Retrospective analysis of liver lobe torsion in pet rabbits: 40 cases (2016-2021).
Journal
The Veterinary record
ISSN: 2042-7670
Titre abrégé: Vet Rec
Pays: England
ID NLM: 0031164
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
revised:
04
05
2022
received:
18
01
2022
accepted:
06
06
2022
pubmed:
17
7
2022
medline:
12
10
2022
entrez:
16
7
2022
Statut:
ppublish
Résumé
Liver lobe torsion (LLT) in rabbits can be under-recognised and potentially fatal. The clinical features of cases presented to an exotic animal veterinary service in Australia were retrospectively reviewed. Medical records of confirmed rabbit LLT cases between 2016 and 2021 were reviewed for signalment, clinical signs and findings, diagnostic imaging results, management strategies and outcomes. Variables of interest were analysed for statistical association with outcome. A total of 40 rabbits were included. The mean presenting age was 56.2 months (SD 30.5). Neutered males (23/40, 57.5%) were over-represented. Common clinical signs and findings included reduced appetite (40/40, 100%), lethargy (32/40, 80.0%), reduced faecal production (16/40, 40.0%), a doughy distended stomach (20/40, 50.0%), pale mucous membranes (19/40, 47.5%) and hypothermia (17/40, 42.5%). Anaemia and elevated plasma alanine aminotransferase and blood urea nitrogen were common clinicopathologic findings. Computed tomography (CT) was performed in 34 of 40 rabbits, confirming the presence and position of LLT (34/34, 100%), stenosis of the caudal vena cava or portal system (28/34, 82.4%) and increased free peritoneal fluid (29/34, 85.3%). Fifteen (15/40, 37.5%) rabbits were medically managed, and surgical intervention was performed in 23 of 40 (57.5%) rabbits. Overall, 30 of 40 (75.0%) rabbits survived. Surgical intervention did not confer a significant difference in outcome compared to medical management (odds ratio 0.77, 95% confidence interval 0.15-4.10, p = 0.761). CT can be an invaluable diagnostic modality for rabbit LLT. Favourable outcomes can be achieved in selected cases with medical management alone.
Sections du résumé
BACKGROUND
Liver lobe torsion (LLT) in rabbits can be under-recognised and potentially fatal. The clinical features of cases presented to an exotic animal veterinary service in Australia were retrospectively reviewed.
METHOD
Medical records of confirmed rabbit LLT cases between 2016 and 2021 were reviewed for signalment, clinical signs and findings, diagnostic imaging results, management strategies and outcomes. Variables of interest were analysed for statistical association with outcome.
RESULTS
A total of 40 rabbits were included. The mean presenting age was 56.2 months (SD 30.5). Neutered males (23/40, 57.5%) were over-represented. Common clinical signs and findings included reduced appetite (40/40, 100%), lethargy (32/40, 80.0%), reduced faecal production (16/40, 40.0%), a doughy distended stomach (20/40, 50.0%), pale mucous membranes (19/40, 47.5%) and hypothermia (17/40, 42.5%). Anaemia and elevated plasma alanine aminotransferase and blood urea nitrogen were common clinicopathologic findings. Computed tomography (CT) was performed in 34 of 40 rabbits, confirming the presence and position of LLT (34/34, 100%), stenosis of the caudal vena cava or portal system (28/34, 82.4%) and increased free peritoneal fluid (29/34, 85.3%). Fifteen (15/40, 37.5%) rabbits were medically managed, and surgical intervention was performed in 23 of 40 (57.5%) rabbits. Overall, 30 of 40 (75.0%) rabbits survived. Surgical intervention did not confer a significant difference in outcome compared to medical management (odds ratio 0.77, 95% confidence interval 0.15-4.10, p = 0.761).
CONCLUSION
CT can be an invaluable diagnostic modality for rabbit LLT. Favourable outcomes can be achieved in selected cases with medical management alone.
Substances chimiques
Alanine Transaminase
EC 2.6.1.2
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1971Informations de copyright
© 2022 British Veterinary Association.
Références
Schwartz SG, Mitchell SL, Keating JH, Chan DL. Liver lobe torsion in dogs: 13 cases (1995-2004). J Am Vet Med Assoc. 2006;228(2):242-7.
Haider G, Dokic Z, Petritsch B, Lorinson D. Left lateral liver lobe torsion in a cat with moderate pectus excavatum. J Feline Med Surg. 2015;17(12):1077-9.
Picavet PP, Vidal PA, Bolen G, Gommeren K, Noël S. Gallbladder and liver lobe torsion in a young cat presented with hemoabdomen. J Am Anim Hosp Assoc. 2021;57(5):247-51.
Tennent-Brown BS, Mudge MC, Hardy J, Whelchel DD, Freeman DE, Fischer AT Jr. Liver lobe torsion in six horses. J Am Vet Med Assoc. 2012;241(5):615-20.
Morin M, Sauvageau R, Phaneuf JB, Teuscher E, Beauregard M, Lagace A. Torsion of abdominal organs in sows: a report of 36 cases. Can Vet J. 1984;25(12):440-2.
