During my week spent observing in the ultrasound department, I spent most of my time either cuddling patients to help keep them calm during their exam or staring fixedly at the ultrasound screen. It could be a little boring watching scans being performed, especially if the abdomen ended up looking normal. But at least now I feel 100% confident that I can tell a colon from the small intestine, and a liver from the spleen. We saw some interesting things, too: large splenic masses, an adrenal gland tumor invading the vena cava, some angry-looking liver masses, and an immature gallbladder mucocoele.
One morning our exotics department came to us with a gorgeous Lop bunny, who had been suddenly lethargic, inappetent, and producing scant feces. The doctors suspected a liver lobe torsion as the cause of the bunny’s gastrointestinal stasis and sought an ultrasound to confirm the diagnosis. I watched as the bunny was positioned on its back, its tummy clipped, and ultrasound lube liberally smeared on. Sure enough, one liver lobe was distinctly darker in color (hypoechogenic), causing the blood vessels to stand out and appear brighter. Once we placed Doppler over the region of interest, we could clearly see that no blood was flowing in the abnormally dark liver lobe. Since the liver lobe torsion was confirmed, we sent both the bunny and the exotics department on their way, recommending surgical excision of the affected liver lobe.
It was an interesting case, and I ended up scouring the literature to find some pertinent experimental data on liver lobe torsions in rabbits to present during rounds the next day. It turns out that nonspecific gastrointestinal signs are a common presentation for rabbits with liver lobe torsions, and that liver lobe torsions seem to occur more often in Lop bunnies than in other breeds.