Clinicopathological findings in and prognostic factors for domestic rabbits with liver lobe torsion: 82 cases (2010–2020)

Sarah M. Ozawa Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC

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Jennifer E. Graham Graham Veterinary Consulting LLC, Madison, AL

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David Sanchez-Migallon Guzman Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA

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Samuel M. Tucker Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC

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Olivia A. Petritz Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC

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Patrick Sullivan Angell Animal Medical Center, Boston, MA

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James B. Robertson Office of Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC

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Michelle G. Hawkins Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA

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Abstract

OBJECTIVE

To document clinicopathologic findings in domestic rabbits with liver lobe torsion and identify prognostic factors.

ANIMALS

82 rabbits.

PROCEDURE

Medical records of 4 institutions were reviewed to identify rabbits with an antemortem diagnosis of liver lobe torsion that were examined between 2010 and 2020.

RESULTS

The prevalence of liver lobe torsion was 0.7% (82/11,402). In all 82 rabbits, the diagnosis was made by means of abdominal ultrasonography. Fifty (60.1%) rabbits underwent liver lobectomy, 23 (28%) received medical treatment alone, and 9 (10.9%) were euthanized or died on presentation. Overall, 32 (39%) rabbits died within 7 days of initial presentation and 50 (61%) survived. Seven-day survival rate did not differ significantly between medical treatment alone and surgical treatment. However, median survival time following medical treatment (530 days) was shorter than that following surgical treatment (1,452 days). Six of 14 rabbits had evidence of systemic inflammatory disease on necropsy. Rabbits with right liver lobe torsion were less likely to survive for 7 days than were those with caudate torsions (P = 0.046; OR, 3.27; 95% CI, 1.04 to 11.3). Rabbits with moderate to severe anemia were less likely to survive for 7 days than were rabbits that were not anemic or had mild anemia (P = 0.006; OR, 4.41; 95% CI, 1.55 to 12.51). Other factors associated with a decreased 7-day survival rate were high heart rate at admission (P = 0.013) and additional days without defecation after admission (P < 0.001). Use of tramadol was associated with an increased survival rate (P = 0.018).

CLINICAL RELEVANCE

The prognosis for rabbits with liver lobe torsions was more guarded than previously described. Rabbits that underwent liver lobectomy had a longer median survival time than did rabbits that only received medical treatment.

Abstract

OBJECTIVE

To document clinicopathologic findings in domestic rabbits with liver lobe torsion and identify prognostic factors.

ANIMALS

82 rabbits.

PROCEDURE

Medical records of 4 institutions were reviewed to identify rabbits with an antemortem diagnosis of liver lobe torsion that were examined between 2010 and 2020.

RESULTS

The prevalence of liver lobe torsion was 0.7% (82/11,402). In all 82 rabbits, the diagnosis was made by means of abdominal ultrasonography. Fifty (60.1%) rabbits underwent liver lobectomy, 23 (28%) received medical treatment alone, and 9 (10.9%) were euthanized or died on presentation. Overall, 32 (39%) rabbits died within 7 days of initial presentation and 50 (61%) survived. Seven-day survival rate did not differ significantly between medical treatment alone and surgical treatment. However, median survival time following medical treatment (530 days) was shorter than that following surgical treatment (1,452 days). Six of 14 rabbits had evidence of systemic inflammatory disease on necropsy. Rabbits with right liver lobe torsion were less likely to survive for 7 days than were those with caudate torsions (P = 0.046; OR, 3.27; 95% CI, 1.04 to 11.3). Rabbits with moderate to severe anemia were less likely to survive for 7 days than were rabbits that were not anemic or had mild anemia (P = 0.006; OR, 4.41; 95% CI, 1.55 to 12.51). Other factors associated with a decreased 7-day survival rate were high heart rate at admission (P = 0.013) and additional days without defecation after admission (P < 0.001). Use of tramadol was associated with an increased survival rate (P = 0.018).

CLINICAL RELEVANCE

The prognosis for rabbits with liver lobe torsions was more guarded than previously described. Rabbits that underwent liver lobectomy had a longer median survival time than did rabbits that only received medical treatment.

Contributor Notes

Corresponding author: Dr. Ozawa (sozawa@ncsu.edu)
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