by Alexandra Logsdon
How The Rabbit Gastrointestinal Tract (GIT) works, a quick overview:
Digestion begins in the mouth. When the rabbit chews its food it is mixed with saliva, which contains proteins that begin breaking down the food.Food is swallowed, enters the stomach where it is mixed with stomach acid and digestive enzymes, which continue the digestion process.The food then exits the stomach into the small intestine, where nutrients are absorbed into the body, and then it continues on into the large intestine where the food particles are sorted by size: larger particles of indigestible fiber (those nice long pieces of fresh timothy hay) drive the smaller fragments of digestible fiber backwards into the cecum. The cecum is a large blind-ended sac located at the junction of the small and large intestines. The indigestible particles are then passed out in the fecal pellets (regular poop) and the cecum begins the fermentation process that will produce what is commonly referred to as night feces or cecotropes, which a rabbit will ingest directly from the anus.What Is GI Stasis?
When the speed with which material moves through the GIT is altered it can affect how quickly the stomach and cecum empty. This will generally decrease the appetite for both food and water, causing the body to extract the water from the stomach, which exaggerates the problem by causing the contents of the entire GI tract (food, hair from grooming, etc.) to become further dehydrated and impacted. The bunny is then unable to pass the mass of food/hair in the stomach, feels full, uncomfortable and often gassy (due to the build-up of bad bacteria in the cecum), which only adds to his “I don’t want to eat” mentality. Rabbits who are not eating can quickly become anorexic and can die from something called hepatic lipidosis or commonly “Fatty Liver Disease,” which is caused by the toxins produced by the bad bacteria in the cecum. A rabbit in GI Stasis is often said to have a “hairball” – and while this may be a part of the problem, the hair/food mass in the gut is a RESULT of the stasis, not the cause. Causes Of GI Stasis - hair ingested during grooming
- a high fat, low fiber diet (such as a pellet-only diet)
- too many carbohydrates in the diet (breads, crackers, etc.)
- stress (moving, illness, changes in family life, loss of rabbit companion, etc.)
- long term use of antibiotics
- partial paralyzation or mobility problems
- lack of proper exercise
Treating GI Stasis
The first and most important thing to do is learn to recognize the early signs of GI problems and treat your rabbit accordingly or get him or her to your Rabbit Vet before things get worse. Signs Of GI Stasis - feces strung thickly together with hair (from grooming)
- decreasing or sudden lack of appetite for both water and food
- periodic soft, pudding-like stools followed by erratically shaped fecal pellets
- on-again/off-again diarrhea
- on-again/off-again diarrhea in combination with irregular shaped poops
What To Do If You Notice Early Signs Of GI Problems
If you notice that your rabbit’s feces are strung with hair, smaller than usual or not uniform in shape and size there are several things you can do before getting extra-concerned and calling your vet: - INCREASE rabbit’s fiber intake: offer her a variety of fresh hays. Change or add hay frequently throughout the day to encourage bunny to investigate and munch.
- DECREASE pellets for a day or two to encourage a hungry bunny to eat more hay (fiber).
- INCREASE produce. Rinse it and offer bunny wetter veggies to encourage water consumption..
- INCREASE water consumption to help hydrate impacted gut:
- offer your rabbit water in a crock as well as water bottle; crocks offer rabbits a more natural way of consuming water, which may encourage them to drink more;
- add a small amount of sugar free fruit juice, such as apple, grape or (our choice) Gerber’s baby “Apple Carrot” juice to the water for a day or two (change water frequently to avoid spoilage) and make sure to ask your vet about the use of fruit juice for each rabbit/case;
- some rabbits will even drink a V-8/water mixture!
- INCREASE your rabbit’s exercise routine. If this is a “caged” rabbit, get her out to run around your house (supervised) for several hours a day. Often just getting the body going will motivate the gut to function better.
- Give your bunny malt flavored cat hairball remedy, 1 inch 2 to 3 times a day for 2 days.
If your rabbit’s feces do not improve within 2 days, or if they get worse(smaller) or stop altogether – or if her appetite diminishes – contact your rabbit vet IMMEDIATELY. Common Things Your Vet May Do Or Prescribe Your vet will examine your rabbit, listen to and palpate (feel) her gut and often ask to take x-rays (and occasionally even a blood sample) in order to make her diagnosis. It is worth it to mention that allowing your vet to take x-rays, even if she is already fairly sure it is a hair/food mass, is an important procedure prior to prescribing medication. If a real “obstruction” is present, the use of GI “motility” drugs could cause the mass to move into a smaller area, causing an intestinal eruption. GI Surgery should only be considered as a last resort. - Intestinal Motility Agents: Propulsid® (cisapride) or Reglan® (metaclopramide) are safe and effective drugs which can help get the GI tract moving again. Propulsid works mainly on the lower GI and Reglan on the upper. In severe cases, both drugs may be prescribed simultaneously.
