Anxiety over rabbit with GI Stasis

[Jessica6829]

Hi everyone. My bunny Rue has been battling GI Stasis for the past month. She’s been on cisapride and has been back and forth from the vet numerous times. The last time I took her in about a week ago, the vet said that she was completely fine, her abdomen felt normal, she was alert, didn’t exhibit any signs of pain etc. so we should start weaning her off the meds.

This is the second time I’ve tried to wean her off the meds. The first time she just steadily declined with her poop getting smaller and smaller and her becoming more and more lethargic during each day of weaning. This time she seemed to be doing pretty well for the first 3 days, but then last night she wasn’t really interested in eating (wasn’t interested in her treats), but would munch some hay and eat some lettuce and cilantro, and had mostly small poops. She was also super into trying to eat cardboard. The vet told me not to worry if she had small poops, but her lack of interest in food concerned me.

This morning, she was similar to last night, not super interested in hay, but would munch on some and had a bunch of small poops. Then a couple hours later, she was hopping around and acting normal. Eating hay doing a few zoomies and binkies, and her poop seemed to normalize.

And now she’s back to how she was last, night, she just been sitting loafed and not interested in treats or food. She’s been munching on hay here and there and has eaten some lettuce, but it has taken some convincing. Her tummy is gurgling and I’ve been trying to give her belly massages as much as possible.

I am just at my wits end. I am so anxious about her being ok and am just so exhausted. This has been going on for over a month now and I am about to return to work full time on Monday and I just don’t know what to do. I’m just really looking for any support or advice anyone has. This has been such an isolating experience. Thanks for taking the time to read all this!

[Bam]

Im sorry you are going through this. Ive been in a similar situation.

First of all, a gurgling tummy is a million times better than a completely silent tummy. It means there is peristalsis (movement of the intestines). The literal meaning of the word stasis is complete stop of intestinal movement.

Have your vets said anything about a root cause for this prolonged bout of tummy trouble? Have they given her a proper dental exam? A bun’s molars cant be seen with the naked eye. An otoscope is required, and even with an otoscope, the bun often needs to be sedated for the vet to get a proper look.

Light tummy massages plus exercise are very good interventions. The bun should be made to hop around some every 30-40 minutes. Exercise gets the intestines moving and helps propel the intestinal contents incl gas along the lenght of the intestine. During massage, its good to lift up the rabbit’s hind end, so gas can escape more easily. Even a tiny bit of gas can be very uncomfortable for a bun.

Please provide us with some more info about your bun! How old is she? Is she spayed? If so, how long ago was it that she was spayed? Is she currently molting? What’s her daily diet like? The more info you can give us, the better!

 

[Jessica6829]

Thank you so much for your reply Bam! It really makes me feel so much less alone in this. Rue is about 7 months old  and not yet spayed. I was planning on having her spayed around now, but with all this going on I haven’t been able to. She may be may be molting but I can’t really tell. Since she’s been dealing with stasis she’s been on a hay and veggie only diet. She gets about 3/4 cup of romaine lettuce, cilantro, and arugula twice a day and unlimited Timothy hay. I haven’t added pellets back yet but when I offer her a couple she’ll eat them.

I don’t think the vet has looked at her teeth and the vet hasn’t said anything about the root cause. When the stasis initially started she was very malnourished and had lost a lot of weight. I had gone out of town for my honeymoon and the person looking after her apparently didn’t so I rushed her to the vet the day after I returned. The vet and I both thought the stasis was dietary related because of the malnourishment, but now I think theres another cause but I don’t know what that might be. There doesn’t seem to be anything else wrong with her.

Since she’s been going through this she will be fine in the morning, binkying, zooming around, eating hay and pooping normally but then will go down hill in the afternoon and have small poops before eventually having normal poops. The vet can’t seem to find a reason why this might be time based.

Today, however, she’s had mostly small poops. I’ve been trying to massage her as often and as long as she’ll let me. She has moments where she doesn’t want me to touch her tummy. How much hopping should she be doing every 30-40 min because sometimes she just wants to hop from one spot to another to lay down?

She was also put on an opioid pain med (I can’t remember the exact name but it started with a B) for a little while as I had to rush her to the vet a couple weeks ago because she had completely stopped eating and was visibly uncomfortable. They gave her fluids and said it felt like she had a lot of food in her stomach. The fluids and pain meds seemed to resolve that situation and she was relatively back to normal.

[Bam]

It could be the malnourishment and weight loss threw her gut out of balance. Raoid weight loss can harm the liver. The liver is very good at repairing itself, but it takes time. She’s a bit too young to have serious dental issues, unless from some sort of trauma.

Does she eat her hay? Has she regained weight?

