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Lung Lobe Torsion 593

Acute General Treatment
• Conservative management: strict cage rest
VetBooks.ir activity over 6-8 weeks. Antiinflammatory/ Diseases and Disorders
(4-6 weeks), then gradually increasing
analgesic medication to control pain as
needed. Consider tramadol 2-5 mg/kg PO
q 8-12h and gabapentin 10 mg/kg PO q
8-12h in combination with a nonsteroidal
antiinflammatory drug.
• Anxiolytics (trazodone 5-7 mg/kg PO q 12h;
if combined with tramadol, reduce dose to
3.5 mg/kg) or sedatives (acepromazine
0.5-2 mg/kg PO q 8-12h) may be needed
during cage rest, but avoid oversedation.
• Epidural injection of glucocorticoids (e.g.,
methylprednisolone acetate 1 mg/kg) was
reported to confer improvement in up to LUMBOSACRAL STENOSIS, DEGENERATIVE Sagittal T2-weighted MRI of the lumbar region of a mature
80% of dogs. Multiple injections may be dog with degenerative lumbosacral stenosis; cranial is to the left. The disc at the LS junction (arrow) is protruding
required. into the spinal canal and shows low signal intensity that is consistent with degeneration.
• Dogs with moderate to severe signs, fecal/
urinary incontinence, or failure to improve Possible Complications • The severity of stenosis/nerve root compres-
despite conservative management are sur- • Failure to improve sion does not always correlate with severity
gical candidates. Surgical treatment most • Infection of clinical signs.
frequently consists of decompression through • Increased LS instability • LS pain and lameness are the earliest and
dorsal laminectomy. • Implant failure most consistent signs. Urinary and fecal
• Additional interventions can include forami- • Laminectomy fibrosis incontinence are most likely to occur with
notomy, discectomy, and stabilization. progressive disease but may be the initial
PROGNOSIS & OUTCOME complaint.
Chronic Treatment
• Strict confinement is necessary for 4-6 weeks • 55% success rate with conservative Technician Tips
after surgery, followed by gradual return to management In patients with urinary incontinence, monitor
function over 2 months. • 70%-80% success rate with surgical closely for urine scald. Ensure patient is kept
• Sling support may be necessary in the early management clean and dry at all times.
postoperative period. • Surgical outcome is not typically negatively
• Urinary bladder management is imperative influenced by attempting medical manage- SUGGESTED READING
until there is normal voluntary voiding. ment first. Dewey CW, et al: Disorders of the cauda equina.
Consider placement of urinary catheter • Recovery with fecal/urinary incontinence less In Dewey CW, et al, editors: Practical guide to
during early management. favorable and may take weeks to months. canine and feline neurology, ed 3, Ames, IA, 2016,
• Recurrence in 3%-18% of cases, with Wiley-Blackwell.
Nutrition/Diet working dogs at increased risk
Maintenance of ideal body condition is RELATED CLIENT EDUCATION
beneficial. PEARLS & CONSIDERATIONS SHEETS
Behavior/Exercise Comments Consent to Perform Computerized Tomography
• Physical rehabilitation, including passive • When assessing pelvic limb reflexes, pay (CT Scan)
range of motion, acupuncture (p. 1056), and attention to reduced stifle and tarsal flexion How to Assist a Pet That Is Unable to Rise
underwater treadmill, is often advantageous. during the withdrawal reflex. Hip flexion and Walk
• High-impact activity such as jumping should be normal.
and climbing stairs should be avoided • LS discospondylitis can be difficult to Reproduced from the third edition in modified
indefinitely. distinguish from degenerative LS stenosis. form. Third edition author: Boel A. Fransson,
In cases with osteolytic or severely prolifera- DVM, PhD, DACVS
Drug Interactions tive changes, urine, blood, and if surgery AUTHOR: Danielle M. Zwueste, DVM, DACVIM
Monitor for signs of serotonin syndrome if is performed, the removed disc should be EDITOR: Kathleen Linn, DVM, MS, DACVS
using both tramadol and trazodone (p. 1281) submitted for bacterial and fungal culture.

Lung Lobe Torsion Client Education
Sheet

Epidemiology GENETICS, BREED PREDISPOSITION
BASIC INFORMATION
SPECIES, AGE, SEX • Spontaneous lung lobe torsion (LLT): large
Definition • Dogs (and rarely, cats) breeds > small breeds
Rotation of a lung lobe along its long axis, • Middle-aged dogs more commonly affected • Dogs with deep, narrow chests have a higher
with twisting of the bronchus and pulmonary • No sex predisposition. incidence.
vessels at the hilus • Afghan hounds are overrepresented.
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