Gastrointestinal (GI) Stasis in Rabbits

What Is GI Stasis in Rabbits?

Gastrointestinal stasis, or GI stasis, is a common condition in rabbits that causes decreased intestinal function and unbalanced intestinal bacteria.

A rabbit’s digestive process is called hindgut fermentation. They have a large chamber in their intestinal tract, called the cecum, that houses the specific bacteria and enzymes required to break down food for proper nutrition. Hindgut fermenters need high levels of fiber and normal, balanced bacteria in their gut to stay healthy. When bacteria are out of balance, they can create excessive gas, which can accumulate to cause bloating, pain, and fatal toxins.

As GI stasis sets in, your rabbit will stop eating and/or defecating. Rabbits must eat and defecate continuously throughout the day, and it’s abnormal for a rabbit to go more than eight hours without eating or having a bowel movement.

GI stasis is a medical emergency and pet parents should seek immediate veterinary intervention.

Symptoms of GI Stasis in Rabbits

Rabbits may exhibit numerous symptoms that vary in intensity, depending on the severity of gastrointestinal stasis and the cause of the stasis. Common symptoms include:

• Decreased or no appetite

• Reduced or no fecal output

• Grinding teeth, or bruxism

• Bloating

• Diarrhea

• Abdominal pain when touched

• Hunched posture

• Low body temperature (pet parents may notice cold ears or limbs)

Causes of GI Stasis in Rabbits

Gastrointestinal stasis may occur independently, but it’s often secondary to other diseases or care issues. Anything that causes rabbits pain, causes them to eat less, or causes dehydration can result in GI stasis.

Poor Diet

Poor diet is a common cause of gastrointestinal stasis. Rabbits should have constant access to high-quality hay. As hindgut fermenters, their diet should be approximately 25% fiber. Low fiber and high carbohydrate diets can alter the bacteria in the GI tract and decrease muscle contractions in the intestines, leading to delayed food movement (ileus).

Rabbits only fed pellets are at increased risk of developing stasis, as the pellets don’t provide the essential fiber-to-carbohydrate ratio alone.

Stress or Pain

Stress, pain, and other illnesses can cause decreased food and water intake and, thus, a secondary slowing down or stasis of the GI tract. Dehydration secondary to other conditions can also cause electrolyte imbalances and subsequent stasis.

Dental Disease

Dental disease is another leading cause of GI stasis in rabbits. Improper alignment of a rabbit’s teeth can cause poor digestion or make it difficult to swallow appropriate amounts of food.

Urinary Tract Issues

Kidney disease and bladder stones are common causes of pain and decreased appetite in rabbits, often leading to GI stasis.

Other potential causes of GI stasis include the following:

• Certain medications, such as opioids, can slow down the GI tract

• Antibiotics may also alter bacteria significantly

• Surgery and handling of the GI tract can cause inflammation and altered bacteria

• Gastrointestinal obstruction, such as hairballs or foreign material

• Lead toxicity; while uncommon, chronic exposure may cause gastrointestinal issues

• Reproductive issues, such as uterine cancer

How Veterinarians Diagnose GI Stasis in Rabbits

Veterinarians can diagnose gastrointestinal stasis based on physical exam, history, and basic diagnostic tests. Common questions that may help a veterinary team diagnose stasis include:

• Diet history, including any recent changes

• Recent medication history

• When the rabbit had the most recent bowel movement

• When the rabbit last ate

• Any changes in behavior

• Whether a female rabbit is spayed

Physical Exam

Rabbits with GI stasis may have obvious dental issues causing poor digestion. As GI stasis progresses, rabbits may have low body temperatures, slow heartbeats, and become dehydrated to the point of being in shock.

Some rabbits may have distended or bloated abdomens secondary to gas accumulation, and they may be extremely painful to the touch. Severe cases may have pale (not pink) mucous membranes, low blood pressure, altered mentation, and some may die from severe disease.

Blood Testing

Blood work provides valuable information regarding the health of the rabbit. Often, it can identify an underlying condition, such as kidney or liver failure, and provide insight into how sick the rabbit is. Vets commonly run a complete blood count and biochemistry panel to assess the overall organ function and severity of disease.

