Bilateral lung lobe torsions in a cat

Abstract

A 13-year-old spayed female domestic longhair cat was presented for tachypnea and was identified to have reduced lung sounds over the left hemithorax. Thoracic ultrasound examination and computed tomography identified changes consistent with bilateral lung lobe torsion. A median sternotomy confirmed torsion of both the cranial portion of the left cranial lung lobe and the right middle lung lobe. The affected lobes were resected. Pleural fluid analysis was indicative of a modified transudate and histopathology was consistent with a subacute to chronic torsion with no evidence of neoplasia or infection. The patient recovered without complication. Lung lobe torsion is an uncommon presentation across all species and is especially rare in cats. To the authors' knowledge, bilateral lung lobe torsion has not been previously reported in small animals.

Figure 1

Ventrodorsal (A) and right lateral (B) thoracic radiographs taken following thoracocentesis demonstrating consolidation of the cranial segment of the left lung lobe and the right middle lung lobe. The cardiac silhouette is shifted to the right and there is a small amount of remaining pleural effusion.

Figure 2

Thoracic ultrasound image of the right middle lung lobe demonstrating a hepatized appearance. No color doppler flow was detected within the lobe.

Figure 3

Coronal CT image demonstrating a completely consolidated and swollen right middle lung lobe, with the lobar bronchus discontinued at the hilus. There is a resultant leftward mediastinal shift. The left cranial lung lobe is almost completely consolidated with a vesicular pattern, with the associated bronchus ending bluntly at the hilus. There is persistent arterial supply and occluded venous supply from the left cranial lung lobe. The caudal portion of the left cranial lobe is reduced in size and partially infiltrated with soft tissue attenuation, with a normally positioned lobar bronchus.