What is Gastrointestinal stasis (GI Stasis)?
GI stasis is by far one of the most common disorders seen in pet rabbits.
GI stasis is when muscular contractions of the stomach and intestines are reduced which slows down digestion and normal bacteria in the digestive tract become out of balance causing bloating, compacted hair balls and more. These conditions are painful for the rabbit which will cause withdrawal from eating and the lack of food in the intestinal tract will only intensify GI stasis. Left untreated, GI stasis can rapidly become life-threatening.
UNDERSTANDING RABBITS DIGESTION SYSTEM
- ·The Role of Fiber
To understand GI diseases in rabbits, we must understand a rabbit’s digestion system first.
In rabbits, the main driving force for normal intestinal motility is the presence of LARGE quantities of fiber. Diets high in fiber promote muscular contractions of the stomach and intestines, creating wave-like movements that push the contents of the canal forward.
In other words, rabbits need high amounts of fiber to get their gut moving.
- Low Fiber Consequences
If fiber levels are low, muscular contractions of the stomach and intestines are reduced which slows down digestion and normal bacteria in the digestive tract become out of balance causing bloating, compacted hair balls and more. This causes the rabbit pain which in turn will stop eating because it feels discomfort – making digestion even slower and making the situation worse.
Furthermore, the hair that rabbit ingest in grooming will also not move out quick enough causing it to accumulate and become compacted also causing pain or worse becoming a blockage.
Causes of GI Stasis
- Inappropriate diet (low fiber diets) A diet high in hay is ideal. (please look at “recommended Rabbit nutrition” below)
- Stress, anxiety, depression
- Dental problems (lops and other dwarf breeds are known for dental issues)
- gastrointestinal blockage (usually caused by a compact mat or “felt” of hair)
- underlying medical conditions
Recommended Rabbit Nutrition
Recommended brands: Oxbow & Small Pet Select
Birth to 12 weeks – https://rabbit.org/faq-diet
12 weeks – 7 months
- Unlimited alfalfa
- Unlimited pellets
- Introduce fresh veggies/greens (½ oz max) one at a time to see if bunny can tolerate. Sample of veggie/greens – https://rabbit.org/greens-are-great
7 months – 1 year
- Introduce timothy hay
- Pellets – decrease to 1/8- 1/4 cup per 6 lbs body weight
- Increase fresh veggies/greens gradually (2 cups max) to see if rabbit can tolerate
Adult Rabbits (1 yr – 5 yrs)
- Unlimited timothy hay
- Fresh veggies/greens – max 2 cups chopped vegetables per 6lbs body weight Sample of veggie/greens – https://rabbit.org/greens-are-great
- Pellets – 1/8 to 1/4 cup per 6lbs body weight
Elderly Rabbits – https://rabbit.org/faq-diet
Signs of GI Stasis
We recommend that rabbits are fed pellets and greens separate or split between morning and night. The point is to have 2 separate feeding times, one in the morning and one at night to check up on their appetite. If they don’t want to eat at either one of these feeding times, then you know there might be something affecting their appetite. This could lead to GI stasis if not treated. It is better to be preventive then reactive.
Beginning signs of GI Stasis
- Gradual decrease in appetite
- Decrease in activity due to discomfort
- Decrease in fecal production or small in size
- Soft stools or diarrhea
- Decreased water consumption
- Appear less social
- May grind their teeth
- Sit in a hunched position
- Ears might be cold due to lack of movement
When you notice your bunny doesn’t want to eat his/her pellets/greens, please start monitoring their behavior, food and water intake. Try giving your rabbit pellets/greens 8 hrs later. If your rabbit still doesn’t want to eat, please start preventive treatments below.
At Home Treatment of GI Stasis
The key principles in the treatment of GI stasis are to:
- Re-hydrate the patient – Fluid therapy is essential to recovery. Administer fluids orally with a syringe and/or subcutaneously if needed depending on the level of dehydration. Many rabbits respond well to oral and subcutaneous fluid administration and are less stressed when treated at home.
- Provide nutrition – It is often necessary to hand or force-feed liquid hay products (Critical Care, Oxbow Pet Products) with a syringe. Place syringe into the side of rabbit’s mouth and feed a little squirt at a time. The act of eating itself stimulates gut motility.
- Alleviate Pain – Rabbits with GI stasis have moderate to severe gut pain, especially if the intestines are distended with gas. Most will not begin to eat until this pain is alleviated.
- Gas Relief Drops – Give the rabbit “Pediatric Simethicone” which is baby gas drops in a syringe by mouth. This medication helps to reduce the amount of gas in the digestive tract. Give 1 milliliter (1cc) per hour for 4 hours straight. If there’s no difference by the fourth dose, a difference isn’t probably going to happen from that.
- Belly Massages – rabbit belly massages helps move trapped air in the digestive track around to relieve the bunny’s pain. Sometimes you’ll hear the gas bubbling around in their bellies. It’s a relief, it’s kind of like rubbing your belly when you have a stomachache. Watch your bunny’s feedback, and you’ll know if you’re doing something painful, stop doing it. Watch video tutorial on belly massages: https://youtu.be/LbyC6CWbm5M
- GI motility drugs — These drugs can help stimulate the digestive tract to begin working properly again. (prescribed by a veterinarian)
- Keep Warm – Rabbit’s ears should always feel warm. A bunny in discomfort may not move around enough and will get colder as a result, so keeping the bunny warm is important.
Offer rabbits free-choice water in a bowl, fresh hay, and a variety of greens to provide every opportunity to self-feed. Ingestion of fibrous food is critical to reestablish GI motility.
GI Stasis, Unbalance Gut Bacteria & Kidney/Liver Damage
Diets low in fiber reduce muscular contractions of the stomach and intestines are which prolong the retention of digestion ultimately producing changes in intestinal bacteria (cecal microflora). The longer the digestible content sits in the intestinal track the more it will cause fermentation and in turn alter the bacteria population. This threatens favorable microorganisms and promotes disease causing bacterial, and toxin production.
The toxin production can potentially cause kidney and/or liver damage. Kidneys and the liver are in charge of filtering out blood. Increased toxins in the bloodstream as a result of increased bacteria in the intestines paired with dehydration (most likely from the rabbit not drinking enough water due to stasis) stress the kidneys/liver potentially causing damage.
Stress and GI Stasis
Stressful conditions have a negative effect on gut motility. GI motility is regulated in part by the autonomic nervous system; stress increases the adrenal output of epinephrine and inhibits the involuntary constriction and relaxation of the muscles of the intestine that push the contents of the canal forward.
Common causes of stress include:
- Dental disease (malocclusion, molar elongation, odontogenic abscesses)
- Metabolic disease (renal disease, liver disease)
- Pain (oral, trauma, postoperative, urolithiasis)
- Anxiety (dyspnea, fear, fighting, lack of hide box)
- Neoplasia, infection, parasitism, and environmental changes (boarding, new pets, unfamiliar noises).
The Role of Hair in GI Stasis
Rabbits ingest hair routinely in the process of grooming. However, they cannot vomit to eliminate accumulated hair. If GI motility is normal, ingested hair moves along with food out of the stomach at regular intervals and is ultimately expelled in the feces.
If GI motility is impaired, hair accumulates in the stomach and becomes compacted. This causes discomfort, which will cause rabbit to stop eating and make it worse.
A vicious cycle can result, until large amounts of hair are compacted and accumulate in the stomach. This accumulation is erroneously referred to as a “hairball,” “wool block,” or “trichobezoar.” These terms imply, incorrectly, that the hair accumulation is the cause of the problem rather than simply being the consequence of impaired intestinal motility.