Liver Lobe Torsion

[benjaminbinky]

Hi! This is my bunny Benjamin’s experience with liver lobe torsion. This is a success story 🙂 

 

For context: Benjamin is 4 years old and 4 months. He is a beautiful brown rex rabbit. I got him as a baby (I think 3-4 months old) and he had bloat from a poor diet from the people that had him previously. He’s always had a very sensitive stomach so his diet is timothy hay with occasional treats. 

 

It began September 2023. Labor day weekend he was eating slightly less and had mucous in his poops. It cleared in a day and a half and he did continue eating and drinking the whole time, so we didn’t go to the vet but I did bring his poops in to be tested for parasites or some other sickness. The vet didn’t find anything wrong and we chalked it up to a small bout of GI upset. He seemed totally fine after that. In hindsight, I do want to mention that the weeks leading up to his liver lobe torsion he was a bit less friendly and he drank WAY more water than he usually does. 

 

On Tuesday September 19 2023 I woke up around 3AM because my other bunny was hopping around and I heard one of his tents get knocked over. I got up to fix it and I checked on Benjamin. Ben was displaying signs of gas so I began treating him for gas immediately with baby gas drops and tummy rubs. Based on past experiences his gas clears within 3-4 hours, but 8am rolled around and he still wasn’t doing okay and I wasn’t comfortable leaving him like that and going to work. I have a really awesome vet and they were able to see Benjamin at 8:20am that morning! They examined him and could feel in his upper abdomen that something wasn’t quite right. I had noticed in the earlier hours that if I gently touched his upper abdomen (I know to massage the lower belly, but I was just feeling around) he would grind his teeth. So the vet took xrays and took care of Benjamin while I went to work. 

 

Around 10am the vet texted me the results of his xray – very little gas in his system, still significant amount of food in his stomach, and an abnormality in his liver. She asked to do blood work and send the xrays to a radiologist for interpretation. I agreed. 

 

Around 2pm that afternoon she called and told me that his liver levels were literally off the charts. She told me she suspected liver lobe torsion and that this is very time sensitive and that she contacted the emergency vet (who is also awesome, thank goodness!) who would be able to do an ultrasound to confirm the liver lobe torsion and begin surgery that night if need be. I quickly left work to bring Benjamin from his regular vet to the emergency vet. Upon arrival they quickly swept Benjamin away and I waited an hour or so for the ultrasound and results. During this time I scoured every medical paper and post online that I could about liver lobe torsion. I read a lot on binkybunny forums and it was a comfort to hear a lot of success stories. 

 

So around 4pm the doctor came in to talk. He confirmed Benjamin’s liver lobe torsion (I forget which lobe, but it was one of the smaller ones). We talked about all of the options and essentially it boiled down to two options in my mind: 1) Go ahead with surgery that night – this wasn’t totally ideal because it would mean less time for Benjamin to be stabilized, the whole exotics team wouldn’t be there to give him the best possible care, and it would be more expensive. Option 2) stabilize Benjamin over night and do surgery first thing in the morning with the whole exotics crew on hand, and less expensive. We went with option 2. While it was a risk to wait until the morning, the doctor and I did feel it would give Benjamin his best chance at making it through the surgery. 

 

I left Benjamin with them that night. They kept a close eye on him and syringe fed him and gave him IV fluids. The next morning they called and told me that Ben made it through the night with no significant blood loss and they were about to go into surgery. They called me after surgery at about 10am and said he was slowly waking up! They said they would call me later and give me an update. 

 

Well, later that evening (Wednesday Sept 20 2023) the doctor called me and was kind of bummed to not be giving me great news. He said that after the surgery Benjamin had low blood pressure despite not losing much blood during surgery so they treated him for that. He said that during the surgery the torsed lobe wasn’t quite as twisted as it looked in the ultrasound. He believed that overnight the torsed lobe may have untwisted itself a bit and released some blood and toxins into the body and because of that he isn’t recovering as fast as is normal in this situation. He said the next 12 hours would be crucial for his recovery and deciding what to do next. 