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):321-6.
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):136-9.
Warns-Petit ES. Liver lobe torsion in an oriental small-clawed otter (Aonyx cinerea). Vet Rec. 2001;148(7):212-3.
Thakral CL, Shivalingam G, Dar FM, Thakral N. Torsion of an accessory hepatic lobe with embedded gallbladder: in an 11-month-old boy. Eur J Pediatr Surg Rep. 2017;5(1):e62-4.
Natarajan S, Jayasudha, Periasamy M, Rangasamy S. Torsion of accessory hepatic lobe. J Indian Assoc Pediatr Surg. 2017;22(1):55-6.
Lowther E, Corso O, Schammel C, Schammel D, Trocha S, Devane AM. Hepatic lobe torsion: a rare disease necessitating surgical management. Clin Imaging. 2021;71:121-5.
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):258-65.
Chu M. How to efficiently and precisely diagnose and treat liver lobe torsion in rabbits. Paper presented at: ExoticsCon, Atlanta, GA. 2018.
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):210-7.
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):195-202.
Swann HM, Brown DC. Hepatic lobe torsion in 3 dogs and a cat. Vet Surg. 2001;30(5):482-6.
Stanke NJ, Graham JE, Orcutt CJ, Reese CJ, Bretz BK, Ewing PJ, et al. Successful outcome of hepatectomy as treatment for liver lobe torsion in four domestic rabbits. J Am Vet Med Assoc. 2011;238(9):1176-83.
Roberts BK. Basic shock physiology and critical care. Vet Clin North Am Exot Animal Pract. 2016;19(2):347-60.
Barone R. Apparatus digestorius. In: Barone R, editor. Atlas d'anatomie du lapin: atlas of rabbit anatomy. Paris: Masson; 1973. p. 76.
Popesko P, Rajtova V, Horak J. The liver: view of the diaphragmatic (A) and visceral (B) surfaces. In: A colour atlas of anatomy of small laboratory animals. Vol 1: Rabbit guinea pig. London, UK: Saunders; 1990. p. 89.
Páramo M, García-Barquin P, Santa María E, Madrid JM, Caballeros M, Benito A, et al. Evaluation of the rabbit liver by direct portography and contrast-enhanced computed tomography: anatomical variations of the portal system and hepatic volume quantification. Eur Radiol Exp. 2017;1(1):7.
Stan FG. Comparative study of the liver anatomy in the rat, rabbit, guinea pig and chinchilla. Bulletin UASVM. 2018;75(1):8.
Wenger S, Barrett EL, Pearson GR, Sayers I, Blakey C, Redrobe S. Liver lobe torsion in three adult rabbits. J Small Anim Pract. 2009;50(6):301-5.
Saunders R, Redrobe S, Barr F, Moore AH, Elliott SC. Liver lobe torsion in rabbits. J Small Anim Pract. 2009;50(10):562.
DeCubellis J, Graham J. Gastrointestinal disease in guinea pigs and rabbits. Vet Clin Exotic Anim Prac. 2013;16(2):421-35.
Pignon C, Donnelly TM, Mayer J. Hepatic lobe torsion in a rabbit (Oryctolagus cuniculus) Torsion de lobe hépatique chez un lapin (Oryctolagus cuniculus). Prat Méd Chir Anim. 2013;48(3):91-8.
Ozawa SM, Graham JE, Guzman DS, Tucker SM, Petritz OA, Sullivan P, et al. Clinicopathological findings in and prognostic factors for domestic rabbits with liver lobe torsion: 82 cases (2010-2020). J. Am. Vet. Med. Assoc. (published online ahead of print 2022). Retrieved Jun 29, 2022, from https://avmajournals.avma.org/view/journals/javma/aop/javma.22.03.0154/javm
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):288-97.
Abaxis Global Diagnostics. Rabbit reference ranges for common analytes. 2006. https://www.abaxis.com/sites/default/files/resource-papers/Rabbit%20Reference%20Ranges%20for%20Common%20Analytes.pdf. Accessed 23 Sep 2016.
Chen S, Quesenberry KE. Rabbits. In: Birchard SJ, Sherding RG, editors. Saunders manual of small animal practice. 3rd ed. Saint Louis: W.B. Saunders; 2006. p. 1858-80.
Lichtenberger M, Lennox AM. Critical care of the exotic companion mammal (with a focus on herbivorous species): the first twenty-four hours. J Exot Pet Med. 2012;21(4):284-92.
Huynh M, Boyeaux A, Pignon C. Assessment and care of the critically ill rabbit. Vet Clin North Am Exot Anim Pract. 2016;19(2):379-409.
Adawi D, Kasravi FB, Molin G, Jeppsson B. Effect of Lactobacillus supplementation with and without arginine on liver damage and bacterial translocation in an acute liver injury model in the rat. Hepatology. 1997;25(3):642-7.
Fouts DE, Torralba M, Nelson KE, Brenner DA, Schnabl B. Bacterial translocation and changes in the intestinal microbiome in mouse models of liver disease. J Hepatol. 2012;56(6):1283-92.
