Gastrointestinal stasis

Gastrointestinal stasis, GI stasis, GI hypomotility or ileus is a serious condition that requires immediate attention. The condition occurs when the gut stops moving, is blocked, or is full of gas.

Symptoms



 * Loss of appetite (anorexia) or changes in eating habits. A good way to test this is to offer fresh herbs or a favorite treat.
 * Small to no stool, loose or mucous covered stool or diarrhea.
 * Sitting in a hunched position or pressing stomach against the floor.
 * Loud tooth grinding which is an indication of pain. This is different than the "tooth purr" that indicates pleasure or contentment.
 * Loud GI sounds or complete silence in the stomach. You can use a stethoscope or listen with your ear pressed against the stomach.

Causes

 * Stress
 * Pain from an underlying condition (e.g. gas, dental problems, infections, or urinary tract disorders)
 * Dehydration
 * Lack of dietary fiber
 * Intestinal blockage

Diagnosis
Gastrointestinal stasis can be usually diagnosed as non-obstructive or obstructive ileus.

From Emma Keeble, Anna Meredith, et al., Rabbit Medicine & Surgery, 2006.

Treatment
You should seek immediate veterinary assistance if your rabbit has not eaten or passed stools in the past 12 hours or is exhibiting other symptoms of GI stasis. Your vet will provide proper treatment and care. If left untreated, GI stasis can be fatal in 48 hours.

For at-home initial treatment when you first notice symptoms, you can do the following:


 * For an acute gas attack, feed 0.5cc to 1cc of infant simethicone (20 mg/mL suspension) to your rabbit (all sizes) every hour for the first three hours, then every three to eight hours. This product is easily obtainable in the baby sections in a drugstore, pharmacy, or supermarket. Simethicone has no known drug interactions and is not absorbed through the intestinal lining. It acts only on a mechanical principle: it changes the surface tension of the frothy gas bubbles in the gut, joining them into larger, easier-to-pass bubbles.
 * Try to keep your bunny hydrated to help break up any masses in the stomach. Offer up herbal teas and cold wet fresh vegetables nearby within easy access if your rabbit does not seem to want to move.
 * Making sure that the stomach is not hard with an obstruction, reach under your rabbit's belly and gently massage your rabbit's abdomen to help stimulate the muscle and break up gas bubbles. Pocket vibrators and vibrating toothbrushes are also great for this purpose. Be sure to keep any massage gentle as an aggressive massage can cause torsion, internal bleeding, or rupture organs. Elevating the hindquarters a few inches can also help any gas pass more easily.
 * Make a heat pad available to your rabbit to lay its stomach on. Heat can help prevent your rabbit from going into shock. A heating pad, a plastic bottle full of hot water, or a SnuggleSafe disc should be wrapped in a towel to prevent burns.

For the following tips, only feed without a veterinary visit if your rabbit is swallowing and not refusing the syringe:


 * Metacam (Meloxicam) can be given for pain. 0.05ml (cc) should be given to rabbits up to 5 pounds and 0.1ml (cc) should be given to rabbits over 5 pounds.
 * A gut motility drug such as cisapride (Propulsid) or metoclopramide (Reglan) can be given to get your rabbits GI tract working again. The dosage is 0.1cc per pound of body weight. NOTE: Using a 0.05ml(cc) dose of the 1.5mg/ml concentration of Metacam for a 5 pound rabbit (2.27kg) equals a 0.03mg/kg dose. This is extreamly low does based on the current studies. The Textbook of Rabbit Medicine, 2nd edition, updated by Molly Varga recommends 0.3-0.6mg/kg once or twice aday, and up to 1.5mg/kg without accumulation.

Below are links with more information about various treatments for GI stasis.
 * Kinenchen, Is my bunny sick?
 * House Rabbit Society - MD, DC, & NoVA, Laurie Kuhn, Help Me Make It Through the Night
 * Wisconsin House Rabbit News, Julie Smith, When Your Bunny Stops Eating
 * Suite 101, Sarah Goodwin-Nguyen, Helping a Bunny With G.I. Stasis
 * Examiner.com, Phyllis O'Beollain, Is Lactobacillus supplementation useful for the house rabbit?
 * Equidane Vetline, The role of Probiotics in the management of rabbit gut stasis.