 

At 8am the next morning (Thursday Sept 21 2023) the doctor called and said that Ben made awesome progress over night!! He became much more alert and looked much more like a normal bunny. He said that he thinks we are out of the danger zone 🙂 Depending on how Benjamin would do that day I would either get to bring him home that night or the next day. They began to wean him off the fluids and continued to monitor and take care of him. I got to visit my bunny after work that day and he was a very sorry and grouchy sight. I can chuckle a little bit about it now because Benjamin is the picture of health now, but at the time it was hard! The vet tech laid a blanket down and let Benjamin hop around with me for a bit. He was extremely grouchy looking and didn’t want to hop much or have anything to do with me lol. I groomed the loose fur off of him and gave him lots of kisses and reassurance. It was scary to see the shaved bits on his arms (for the IV fluids) as well as his belly which was also shaved and sown up from the surgery. 

 

Friday morning September 22 2023 I got to bring Benjamin home!!! He pooped a BUNCH as soon as I put him in his cage. They were extremely wet and messy poops and for 30 minutes or so I was cleaning the poops out as they came. Once they slowed down I went to work. 

 

During the next few days I syringe fed him critical care  4-6 times a day along with his meds. He was on I think 5-6 meds for the first few days. I can post them in a response if anyone is interested in knowing exactly what he was on. 

 

The next couple of weeks were rough to see because I could only take him out of his cage to syringe feed him, which he hated. I did get really efficient at the bunny burrito though! Lol. My other bunny often sat outside of Benjamin’s cage to give him reassurance and encourage him to eat and drink and clean himself. Often times when one of my bunnies starts eating or drinking or cleaning, the other one will do the exact same action a few seconds later 🙂 

 

Benjamin was grinding his teeth a lot the week after surgery and still not eating much on his own. Over the weekend his belly sounded like a bubbling brook! I could hear loud bubbles and pops from across the room every few minutes. The doctor at the emergency vet prescribed him omeprazole and an appetite stimulant. The bubbling brook – I mean, belly sounds – calmed down after that but the appetite stimulant didn’t do much to help him eat on his own. 

 

I brought him to his regular vet for a recheck a few days later. They examined him and said he’s coming along really well! They gave him a shot of cerenia in his abdomen to clear any residual pain and while cerenia only lasts 24 hours, WOW the progress Benjamin made in that time was phenomenal! He was so alert and happy and ate a bunch on his own! He regressed a little over the weekend and went back to not eating much on his own, but was still alert and wasn’t grinding his teeth as much. 

 

I don’t have an exact timeline for this one part but I did want to quickly mention that his poops did get better the weekend after his surgery but the next week they got messy again. 

 

13 days after Benjamin’s surgery the doctor wanted to do a recheck and blood work to check Ben’s liver levels. I dropped Benjamin off in the morning and picked him up after work. The doctor called me that afternoon and said the blood work looked great and they actually put it off for 20 minutes because Benjamin was eating SO much hay on his own and they didn’t want to interrupt him! 🙂 I got a couple of varieties of hay after work and now I mix his regular hay with other hays and Benjamin eats super well ever since then! 

 

So, that’s the story! Benjamin is doing extremely well now. He used to just have second cutting timothy hay from Small Pet Select. Now he eats that, plus oxbow timothy hay (this bag he’s eating from now looks like it’s first cut hay) as well as oxbow orchard hay. The orchard hay has been extremely important because that’s what got him to eat more hay when we got home! He does prefer the orchard hay but once he starts eating he will eat the timothy hay without a problem. I bought a box of orchard hay from small pet select to mix into his timothy hay once we’re finished with my supply of oxbow stuff. 

 

Benjamin has had a few personality changes since the surgery. The first change is his taste in hay – he prefers orchard hay over all else. The second change is that he LOVES to chew toys, especially untreated wood. Thankfully he knows what his toys are and leaves my furniture alone, lol! But really, he didn’t care for toys before surgery unless it was something like hay that he could eat. Now he chews on toys for 30 minutes at a time like a dog with a bone! And the third change is that he is so extremely lovey! Like, he was a wonderful bunny before the surgery but now he is just.. Omg. He loves to cuddle me and will half climb into my lap just for cuddles and kisses. He leans into my kisses too!! I’ll give him a kiss on the top of his head and go to move away and he’ll follow me for more!! When I walk around the room he excitedly follows me, and when I leave my room he will sit in the doorway until I come back! I even picked him up and held him for 15-20 minutes yesterday while I was visiting with my Aunt in the kitchen. Before the surgery Benjamin hated being held but this time he totally eased into me and relaxed and didn’t squirm at all. He’s just so happy to give and receive affection, it melts my heart. 

