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Gastrointestinal (GI) Stasis in Rabbits

Gastrointestinal (GI) stasis is a potentially dangerous condition in rabbits, where muscular contractions of the stomach and intestines are reduced and normal bacteria in the digestive tract become out of balance.

Rabbits with GI stasis can quickly become lethargic and may exhibit signs of pain such as teeth grinding and a hunched posture. They may also begin to produce excessive gas and sometimes soft stool or diarrhea. If this is left untreated, severe cases of GI stasis can be fatal.

There are many causes of GI stasis including stress, dehydration and anorexia from other underlying medical conditions or gastrointestinal blockage. A common cause is a lack of crude fiber in the diet, specifically, hay.

Hay is essential for normal gastrointestinal function. Pellets contain hay but some brands contain many other types of ingredients. Some pellets are chopped and processed to a finer, more easily digested product, which is actually not to the rabbit's overall benefit.

Hay also provides the best environment for growth of the beneficial bacteria growing in the rabbit's digestive tract. Hay also allows for passage of hair that is normally ingested by the rabbit. Without adequate fiber, hair may accumulate in the stomach causing a partial or complete blockage, since rabbits are unable to vomit. The rabbit may feel "full" and its appetite may often decrease.

When the bacterial population in a rabbit's digestive tract changes, gas-forming bacteria may proliferate causing painful, excessive gas accumulation. Some gas-forming bacteria produce deadly endotoxins that can cause rapid death.

Treatment for Gastrointestinal (GI) Stasis

 

If you suspect your rabbit/s to have GI Stasis, it is best to take them to a Veterinarian immediately. Treatment of GI stasis varies depending on severity and underlying causes. Recovery is often slow and may take several days to weeks.

  • Fluid therapy — Many affected rabbits are dehydrated or suffering from electrolyte imbalances.

  • Simethicone — This medication helps to reduce the amount of gas in the digestive tract.

  • GI motility drugs — These drugs can help stimulate the digestive tract to begin working properly again.

  • Pain relief — This is important to relieve discomfort associated with GI stasis and distention.

  • Hand feeding — Many rabbits with this condition have decreased or no appetite. It is often necessary to hand or force-feed liquid hay products (Critical Care, Oxbow Pet Products) with a syringe.

  • Hay — Rabbits that will eat on their own must be encouraged to eat grass hay.

  • Treatment of other underlying medical problems — If examination and testing by a Vet reveal additional problems, these must be treated as well.

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Bloat in Rabbits

Can Sometimes Be Mistaken For GI Stasis - See Veterinarian

Gastric Dilation (Bloat) in Rabbits is an acute and often life-threatening condition in rabbits that requires immediate veterinary attention. It can cause a perfectly healthy rabbit to become very unwell very quickly. The most common cause of this condition is an intestinal obstruction caused by a trichobezoar (a hair ball). It is normal for rabbits to ingest hair as they groom however in some cases the hair can join together with some of the ingesta (food) and can form a ‘ball’ shape. This ‘ball’ is normally slightly larger than the rabbit’s normal feces. While it sits in the stomach no harm is generally done however if it starts to mobilize from the stomach and moves into the small intestine then in some cases a blockage can occur. Rabbit stomachs only have one entry and exit, and unlike most species, rabbits are unable to vomit or ‘burp’. This means that if the exit from the stomach to the intestine is blocked then there is nowhere for the fluid and gas that normally accumulates in the stomach to go. This leads to the rapid increase in the size of the stomach which can cause a lot of pain and discomfort. This gastric dilation can put pressure on the chest and compromise breathing and the normal circulation of blood. In addition to this, changes to blood volume and electrolyte levels can occur.