Blood glucose is beneficial in the diagnosis of obstructions in rabbits. Higher glucose values and other factors like radiographs and physical exams support the diagnosis of an obstruction.

Imaging and Sampling

Abdominal radiographs, or X-rays, are essential to identify intestinal obstructions and harmful gas patterns. Radiographs are extremely helpful in monitoring the progress of the disease and treatment. They are often taken multiple times throughout treatment. Radiographs of the skull and chest can also rule out conditions or diseases that may predispose the rabbit to stasis.

Fecal samples may be analyzed to rule out infectious or parasitic causes of gastrointestinal disease.

Treatment of GI Stasis in Rabbits

Identifying and treating primary conditions are the priority when treating GI stasis. Stasis treatment varies depending on the signs and severity of the disease. Veterinarians will monitor the following:

• Temperature

• Heart rate

• Pain level

• Appetite

• Fecal production

Basic treatment principles for GI stasis include:

• Heat support: Rabbits with low body temperature, heart rate, and blood pressure have a worse prognosis. Gradual re-warming while rehydrating is crucial.

• Nutritional support: Rabbits require consistent nutrition and food intake. Oral feeding is preferred, although forced feeding may increase rabbit stress and exacerbate the condition. Feeding tubes may be placed to help provide nutrition to rabbits who won’t eat on their own. Oxbow Critical Care® is a common nutritional replacement. Veterinarians will continue offering hay and veggies until the rabbit eats independently.

• Fluid support: Mild cases may only require subcutaneous fluids, but many rabbits with GI stasis require intravenous catheters and more aggressive fluid replacement to battle dehydration.

• Pain medications: All cases of gastrointestinal stasis have a degree of discomfort ranging from mild to severe. Pain medications must be given as part of the treatment plan, as painful rabbits are highly unlikely to eat, compounding the condition. Common pain relievers in rabbits include:

  • Meloxicam

  • Buprenorphine

  • Butorphanol

  • Fentanyl

  • Hydromorphone

  • Lidocaine

  • Tramadol

• GI medications

  • Motility agents, such as cisapride or metoclopramide, may be used in non-obstructive stasis cases after the rabbit has been rehydrated.

  • Simethicone may be helpful in some cases to decrease gas production

  • Antibiotics are only used if severe bacterial imbalance, toxicosis, or infection are suspected. Rabbits are very sensitive to antibiotics. Common antibiotics include:

    • Enrofloxacin

    • Metronidazole

    • Trimethoprim-sulfa (TMS)

Never give your rabbit medications without the approval of a veterinarian first. Given inappropriately, it can cause severe illness and even death.

GI Stasis Surgery

GI surgery carries a more guarded prognosis than non-surgical GI stasis cases. Hair is the most common obstruction in rabbits, primarily if the diet does not provide adequate fiber. The obstruction can sometimes be manipulated without cutting into the intestinal tract. However, foreign material or hairballs often require the veterinary surgeon to cut into the rabbit’s stomach, intestines, or cecum to remove the material manually.

Rabbits are prone to complications following surgery, so medical management is usually attempted first. Rabbits should be stable and well-hydrated before going under general anesthesia. Pain medications are critical after the procedure, as stasis may continue or worsen secondary to surgery and pain.

Recovery and Management of GI Stasis in Rabbits

Most uncomplicated cases of stasis resolve with veterinary intervention over three to five days. Typically, these rabbits are hospitalized for supportive care and repeat diagnostics to guide treatment. More severe cases may require weeks of treatment. Approximately 70% of rabbits survive GI stasis.

Diarrhea is a common problem after stasis, especially after surgery. Some studies indicate a worse prognosis for rabbits developing diarrhea.

Rabbits can also develop a type of liver failure called hepatic lipidosis if they don’t eat for 24 hours or more. In hepatic lipidosis, the body uses alternate fuel sources, which causes metabolic problems and even death.

Proper rabbit care, including diet, temperature, environment, and veterinary care, decreases the chances of GI stasis in rabbits and helps them live long, full lives.