 

Thanks for reading!! Thank you binkybunny forums for being a source of knowledge and comfort for me over the years. 

 

Oh, and I also want to share – From the start of this experience up to the time of posting this – the total cost of all of this is between $5k and $6k. The estimate before surgery was $3k, but the extra care Benjamin needed ended up raising the cost. I’m very thankful to have the funds to care for Benjamin, and I hope for future bunny owners that the cost isn’t as high! I can post the breakdown of everything here if anyone is interested, or I see that the forum has a vet bill database and when I have the time I can submit it there. 

[Bam]

Thank you very much for sharing this success story! It will be very helpful for people seeking info about liver lobe torsion!

 

 

 

[Wick & Fable]

Thank you for sharing! There is an online database for entering vet bills, if you want to take the time to contribute your experience in another way as well: https://www.reddit.com/r/Rabbits/comments/puugtr/new_community_rabbit_veterinary_bill_database/

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[benjaminbinky]

Hi, wanted to give an update.

Benjamin has lost a lot of weight the last two weeks so the vet and I came up with a new feeding plan. He’s getting a tablespoon of Oxbow Garden Select pellets each day and I will weigh him weekly. He’s getting benebac once a week too. The amount of pellets will increase by half a tablespoon if he isn’t maintaining or gaining weight next week.

Aside from the weight loss Benjamin is doing really well! He’s happy and alert and eating hay nearly constantly. He’s drinking lots and his poops are getting better each day – no more extra cecals from trying oats this last weekend (the vet told me to try giving him 1 tsp of oats a day to help him gain weight.. I knew it might go poorly so I started with 1/4 tsp and yep, Ben had extra cecals and a messy butt. No oats for him!). His poops were also oblong for a couple of days this week. Like, oblong poops mixed with regular ones. Ever since starting him on those new pellets his poops are totally normal and healthy!

My main priority is getting him back to a healthy weight because right now he his a very skinny rabbit. The vet and I believe he’s lost the weight from the stress of the surgery and the recovery afterwards.. he really hates critical care! He’s on a good track now though. My next priority will be retraining him to use his litter box. He’s doing a good job of keeping the pee in his cage, but he’s pooping anywhere he pleases. Even in his cage he’s not using his litterbox much and is just going wherever. I’m cleaning his cage every day to keep an eye on the quality and quantity of his poop. I’d really like him to use the litter box like he used to though!

I’ll update when I have more to share. Thank you!

[LBJ10]

Thank you for the update!

Thoughts: Could he be having trouble getting into the litter box? Maybe you could try cutting out the side so he can just “step” in. As for the Critical Care, some bunnies don’t like it. You could try something different. Sherwood makes a recovery food that others here on the forum have had luck with.

[benjaminbinky]

I don’t think he’s having trouble getting in :/ I gave him a new litter box with a low side entry right when this all started and maybe he just didn’t get used to it? I feel like it’s a habit thing. Like when he was recovering from the surgery he didn’t move much and I kept his water and food super close to him. Today I’m trying a new thing where I keep his food next to his litterbox and when I see him eating I gently move him into the litterbox since he poops and pees while he eats. I can’t do that all day though, but perhaps it’ll remind him!

