Computed tomographic and clinical findings in a dog with suspected liver lobe torsion, secondary disseminated intravascular coagulation and multiorgan infarction

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

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.

Acute liver lobe torsion in a kitten

CASE SUMMARY

A 10-week-old intact male domestic shorthair kitten presented for an acute onset of lethargy, vomiting and anorexia. An abdominal mass effect was palpable on presentation. Blood work, abdominal radiographs and point-of-care abdominal ultrasound showed severe anemia, decreased serosal detail and abdominal effusion, respectively. Based on the concern for an abdominal organ torsion or ruptured mass, an emergency abdominal exploratory surgery was performed. Torsion of the entire caudate liver lobe was discovered with a secondary hemoabdomen, and a liver lobectomy was performed. The kitten was stabilized and discharged 3 days after surgery. At the recheck examination, 15 days postoperatively, the patient was reported to be doing well.

RELEVANCE AND NOVEL INFORMATION

Liver lobe torsion is a rare condition previously reported in six other cats; however, this is the first peer-reviewed report in a kitten successfully treated with surgery with no identifiable underlying cause.