Testicular Torsion in the Scrotum of a Young Canine

Resumo

Background: Testicular torsion is a rare condition in canines, affecting any animal, regardless of age and racial predisposition. The possible cause, when talking about young dogs, is often unreliable, and can be associated with traumatic processes or excessive physical activity. Dogs with spermatic cord twist usually show signs of acute and sudden pain in one of the testicles that can be propagated to the abdomen; besides edema, heat and scrotal flush. The absence of blood flow toward the affected testicle can be observed, however, the definitive diagnosis can only be confirmed through a surgical procedure or necropsy. This situation is considered a medical emergency that requires surgical intervention for resolution
and has treatment of choice bilateral orchiectomy. The objective of this study was to report the case of a testicular torsion inside the scrotal pouch of a young dog.
Case: A 6-month-old male Poodle dog, weighing 6.40 kg, was attended at the Metropolitan Veterinary Polyclinic, located in the municipality of Caucaia, Ceará, Brazil. During anamnesis it was reported by the owner of the animal an suddenly increase in volume of the scrotal pouch and right testicle. The physical examination observed normal mucous membranes,
lymphadenopathy, capillary refill time of 2 s, temperature of 39.2°C, heart rate of 72 beats per minute and 68 breaths per minute. Hematologic test was requested, creatinine, dosage of ALT and ultrasound as complementary exams. The result of hemogram presented thrombocytopenia (150,000/mm3) and the presence of giant platelets. Besides, a biochemical series presented no alterations. On the Doppler ultrasound, the right testicle proved to show loss of normal structure, enlarged scrotum, hyperechoic epididymal region with adjacent liquid and absence of local vascularization. Pre-scrotal orchiectomy was performed and an enlarged right testicle was observed with blackened coloration and torsion of spermatic cord, that, possibly resulted in ischemia and testicular necrosis. On that occasion, the testicle was displaced to the incision line and maintained until the previous incision in the tunica albuginea, spermatic fascia and tunica vaginalis, parietal and visceral, in this order. After the identification of the torsioned spermatic cord, a ligature was made in order to remove testicle. The process was accomplished in both testicles. The contralateral gonad was found without alterations. The patient returned
after fifteen days of surgical procedure for evaluation and presented evident improvement of overall clinical overview and surgery recuperation.
Discussion: In spite of the testicular torsion be more associated to cases of senile and criptorquid animals, the present overview occurred in a testicle located in the interior of the scrotal sac in an extremely young animal. This can be related to a rupture of scrotal ligament, due to trauma or excessive physical effort, which fits overall overview of the patient in evidence. This results as presented in this report, in venous heart attack with testicle and epidimo becoming enlarged, congestioned with necrosis points. The rapid establishment of therapeutical surgery of orquiectomy can avoid the patients’ instability and evolution of the overall clinical overview. The rarity in literature of the reports of testicle torsion at the clinic of small animals demonstrated the importance, need for further investigation and previous knowledge regarding the origin of the abnormality. The ultrasound and surgical treatment of orquiectomy demonstrated an alternative capable and efficient to produce a favorable prognostic of this report.
Keywords: testicular dilatation, vascular rupture, ischemia, necrosis, orchiectomy.