It looks very much like this one –

https://www.petsmart.com/small-pet/litter-and-bedding/litter-pans/full-cheeksandtrade-small-pet-high-side-litter-pan-5319232.html?gclsrc=aw.ds&gbraid=0AAAAADiLNNm5yd6DetMr9AiNJNT8LuOJA&gclid=EAIaIQobChMI54qm7bmHggMV5ffjBx2qhBIHEAQYJCABEgJYC_D_BwE

 

I’ll check out the Sherwood CC. Thank you very much! 🙂

[Bam]

I was thinking perhaps you could ask your vet about supplementing Ben with N-acetylcystein. It is used for liver detox and to help improve liver function in humans with certain liver ailments, and it seems it can be given to rabbits with no ill effects. The liver is great at rejuvenating itself, but it obviously takes time. It could perhaps be  worth to discuss it with your vet. NAC is inexpensive, but I think it might be prescription only in the USA nowadays, due to some debate about whether it is a traditionally used supplement or if its a medicine. (It is otc in the EU).

Please google it yourself first to get a rough idea. I found some interesting stuff when I recently looked into it a little bit.

[benjaminbinky]

Hi all, update on Benjamin –

He lost a lot of weight throughout October despite increasing the amount of critical care and pellets he got daily. Just this past week/week and a half his head started to tilt. He had head tilt from E. Cuniculi a couple of years ago but we started treatment quickly and reversed it. So a few days ago I took him to the vet for a check up and blood work. The night before I noticed an odor from his dewlap and discovered a skin infection 🙁 so the vet took blood work to check his liver and organs, as well as for a blood panel to test for EC. We went home with antibiotics for EC and his skin infection. The EC rest won’t be back for another week but we agreed it would be important to start treatment ASAP as EC could be the cause of his weight loss as well.

The past 5 days I’ve been syringe feeding him Sherwood Timothy Recovery Food (critical care but a different brand) 4 times a day and he LOVES the stuff. This weekend I got the Sherwood Timothy Adult Rabbit Food as well and he likes those too and they seem to be agreeing with him better than Oxbow Garden Select Pellets. So currently he’s getting the recovery food 4x a day and 4tbsp of pellets. He’s on antibiotics for EC and his skin infection and I have a spray that the vet gave me to put on his infected area twice a day.

Two days ago he was 4.5lbs, and today he is 4.6! It’s the first weight gain we’ve seen in a month and I’m very hopeful. I really hope things keep getting better and that his blood test comes back postive for EC because that would give us an answer and solution to his weight loss. Not knowing is the worst.

His other blood work for his liver and kidneys and stuff came back looking good and the vet is happy with the results.

So yeah! That’s the update. He is still extremely cuddly and he tries to follow me into the kitchen when he hears me mixing the recovery food 🙂 I think I included all of the relevant info. I apologize if this is rambling or poorly written — I’m changing my schedule so I can feed him more often in the afternoon which means waking up earlier than usual to go to work. This is working well so far tho! Oh, and his mushy poops are clearing up. They’re getting smaller and more golden from the recovery food.

Thank you! </p>
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[benjaminbinky]

I forgot a couple of details –

His skin infection is most likely from a couple of weeks ago when he had a day or two when he was being messy about drinking water. The vet thinks that moisture got trapped in his dewlap. He’s not drooling and his teeth look good!

He’s still eating timothy hay first and second cut with some orchard hay mixed in. He won’t eat the timothy without a little orchard mixed in. I switched him from the garden select pellets to the sherwood pellets because: 1. The garden select was giving him mushy poops 2. Ben was starting to not eat the garden select pellets, he didn’t like them anymore 3. The sherwood pellets are healthier.

Ben is 4.6lbs currently and I’d like to get him close to 6lbs. Let’s hope for swift and healthy weight gain!

 

[DanaNM]

That’s great he loves the recovery food! Finding a brand they like is so wonderful and really takes away a lot of the stress of giving it to them. Sounds like he is on the mend!

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[benjaminbinky]

Hi all. Benjamin’s blood test for EC came back positive yesterday, so it’s a good thing we started treatment already. His head tilt is getting better. I’ve done a couple of fecal transfers from my healthy bunny to Ben and that’s helping with Ben’s poops. Ben’s recovery is up and down – some days he has lots of energy and a great appetite, and other days not so much. His weight is fluctuating too. He was almost 5lbs on Monday and he dipped back down to 4.64lbs on Wednesday but he is back to 4.86lbs as of yesterday. Let’s hope he continues to gain weight!
His current daily schedule looks like:

4tbsp of Sherwood Timothy Recovery Food. 1 feeding in the morning and 3 feedings spread out every few hours when I get out of work. On weekends he gets an extra feeding of recovery food.

