings included mediastinal shift (nine), curved and dorsally displaced trachea (seven), and axial rotation of the carina (seven). Ultrasonography was used in seven patients and considered generally useful, although variable signs were observed.     

Torsion of abdominal organs in sows: a report of 36 cases

Necropsy records of 36 sows with torsion of abdominal organs involving individually the stomach, the spleen, a liver lobe or the intestine were reviewed for the years 1970 to 1983, and the age, the clinical signs and the gross lesions were recorded. These acute abdominal accidents were characterized clinically by sudden death. Dry sows from large breeding units were affected. Twenty-six cases were diagnosed between January 1981 and December 1983 while only ten cases had been seen between 1970 and 1980. Gastric torsion was the most common condition (40% of the cases) and the other three conditions were equally represented (20% each). Management practises that could be responsible for the apparent increase in occurrence of this problem are discussed.     

Hepatic lobe torsion in a horse

A 4-year-old Belgian mare was presented with a 1-week history of fever, suspected of being caused by peritonitis. The mare died before the diagnostic procedures had been completed; postmortem examination revealed torsion of the left medial lobe of the liver, resulting in diffuse necrosis of liver tissue and severe peritoneal effusion.     

Effect of foodstuff contamination by aflatoxin on the one-humped camel (Camelus dromedarius) in Al Ain, United Arab Emirates

Twenty young female adult one-humped racing camels (Camelus dromedarius) kept in camps scattered outside Al Ain city and aged between 3- and 6-years-old, died after a short clinical illness. Affected camels were dull, inappetant and pyrexic, with submandibular oedema and enlargement of submandibular lymph nodes. Of 100 camels within the camps, 31 showed clinical signs. At necropsy examination, the liver of dead animals appeared yellowish, enlarged, congested and friable. The main hepatic histological findings were centrolobular necrosis, haemorrhages and cellular vacuolation. Aflatoxins were detected in sera, liver, ruminal contents and in feed ingested by affected animals. Sera of symptomatic and recovered camels also showed increased levels of glutamic oxaloacetic transaminases, glutamic pyruvic transaminases, aspartate transaminases, gamma glutamyl transaminases, glucose, urea nitrogen, phosphorus and total iron. Decreased levels of albumin, calcium, cholesterol and triglycerides were also observed. It was probable that aflatoxicosis was responsible for clinical signs and subsequent death of the camels. The need for suitable and appropriate storage conditions of animal feed to prevent fungal growth and aflatoxin contamination is highlighted.     

Gross and histopathological studies on pulmonary lesions of camel (Camelus dromedarius) slaughtered at Addis Ababa abattoir,Ethiopia

This study was carried out with the aim of identifying types of gross and histopathological lesions in lungs of camels slaughtered between October 2009 and April 2010 at Addis Ababa abattoir enterprise, Ethiopia. All camels were originated from Borana and Kereyu areas. A total of 387 slaughtered camel lungs were inspected during the study period. Of which, one or more gross lesions were encountered on 300 lungs. Lesions were further subjected for detail gross and histopathological examinations. The occurrence of pulmonary lesions was 77.5%. The gross and histopathological examination of these lesions had revealed 60.2% emphysema, 21.2% hydatidosis, 18.6% pneumonia, 10.6% atelectasis, 4.9% aspiration of blood, 3.9% pneumoconiosis, 2.6% pulmonary edema and congestion, 1.6% abscess, 1% pleurisy, and 0.8% granulomatous pneumonia. Most camels had one or more pulmonary lesions on postmortem examination, but they were apparently healthy during antemortem inspection. Therefore, the prevailing stressful environmental condition coupled with the existing poor level of veterinary service in camel-rearing areas of the country might reverse these hidden inactive lesions and thereby contributed for the higher occurrence of respiratory diseases in camels.     

Liver torsion and associated bacterial peritonitis in a dog.

A Malamute was examined for acute abdominal pain and collapse. Radiographs of the abdomen showed a pneumoabdomen, and a lucent mass in the region of the liver. Abdominocentesis yielded an inflammatory exudate with bacteria compatible with a Bacillus or a Clostridium sp. A quadrate lobe torsion was found at postmortem.     