Wagner KA, Hartmann FA, Trepanier LA. Bacterial culture results from liver, gallbladder, or bile in 248 dogs and cats evaluated for hepatobiliary disease: 1998-2003. J Vet Intern Med/Am College Vet Inter Med. 2007;21(3):417-24.
Radlinsky MA, Fossum TW. Surgery of the liver. In: Fossum TW, editor. Small animal surgery e-book. 5th ed. Philadelphia: Mosby; 2018. p. 540-70.
Lichtenberger M. Transfusion medicine in exotic pets. Clin Tech Small Anim Pract. 2004;19(2):88-95.
Giger U. Transfusion therapy. In: Silverstein DC, Hopper K, editors. Small animal critical care medicine. 2nd ed. St. Louis: W.B. Saunders; 2015. p. 327-32.
Kanfer S. Step-by-step guide to blood transfusion in the rabbit. Paper presented at: Annual Conference of Association of Exotic Mammal Veterinarians, Orlando, FL. 2014.
Weisbroth SH. Torsion of the caudate lobe of the liver in the domestic rabbit (Oryctolagus). Vet Pathol. 1975;12(1):13-5.
Wilson RB, Holscher MA, Sly DL. Liver lobe torsion in a rabbit. Lab Anim Sci. 1987;37(4):506-7.
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):175-8.
Huynh M, Pignon C. Gastrointestinal disease in exotic small mammals. J Exot Pet Med. 2013;22(2):118-31.
Rooney NJ, Blackwell EJ, Mullan SM, Saunders R, Baker PE, Hill JM, et al. The current state of welfare, housing and husbandry of the English pet rabbit population. BMC Res Notes. 2014;7:942.
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):837-45.
Culp WT, Weisse C, Kellogg ME, Gordon IK, Clarke DL, May LR, et al. Spontaneous hemoperitoneum in cats: 65 cases (1994-2006). J Am Vet Med Assoc. 2010;236(9):978-82.
Lux CN, Culp WT, Mayhew PD, Tong K, Rebhun RB, Kass PH. Perioperative outcome in dogs with hemoperitoneum: 83 cases (2005-2010). J Am Vet Med Assoc. 2013;242(10):1385-91.
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):200-4.
Di Girolamo N, Binanti D, Nicoletti A, Selleri P, Fonti P. Confirmation of naturally occurring liver lobe torsion in pet rabbits by means of contrast-enhanced ultrasound. Paper presented at: Proceedings of the Association of Exotic Mammal Veterinarians, Dallas, TX. 2017.
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. 2019;61(4):31-5.
Massari F, Verganti S, Secchiero B, Orifici F, Bonfanti U, Romanelli G. Torsion of quadrate and right middle liver lobes and gallbladder in a German Shepherd dog. Aust Vet J. 2012;90(1-2):44-7.
Sargent JM, Dennis S, Fuentes VL. ECG of the month. Liver lobe torsion. J Am Vet Med Assoc. 2013;242(6):748-50.
Popesko P, Rajtova V, Horak J. Syntopy of the cranial abdominal organs; caudal view, dorsal surface in the upper part. In: A color atlas of anatomy of small laboratory animals, Vol 1: Rabbit, guinea pig. London, UK: Saunders; 1990. p. 90.
Popesko P, Rajtova V, Horak J. Syntopy of organs at the diaphragm; caudal view, dorsal surface at upper level. In: A colour atlas of anatomy of small laboratory animals. Vol 1: Rabbit, guinea pig. London, UK: Saunders; 1990. p. 80.
Andreucci M, Faga T, Serra R, De Sarro G, Michael A. Update on the renal toxicity of iodinated contrast drugs used in clinical medicine. Drug Healthcare Patient Saf. 2017;9:25-37.
Cronin RE. Contrast-induced nephropathy: pathogenesis and prevention. Pediatr Nephrol. 2010;25(2):191-204.
Arakawa K, Suzuki H, Naitoh M, Matsumoto A, Hayashi K, Matsuda H, et al. Role of adenosine in the renal responses to contrast medium. Kidney Int. 1996;49(5):1199-206.
Schultz SG, Lavelle KJ, Swain R. Nephrotoxicity of radiocontrast media in ischemic renal failure in rabbits. Nephron. 1982;32(2):113-7.
Harcourt-Brown F. Digestive system disease. In: Meredith A, Lord B, editors. BSAVA manual of rabbit medicine. Gloucester: British Small Animal Veterinary Association; 2014. p. 168-90.
Wagner KA, Hartmann FA, Trepanier LA. Bacterial culture results from liver, gallbladder, or bile in 248 dogs and cats evaluated for hepatobiliary disease: 1998-2003. J Vet Inter Med/Am Coll Vet Inter Med. 2007;21(3):417-24.
Martin R, King M. Hepatobiliary surgery. In: Bojrab MJ, Waldron D, Tooms JP, editors. Current techniques in small animal surgery. 5th ed. Jackson, WY: Teton NewMedia; 2014. p. 318-52.