4 to 5tbsp of Sherwood Adult Rabbit Pellets. I serve a tablespoon of pellets to him after each syringe feeding and an extra tablespoon when I put him in his cage for the night.

Unlimited timothy hay first and second cut. Small amounts of orchard hay mixed in. He won’t eat the timothy hay unless I mix orchard hay into it.

In the morning he gets his antibiotic for his skin infection and EC. He gets a second dose for his skin infection in the afternoon. He gets a dose of benebac once a week.

He’s had a couple of upsets – a week ago and a few days ago. Both times I gave him .5ml of baby gas drops (he wasn’t acting like he had gas but it was worth a try) and 1ml of metacam. A few hours later he was back to good energy and appetite.

I’m writing this on Saturday. On Monday we’re going back to the vet for a recheck and a full blood count to make sure the Panacur isn’t harming his bone marrow. If Ben doesn’t continue to gain weight we’re considering doing an ultrasound but that would have to be at the emergency vet since my regular vet isn’t equipped to do that. His liver is healing well and his kidneys are great as of the blood work we did recently.

The vet recommended a full clean of his environment once or twice throughout the course of his EC treatment to decrease the amount of spores. I’ve been spot cleaning his cage twice a day since he still isn’t taking to being re-litterbox trained. I fully clean his cage every 3-4 days. Today I did a full clean of both his and my other bunny’s cage. I also deep cleaned my carpet with a carpet cleaning machine. I’m sanitizing and washing the blankets I’ve had out for him as well.

The vet isn’t sure why his recovery is fluctuating. I’m being consistent about his feedings and meds and what time I do them. He’s taking well to the pellets so I might slowly increase those a bit. He really needs to gain weight still. Is it normal for rabbits to fluctuate in their recovery progress?

Thank you. 
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[LBJ10]

It’s OK to clean his environment a few times, but don’t stress about it too much. It’s unlikely he is actively shedding spores at this point. EC recovery can be up and down at times, so don’t get discouraged if there’s a little setback. I’m glad he likes the recovery food, that makes things much easier.

[benjaminbinky]

That is a relief to hear, thank you <3

[benjaminbinky]

Hi all, another update on Ben. He’s doing really well lately!
Last week we had 2 vet visits. We checked his bone marrow and blood count, both of which are good. We also did a couple of blood panels and a radiograph and ultrasound. His liver is healing very well.

The reason for the vet visits were to figure out why he’s fluctuating so much in his recovery. The ultrasound showed a lot of food in his stomach which may have been part of the reason for his weight gain – so, not true weight gain really. Based on the blood panels we believe his fluctuations and upset tummy stuff is GI related, not liver related. So doc put  Benjamin on milk thistle and cisapride. The couple of days after that last vet visit weren’t great and he didn’t have much of an appetite or poop much. But on Sunday he pooped a BUNCH and ever since then he’s been really good!!!

To entice him to eat more hay – I’m giving him mostly first cut timothy hay with orchard hay mixed in – I’m sprinkling in a pinch of dried herbs. The herbs are from Rosewood Naturals and my vet said she thinks it’s a good idea. Ever since I did that it seemed to ignite Ben’s passion for hay again. Now I just sprinkle the herbs once a day or two. I love that he is drinking more water as well.

He’s almost done with his panacur treatment too. His weight is maintaining around 5lbs. I still want him closer to 6lbs. I know that will take time though. He is looking a little better and the vet and I agree he’s getting that padding back on his spine slowly but surely. He’s consistently having more energy and is starting to hop and play more and chew on toys! It’s so good to see. It’s been so long since I’ve seen him binky, I hope one of these days he will zoom and binky again <3 He’s also starting to potty train again, which confirms to me that before he was just feeling too crummy to follow that habit.

So currently his daily diet/meds are:
-Unlimited first cut hay with small amounts of orchard hay mixed in
-4 tbsp Sherwood Adult Rabbit Pellets spread throughout the day
-3 tbsp Sherwood Timothy Recovery Food spread throughout the day (makes about 90ml)
-Panacur once a day
-Milk thistle twice a day (almost finished)
-Cisapride twide a day for another two weeks

Thank you!

