• 1.

    Schwartz SGH, Mitchell SL, Keating JH, Chan DL. Liver lobe torsion in dogs: 13 cases (1995–2004). J Am Vet Med Assoc. 2006;228(2):242247. doi:10.2460/javma.228.2.242

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Knight R, McClaran JK. Hemoperitoneum secondary to liver lobe torsion in a cat. J Am Anim Hosp Assoc. 2020;56(1):e56102. doi:10.5326/JAAHA-MS-6758

  • 3.

    Nazarali A, Singh A, Chalmers H, Stevens B, Plattner BL. Chronic liver lobe torsion in a cat. J Am Anim Hosp Assoc. 2014;50(2):119123. doi:10.5326/JAAHA-MS-5969

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Tennent-Brown BS, Mudge MC, Hardy J, Whelchel DD, Freeman DE, Fischer A Jr. Liver lobe torsion in six horses. J Am Vet Med Assoc. 2012;241(5):615620. doi:10.2460/javma.241.5.615

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Morin M, Sauvageau R, Phaneuf J-B, Teuscher E, Beauregard M, Lagacé A. Torsion of abdominal organs in sows: a report of 36 cases. Can Vet J. 1984;25(12):440442.

    • Search Google Scholar
    • Export Citation
  • 6.

    Warns-Petit ES. Liver lobe torsion in an oriental small-clawed otter (Aonyx cinerea). Vet Rec. 2001;148(7):212213. doi:10.1136/vr.148.7.212

  • 7.

    Ibrahim A, El-Ghareeb WR, Aljazzar A, Al-Hizab FA, Porter BF. Hepatic lobe torsion in 3 dromedary camels. J Vet Diagn Invest. 2021;33(1):136139. doi:10.1177/1040638720971813

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Vilalta L, Espada Y, Majó N, Martorell J. Liver lobe torsion in a domestic ferret (Mustela putorius furo). J Exot Pet Med. 2016;25(4):321326. doi:10.1053/j.jepm.2016.06.008

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Waugh S, Andrie KM, Johnson V, Biggo M, Aboellail T, Sadar MJ. Liver lobe torsion in a guinea pig (Cavia porcellus). Top Companion Anim Med. 2021;(43):100517. doi:10.1016/j.tcam.2021.100517

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Graham JE, Orcutt CJ, Casale SA, Ewing PJ, Basseches J. Liver lobe torsion in rabbits: 16 Cases (2007 to 2012). J Exot Pet Med. 2014;23(3):258265. doi:10.1053/j.jepm.2014.06.010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Wenger S, Barrett E, Pearson G, Sayers I, Blakey C, Redrobe S. Liver lobe torsion in three adult rabbits. J Small Anim Pract. 2009;50(6):301305. doi:10.1111/j.1748-5827.2008.00719.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Stanke NJ, Graham JE, Orcutt CJ, et al. Successful outcome of hepatectomy as treatment for liver lobe torsion in four domestic rabbits. J Am Vet Med Assoc. 2011;238(9):11761183. doi:10.2460/javma.238.9.1176

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Weisbroth SH. Torsion of the caudate lobe of the liver in the domestic rabbit (Oryctolagus). Vet Pathol. 1975;12(1):1315. doi:10.1177/030098587501200103

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Stock E, Vanderperren K, Moeremans I, De Rooster H, Hermans K, Saunders JH. Use of contrast-enhanced ultrasonography in the diagnosis of a liver lobe torsion in a rabbit (Oryctolagus cuniculus). Vet Radiol Ultrasound. 2020;61(4):3135. doi:10.1111/vru.12709

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Taylor HR, Staff CD. Clinical techniques: successful management of liver lobe torsion in a domestic rabbit (Oryctolagus cuniculus) by surgical lobectomy. J Exot Pet Med. 2007;16(3):175178. doi:10.1053/j.jepm.2007.06.005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Graham J, Basseches J. Liver lobe torsion in pet rabbits: clinical consequences, diagnosis, and treatment. Vet Clin North Am Exot Anim Pract. 2014;17(2):195202. doi:10.1016/j.cvex.2014.01.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Pignon C, Donnelly T, Mayer J. Hepatic lobe torsion in a rabbit (Oryctolagus cuniculus). Pratique Med Chirurgicale Anim Compagnie. 2013;48(3):9198. doi:10.1016/j.anicom.2013.05.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Daggett A, Loeber S, Le Roux AB, Beaufrere H, Doss G. Computed tomography with Hounsfield unit assessment is useful in the diagnosis of liver lobe torsion in pet rabbits (Oryctolagus cuniculus). Vet Radiol Ultrasound. 2021;62(2):210217. doi:10.1111/vru.12939

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Di Girolamo N, Toth G, Selleri P. Prognostic value of rectal temperature at hospital admission in client-owned rabbits. J Am Vet Med Assoc. 2016;248(3):288297. doi:10.2460/javma.248.3.288

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Fisher P, Graham J. Rabbits. In: Exotic Animal Formulary. Elsevier; 2018:494531.

