Gastrointestinal stasis

When a rabbit’s digestive system is compromised, either due to illness, pain or stress, then their hydration and food intake is likely to be reduced, which can lead to a reduction in gut motility (gastrointestinal (GI) stasis). This is a serious condition, so you MUST seek veterinary advice immediately if you think you rabbit has GI stasis.

Rabbits are unable to go any significant amount of time without food in their digestive system. If a rabbit stops eating or reduces its food intake then the gastrointestinal tract will go into stasis or ileus, where it slows down or comes to a complete standstill. This in itself can prove fatal within just a matter of hours so if you haven’t seen your rabbit eat in the last 4 hours you should be paying special attention to their behavior and seeking veterinary advice.

Rabbits require a high-fiber (+25%), moderate protein (12-13%) and low carbohydrate diet in order to maintain optimum gastrointestinal function.

The majority of pet rabbits are overfed on concentrated mixes and don’t eat enough hay and grass which should make up the majority of a rabbit’s daily food intake. 80% of the diet should be made up of hay and grass, 15% fresh greens and 5% pellets/nuggets.

Rabbits who are fed a muesli mix and pick out their favourite pieces of food, which often contain high levels of sugar and minimal amounts of fibre, often suffer with dental problems and GI stasis episodes.

Selective feeding can be prevented by changing the rabbit onto an extruded nugget type feed that prevent selective feeding. This type of feed is high in fibre and contains the correct amount of protein and carbohydrate in order to maintain good GI tract health but must still be fed in strict moderation.

Rabbits should have 1 level tablespoon of pellets per kg of ideal bodyweight each day, unlimited amounts of hay and grass, and a mound of fresh vegetables the size of their own body each day. Treats, such as those bought from pet shops and fruits, should be avoided due to their high sugar content and poor nutritional value.

The colon is responsible for sorting digestible and indigestible fiber. The rabbit eliminates the indigestible fiber as the hard round droppings, as these have no nutritional value to the rabbit.

The digestible fiber components are moved into the cecum where microbial digestion takes place.

The digestible fibre is excreted in the form of cecotrophs; these are small, clumps of smelly droppings covered in mucous. These are usually eaten directly from the anus by the rabbit and contain amino acids, fatty acids and vitamins B and K, from previously undigested foods. Consumption of the cecal pellets is important for the GI tract and overall health of the rabbit. The mucous protects the cecal pellets from the acidic pH of the rabbit’s stomach.

There are many potential reasons for a rabbit to reduce or cease eating and drinking, and are just some of the more common causes:

• Any pain.
• Dental problems causing pain or stopping the rabbit physically eating.
• Illness.
• Not enough fiber in the diet.
• Dehydration.
• Toxins.
• Foreign body.
• Stress from the loss of a partner, a sudden change in diet, a change in the environment or transportation, extreme heat or cold or being around a predator.

A rabbit’s digestive system is designed never to be empty and constantly contains food, cecal pellets and hair ingested during grooming. Fur-blockage is still thought, by some veterinarians, to be a primary cause of GI stasis, but in truth it is normal to find some hair in a rabbit’s digestive system. Problems occur when the hair dries out due to a decrease in appetite and hydration, often as a result of pain, and as such should be treated as a secondary problem due to the stasis and not a primary cause of stasis. The exception to the rule may be in long-haired rabbits, where true fur-blockage may be a primary cause of GI stasis.

It is all very well and good treating GI stasis, but the route of the primary cause needs to be identified and addressed to stop the rabbit suffering from further episodes. This may include a thorough dental examination, looking at the rabbit’s housing and social status, examining the diet, checking bloods, checking for osteoarthritis, pododermatitis and looking back over recent events to see if a stressful occurrence can be identified.

Normally the symptoms will have a gradual onset and owners may notice the rabbit eating slightly less, being slightly less active and perhaps see droppings that are strung together on hair and the rabbit producing less droppings. The droppings will get smaller, fewer and lack the spherical shape and fibrous look.

The symptoms may gradually worsen over the coming days or week or so, until the rabbit may completely stop eating and drinking altogether, pass no droppings at all and not want to move. The rabbit may also grind its teeth in pain. If you are ever concerned about your rabbits eating or the appearance of their droppings, then you should seek veterinary advice as soon as possible. Treating the condition early on carries a far better successful prognosis.

Treatment needs to be started immediately and in an aggressive form.

Once a blockage has been ruled out, the rabbit should be syringe fed or an esophageal feeding tube fitted if the rabbit is unwilling to take syringe feeds; aim for 20-50 ml/kg per day, split into several, regular feeds. Offering tempting foods, such as freshly picked grass, fresh greens and sweet-smelling hay may encourage the rabbit to begin eating again.

Medications to kick-start the GI tract, known as prokinetics, should be commenced and intravenous fluid therapy should also be started. Pain relief (analgesia) must also be included in the treatment regime as rabbits that are in pain will not eat.

If a blockage of some description is suspected, then this must be ruled out before any prokinetic medications are given.

If the rabbit is treated at an early stage, ie within a couple of hours of not eating, then the prognosis for recovery is good. If treatment is delayed for a number of hours, then a full recovery is less likely.

Some rabbits may take several days of treatment before any improvement is seen, so it is worth persevering with treatment if the rabbit can be kept comfortable during its recovery.