[Bam]

Thank you for the update! I’m happy to hear that he’s doing so well now!

[benjaminbinky]

Hi all,

I have a question about getting Benjamin to gain weight. He’s still on the same diet as I said in my last post. He’s maintained his weight at 5lbs for the past week, which is great! However I’d love for him to continue to gain weight and get closer to 6lbs like he used to be.

I have a few questions about this. Do I keep him on his current diet, or add more critical care feedings or pellets? Will he keep gaining weight on his current diet or has his body gotten used to what he’s having now and is plateau-ing?

The thing is that he’s still having pretty soft poops. He’s been eating a lot more first cut hay though. It’s possible he has cecal dybiosis but I don’t think it’s a good idea to put him on just hay yet. It’s taken a month to get him to gain and stay at 5lbs and I really don’t want to lose that progress by cutting stuff out suddenly. The soft poops might be from the extra moisture in the critical care feedings? Or maybe it’s from the cisapride? Or maybe his gut is still a bit out of whack from surgery and is taking a long time to rebalance. I’m not sure.

The vet wanted to get him to 5lbs and maintain, which is where we’re at. Ben is still skinny though and I can still see his spine bumps through his fur. Maybe at this point it’s a matter of putting muscle back on and that will just take time. Like I said, I think 6lbs is much safer and healthier for him.

I did try a pinch of oats for a couple of days a long time ago and it gave him SUPER messy poops. His GI is so sensitive right now and I’m not sure what to do to help him gain weight besides more daily pellets or CC feedings.

 

What do you all think? What do you recommend we do?

Thank you!

[DanaNM]

It’s great he has stayed a constant weight rather than losing. I would increase his critical care rather than pellets. You can also try adding in a different recovery food to see if it agrees with him better or he likes it more (I really had good success with Emeraid Herbivore Sustain). Sherwood also makes a recovery food that most of my buns liked.

I think the soft poops are more likely from the medications and surgery recovery. You could try including a probiotic and see if that helps as well.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[benjaminbinky]

Hi,

 

Benjamin is doing really well and I wanted to give a final update for this thread. In January he was doing very unwell and wasn’t keeping his weight, so thanks to advice from members on this forum I switched him over to Emeraid and starting giving him Equa Holistics HealthyGut Probiotics for Bunnies. He has made a full recovery and is a healthy weight! 🙂 I’d say at the 6 month mark after his surgery he finally stabilized and became healthy again. Thank you to this forum for helping me through the thick of things!

Benjamin is so full of life and affection every day now 🙂 he started doing this thing at the very end of January where he would do a bunny flop in my lap at least once daily around feeding time and he’s continued every day since!! I feel so special and honored that he flops and cuddles in my lap! He’s eating more hay, his poops are getting better as I need to give him less Emeraid – I think part of why he was having such messy poops is because he was getting too many nutrients for his body to really digest and use? Either way, he’s doing so well 🙂

 

If I could go back to the start of all of this I would have gotten a ton of Emeraid and the equa probiotics stocked up. I would have started him on a round of panacur after the surgery to nip the EC in the bud. I also wish I could go back and tell myself to be patient because major surgery takes a long time to heal from, and that Benjamin will be even better than before and to just give him time.

I thank the members of this forum from the bottom of my heart for the guidance and comfort you all have provided me. It can be so hard having an ill bunny and nobody in your life gets it because they don’t understand just how special bunnies are. This forum is a haven of information and advice and it saved my bunny and my sanity. Thank you!!!

[DanaNM]

I’m so happy to hear he’s doing so well! What a lovely update!

You did amazing with him, hindsight is always 20/20 as they say. EC is a pretty insidious disease so definitely don’t beat yourself up about not treating for it sooner. I had the same struggle with my bun, as I thought he just had worsening arthritis for months, turns out he also had EC. Since they can’t talk to us and tell us what’s happening, all we can do is go off the information we have at the time!

Anyway yay Benjamin!

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[LBJ10]

A wonderful update! I’m glad Benjamin is doing well now. 🙂

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