Some vets would be willing to prescribe the gear you need to give sub q fluids at home. They can show you how. It could be good to have that option since she seems to relapse so frequently.

Buns can get gastritis which cause them to lose their appetite. If your vet feels she’s at risk for that, Pepcid (famotidine) is a rabbit safe med that prevents gastric ulceration.

As for moving around, I just pick the bun up and carry it away from its favorite resting spot so it has to hop back to where it wants to be. This doesnt help if the bun is so uncomfortable that it just refuses to move and sinks to the floor the moment you put it back down. In those instances you have to gently push the bunny butt so as to make the bun move at all.

The opioid could’ve been buprenorphin. It’s bunny safe and widely used for moderate to severe pain.

[Jessica6829]

I didn’t even think of liver damage! I wonder how long that takes to heal? She has gained weight back. She was originally 1.42kg and is up to 1.68kg as of her last vet visit. The vet said he’d be more concerned if she wasn’t gaining weight. I just don’t know how to get her off the meds since it seems like every time I try to wean her off she goes backwards. That leads me to believe something else is going on. Could a UTI or other bladder issue cause this? I don’t see anything wrong with her urine, but she does seem uncomfortable every once in awhile when she’s peeing.

Generally speaking she eats her hay pretty regularly. I don’t see her munch too much in the afternoons though as she’s usually resting or sleeping. If I wake her up though she’ll usually go munch a couple sprigs of hay before going back to sleep. The concerning part for me the last couple days has been that she didn’t want to eat her treats and was only nibbling hay, not really eating anything when I would wake her up. Her belly was also noticeably harder yesterday than it was this morning and after she pooped last night. It seems like she’s holding food in her belly.

She perked up a bit last night and I was able to get some critical care in her. She ate all her greens last night and this morning, but she’s definitely still off. Her poops last night were smaller than usual, but all the same size and well formed which I think is good. She had a few small poops this morning but otherwise normal and ate a lot of hay. She wasn’t her usual energetic self though. Mostly just munched on hay and hopped around a bit.

My regular vet is closed today so I made an appointment with a different vet, so I’m hoping maybe they can figure out what’s wrong.

[LBJ10]

How long ago was your honeymoon? If she was essentially starved while you were gone and began losing weight due to a lack of food, then it is possible that her stomach and intestines physically changed (i.e. “shrank”). Perhaps her body is having trouble readjusting to eating food normally again?

[Jessica6829]

We’ve been home for about a month and a week. She has been gaining weight steadily. If her intestines and stomach did shrink will they stay that way or is that something that will develop again with time?

[Jessica6829]

I should also add we were gone for a little over 3 weeks and while I left detailed instructions for our pet sitter, it appeared they were not followed. I think in the time I was gone she only had a little hay and mostly greens but I am not sure. She was eating pellets when I left but wasn’t given any while I was gone.

[LBJ10]

If that is what happened, then they should go back to normal eventually. There was a bunny on here awhile back that was very skinny from malnutrition. I’m wondering what the member did to help him gain weight without giving him too much too soon.

[Jessica6829]

Well that’s good to hear! I’ve also noticed that she’s been grooming a lot recently. I can’t tell if she’s in a molt or not. She’s specifically been focused on her back legs, chest, and left side. She needs a nail trim but I haven’t wanted to stress her out with all the gut issues.

[jerseygirl]

I’m so sorry you had that experience with the pet sitter. 🙁 The timing does look like it’s somewhat related.

It wouldn’t hurt to get her on a probiotic. It may help and certainly won’t harm.

Rabbits can get a bit out of sorts when coming into a moult so I’m curious if you do see more obvious signs of moulting soon. She’s also at the age bunny hormones could be affecting her. Did she stay with the pet sitter or did they visit her? I just wonder if she was with them and they have other rabbits, whether it could have triggered some hormonal changes.

They cyclic nature of this makes me wonder if it’s her cecum that is not operating fully. Especially of the cisapride helped as that’s supposed to work on the hind gut rather then the stomach. I think an ultrasound might be helpful to see if there is some partial obstruction in the GI tract somewhere or see if her cecum is emptying effectively.  Im not certain if they’d need to sedate for that, it would obviously be better if they can do this while she’s conscious. Or even a conscious X-ray.

My go-to foods for when a bun doesn’t what to eat are rose petals & leaves, fresh grass and willow if I can find it.  They’ve always proven to be successful in getting them start to eat.
Interesting that she went for cardboard. Rabbits can do this when they’re looking for fibre during gut issues-despite having access to hay 🙄.  Some can regularly eat cardboard without issue but it is known to cause some impaction too. Perhaps more so in those rabbits already experiencing some gut slowdown. Mysterious creatures, our rabbits!