  • 21.

    Lord B, Boswood A, Petrie A. Electrocardiography of the normal domestic pet rabbit. Vet Rec. 2010;167(25):961965. doi:10.1136/vr.c3212

  • 22.

    Dettweiler A, Klopfleisch R, Müller K. Anaemia in pet rabbits: causes, severity and reticulocyte response. Vet Rec. 2017;181(24):656656. doi:10.1136/vr.104472

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Melillo A. Rabbit clinical pathology. J Exot Pet Med. 2007;16(3):135145. doi:10.1053/j.jepm.2007.06.002

  • 24.

    Zoller G, Di Girolamo N, Huynh M. Evaluation of blood urea nitrogen concentration and anorexia as predictors of nonsurvival in client-owned rabbits evaluated at a veterinary referral center. J Am Vet Med Assoc. 2019;255(2):200204. doi:10.2460/javma.255.2.200

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Washington IM, Van Hoosier G. Clinical Biochemistry and Hematology. In: Suckow MA, Stevens KA, Wilson RP, eds. The Laboratory Rabbit, Guinea Pig, Hamster, and Other Rodents. Academic Press; 2012:57116.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Büchter RB, Fechtelpeter D, Knelangen M, Ehrlich M, Waltering A. Words or numbers? Communicating risk of adverse effects in written consumer health information: a systematic review and meta-analysis. BMC Med Inform Decis Mak. 2014;14:76 doi:10.1186/1472-6947-14-76

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Oparil KM, Gladden JN, Babyak JM, Lambert C, Graham JE. Clinical characteristics and short-term outcomes for rabbits with signs of gastrointestinal tract dysfunction: 117 cases (2014–2016). J Am Vet Med Assoc. 2019;255(7):837845. doi:10.2460/javma.255.7.837

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Chrysohoou C, Tousoulis D, Tentolouris C, Stefanadis C. The turtle still wins the rabbit? Int J Cardiol. 2012;161(2):113115. doi:10.1016/j.ijcard.2012.06.032

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Hayakawa I, Sakakibara H, Atsumi Y, Hataya H, Terakawa T. Tachycardia may prognosticate life- or organ-threatening diseases in children with abdominal pain. Am J Emerg Med. 2017;35(6):819822. doi:10.1016/j.ajem.2017.01.032

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Leibovici L, Gafter-Gvili A, Paul M, et al. Relative tachycardia in patients with sepsis: an independent risk factor for mortality. QJM. 2007;100(10):629634. doi:10.1093/qjmed/hcm074

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Morse EE. Mechanisms of hemolysis in liver disease. Ann Clin Lab Sci. 1990;20(3):169174.

  • 32.

    Gonzalez-Casas R, Jones EA, Moreno-Otero R. Spectrum of anemia associated with chronic liver disease. World J Gastroenterol. 2009;15(37):46534658. doi:10.3748/wjg.15.4653

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Tallaj KM, Cortes Y, Gannon KM, Fettig AA. Acute liver lobe torsion in a kitten. JFMS Open Rep. 2021;7(1):2055116921990295. doi:10.1177/2055116921990295

    • Search Google Scholar
    • Export Citation
  • 34.

    von Pfeil DJF, Jutkowitz LA, Hauptman J. Left lateral and left middle liver lobe torsion in a Saint Bernard puppy. J Am Anim Hosp Assoc. 2006;42(5):381385. doi:10.5326/0420381

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Downs MO, Miller MA, Cross AR, Selcer BA, Abdy MJ, Watson E. Liver lobe torsion and liver abscess in a dog. J Am Vet Med Assoc. 1998;212(5):678680.

    • Search Google Scholar
    • Export Citation
  • 36.

    Steyn PF, Wittum T. Radiographic, epidemiologic, and clinical aspects of simultaneous pleural and peritoneal effusions in dogs and cats: 48 cases (1982–1991). J Am Vet Med Assoc. 1993;202(2):307312.

