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Fatal Intraoperative Pulmonary Fat Embolism During Cemented Total Hip Arthroplasty in a Dog

From the Departments of Pathobiology (Terrell, Chandra), Large Animal Clinical Sciences (Pablo), and Small Animal Clinical Sciences (Lewis), College of Veterinary Medicine, University of Florida, Gainesville, Florida 32610.

A 3-year-old, German shepherd dog died suddenly during cemented total hip arthroplasty. Gross necropsy findings included severe pulmonary edema and congestion as well as congestion of the liver and kidneys. Acute pulmonary embolism was suspected as the cause of death. Microscopic examination of hematoxylin and eosin-stained, formalin-fixed, and oil red O-stained frozen tissue sections confirmed the presence of large numbers of fat globules in blood vessels in the lungs, liver, and kidneys. Fat embolism during total hip arthroplasty is a common surgical complication in humans, but it is uncommon in veterinary cases and is rarely a cause of death.