New case report links ultrasound ‘whirl sign’ to canine pancreatic torsion: full analysis

A new canine imaging case report may give veterinarians a more specific preoperative clue for one of the rarest pancreatic emergencies in dogs. In Veterinary Radiology & Ultrasound, Chris Holm and Jonathan T. Shiroma describe a 7-month-old Labrador Retriever with vomiting, inappetence, and lethargy whose abdominal ultrasound showed a “whirl sign,” with pancreatic torsion later confirmed at surgery and on histopathology. Based on the report abstract, this is the first published description of that ultrasound sign in a dog with pancreatic torsion. (pubmed.ncbi.nlm.nih.gov)

That’s notable because pancreatic torsion is still represented in the literature mostly by isolated case reports. A 2015 Canadian Veterinary Journal report described a 6-month-old Cane Corso with vomiting, abdominal pain, and lethargy; in that case, pancreatic torsion was diagnosed during exploratory surgery and confirmed histopathologically after partial pancreatectomy. More recently, a 2024 Veterinary Medicine and Science case report described successful surgical management in a 3-month-old Bernese Mountain Dog, with no evidence of long-term pancreatic dysfunction 14 months after surgery. The authors of that paper said only a single prior canine pancreatic torsion case report had been described at the time, underscoring how limited the evidence base remains. (pubmed.ncbi.nlm.nih.gov)

The new report adds a diagnostic detail that could matter in practice: a recognizable sonographic “whirl sign” in the region of the pancreas. In veterinary imaging, the “whirl sign” is already familiar from other torsion syndromes. A 2020 Veterinary Radiology & Ultrasound study of eight dogs with surgically confirmed splenic torsion found the sign in seven cases on CT, and newer reports have also described it in urinary bladder and testicular torsion. The implication is that radiologists and emergency clinicians may be able to apply an already known pattern-recognition concept to a much rarer pancreatic presentation. (pubmed.ncbi.nlm.nih.gov)

At the same time, ultrasound of the pancreas is far from straightforward. Professional small-animal ultrasound guidance notes that pancreatic ultrasound has a significant false-negative rate for serious pancreatic disease, and that normal-appearing imaging does not exclude pathology. The pancreas can be difficult to visualize because of bowel gas, patient conformation, and the organ’s often subtle echogenic distinction from surrounding mesentery. That context makes a more distinctive sign, if reproducible, especially relevant for frontline practice and tele-ultrasound interpretation. (bmus.org)

I wasn’t able to find a press release or outside expert commentary specifically addressing this new Labrador case, which is typical for narrowly focused veterinary case reports. But the broader literature points in a consistent direction: when torsion is suspected in abdominal organs, surgery is often both diagnostic and therapeutic. In the previously published pancreatic torsion reports, exploratory laparotomy and partial pancreatectomy were used to confirm and treat the lesion, and both dogs recovered without reported major postoperative complications; the 2024 case also documented reassuring long-term pancreatic function testing. (pubmed.ncbi.nlm.nih.gov)

Why it matters: For veterinary professionals, this report doesn’t change standard of care on its own, but it may refine the differential list in the right case. A young dog with acute vomiting, lethargy, abdominal pain or inappetence, and an atypical cranial abdominal or pancreatic-region lesion on ultrasound might not simply have pancreatitis, a mass, or nonspecific inflammatory change. If the “whirl sign” is present, pancreatic torsion may deserve earlier consideration, especially because the published canine cases to date have involved very young dogs and required surgery for confirmation and treatment. Earlier suspicion could improve communication with pet parents, accelerate referral decisions, and reduce delays to exploratory surgery in unstable patients. (pubmed.ncbi.nlm.nih.gov)

There are still important limitations. This is a case report, not a validation study, so clinicians can’t assume the sign will be present in every case or that it’s specific to pancreatic torsion. Similar “whirl” patterns occur in other torsion disorders, and pancreatic disease on ultrasound remains vulnerable to false negatives and interpretation challenges. In other words, the new finding is best viewed as an additional clue, not a standalone rule-out or rule-in test. That’s an inference based on the broader torsion and ultrasound literature, rather than a direct claim from the case abstract itself. (pubmed.ncbi.nlm.nih.gov)

What to watch: The next step is whether the full paper, and any follow-on reports, define the sonographic appearance in enough detail for wider adoption, and whether future canine cases show the “whirl sign” consistently enough to become a practical trigger for urgent surgical consultation. (pubmed.ncbi.nlm.nih.gov)