- For rabbits with mucous in their stools: Questran® (cholestyramine), generally used to reduce serum cholesterol in humans, can be used to absorb the harmful toxins which cause the mucous and pass them out through the feces.
- Subcutaneous (Sub-q) Fluids: For the rabbit with an impacted gut who refuses to drink and is getting sick of being syringe fed/watered. Sub-q fluids not only hydrate the body, but help to balance the electrolytes as well. Your vet or vet tech will teach you how to administer these fluids at home as well.
- Antibiotics: Sometimes an antibiotic such as Flagyl, Bactrim or Baytril is prescribed to help combat the overgrowth of “bad bacteria” (clostridium spp). This is not always necessary and should be only be done if bacterial infection is suspected.
- PAIN RELIEF: Pain relief for a rabbit is often the critical key to his or her recovery. Rabbits do not deal well with pain and will sometimes give up and die. The gases caused by stasis can cause a lot of abdominal pain. Sometimes simply relieving the pain will encourage them to begin eating/drinking and becoming more active.
At-Home Care of the Rabbit in GI Stasis
Patience. Patience. Patience. Patience, proper vet care, observation and at-home supportive care will almost always solve this problem. Once you have visited your vet and started your rabbit on the proper road to recovery, there are things that can be done at home to help your bunny. Mechanical Pain Relief
Frequently a rabbit in GI Stasis simply feels too yucky to eat. The build-up of gas in her gut can be painful and she probably feels full and uncomfortable. There are some extra at-home things you can do to help break up the gas in the tummy, as well as to help stimulate the GI tract and get it moving again: - Simethicone (liquid pediatric suspension, can be purchased at grocery stores or pharmacies). Simethicone helps gather and pass gas bubbles in your rabbit’s gut, which will relieve a lot of pain and may be what’s needed to encourage your rabbit to begin eating. It has no known side effects and is inexpensive. Administer 1ml per hour for first three hours, then 1ml every 3 – 8 hours, as needed. You may hear your bunny pass gas: a bunny who poots is a bunny on the road to recovery! We recommend that ALL bunny owners keep some Simethicone on hand.
- Massaging or vibrating your rabbit’s tummy is one of the best ways to help break up gas bubbles and encourage the gut to ‘get moving’. Sit bunny on your lap or on a towel on the counter and with your hands gently knead your rabbit’s abdomen, as deeply as she will allow. If she reacts in a painful manner, stop. You can also vibrate bunny’s tummy by holding your hand, palm up, under her belly, or one hand on either side of the belly and jiggling as quick as bunny will allow. Do these for as long and as often as bunny will tolerate. Ask your vet to show you where your bunny’s tummy is, it may not be where you think it is!
Getting Bunny To Eat
As stated, most often a rabbit in stasis will not want to eat or drink on his or her own, yet it is absolutely crucial to keep your rabbit eating! Following are some suggestions that have worked well for us at Zooh Corner - for many many rabbits: - Microwaved pellet mixes. In a small bowl, add about 1-2 tablespoons of your rabbit’s pellets and enough water to cover them, with a tiny bit to spare. Microwave for 15-20 seconds, until water is absorbed and pellets are puffed almost completely apart (looks a bit like fluffed rice). Fluff with fork an allow to cool until luke- warm and give to bunny. Often the aroma will entice bunny to eat.
- Sometimes adding a bit of sugar-free applesauce or sugar-free fruit juice to the pellet mix will entice bunny. Ask your vet if this is okay in your rabbit’s specific case, as sometimes sugary fruits can add to an existing problem.
- Make sure you offer bunny a VARIETY of FRESH hays throughout the day. Pet store hays are often stale and un-enticing. Buy your hays instead a local rabbit rescue or feed store. Change hay often to encourage bunny to investigate and munch. Pick out pieces and “play” with your bunny by waving it in her face, hoping she will get nip at them, like the taste and eat them.
- Offer bunny a variety of fresh vegetables throughout the day. Kale has a lot of fiber and is often a good choice, but try all sorts of veggies, including fresh fragrant herbs, such as basil, cilantro, dill, etc.. You can also offer your rabbit fresh, pesticide, chemical free grass clippings from your yard! Again, pick out pieces of produce or grass and “play” with your bunny – try to entice her to eat.
