Hepatic lipidosis

Abdominal haemorrhage was found in this rabbit that died on the way home after examination and treatment for anorexia. During the consultation. the rabbit struggled as the owner was returning it to its carrier.  Unfortunately the rabbit escaped and fell from the consulting table. Post-mortem examination showed that abdominal haemorrhage from a ruptured liver was the cause of death. The liver was pale (arrow). Histopathology confirmed the presence of heaptic lipidosis.

This image shows the liver of a rabbit that died with hepatic lipidosis. She died a few hours after admission, despite intravenous fluids and other supportive treatment.  She was ataxic and hypothermic with a low blood glucose (4.2 mmol/l) on admission.  Her urine was acidic on a dipstick due to ketoacidosis. The rabbit had undergone radical dentistry at another practice 4 days earlier and had not eaten since she was discharged on the day of dentistry.

Hepatic lipidosis is the end point of gut stasis, which is associated with loss of appetite and reduced or absent faecal output. It is not really a cause of sudden death but will be a cause of unexpected death. Owners can easily miss a rabbit that is not eating or defaecating normally, especially if the rabbit lives with companions, so the owners are not aware of a problem until the rabbit is dying.  Gut stasis is secondary problem and the underlying reason may be detected during post-mortem examination. Dental disease is a common cause of gut stasis. On post-mortem examination, the liver is swollen and very pale. Occasionally there may be abdominal haemorrhage if the liver has ruptured (see right).