    • Search Google Scholar
    • Export Citation
  • 37.

    Kilimci FS. Rabbit liver lobes: an anatomical study of experimental surgical approaches. Erciyes Univ Vet Fak Derg. 2020;17(2):103108. doi:10.32707/ercivet.760679

    • Search Google Scholar
    • Export Citation
  • 38.

    Stamatova-Yovcheva K, Dimitrov R, Kostov D, Yovchev D. Anatomical macromorphological features of the liver in domestic rabbit (Oryctolagus cuniculus). Trakia J Sci. 2012;10(2):8590.

    • Search Google Scholar
    • Export Citation
  • 39.

    Stan FG. Comparative study of the liver anatomy in the rat, rabbit, guinea pig and chinchilla. Bull Univ Agric Sci Vet Med Cluj-Napoca Vet Med. 2018;75(1): doi:10.15835/buasvmcn-vm:002717

    • Search Google Scholar
    • Export Citation
  • 40.

    Donneley T, Vella D. Basic anatomy, physiology and husbandry of rabbits. In: Quesenberry K, Mans C, eds. Ferrets, Rabbits, and Rodents: Clinical Medicine and Surgery 4th eds. Elsevier; 2020:131149.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    Sohn J, Couto MA. Anatomy, physiology, and behavior. In: The Laboratory Rabbit, Guinea Pig, Hamster, and Other Rodents. Academic Press; 2012:195215.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    Brodbelt DC, Blissitt KJ, Hammond RA, et al. The risk of death: the Confidential Enquiry into Perioperative Small Animal Fatalities. Vet Anaesth Analg. 2008;35(5):365373. doi:10.1111/j.1467–2995.2008.00397.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43.

    Egger CM, Souza MJ, Greenacre CB, Cox SK, Rohrbach BW. Effect of intravenous administration of tramadol hydrochloride on the minimum alveolar concentration of isoflurane in rabbits. Am J Vet Res. 2009;70(8):945949. doi:10.2460/ajvr.70.8.945

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44.

    Souza MJ, Greenacre CB, Cox SK. Pharmacokinetics of orally administered tramadol in domestic rabbits (Oryctolagus cuniculus). Am J Vet Res. 2008;69(8):979982. doi:10.2460/ajvr.69.8.979

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45.

    Udegbunam RI, Onuba AC, Okorie-Kanu C, Udegbunam SO, Anyanwu MU, Ifeanyi OL. Effects of two doses of tramadol on pain and some biochemical parameters in rabbits post-gastrotomy. Comp Clin Path. 2015;24(4):783790. doi:10.1007/s00580–014–1982-y

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 46.

    Powers LV, Cox ER, LeGrange S, Schillinger S, Garner MM. Thromboembolic disease associated with hepatic lobe torsion in a domestic rabbit. Presented at: ExoticsCon (AEMV); 2016; Portland, Oregon.

    • Search Google Scholar
    • Export Citation
  • 47.

    Sumping JC, O’Connell EM, Mortier J. Computed tomographic and clinical findings in a dog with suspected liver lobe torsion, secondary disseminated intravascular coagulation and multiorgan infarction. Vet Rec Case Rep. 2020;8(4):e001166. doi:10.1136/vetreccr-2020-001166

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 48.

    Levi M. Pathogenesis and diagnosis of disseminated intravascular coagulation. Int J Lab Hematol. 2018;40(S1):1520. doi:10.1111/ijlh.12830

  • 49.

    Krishna M. Patterns of necrosis in liver disease. Clin Liver Dis (Hoboken). 2017;10(2):5356. doi:10.1002/cld.653

  • 50.

    Birgens HS, Henriksen J, Matzen P, Poulsen H. The shock liver. Acta Med Scand. 1978;204(5):417421. doi:10.1111/j.0954–6820.1978.tb08465.x

    • Crossref
    • Search Google Scholar
    • Export Citation

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

Sarah M. Ozawa DVM, DACZM1, Jennifer E. Graham DVM, DABVP, DACZM2, David Sanchez-Migallon Guzman LV, MS, DECZM, DACZM3, Samuel M. Tucker DVM1, Olivia A. Petritz DVM, DACZM1, Patrick Sullivan DVM, DABVP4, James B. Robertson MS5, and Michelle G. Hawkins VMD, DABVP3
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  • 1 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
  • | 2 Graham Veterinary Consulting LLC, Madison, AL
  • | 3 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA
  • | 4 Angell Animal Medical Center, Boston, MA
  • | 5 Office of Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC

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)