Hepatic (Liver) Themes

Hepatic Lipidosis

Hepatic lipidosis also called fatty liver is when the liver stops absorbing volatile fatty acids (those produced from fermentation of the greens) and begins to consume free fatty acids for survival of anorexia, but can’t effectively process them.
The liver thus needs more fats to produce more energy, creating ketones and releasing hydrogen which causes acidosis.
Due to normal bodily functions halting, this free fatty acids are unable to be processed and build up in the liver.
The fat continues to be sent to the liver that starts to fail causing lethargy and more anorexia.
This anorexia caused by a myriad of issues that prevent rabbits to eat among other issues like low-fibre diets, obesity, and difficult pregnancies.
Obese rabbits that cannot consume the caecotrophs are prone to fatty liver as they cannot absorb these acids and other nutrients from them.
Obese rabbits are also prone if an aggressive diet is introduced, as they may start ketosis and consume free fatty acids.
Sadly, the visible symptoms are general sickness symptoms including loss of appetite, depression, weight loss. The rabbit may also develop ataxia.
It can be helpful to check for urine sludge, as there will be dehydration.
Treatment mainly consists of immediate nutritional support, like syringe-fed high-fibre food and subcutaneous or intravenous fluids, which should ultimately correct the anorexia too.
Analgesics and prokinetics can be provided too.
It can only be fully diagnosed with a biopsy of the hepatic tissue, and the prognosis may vary depending on the severity of the disease.
Another thing that may point towards hepatic lipidosis is elevated hepatic enzymes in blood. These are found because the liver tissue breaks up and spreads through the blood.
Learn more about hepatic lipidosis and other liver issues in:
The House Rabbit Society’s page on Liver Disease.
(The House Rabbit Society are updating their pages, so this link may be broken soon).
Oxbow’s page on the rabbits’ livers.
Burgess’ page on Hepatic Lipidosis.

Healthy Liver - MediRabbit.
Liver with hepatic lipidosis - Frances Harcourt-Brown.

Visible difference from these two post-mortem examinations.

As the fat adheres to the liver, this one takes on a pink pale colour.

Could this be helpful to diagnose hepatic lipidosis?

Liver with torsion in the caudate lobe - The Joint Pathology Center.

Observe the torsion of the lobe and the brown undertones of its colour under the white (fat?).
Could this be because of necrosis or because of toxins?

See the connective white tissue (fat? ligament?) extended

Liver Lobe Torsion

Liver lobe torsion is when one of the five lobes of a rabbit’s liver rotates.
These five lobes (Left lateral, Left Medial, Quadrate lobe, Right lobe and Caudate lobe) can all be affected, but the caudate lobe is the most affected. The Caudate lobe is also close to the right kidney and the pancreas.

We are not sure why it occurs and based on other animals like dogs who can develop lobe torsion, it may be due to size, gastric dilation, trauma, or vigorous jumping amongst others.
In rabbits it is thought that the lack of hepatic supporting ligaments, GI stasis, torsion of the existing ligaments, and hepatitis, can be contributing factors.

Lop rabbits may be prone to lobe torsion, but this is still a hypothesis.

The effects of the torsion are well known though.
As the liver veins are twisted, these cannot release the blood within, but the arteries are still functional and release more blood into the liver.
The liver becomes swollen with blood that damages the tissues and releases blood into the abdomen, which ultimately causes anaemia and liver damage. And because the twisted lobe is not able to work correctly, all the toxins and waste cannot be processed and build up in the lobe.
Jaundice can sometimes be seen depending on the situation.

In diagnosis, high liver enzymes and anaemia are common.
Confirmation is achieved with ultrasounds or tomographies.

Treatment is possible, but rabbits that are only treated with medication have a reduced survival rate of 43% compared with rabbits that undergo surgery to remove the lobe, which ensures survivability post-surgery.
There are though situations where rabbits have died in-surgery and post-surgery due to their compromised circulatory and bodily systems.
Sometimes, it may be necessary to transfuse blood to the rabbit if anaemia is acute.

Once surgery is done, painkillers will be provided, and assistance with feeding will be required just like with other rabbit issues.

This entry was based on:
Exotic Vet Care Charleston’s blog post about Liver Lobe Torsion.
The Veterinary Nurse’s information sheet about the Clinical Presentation and Management of Liver Lobe Torsion.

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