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Lung lobe torsion in a 2 year old FS pug

Case Study

Case Study

Lung lobe torsion in a 2 year old FS pug

A 2½-year-old SF Pug dog with a 3-week history of coughing was presented for evaluation of sudden onset anorexia. Mild leukocytosis was present on CBC. Serum chemistries showed mildly elevated amylase, lipase, and ALP activity. The sonographer noted minor tachypnea at the time of the abdominal sonogram. 

A 2½-year-old SF Pug dog with a 3-week history of coughing was presented for evaluation of sudden onset anorexia. Mild leukocytosis was present on CBC. Serum chemistries showed mildly elevated amylase, lipase, and ALP activity. The sonographer noted minor tachypnea at the time of the abdominal sonogram. 

DX

Lung lobe torsion with lobar pneumonia

Sonographic Differential Diagnosis

Suspect lung lobe torsion given the clinical history, breed and sudden onset with unexplained lung consolidation and hemothorax. Underlying neoplasia possible.

Image Interpretation

Ill-defined left cranial lung consolidation with echogenic fluid. Air interface obscured adequate imaging.

Outcome

Left cranial lung lobe torsion diagnosed on CT and surgery. Underlying lobar pneumonia. Patient recovered uneventfully.

Clinical Differential Diagnosis

Cough – tracheo-bronchial (bacterial, allergic, foreign body, airway collapse), pulmonary (bacterial/fungal pneumonia, aspiration, abscessation, foreign body, granuloma), diaphragmatic hernia.

Sampling

Ultrasound-guided thoracocentesis revealed frank blood. The patient was referred for immediate thoracotomy on suspicion for lung lobe torsion.

Video

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Patient Information

Patient Name : Molly C
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 10_00066

Clinical Signs

  • Anorexia
  • Coughing

Images

lung_lobe_torsion_molly_clung_lobe_torsion_molly_c_5lung_lobe_torsion_molly_c_4

Blood Chemistry

  • Alkaline Phosphatase (SAP), High
  • Amylase, High
  • Lipase, High

CBC

  • WBC, High

Clinical Signs

  • Anorexia
  • Coughing