Lung lobe torsion in the Pug: surgical technique
2-year-old Pug with dyspnoea, cough and anorexia for 3 days, with no history of trauma. Serosanguineous pleural effusion. CT shows a consolidated, enlarged left cranial lung lobe with an abruptly truncated lobar bronchus and a vesicular gas pattern.
Which surgical approach is correct?
chevron_right Show answer and explanation
A. Untwist the lobe and preserve it if its colour returns after a few minutes
A lobe that has been twisted for days has necrosis and thrombosis even if its colour changes; preserving it risks recurrence, infection and toxin release.
B. Lobectomy without untwisting the pedicle, ligating it in its twisted position
Correct. Untwisting the lobe before ligating the pedicle can release accumulated inflammatory mediators, endotoxins and thrombi into the circulation. The hilus is ligated or stapled as it lies and the whole lobe is removed.
C. Untwist the lobe and fix it to the thoracic wall to prevent recurrence
Lobopexy is not indicated: the affected lobe is no longer viable, and untwisting it carries the risk of releasing toxins and thrombi.
D. Chest drain and antibiotics; surgery only if no improvement within 72 hours
Torsion does not resolve spontaneously; delaying surgery increases necrosis, effusion and the risk of sepsis.
lightbulb Key takeaway
In Pugs, torsion usually affects the left cranial lobe, often with no underlying cause and with a good prognosis after lobectomy. In deep-chested dogs the right middle lobe is more typical. In Afghan Hounds it is associated with chylothorax, which worsens the prognosis: always analyse the pleural fluid.
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Updated: November 1, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.