Clinical presentation and management of liver lobe torsions in domestic rabbits

A liver lobe torsion is when one or more of the liver lobes twist, with some reports documenting this including the gall bladder (Massari et al, 2012). Liver lobe torsions are documented in a variety of species including dogs (Schwartz et al, 2006), humans (Umehara et al, 2009), cats (Nazarali et al, 2014), horses (Bentz et al, 2009), guinea pig (Waugh et al, 2021), otters (Warns-Petit, 2001), camels (Ibrahim et al, 2021), ferrets (Vilalta et al, 2016) and rabbits among others.

The condition of liver lobe torsion is considered rare in rabbits, but the author believes that the condition is likely to be underdiagnosed, especially in this species because of the difficultly in recognising clinical signs. A study in 984 laboratory rabbits showed that 0.3% of asymptomatic rabbits had suffered from a liver lobe torsion (Weisbroth, 1975), highlighting that these can be subclinical. A rabbit's liver comprises four lobes, the caudate lobe and three cranial lobes called the right, medial left and lateral left lobes. The most commonly affected lobe is the caudate lobe, accounting for 62.5% of liver torsions documented at one clinic (Graham et al, 2014), however, torsion of other lobes is documented (Graham and Basseches, 2014). The reason for the torsion is not fully understood, but in dogs suggested causes include large breed predisposition, previous gastric dilatation and volvulus, neoplastic changes, trauma and vigorous jumping (Bhandal, 2008). Predisposing factors are not fully described in rabbits, however, theories include the absence of hepatic supporting ligaments, trauma, episodes of gastrointestinal stasis resulting in gastric dilatation and stretching of the left triangular ligament, and bacterial or parasitic hepatitis (Summa and Brandão, 2017).