Analysis of clinical signs associated with bovine spongiform encephalopathy in casualty slaughter cattle

Clinical signs associated with bovine spongiform encephalopathy (BSE) were studied in 1008 casualty slaughter cattle over 30 months of age to compare the results with the BSE status as determined by postmortem tests. The clinical BSE status was assessed using seven different criteria based on various publications. Only one (0.10%) out of 997 casualty slaughter cattle with a matching postmortem test result was positive for BSE. The BSE case was identified by only two case definitions tailored specifically to recumbent cases. The variety and often equivocal definition of clinical signs associated with BSE is reflected by the difference in the criteria that usually identified different animals as BSE suspects. The BSE status may be more difficult to assess in recumbent animals that do not allow a full clinical examination, and BSE may not be suspected if another disease is present that may mask signs of BSE.     

Aspergillosis in camels affected with a specific respiratory and enteric syndrome

During the summer of 1990 deaths, occurred in racing camels (Camelus dromedarius) associated with a specific disease syndrome. Clinical signs included pyrexia, coughing, lachrymation, oedema of the throat and submandibular region and enlargement of submandibular lymph nodes. In terminal cases nervous signs were present and sometimes there was bloody diarrhoea and vomiting. Of 480 camels at least 70 animals were affected with the disease and about 40 died. Morbidity and mortality was greater in camels recently imported. Consistent necropsy findings were extensive petechial and ecchymotic haemorrhage beneath the epicardium, endocardium and visceral pleura and in the mediastinal lymph nodes, and haemorrhagic oedema of the pharyngeal and laryngeal areas. Haemorrhages occurred more variably in abdominal organs and on the omasal and abomasal mucosa. Bronchopneumonia, omasitis and abomasitis were observed on microscopic examination, together with liver and kidney lesions of presumed toxic origin. Fungal hyphae and, occasionally, the characteristic conidial morphology of Aspergillus fumigatus were seen in sections and direct smears from lesions in the respiratory and alimentary tracts. A fumigatus was cultured from trachea, bronchi, bronchioles, lung tissue, heart blood, omasum, abomasum, ileum and submandibular lymph nodes. Whether the role of Aspergillus in the overall syndrome is primary or secondary has not been established; no other potential aetiological agent has been identified.     

Lung lobe torsion associated with chylothorax in a cat

A 10.5-year-old domestic shorthair presented with a history of progressive inappetence, lethargy and elevated respiratory rate. Clinical and diagnostic findings confirmed the presence of a chylothorax with evidence of a mass or collapsed lung within the right cranial thorax. Computed tomography, sternotomy and histopathology confirmed the presence of a right middle lung lobe torsion associated with a chylothorax. The torsion was successfully managed with surgical removal of the affected lung lobe, and the patient continues to be asymptomatic 6 months postoperatively.     

Segmental lung lobe torsion in a 7-week-old Pug

Case summary: A 7‐week‐old, intact female Pug was referred with an acute history of expiratory dyspnea, tachypnea, and pyrexia. Radiologic evaluation revealed bilateral pleural effusion and a poorly demarcated area of soft tissue opacity cranial to the heart. The presence of air bronchograms in the cranial lung lobes suggested alveolar parenchymal pathology consistent with pulmonary edema, congestion, or cellular infiltration. Exploratory thoracotomy revealed a segmental torsion of the left cranial lung lobe. The affected lobe was removed and the puppy recovered uneventfully. Unique information: Lung lobe torsion tends to occur more frequently in mature large breed dogs at a mean age of 3 years. The age, breed, and segmental nature of the torsion in the reported case are contrary to most of the previously documented cases of lung lobe torsion. To the authors' knowledge, this is the first report of lung lobe torsion in a 7‐week‐old dog.     

Clinical signs and pathology of accidental monensin poisoning in sheep

The clinical signs and postmortem findings in sheep from two flocks accidentally poisoned with monensin are described. Clinical signs began within 24 hours of exposure to monensin. In the acute stages they consisted of lethargy, stiffness, muscular weakness, a stilted gait and recumbency. Feed refusal was seen in one flock but not in the second. Subacute to chronic clinical signs were decreased muscle volume of the rump and thigh. When forced to run, chronically affected sheep had a stilted, stiff legged, rocking horse gait.

Gross postmortem changes were not always visible. Where visible, they affected skeletal muscles and consisted of pale streaking, with atrophy in the chronic stages. Lesions were most severe in muscles of the rump and hind limbs. Microscopically myofiber swelling and hyalinization were seen with interstitial mononuclear cell reaction and extensive sarcoplasmic mineralization in some cases. Chronic lesions consisted of fibrosis and myofiber atrophy. In lambs less than one month old, diffuse gastrointestinal hemorrhage was the only finding.