PRACTITIONERS' CORNER LE COIN DES PRATICIENS

Mesenteric torsion in a dog

Sheila C. Rahal, Maria 1. Garib, Maria J. Mamprim, Carlos R. Teixeira
A1.5-year-old, intact crossbreed bitch, weighing 7 kg, (0.2 mg/kg/BW, IV), and induction and maintenance with
was referred to the Veterinary Hospital with a sus- isoflurane. A great amount of brownish fluid with a
pected intussusception. According to the owner, the foul odor in the peritoneal cavity; mesenteric twisting;
animal suddenly became depressed after an onset of and loops of small intestine dilated with gas, black in
yellow diarrhea 24 h before, followed by fluid vomiting, color, and without motility were observed. Devitalized
without blood, that started 6 h after the diarrhea. Twenty small intestine was resected without derotation, and
days earlier, she had given birth to 5 puppies, 1 of them end-to-end duodenoileal anastomosis was performed
dead. with size 4-0 nylon. The pancreas seemed normal on
Physical examination revealed, pale mucous mem- macroscopic evaluation. The peritoneal cavity was
branes, prolonged capillary refill time, temperature of lavaged with warm physiologic saline.
38.4°C, heart rate of 180 beats/min, weak pulse, and a Postoperative management involved blood transfusion,
tense and painful abdomen upon palpation. The IV fluids, and parenteral nutrition for 3 d. Enrofloxacin
hemogram was normal, with the exception of total pro- (10 mg/kg BW, SC, q24h) plus metronidazole (20 mg/kg
tein (50 g/L). The animal received, IV, lactated Ringer's BW, PO, ql2h) was administered for 15 d. A small
solution (90 mL/kg body weight (BW)/h), hypertonic amount of food was offered 4 d after surgery and daily
(7%) saline (4 mL/kg BW), and enrofloxacin (10 mg/kg vitamin-mineral supplement was initiated. Initially, the
BW). A plain abdominal radiograph showed reduced animal had liquid feces that became soft a few weeks
organ detail and loops of small intestine moderately later. However, diarrhea was observed occasionally for
distended by gas (Figure la). Ultrasonography demon- 5 mo. In the last evaluation, 8 mo after the surgery,
strated liquid in the abdominal cavity and loops of the the animal was alert, more active, without weight loss,
intestine containing gas and fluid, without peristaltic con- and with normal stools. Contrast radiographs showed bar-
tractions (Figure lb). Obstruction of the small intestine ium in the distal colon after 60 min and signs of enteri-
was suspected, and an exploratory laparotomy through tis were observed.
the ventral midline was performed. Mesenteric torsion is infrequent in dogs (1), but small
The anesthetic protocol consisted of premedication intestine (2,3), large intestine (4), or both (5), can be
with buprenorphine (5 ,ug/kg BW, IV) plus diazepam involved. It has been reported in young adult, male,
medium- to large-sized dogs (1), but it should also be a
Department of Veterinary Surgery and Anesthesiology (Rahal, differential diagnosis for acute abdominal disease in
Garib, Teixeira), Department of Animal Reproduction and small dogs (6), as observed in the present case. It
Radiology (Mamprim), Faculty of Veterinary Medicine and has been associated with tumor (2), gastric dilation-
Animal Science, UNESP Botucatu, Caixa Postal 560, Rubiao volvulus (3), exocrine pancreatic insufficiency (7),
Junior, s/n, CEP: 18618-000, Botucatu (SP), Brazil.
enteritis (5), and intussusception (5,8), among other
Address correspondence to Dr. Sheila C. Rahal. conditions. In this case, the only known circumstance

Figure 1. Lateral preoperative abdominal radiograph showing small intestine distended with gas and loss of abdominal detail
(a), and ultrasonography showing loops of the intestine with gas and fluid (b).

