Liver Lobe Torsion in Rabbits: Symptoms, Diagnosis, and Treatment

Liver Lobe Torsion in Rabbits

We were recently contacted by Robyn, a longtime Hot Cross Buns client and friend, with frightening news about one of her rabbits.

Her four-year-old neutered buck, Hamish, had suddenly stopped eating and was diagnosed with Liver Lobe Torsion (LLT). He required emergency surgery to save his life.

Fortunately, Hamish received excellent veterinary care and has made a full recovery. His story gives us a good opportunity to learn more about this serious condition so rabbit families can recognize the warning signs and act quickly if needed.

Hamish’s Story

Hamish had always been a happy, healthy rabbit. He was even in the early stages of getting to know another one of Robyn’s rabbits, Sweet Pea, as a potential bonding companion.

Robyn shared the following update with us:

"He stopped eating mid-day Friday and wouldn’t eat Saturday morning. I put him in Sweet Pea’s cage at 6 AM to try to get him moving around, but he just stayed like a lump in the corner. Sweet Pea was very disappointed he wasn’t interested in her attention.

I called my vet when they opened at 8:30, but they had no openings. I called the emergency vet nearby and got a 10:30 appointment.

The vet examined him and did blood work. She discovered a liver-related value that should normally be under 100 was over 500. An ultrasound confirmed liver lobe torsion.

She performed surgery that afternoon and said he did great. The next morning she told me he was bright-eyed and already showing a little sass. He was on fluids, syringe feeding, and pain medication. Once he began pooping normally, I could bring him home."

Thankfully, Hamish recovered well and is now back to his usual self.

But what exactly is liver lobe torsion?

What Is Liver Lobe Torsion?

Liver lobe torsion is a serious medical condition that can affect many species, including rabbits.

A rabbit’s liver is divided into five sections called lobes. Liver lobe torsion occurs when one of these lobes twists around its own blood supply. When this happens, circulation to that portion of the liver is cut off.

Without blood flow, the affected tissue begins to die, causing severe internal pain and distress. Without prompt veterinary treatment, liver lobe torsion can become fatal.

Why Are Lop Breeds More Prone to LLT?

Liver lobe torsion appears to occur more frequently in lop-eared breeds such as:

• Holland Lops

• Mini Lops

• English Lops

• French Lops

• American Fuzzy Lops

Researchers are still studying the exact cause, but anatomy may play a role. Lop rabbits often have a compact body structure and deeper chest cavity, which may allow the liver to move more freely inside the abdomen.

This increased mobility may make it easier for a liver lobe to twist.

Some researchers also suspect there may be a genetic component, though more studies are needed to confirm this.

What Causes Liver Lobe Torsion?

In many cases, the exact cause of LLT is unknown.

Some rabbits appear to develop the condition spontaneously without any clear trigger. However, several factors may contribute to the risk, including:

• sudden or vigorous movement

• digestive disturbances

• trauma

• anatomical differences

Because liver lobe torsion occurs internally, it often goes unnoticed until the rabbit begins showing signs of serious discomfort.

Symptoms of Liver Lobe Torsion

The early signs of liver lobe torsion can look very similar to gastrointestinal stasis, which is why veterinary evaluation is so important.

Common symptoms include:

• sudden loss of appetite

• lethargy

• reduced fecal output

• hunched posture

• teeth grinding from pain

• reluctance to move

As the condition progresses, rabbits may show signs of shock, including rapid breathing, pale gums, and extreme weakness.

Any rabbit showing these symptoms should be seen by a rabbit-knowledgeable veterinarian immediately.

How Veterinarians Diagnose LLT

Diagnosis usually involves several steps.

A veterinarian will begin with a physical examination and bloodwork. In cases of liver lobe torsion, certain liver enzymes are often dramatically elevated, including:

• ALT (alanine aminotransferase)

• ALKP (alkaline phosphatase)

• AST (aspartate aminotransferase)

Imaging, particularly abdominal ultrasound, is typically used to confirm the diagnosis.

Accurate diagnosis is essential because treatment options for LLT are very specific.

Treatment for Liver Lobe Torsion

In most cases, the only effective treatment is surgery.

The procedure, called a hepatectomy, involves removing the affected liver lobe. While this sounds alarming, rabbits can recover very well from this surgery because the liver has an impressive ability to regenerate.

If the condition is caught extremely early, some less invasive approaches may be attempted, but most rabbits ultimately require surgery.

Early diagnosis greatly improves the chances of a successful outcome.

What Happens Without Treatment?

Without surgery, the twisted liver lobe loses blood supply and the tissue begins to die.

As the damaged tissue breaks down, toxins can enter the bloodstream. This can lead to infection, organ failure, and eventually death.

Because of this progression, liver lobe torsion should always be treated as a veterinary emergency.

Cost of Diagnosis and Treatment

Treating liver lobe torsion can be expensive.

In the greater Cleveland area, treatment often averages around $2,500, though costs vary depending on location and severity. Diagnostic tests, surgery, hospitalization, medications, and follow-up care all contribute to the final cost.

Because rabbits can require complex medical care, some families choose to purchase pet insurance to help manage unexpected veterinary expenses.

Long-Term Outlook

The encouraging news is that rabbits who receive prompt treatment for liver lobe torsion often recover very well.

Once the affected lobe is removed and healing has occurred, most rabbits go on to live completely normal, happy lives. Recurrence of LLT in the same rabbit appears to be extremely rare.

Hamish is now doing wonderfully and is back to his lively self. We are looking forward to welcoming him and his bunny friends Sweet Pea, Basil, and Rosie for a stay at Camp HCB later this summer.

Additional Reading

Veterinary article on LLT diagnosis and treatment:
https://www.mspca.org/angell_services/identification-and-management-of-liver-lobe-torsion-in-domestic-rabbits/

Veterinarian Q&A on liver lobe torsion:
https://rabbitsavior.com/2022/12/kanfers-answers-liver-lobe-torsion/