Recurrent GI Stasis Underlying Condition?

[Katiee]

Hey all

I’m posting this to see if anyone else has had similar issues and may have a hypothesis as to what may have been causing the issues.

We recently had to say goodbye to our beautiful 2yr 5month old house rabbit named ‘Bunny’. He was a male lionhead/lop mix who in his short life suffered approximately 6-8 episodes of GI stasis.

His first episode happened at around 1yr of age, he was treated on an outpatient basis (subcut fluids, prokinetics, pain meds etc) but eventually needed an X-ray and then an exploratory lap. The X-ray showed a large amount of ingesta but no obvious blockage or gas signs, there was also sludge in his bladder which was expressed. The exp lap showed no foreign material but there was a larger than normal amount of fur and ingesta (hay, pellets, crit care) in the stomach.

He had multiple episodes in between and leading up to the one which finally took his life, and we spent a lot of time and money taking him to specialist exotic vets (including Molly Varga who’s a world renowned specialist) and no one could figure out what was causing the issues… He was tested/checked for all possible underlying common causes (E.cuniculi, dental, renal, diet, lifestyle etc) and no common causation could be found.

He never presented as a typical GI stasis case and truly baffled every vet we took him to… During his last week he went downhill so fast it was unbelievable. He stopped eating and producing urine and droppings overnight with no obvious decline in appetite or activity in the days leading up to GI stasis… If anything before he had a serious episode he would be more active, almost hyper.

Over the course of the next three days he presented with a blood glucose of 15.2 and steadily climbing, steadily decreasing gut sounds, gas sounds, but normal renal function and body temperature.

We opted for a X-ray to see if there was a blockage (not found) and sadly he went into cardiac arrest whilst under anaesthesia and could not be revived.

The only other test we could have had was an MRI, but he was never stable enough to perform the scan since the first surgery, and I felt like he probably would have passed during the scan.

The vets have hypothesised that the cause may have been a gut motility disorder similar to ‘grass sickness’ seen in horses and wild hares, but these are not understood well in domestic rabbits.

Has anyone had a similar experience? I have an MSc and worked for years in a research lab and being science minded I’m desperately looking for answers… I feel like I never had closure and failed him, but I don’t know what more we could have done.

Thank you for taking the time to read his story, any suggestions are greatly appreciated.

[LBJ10]

Hmm… I don’t know if the glucose means anything. You will see a rise in blood sugar when a rabbit is stressed. But… perhaps he had some sort of endocrine disorder? What about his liver? A liver lobe torsion can cause symptoms similar to GI stasis and cause elevated blood glucose.

[Katiee]

Hey thanks for getting back to me!

I should’ve been more specific with the blood glucose. When he first had stasis and the vet chose to do an exp lap he started with a blood glucose of around 15-16 but by day 5 of trying IV meds and supportive care it had risen to 26-28 which was when a decision was made to operate.

He was still producing very small faecal pellets throughout and the best way I can describe it is it’s like his stomach just stopped emptying, which allowed a bezoar to form… The vet however said the bezoar was a secondary issue and a result of the gut stasis, as rabbits usually have fur in their stomach naturally and it only becomes an issue if there’s an underlying condition causing the gut to slow/stop.

The final time he had gut stasis he appeared to be beginning to present the same way (gradually increasing blood glucose as if there was an obstruction) but you’re right it may have been stress related also.

I did wonder if it could be chronic liver lobe torsion… I might ask the vet if they checked for this. I know when he had surgery it was quite extensive and they checked the organs which were visible in the abdominal cavity (he ended up being fully opened up) but I do know they checked his liver enzymes and they were fine. The big mystery to me is why he stopped producing urine also and was straining to go, yet appeared to have completely normal renal functions…

I wondered also if it may have been a form of Addison’s? However I’m really struggling to find literature… Anything else you can think of please don’t hesitate to update me and thank you for reading and responding.

[DanaNM]

I’m very sorry for you loss, what an ordeal you went through with him. 🙁

I don’t have any real answers, but given his age it sounds like possible a congenital (genetic) issue, especially considering all of the advanced veterinary care you gave him. I was also wondering what the blood glucose values meant. There is a gut motility disorders tied with the “charlie” En gene (also called megacolon or cow pile syndrome), that supposedly only appears in rabbits with those markings, but I know of a bun that did not have those markings and had all the symptoms. So I think these things are still really unknown in rabbit medicine.