[jerseygirl]

@LBJ10 are you thinking of the rabbit who’s caregiver gave her calf manna to her her gain weight? That’s the one that sprung to my mind.

[Jessica6829]

Hi there everyone. Thank you so much for your kind words, advice and shared experiences. Rue is still not doing well and has been to the vet 3x in the last week, once to a rabbit savvy emergency vet, and twice to the regular vet. She had and exam and X-rays done at the emergency vet and they both were normal. She also go fluids there as well since we figured it couldn’t hurt.

Since that visit I took her in to my regular vet who did blood work. The day I took her in for blood work she had mushy poop. The vet said not to worry and just keep pushing hay. Her blood work came back normal and the vet reiterated the importance of hay and told me to cut down her greens to encourage her to eat more hay.

Then 2 days ago, I got home and there was quite a bit of mushy poop. I called the vet and they said to bring her in so I did. They found nothing wrong with her belly or gut, both were normal and weren’t painful. The vet did say that she thought she found some tooth spurs so she ground those down. I was sent home with Meloxicam. As this was a different vet at the practice she said she’d review the case fully and call me the next day.

When I spoke to her the next day she too recommended a probiotic and simethicone (even though she didn’t feel particularly bloated or gassy). She told me to try mixing some pineapple juice into her Critical Care as well. She also said that if the Meloxicam wasn’t strong enough that we could try Buprenorphin. She also said that we could do sub q fluids at home.

Throughout this entire week, Rue’s poops have been getting worse and worse. They were small and misshapen yesterday and today she’s had nothing but mushy poop and a whole bunch of cecotropes. The vet said as long as she’s pooping not to worry too much but that’s easier said than done. She has also stopped eating almost completely today where as she had been eating on her own most of the past week, although not enough.

Today I tried to hand feed her and it was super awful and I’m having a really hard time with it. I have no idea what to do anymore and I feel like I’m just watching her die. I went to the vet today to pick up fluids and have them teach me how to do it since I’d never done it before and they said that they would tell my vet to give me a call when she’s in on Wednesday. I just don’t think she’s gonna make it until Wednesday and it is breaking my heart to watch her struggle. All the tests keep coming back normal and I just want to help her but I have no idea what to do anymore.

[Jessica6829]

I should also add that I am now back to work so I am not able to be home with her all day. If she doesn’t start doing better over this weekend, I don’t know what to do on Monday.

[Bam]

As long as you can keep her hydrated and adequately warm and keep feeding her CC or other rescue formula, sticky poop isnt deadly. A bun can live for many years with sticky poop.

The liver repairs itself rather quickly. Since youve done blood works, they’d have shown elevated liver enzymes if there were liver damage.

Discomfort can be due to gastritis and/or gas. Even a little bit of gas can give rise to great discomfort in a bun. A UTI can absolutely cause a bun to go off its food. Rabbits are very sensitive to pain.

Have you given her any antibiotics?

 

[Jessica6829]

She hasn’t had any antibiotics. The vet said liver enzymes were slightly elevated but not out of the normal range and not enough to be concerning. I haven’t yet explored the urinary path yet but I think that’s next.

She is doing slightly better today. More active and curious. She even did one tiny binky. She’s eating hay on her own and her poops are now solid with only one mushy poop and it was more formed than those yesterday. She’s also taking the smaller feeding syringe without issue today asking as I dip the tip in pineapple juice first so I’m trying to give her about 3-6ml of critical care every hour of so.

We are trying to keep her pain under control so I gave her the Meloxicam this morning and will give her the Buprenorphin this afternoon if she still seems like she’s in pain. I gave her simethicone yesterday and that seemed to help but I have no idea how much to give her or how often. I think I ended up giving her about .5ml every hour and a half to 2 hrs. Should I be giving her more? She only weights 1.7kg so I don’t want to overdo it on anything.

[Bam]

I give 0.5-1ml simethicone baby gasdrops per hour for acute bouts of gas, then every 2 or three hours (not during the night, just during waking hours). After that, I give it once or twice per day together with other meds. It’s not really possible to overdose simethicone gas drops inadvertently, since it is an inert “drug” that isnt taken up into the body. It stays in the intestines and comes out with the poop.

Slightly elevated liver enzymes is very common in GI stasis buns. It’s not alarming. The liver enzymes can be more than slightly elevated when you bring in a stasis bun, but they should start to drop once the bun gets food in the tummy again.

It’s great that she seems a bit more lively today and that her poops are more formed! Very clever move to dip the tip of the syringe in pineapple juice!

Buprenorphine can make a bun very drowsy. It’s a normal reaction and it will pass, but it can be a bit scary for the bunny caretaker to see.

Fingers crossed she will continue to improve!

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