When Bunny Refuses To Eat
Sometimes bunny simply refuses to eat, no matter what you do or try, so you have to resort to “force feeding.” This should only be done if your rabbit vet tells you there is no blockage and that it is safe to do so. We prefer to simply call it syringe feeding and we strongly suggest that before your rabbit EVER gets ill, you begin to get her used to taking food or liquid from a syringe, so that when the emergency time comes, you will have a less stressful situation on your hands. [For “training” your rabbit to use the syringe, use a bit of sugar-free fruit juice mixed with water or some mashed banana (some people even use malt flavored hairball remedy), follow the directions for the actual feeding process listed below]. Items You Will Need - Timothy pellets (or whichever pellets your House Rabbit Vet recommends)
- A CLEAN coffee grinder (one bought for just this purpose is best)
- A bowl or cup for mixing the ground pellets with liquid
- A 30cc or 60cc ORAL syringe, obtainable from your rabbit vet
- Warm water and assorted sugar-free fruit juices for making an enticing formula (again, consult your vet to be sure that using fruit juices is okay for your rabbit)
How To Make the Syringe Formula - Using a your coffee grinder, add the timothy pellets and grind them until they are in a fine, powdery-like state. Even then you will sometimes need to sift through them to pick out larger chunks which will not go through the oral syringe.
- Add 2-4 tablespoons of the powdered mix to your bowl or cup (save the rest in a ziplock for later).
- Add warm water (or Pedialyte), slowly, as you mix - until the mix is about as thick as semi-congealed pudding. Wait 3-5 minutes for pellets to absorb water.
- Add more water until the mix is once again like semi-congealed pudding. Wait another minute or so…
- Now add the juice, a little at a time, waiting 30 seconds to 1 minute, until your mix is the consistency of semi-congealed pudding. It should be liquidy enough to flow well through the oral syringe, but not so watery that you won’t be getting actual food into your rabbit.
NOTE: If you are unable to make your own syringe formula, OxBow Hay Co. makes a wonderful syringe feeding formula called “Critical Care” which can usually be purchased through your rabbit vet. This is GREAT stuff, however, over a long period of time it can become quite expensive.
Syringe Feeding Your Rabbit - Sit bunny on a towel on the counter facing sideways (as opposed to towards or away from you).
- Talk to your bunny and tell her what you are doing as you wrap your arm around your bunny so her bottom or back-end is against your upper arm / crook of your elbow; place that hand on bunny’s head, thumb behind the ears and against cheek closest to you – other fingers along far side of face (I have my index finger in the middle of the face). You can use this hand to help steady bunny’s face and to help keep her from moving forward.
- With the OTHER hand, insert the tip of the filled syringe into the side of bunny’s mouth, behind the incisors (front teeth) and slowly squeeze out 1-2cc at a time, allowing bunny to chew and swallow. Be very careful not to squirt food or liquid straight back down the throat or you could get liquid into her lungs (aspiration), which could kill your rabbit.
- Sometimes it is necessary to make a “bunny burrito” in order to help restrain your rabbit: sit bunny across towel width-wise; fold back of towel up over bunny’s rump; fold either side up and over bunny’s back, the top side wrapping beneath bunny – so that only her head sticks out. This often has a calming/secure effect on a rabbit. Continue as listed above.
Ask your vet how frequently you should do this each day and how many total cc's you should try to get into your rabbit at each feeding. Recovery Time
It is crucial to remain patient while nursing a rabbit through GI Stasis. The road to recovery is often long, and you need to allow the therapies and medications time to do their work. It may be several days before you see any fecal pellets, and several weeks before your bunny is back to normal again. DO NOT STOP any medications or therapies or change them without first consulting your vet! We also suggest that when it is time to stop medications that you not do so abruptly , but in a tapering-off manner. When you do see your vet, if your rabbit has a companion, make sure he or she goes along as well. Separation can cause stress and make matters worse. We cannot stress enough the importance of talking to your rabbit, encouraging her, loving her and giving her extra-special attention during this period. Rabbits respond amazingly well to love and attention. Proper vet care, proper feeding, pain relief, tummy massage, love and patience will almost surely get your rabbit through a bout of GI Stasis.
References
Krempels, Dana M., PhD. GastroIntestinal Stasis, The Silent Killer. 1997, 1999, 2000.Brown, Susan, DVM. Sluggish Motility in the Gastrointestinal Tract. Hand-out. Midwest Bird and Exotic Animal Hospital, Westchester, Ill.Cheeke, Peter R. Rabbit Feeding and Nutrition. Orlando: Academic Press, 1987.Jenkins, Jeffrey R., DVM. Feeding Recommendations for the House Rabbit. The Veterinary Clinics of North America, 1999.Ten plus years of hands-on experience “in the trenches” of rabbit rescue and care.
I would also like to thank Drs. Bronwyn Dawson and Sari Kanfer of Dr. Domotor's Animal House in Monrovia and Dr. Ann McDowell of Chaparral Pet Hospital in Claremont - for answering my constant questions, loaning me books and passing on updated diet and medical information/papers as they get them!
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