I understand how you feel about wanting answers. I lost a bun who was only about a year old after a string of very unusual dental issues, and then he just crashed. Our (very trusted) vet couldn’t find anything in necropsy, so it was really a very sad mystery to all of us.

In any case, it sounds like you did everything you could (above and beyond what many would be able to do) and he was very loved.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Katiee]

Hey thanks for getting back to me and thank you for your kind message of support… It really does hurt even more when you’ve fought to keep them here.

Re the blood glucose, the first time he had stasis and required surgery he started with a blood glucose of around 15-16 and it rose to 26-28 by day 5 of trying IV medication, and it was one of the indications to try an exp lap as the vet wondered if there was an obstruction they couldn’t see on the X-ray.

The final time he had stasis he was beginning to present the same way (blood glucose creeping up) which was why I mentioned it as it may be significant?

The best way I can explain it is it’s like his stomach would just completely stop emptying… I say this as he’d be fine (no decrease in appetite, thirst changes or faecal/urine output) and within the space of hours would appear in a critical form of gut stasis with almost no audible gut sounds. The final time he had gut stasis I’d left on a works job and had been gone for 4 hours. When I came home he’d gone from bouncing around and playing to hiding in his hay bed with his stomach pressed down and teeth grinding… From the onset of symptoms to him passing it took just under 3 days. So whatever he had it must have been serious, and I suspect he was hiding it very well.

I’m also curious as to why he had stopped urinating and was straining to go, as this was a new symptom to me. Yet his renal function was checked and found to be within a normal range. Towards the end he was still producing very small amounts of urine and faecal pellets (like the first time the food had stopped passing from his stomach) but he’d gone from straining to use the toilet to passing small amounts of urine/droppings whilst moving, almost as if it was unintentional.

I reckon you’re right and it was something congenital, or perhaps chronic liver lobe torsion, I just wish I had an answer! I declined getting an autopsy which I regret doing, but at the time I just couldn’t bare the thought of them doing anything else to his little body.

If you come across anything else please do not hesitate to contact me, and thank you again.

[DanaNM]

Your description of the rapid onset and cycles really does sound like a congenital condition as opposed to something like liver torsion. I had a foster who we think had cowpile/megacolon and/or cecal dysautonomia. These are thought to be similar to lethal overo white syndrome in horses. It basically seemed like his nervous system was not controlling his gut properly. He would go from being completely fine to suddenly in severe stasis with extreme gas, then would pass these big wet splats of mucous and unformed feces. It was so heartbreaking, because when he was fine he was so energetic and happy, and then would suddenly be so sick.

I wouldn’t feel any regret for not doing the autopsy, because there is no guarantee you would get an answer that would make you feel better, or any answer at all.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[DanteX]

Hello, I am here to expose the situation with my bunny.

I am from Mexico, English is not my primary lamguage so I’ll try to do my best.

We lost our beloved bunny 3 weeks ago, he was a black mini lop, we are heart broken, we loved him beyond words.

I searched thru this forum and found this post, my bunny had the exact same symptoms:

He was 2 years old, male, neutered at 6 months, I only gave him the best food, lots of Oxbow Hay, and only the recommended portions of Oxbow Pellets, Greens and Oxbow Snacks. I even gave him a daily tablet of Oxbow Natural Science Digestive Support.

He had his first GI stasis episode at 4 moths old, we gave him simethicone, and drugs for motility prescribed by a vet.

From there, he had recurrent episodes each 3 months. Every episode lasted 3 days, and during those episodes he never really stopped eating at all, he ate some hay (not much but a little), and little albahaca. Also had little fecal droppings (really really small and malformed).

On 2 ocassions the droppings had mucous.

Vet did X-Rays and never found anything bad on him, just food on stomach but nothing abnormal.

When he was OK he was the healthiest, happiest bunny ever! Lots of Binkies and zoomies. He ate lots of hay, drank lots of water, he was really healthy and happy and loved.

We lost him on a GI Stasis episode, he never recovered. We cannot explain what happened, I am sure I gave him the best of food and the recommended portions, we cannot understand his recurrent episodes.

Just one more symptom to add. From time to time he won’t ate his cecotropes, 1 o 2 days in a row he won’t ate any cecotropes and cannot explain why.

Please can anybody help us to understand his symptoms or underlying condition? Here in Guadalajara he had one of the best vet on exotics, but even with that, I know that vets are not as good as in other countries, so we are not sure if another veterinarian could detect what could be wrong with him.

I am sure I did my best, and still I feel like I failed him, I miss him so much I am heartbroken.

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