Liver Lobe Torsion

You have a sick rabbit coming in to the clinic, with a painful abdomen, and possibly anaemia.

Alarm bells start to ring, ITS GUT STASIS!

Though maybe it isn’t…

A commonly under diagnosed condition in rabbits is liver lobe torsion. This occurs when the caudate liver lobe, which arises from the right side of the liver, is trapped and twisted. This results occlusion of venous blood supply, followed by artery, leads to acute congestion and subsequent necrosis.

Death of the liver, death of the rabbit.

Clinical presentation and diagnosis

  • Lethargy
  • Inappetance
  • Dehydration
  • Crouched or hunched posture, signifying abdominal pain
  • Collapse
  • Sudden death
  • As well as a palpable hard liver lobe – which is not normally palpable

Your two main tools for diagnosis, include:


You may see inconsistent findings here, the commonly agreed upon answer is anaemia.
Other potential changes include liver enzymes – ALT, ALP and AST, none of which are liver specific, but multiple elevated liver enzymes suggest liver disease.
You may see other changes, though they won’t point directly to liver disease.


You may see an enlarged liver (hepatomegaly), rounded liver margins, free fluid and abnormal heterogenous appearance of the liver.
It is worth ruling out your other main differential, gut stasis, by performing abdominal xrays. You may see an enlarged or displaced liver here too!


Surgical removal of the affected lobe is an option, and may be necessary! Make sure to ligate or isolate the lobe before removal!
Other supportive care (with or without surgery) will include fluid therapy, analgesia and antibiotics.


The prognosis if good if promptly treated, if you have an unstable rabbit, start assertively providing supportive care and check out the liver!

Hop to it, and start to ultrasound your bunnies!


  • Graham, J. Liver Lobe Torsion in Pet Rabbits: Clinical Consequences, Diagnosis, and Treatment.
  • Graham, J. Liver Lobe Torsion in Rabbits: 16 cases (2007 to 2012).
  • Haberfield, J. Emergency Abdominal Surgery in Rabbits. UPAV 2018.