Common causes of intestinal obstruction: By far the most common cause of this condition is a blockage with pellets of compressed hair, known as a trichobezoar. These pellets are similar in appearance to normal fecal pellets but larger in size. Other potential cause of this condition includes:

  • Intestinal cancer

  • Carpet fibers

  • Post-surgery adhesions

  • Intestinal intussusception

  • Other foreign materials that have been eaten when they shouldn’t have been

 

Where does the intestinal obstruction generally occur?

 

The two most common areas of the blockage are at the proximal duodenum (the first part of the small intestine) or at the ileocecal junction (where the small intestine meets the caecum). How is gastric dilation diagnosed? The distended abdomen is often apparent on abdominal palpation. To confirm the blockage radiographs (x-rays) and a blood glucose measurement are generally performed. What are the treatment options? There are two main treatment options that are generally considered: Medical Management Medical management involves active warming if needed, strong pain relief, intravenous fluid therapy and in some cases gastric decompression with a stomach tube under anesthesia.

 

Surgery - An exploratory laparotomy is indicated in some cases. This involves surgery to locate and remove the obstruction from the small intestine. This is often performed by gently compressing the obstruction (remember it is often mainly hair) and ‘milking’ it through to the large intestine where it can be later defecated out. This option is generally performed in conjunction with medical management. What is the prognosis if my rabbit is diagnosed with bloat? The prognosis can be variable depending on the clinical state of the rabbit and the duration of the gastric dilation. In many cases rabbits can make a full recovery if prompt treatment is initiated

Treatment for Gastrointestinal (GI) Stasis

  1. Medical management involves active warming if needed, strong pain relief, intravenous fluid therapy and in some cases gastric decompression with a stomach tube under anaesthesia.

  2. An exploratory laparotomy is indicated in some cases. This involves surgery to locate and remove the obstruction from the small intestine. This is often performed by gently compressing the obstruction (remember it is often mainly hair) and ‘milking’ it through to the large intestine where it can be later defecated out. This option is generally performed in conjunction with medical management.

Fluids are a critical component of the treatment. Severe shock or dehydration results in a drop in blood pressure which decreases the blood supply to major organs and contributes to the hypothermia and shock. Fluid replacement to treat the dehydration and low blood pressure should be administered through an intravenous (in the blood vessel) catheter.

Gastric decompression is performed by sedating the rabbit and passing a tube through the mouth and into the stomach. Some rabbits will have large amounts of hair, food and hay that block the tube and preventing adequate decompression. Immediate surgical intervention is then required. Repeat decompressions may be necessary.

Warmth is also very important. Sick rabbits expend a lot of energy fighting off infections and trying to stay alive. Providing warmth will reduce the amount of energy required to maintain their body temperature.

Exercise is encouraged when the outflow is established to help encourage gastric motility. Dietary therapy is important after the outflow obstruction is removed. Generally a large selection of fresh greens (romaine lettuce, parsley, spinach, collard greens and/or cilantro) are offered as well as a good quality grass hay such as Timonthy.

For patients that refuse to eat, a gruel is offered and gently syringe fed. A common gruel is Critical Care for Herbivores (Oxbow Pet Products) or Emeraid Herbivore (Lafeber). Another option is to grind pellets and mix with fresh greens to form a gruel. Oral water intake is encouraged by offering fresh water, or wetting the fresh greens.

Analgesics (pain medications) help alleviate abdominal discomfort. Commonly used drugs to treat gastrointestinal pain are butorphanol, buprenorphine, hydromorphone, oxymophone. Drugs to teat or prevent gastric ulcerations may include cimetadine (Tagment) or ranitidine (Zantac). Antibiotic use is controversial.

Common complications are gastric rupture and/or kidney failure in the early post-operative period. Early and aggressive medical care still carries a very guarded prognosis. Gastric dilatation can recur. Many pets can go in to kidney failure after surgery. Pets should be monitored closely for 72 hours post-op. After 3 days in patients that are recovering well – the prognosis for complete recovery is good.

Once your rabbit is out of the hospital and back at home, it is important to maintain the treatment protocol regimented by your veterinarian.

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