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Investigation of clinical presentations and clinicohistopathological correlations of spontaneous hepatic lobe torsion and clinical outcomes after hepatic lobectomy in domestic rabbits (Oryctolagus cuniculus)
* 1 , 1, 2 , 1, 3, 4 , 5
1  Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
2  Center of Excellence for Companion Animal Cancer, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
3  Wildlife, Exotic, and Aquatic Pathology Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
4  CU-Animal Fertility Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
5  Department of Obstetrics Gynaecology and Reproduction, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
Academic Editor: Michael Hässig

Abstract:

Hepatic lobe torsion is an uncommon disease that has been described in various species, such as humans,
dogs, and rabbits. Torsion causes vascular occlusion that leads to hepatic necrosis and death in the worst
cases. Predisposing factors to this include external trauma, a congenital absence of hepatic ligaments, rabbit
gastrointestinal syndromes, hepatitis infection, andenvironmental stress, which have been proposed as a
risk factor for hepatic lobe torsion. The objectives of this study are to describe the histopathology grading
scores, clinicopathologic findings, and clinical presentations.
Rabbits were diagnosed from September 2022 to January 2023 (n = 20). The diagnosis was made upon clinical
presentations, physical examinations, Colour Flow Doppler (CFD), Complete Blood Count (CBC), and serum
biochemicals. Hepatic lobectomy was performed to remove the affected hepatic lobe. Samples were
processed and stained with Hematoxylin and Eosin (H&E).
All rabbits had acute onset, such as depression, pale mucous membrane, and abnormal gut sounds. The
use of CFD revealed a decreased in or absence of blood flow in all cases. The gross lesion revealed severe acute
hemorrhage and hematoma. Average BUN, creatinine, ALT, AST, and heterophils were higher than normal
values. Hb, HCT, MCHC, platelets, and lymphocytes were lower than normal. All rabbits were diagnosed
with severe acute diffuse necrotic hemorrhagic hepatitis and severe coagulative necrosis. Anaemia and
thrombocytopenia were commonly presented (90%). The outcome of the percentage of survival rate after
hepatic lobectomy was (16 from 20 rabbits) 80%.
The present study demonstrated that early detection using GI signs, CFD, clinicopathologic, and hepatic
lobectomy is a crucial point in successful treatment, as is using histopathologic scores for
describing severity. For further investigation, the relationship between environmental stress from climate
change, viral transmission from humans to rabbits, and other zoonotic diseases that relate to hepatic lobe
torsion from hepatitis must be researched, and preventive measures must be found in the future.

Keywords: Hepatic lobe torsion; Rabbit; Histopathology; Clinical Pathology; Exotic Pets
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