Gastrointestinal Stasis in Rabbits

Many long time rabbit owners have experienced situations when their rabbits stop eating, produce extremely small or no fecal droppings, and become inactive and act depressed. Some of these cases progress and worsen to the point the rabbit  experiences abdominal bloating and possibly diarrhea. These rabbits quickly become lethargic and hunched over and may even grind their teeth as a sign of being in pain. These are classic symptoms for Gastrointestinal (GI) stasis which is a syndrome where the normal muscular contractions of the stomach and intestines are greatly diminished and the normal intestinal/cecum bacterial flora is thrown off balance. Without medical attention this syndrome can result in a serious, life-threatening illness.

Rabbit with small fecal matter due to stasis

Rabbits with GI stasis will be quiet and hunched over with a painful abdomen. As seen here rabbit poops will be noticeably smaller or you may not see any at all as the intestinal tract slows down.

So what causes GI stasis? Several factors can be involved including environmental stressors, pain from another underlying condition such as dental/tooth points or spurs, intestinal blockage from foreign body ingestion, and most commonly lack of crude fiber in the diet. Grass hay is the most common form of crude fiber for the rabbit and if lacking in the diet can predispose to GI stasis. Making sure the rabbit has unlimited quantities of timothy or other grass hay all the time is the best way to prevent this syndrome form occurring. The rabbit intestinal tract is much like that of the horse (and we all know how much hay horses consume). This hay is needed to not only stimulate normal peristaltic (musculature) contractions of the gastrointestinal tract but also to provide the best environment for the normal bacteria in the intestines which help make needed proteins, vitamins and other nutrients.

So where does the term hairball come in? Rabbits may ingest various quantities of hair through normal grooming. If the bunny is consuming inadequate quantities of hay and the stomach wall is not contracting, this hair doesn’t move through the intestines and can form a thick matt of wadded fur. This wad of hair not only can cause a blockage where food cannot get around this ball of fur and is just one cause of GI stasis. If large enough a hairball may give the rabbit a feeling of a full stomach and the appetite decreases. With time the rabbit’s dietary balance is off and the healthy bacteria normally found in the intestines begins to change and be replaced by abnormal gas-producing bacteria which start to produce excess gas within the intestines (bloat). Anyone who has experienced significant amounts of intestinal gas can testify to how painful this is. The bunny, that is already nutritionally compromised because its appetite is diminished, can become very sick within a short period of time.

X-ray of a bunny in stasis

This radiograph (x-ray) of the rabbit with GI stasis laying on its side shows how gas, which shows up on an x-ray as a dark tubular shape (arrows) can build up in the intestinal tract. This causes quite a bit of pain and takes away the appetite.

How can GI stasis be treated? As with most medical conditions, the sooner the problem is recognized and treated the better the chance for full recovery and survival. Your rabbit veterinarian will institute a variety of treatment measures depending on the severity of the condition. These may include:

(1) Abdominal massage: Gentle, deep massage of the abdomen not only stimulates intestinal contractions but also can break down hair balls and gas bubbles, thus easing colic.

(2) Intestinal motility stimulants: These medications stimulate intestinal motility and can be used to get a sluggish gut back in action. Cisapride and metoclopromide are two such drugs.

(3) Simethicone: To help break down gas bubbles associated with bloating.

(4) Fluid therapy: Since most of these bunnies are dehydrated, fluids are needed to make the bunny feel better, rebalance electrolytes and to add fluids back to the intestines so they can contract normally.

(5) Pain relief: To ease discomfort associated with abdominal gas and bloating pain relief will go a long way in making the bunny feel better.

(6) Appetite stimulants: The sooner the rabbit eats the sooner the intestinal motility will return to normal. Cyproheptadine is an effective appetite stimulant

(7) Hay Hay Hay…and more hay: Again encouraging the rabbit to eat grass hay (timothy, oat or orchard grass) will help stimulate normal gastrointestinal contractions and function. Also try mixed greens such as leaf lettuce, collards, kale or Swiss chard and herbs such as parsley or cilantro. If necessary a powdered dietary supplement (Oxbow Critical Care) that is mixed with water and syringe fed may be the answer to get the rabbit needed nutrition and fiber to get the gut moving again.

Oxbow Timothy HayOrchard Hay by OxbowOxbow Meadow Hay

The fiber rabbits need for nutrition, proper digestion and to aid in normal dental wear comes from feeding grass hays. Variety is the spice of life and that includes the hay you feed your bunny. Oxbow Pet Products offers a variety of hays and Pet Care Veterinary Hospital recommends the timothy, orchard grass, oat or Organic Meadow hays for the adult rabbit.

(8) Laxatives: Lubricating laxatives may help slide dry impacted matter through the intestines and are occasionally recommended.

This list of therapeutic options is not all inclusive and rabbit veterinarians have other treatment protocols they can call upon if a sick bunny isn’t responding. The bottom line to this serious syndrome is to seek veterinary treatment early in the course of the disease and to try and prevent GI stasis through proper nutrition (a diet made up of primarily grass hay, moderate vegetables and limited pellets) and keeping environmental stress to a minimum. The road to recovery can be slow – up to 2-3 weeks for some bunnies to return to near normal – so an ounce of patience needs to be added to the treatment protocol. With early and appropriate treatment, most bunnies will return to full health.

The typical diet for the house rabbit includes free choice grass hay (timothy hay is preferred by most and should be available around the clock), 2 tablespoon to 1/3cup of timothy-based pellets per day, and a cup of fresh leafy greens. Avoid high carbohydrate snacks and treats—Please! The rabbit may like them but their gastrointestinal tract doesn’t! In fact, the number one reason for soft stools is feeding an inappropriate diet.