Gastro Intestinal Stasis in Rabbits

This article is from the Melbourne Rabbit Clinic (http://www.melbournerabbitclinic.com/melbournerabbi/stasis.html) to help rabbit owners recognise the symptoms of GI Stasis.

Unlike a dog or a cat, when a rabbit stops eating for 12 hours it is a very serious problem and can cause death.

When a rabbit stops eating or producing faeces it is called Gut Stasis (Gastrointestinal Stasis or ileus) and medical attention is required as soon as possible.

Rabbits can stop eating for lots of reasons:

* pain from anywhere (abscess, uterine cancer)

* dental problems

* diet (low in fibre, high in carbohydrates or protein)

* stress

* heat stroke

* moulting (excess fur ingested)

Delicate digestive system

Rabbits are hindgut fermenters. In the colon, smaller digestible fibres get passed into the caecum to ferment. Larger unfermentable fibre passes on and is the solid poo that we see. The caecum ferments the fibre (good bacteria! -normal flora in caecum, mainly gram positive and anaerobic bacteria as well as some motile protozoa) and this is then periodically released into the rectum to be eaten directly by the bunny. You don't often see these caecotrophs as they are eaten straight away.

If you see soft faeces, diarrhoea (rabbits rarely have true diarrhoea, unless a sudden high impact of fresh greens), or faeces stuck to fur it is oftena sign of caecal problems. Arising due to an imbalance of good bacteria or an over abundance of bad bacteria, these bacterial changes are adirect result of poor diet.

Pellets and grains are high in sugars, fats, carbohydrates and proteins and low in fibre. High sugars (molasses is a big problem), fats,carbohydrates and proteins promote the growth of the bad bacteria in the caecum. This causes poorly formed caecatrophs, increased gasproduction and abdominal pain. This can cause gut stasis, dehydration and death.**This is why we recommend not feeding rabbit mix!

On top of that pellets promote dental issues (decrease in hay consumption and decrease in grinding action of teeth) and weight gain!! But remember, diet changes need to be gradual over 3-4 weeks. Some bunnies that have been on a long term inadequate diet may get intermittentcaecal problems (intermittent soft stools) life long. These rabbits need to be treated when this progresses to gut stasis and be on a mainly hay only diet.

Common Gut Stasis

Inappetant rabbits dehydrate fast. This causes the fibre and hair matt that is usually in their stomach to become solid. This is often mistaken for a blockage. However, this is not something that needs to be removed or 'dissolved' with pineapple juice (an old wives tale - this only provides your bunny with fluids but too much sugar!) as it is a normal part of a rabbit's intestinal tract. This solid clump of fibre is an indication that your bunny is dehydrated and needs fluids. Depending on how sick your rabbit is, this can mean syringe feeding, subcutaneous fluids or intravenous fluids (drip).

Rabbits affected by GUT STASIS may also need pain relief and medication to increase the gut contractions. An important part of treatment is syringe feeding!! Often early treatment by syringe feeding water and food can resolve a lot of gut stasis.

Intestinal obstruction

An important condition that can cause inappetence and mimic gut stasis is gastric dilation. Gastric dilation is caused by intestinal blockage. Blockages are uncommon.

When there is a blockage in the intestinal tract the stomach fills up with fluid. Rabbits cannot vomit and continually produce intestinal juices. When there is a blockage these continue to collect in the stomach and this fills up like a balloon. The result is a suddenly depressed, lethargic rabbit with a large swelling in the upper abdomen that is painful. This condition is an emergency and surgery is required as soon as possible (do not leave till the morning). The stomach needs to be drained and surgery needs to be done to remove the blockage - if not the stomach can rupture. Radiographs can differentiate between gut stasis and an intestinal blockage if you are at all concerned.

Treatment at home

Early treatment at home can resolve the problem although if you are at all concerned or your rabbit is not improving in 2-3 hours you should seek veterinary attention.

As soon as you notice that your rabbit is depressed or not eating their greens, then giving water and food by a syringe can help and often resolves the gut stasis.

Have on hand a 5 ml syringe and give about 5 mls per kg every 1-2 hours of water by mouth. This will help to keep your rabbit hydrated.

The emergency syringeable diet Critical Care (www.oxbowaustralia.com <http://www.oxbowaustralia.com>) has saved the lives of many bunnies. This is a perfectly balanced diet high in fibre and low in proteins and sugar. Syringing 10 mls per kg every 1-2 hours can resolve gut stasis quickly. This emergency food can be kept in the freezer and is a must for all bunny emergency kits. If you do not have access to Critical Care an alternative is mashed pumpkin or vegetable baby foods. These can be mixed with water and syringe fed every half hour to an hour until your rabbit eats independently.

**Critical care can be purchased from some vet clinics

Pain relief: pain relief is important to rabbits when in stasis as pain can exacerbate the problem. Whether pain is the cause or the result of gas build up in rabbits, relieving this can help your bunny to eat. We have to use pain relief with caution as common medications (Metacam and Rimidyl) can severely damage the gut lining and kidneys if given when dehydrated. There are alternative pain relief medications although these have to be given by a vet (eg. drugs similar to morphine).

Motility drugs: Motility drugs (cisapride) are often given to help start the intestine moving again. These drugs, although not proven with medical research, are often used and appear to decrease the time till the rabbit starts eating again. They should be used with caution as they can cause intestinal rupture if there is a blockage or intestinal obstruction.

Simethicone: is often used in rabbits with intermittent gut stasis once diet and other causes of stasis have been ruled out. Although simethicone (Infacol drops) is a medication directed at 'frothy bloat' to break down the bubbles, something that rabbits do not get, some people use it with good results

Probiotics: although not hurting your rabbit, the probiotics do not make it past the stomach in a rabbit. The rabbit has a very acidic stomach with a ph of 2. This destroys any active ingredient in the probiotics. Also, the major component of probiotics is lactobacillus, a yeast that is not in the native bacterial population of rabbits. If we are concerned about the destruction of normal bacteria in a rabbit's caecum (after antibiotic use), some donor caecotrophs are of more use as they have a protective mucous covering allowing them to get past the stomach.

If your rabbit is not responding to treatment at home, treatment at a veterinary clinic may be of use. After a thorough examination and exclusion of possible other causes for inappetance (intestinal blockage, gastric dilation), possible treatments usually are:

Continuing home care. As much as possible we like to treat rabbits at home as they are more comfortable in their normal surroundings. If your rabbit is not too depressed and lethargic, subcutaneous (under the skin) fluids are administered every 12 hours to increase hydration. Pain relief and gut motilants may be administered and Critical Care feeding continued every 1-2 hours (around the clock).

Your rabbit should be kept in a quiet, dimly lit area and offered favourite foods and fresh hay. Any bonded companion should accompany your rabbit, especially if you take a trip to the vet.

Hospitalization is necessary when the rabbit is severely depressed and lethargic and especially when very dehydrated.

Intravenous fluids are necessary (a drip) and blood tests may be taken to assess the blood concentration, glucose concentration and liver function. Rabbits that have not eaten for over 24 hours are at risk of hepatic lipidosis, this is where the body starts to quickly break down fat stores and the liver is overcome with fat and is unable to convert this to energy.

This can increase the severity of the gut stasis. A nasogastric tube can be placed in some rabbits to enable us to give large amounts of food directly into the stomach. This usually helps to resolve the gut stasis in 24 hours. A rabbit in hospital requires around the clock care and medication (and feeding) and your vet may direct you to a 24 hour emergency clinic for care out of hours.

http://www.melbournerabbitclinic.com/melbournerabbi/stasis.html