Preventative pneumopexy in the management of concurrent right cranial and middle lung lobe torsion following right caudal lung lobectomy in a dog

A 4-year-old female neutered Welsh Springer Spaniel was presented with pneumothorax secondary to a migrating foreign body in the right caudal lung lobe. Within 24 hours following thoracic exploration and hilar lung lobectomy, the patient deteriorated. CT was consistent with lobar torsion. A second median sternotomy identified concurrent right cranial and middle lung lobe torsion. Hilar lobectomy of the affected lobes was performed. To prevent lobar torsion of the remaining lobe, a preventative accessory lobe pneumopexy was performed, potentially averting an additional surgical procedure and reducing total lung capacity to less than the reported minimum critical mass compatible with survival. No complications following accessory lung lobe pneumopexy were encountered in this single case. Although post-lobectomy lung lobe torsion appears to be rare in dogs, clinicians should be aware of this potentially life-threatening complication. This case report documents the first description of pneumopexy as a preventative procedure in a dog.