Case Report: Unilateral uterine torsion in a non-pregnant Siberian-Husky-clinical insights and implications for reproductive management

Abstract

Uterine torsion is a rare condition in dogs, typically associated with pregnancy or uterine pathology. A 5-year-old, female intact, Siberian-Husky presented with a history of lethargy and constipation for 3 days. Physical examination revealed pale mucous membranes and a firm, painful abdomen. Abdominal imaging revealed a thickened uterine body wall with an increased volume of mixed anechoic and heterogeneous echoic intrauterine content. Exploratory laparotomy confirmed the 360-degree torsion of the left uterine horn, and due to the extensive lesions ovariohysterectomy was deemed necessary. Postoperative clinical evaluation indicated ongoing signs of impaired oxygen delivery warranting hemotransfusion, following which progressive stabilization and complete clinical recovery was achieved. Histopathological examination showed diffuse uterine necrosis due to hypoxia from venous stasis, with inflammatory infiltrate of neutrophils, macrophages, and lymphocytes. This report contributes to the limited veterinary literature on uterine torsion in non-pregnant bitches and underscores the importance of including it in the differential diagnosis, even in young patients or when other reproductive pathology is not evident, where a lack of predisposing factors may reduce clinical suspicion. It clearly illustrates how an acute reproductive emergency can abruptly and permanently preclude any future reproductive potential from an otherwise healthy animal.

Keywords: bitch; case report; hematometra; reproductive challenges; uterine torsion.

Figure 1

(A) Left lateral radiographic image of the abdomen in a 5-year-old, female intact, Siberian-Husky with uterine torsion showing loss of peritoneal serosal detail and a mass effect displacing the small intestines in the cranial abdomen; the mildly increased radiopacity in the center of the abdomen (star) is suggestive for the presence of a soft-tissue opacity mass. (B) Ultrasonographic image of the uterus in the same dog showing heterogeneous echogenicity and increased thickness of the uterine wall (between arrowheads) and anechoic content (star) mixed with an irregular moderately echoic content (arrow).

Figure 2

Intraoperative aspect of the twisted uterine horn prior resection. Significant distention and vascular congestion can be observed.

Figure 3

Gross appearance of the sectioned uterine horn. Note the luminal dark-red fluid and clotted blood consistent with advanced hemometra.

Figure 4

Histopathological examination. (A) Uterine wall—venous stasis and venous infarction. Profuse transudate dilacerating uterine structures, especially myometrium; Masson’s trichrome stain, ×40. (B) Severe necrosis of the endometrium and underlying structures, inflammatory reaction in the submucosa, vascular distention (stasis); Masson’s trichrome stain, ×100.