710 710Can Vet J Volume 41, September

Can Vet
2000
J Volume 41, September 2000
before the torsion was the pregnancy, but it is not References
known if this was a contributing factor. Prognosis is con- 1. Fossum TW, ed. Small Animal Surgery. St. Louis: Mosby, 1997:
sidered grave (5), and the mortality rate is almost 100% 316-319.
(3,5-7,9). Mesenteric root torsion causes obstruction of 2. Harvey HJ, Rendano VT. Small bowel volvulus in dogs - Clinical
the mesenteric artery and its branches, so if it is not observations. Vet Surg 1984; 13:91-4.
3. Matushek KJ, Cockshutt JR. Mesenteric and gastric volvulus in a
treated immediately, death will result (1). dog. J Am Vet Med Assoc 1987;191:327-8.
The intestinal resection without derotation differed 4. Carberry CA, Flanders JA. Cecal-colic volvulus in two dogs. Vet
from the procedure frequently used (1,4,6,8). It was Surg 1993;22:225-228.
selected because derotation and tissue reoxygenation may 5. Nemzek JA, Walshaw R, Hauptman JG. Mesenteric volvulus in the
contribute to death (1). The preoperative and postoper- dog: a retrospective study. J Am Anim Hosp Assoc 1993;29:
357-362.
ative management was considered important, because 6. Shealy PM, Henderson RA. Canine intestinal volvulus. A report of
although the intestinal resection was extensive, the ani- nine new cases. Vet Surg 1992;21:15-19.
mal did not develop short bowel syndrome, which is a 7. Westermarck E, Rimaila-Parnanen E. Mesenteric torsion in dogs with
potential complication (1,9). Probably, preservation of exocrine pancreatic insufficiency: 21 cases (1978-1987). J Am Vet
Med Assoc 1989; 195:1404-1406.
the ileocecolic valve was an important factor, since it 8. Stickle R, Walshaw R. What is your diagnosis? J Am Vet Med Assoc
extends the duration of intestinal transit and contributes 1989;194: 1631-1632.
to the prevention of bacterial overgrowth in the small 9. Yanoff SR, Willard M, Boothe HW, Walker M. Short-bowel syn-
intestine (9). drome in four dogs. Vet Surg 1992;21:217-222.

BOOK REVIEWS COMPTES RENDUS DE LIVRES

Voigt GL. Hematology Techniques and Concepts for fluids, plus vaginal cytology, would also be of benefit and
Veterinary Technicians. Iowa State University Press, improve Chapter 14 by making the information more
Ames, Iowa, 2000. 148 pp. ISBN 0-8138-0491-4. meaningful to the student, as would photographs of
US$39.95. normal bone marrow illustrating stages of cell matura-
tion. I realize that the cost of the text would rise, but it
his is an excellent review text for someone who has is already very reasonably priced and these additions
been away from the field for a time and wishes to would obviate the students having to buy yet another text
return to the subject. It is also written at a level that is to have these pictures for reference.
very good for the student of veterinary technology. A larger section devoted to automated cell counters
Previous texts that I have seen are either too in-depth, would be preferred. In western Canada, the IDEXX
being directed at the veterinarian' s level or of someone QBC-V is widely used, and some information on its prin-
who is specialized in clinical pathology. I find this ciples and printout interpretation would be useful.
book supplies the information frequently needed by a As an instructor in a Canadian program, I use SI units
technician in general practice and no more. It is, there- exclusively in the laboratory; these are not covered in the
fore, a valuable, handy resource. However, because, text. However, the calculations set out in the text are well
to date, such a text has been difficult to find, I have writ- done and easy to understand, so this is not a problem that
ten my own laboratory manuals in hematology, immunol- would prevent me from using the textbook. I also prefer
ogy, and clinical chemistry. Therefore, it doesn't supply the use of the term "Mean Corpuscular Values" over
anything that I need for my students. Still, it is a text that "Red Cell Indices." But it is a good idea to expose stu-
I would put on my recommended list, because it provides dents to other terminology. A short section on exotic
a concise location for reference of information, it pro- bloods, particularly avian, including differentials (and
vides the student with another "slant" on the information again photographs) would be a definite asset.
given in the course, and it is a source of information for In summary, this is an excellent text. It provides
those students who either prefer or need to read mater- need-to-know information concisely. If the above recom-
ial in a textbook, either as an initial learning method or mended changes where made, especially the inclusion of
for a review. more photographic plates, I would not hesitate to use this
As an instructor, I would like to see more photo- book as my required text for the hematology course. It
graphic plates to augment the line diagrams and text, par- would also be a very popular text for use in general prac-
ticularly microphotographs of normal cellular morphol- tice. It didn't take me long to make these judgements,
ogy of the major domestic species, as well as of those which is a testament to its ease of reading and the prac-
showing abnormal erythrocytes, leukocytes, and technical tical way in which the book is put together.
artifacts. The book could then become a sole-source
teaching text and I would use it as the required course Reviewed by Patricia Bell, RVT, BSc, Instructor,
text. Veterinary Technology Program, Kelsey Campus,
A further group of pictures showing cytology of nor- Saskatchewan Institute of Applied Sciences and
mal versus infected/inflammatory reactions in body Technologies, Saskatoon, Saskatchewan S7K 3R5.

Can Vet J Volume 41, September 2000 711