Unilateral uterine torsion with a near-complete rip of the affected right horn in a parturient German shepherd bitch

Abstract

Intra-parturient uterine torsion is a rare condition in bitches with multifactorial aetiologies. It is a cause of obstructive dystocia and is difficult to diagnose with most imaging techniques. Medical management of dystocia in parturient bitches with oxytocin often result in uterine rupture with severe consequences on maternal and foetal health. A three-year-old German shepherd (31kg) bitch presented to the Veterinary Teaching Hospital (VTH), University of Ibadan, Oyo State, Nigeria was diagnosed, after a caesarean section, with intra-parturient right horn torsion (180-degrees intracornual and 360-degrees at the ovarian end) and a near-complete rip of the affected horn from the uterine body. Before presentation, the bitch was said to have whelped three puppies but discontinued apparently due to perceived uterine inertia even when injected with three doses of oxytocin by a caregiver. The bitch’s vital signs were abnormal and reflected signs of progressive shock. Haemogram showed severe anaemia, moderate neutrophilia with left shift, normal plasma protein level and platelet counts. An ultrasound examination revealed the presence of two foetuses in-utero but un-engaged at the bitch’s birth canal. Following patient’s stabilisation, a caesarean section unveiled an empty, involuting, left uterine horn, a 180 degrees intracornual twist of the right horn (separating the foetuses into two closed compartments) and a 360 degrees torsion at the ovarian end, which severely strangulated the vessels and ligament. The affected horn, vessels, and ligament were congested. The gravid horn was nearly ripped from the uterine body at the bifurcation. The torsion was corrected, foetuses evacuated and a hemi-cornuectomy performed. The bitch’s recovery was uneventful. The diagnosis and management of obstructive dystocia is a challenge, especially in poor resource settings. The option of surgical intervention should be considered as an emergency by both pet owners and clinicians to preclude further complications, including those caused by oxytocin.
 Keywords: Hemi-cornuectomy, Intra-parturient, Oxytocin, Torsion, Uterine

Unilateral uterine torsion in a preparturient Boer Bull bitch resolved by caesarian section and unilateral cornuectomy

“…This method was not used in this present case because there was practically no Perhaps, erroneous administration of oxytocin in the present condition could have led to uterine rupture. An indiscriminate use of oxytocin was reported earlier as cause of uterine torsion in a pregnant Labrador bitch (Kodie et al, 2019). The primary cause of uterine torsion in this case remains uncertain.…”

“…The caesarean section was performed as described in an earlier study by Kodie et al, ( 2019). Briefly, a ventral midline incision was made from the umbilicus caudally towards the pubis.…”

“…Bilateral uterine torsion has been reported in a non-gravid old bitch (Shull et al, 1978) possibly due to weakness of the broad ligament which supports and hold the uterus in situ. The degree of torsion may vary from 180 o to 270 o (Kumru et al, 2011) while few cases have reported over 360 o torsion in dog especially from the ovarian attachment (Kodie et al, 2019). It may also be congenitally induced as was found with congenital bilateral segmental aplasia of the uterine horn in a Pomeranian bitch (Nakamura et al, 2012).…”