GI Stasis

What is GI Stasis?

Gastrointestinal (GI) Stasis is a lot like it sounds: it’s when the movement of a rabbit's digestive tract slows down or stops, and it is a medical emergency for rabbits. It is also known as ileus and is usually a symptom that results from one or more underlying causes. GI stasis is potentially life-threatening and should be considered an emergency. 

If it has been more than 12 hours since your rabbit has eaten or produced feces, contact a rabbit-savvy veterinarian immediately. This page is for informational purposes only, and cannot replace professional care from a rabbit-savvy veterinarian. If you are in the Portland, Oregon area, please consult our list of rabbit-savvy veterinarians. In addition to the Rabbit Advocates guide, this University of New South Wales resource contains excellent information. Additional works cited are listed at the end of this page.

As prey animals, when rabbits get sick or feel pain, they will often try to hide their symptoms for as long as they possibly can. As a bunny parent, you will need to be a detective who is attentive to your rabbit’s normal behavior. This will enable you to tell if they are acting “strange” and gather information that could be helpful for a veterinarian. If you know your rabbit’s usual habits, you’ll be more likely to notice a problem and get care faster. The more time you spend with your rabbit inside your home, the easier it is to identify medical issues and take swift action.

Signs of GI Stasis:

• Refusing food: When bunnies will not eat their favorite bunny-safe greens and pellets, even their favorite treats, this is cause for concern.

• Refusing water: Failing to drink water or hanging pathetically over the water bowl without drinking are danger signs.

• Decreased fecal output: Small, irregular shaped, dry stool, less stool, and/or “chain of pearls” or “cherry” poops strung together with fur can signal that a problem is present. Save “weird” poops in a plastic bag labeled with the date to show a veterinarian.

• Lethargy: Lack of energy, often staying in a hidey box during usual meal time or other active times of day, that is beyond usual sleepiness, is worrisome.

• Unusual body postures and/or bloating: Odd positions and behaviors such as pressing bellies into the floor, constantly changing positions, and hard bloated abdomens are signs of trouble. 

• Teeth grinding: Loud teeth grinding is a sign of pain. If you can hear it from a couple feet away, it’s not the soft teeth purring of a happy bunny.

• Hot or cold ears: Fever or hypothermia may be present and the bunny may be struggling to regulate their body temperature.

• Silent or loud/irregular gut sounds: Rabbits need to eat, drink, and go potty constantly to stay healthy. If you hear nothing or can hear loud GI noises, it’s not normal and it’s not okay.

Potential underlying causes of GI stasis include: 

• Improper diet: The single most common cause of GI Stasis is insufficient hay consumption. Starchy foods and sugars can be dangerous. Fruit, treats, and junk food are frequent culprits in GI Stasis. Foods that produce excessive gas such as kale, cabbage, and broccoli make bunnies feel full, even when their systems are mainly full of gas. Never feed rabbits unsafe treats like yogurt drops, nuts, or seeds even if they appear to be marketed to rabbit parents.

• Intestinal blockage: A blockage can occur from fur, for example, or ingestion of a foreign object such as carpet or staples, or from unsafe foods such as nuts or seeds.

• Pain from another medical issue: Dental problems, ear infections, respiratory/sinus issues, pain from injuries, and other illnesses can cause bunnies to stop eating.

• Parasites and vector-borne illnesses: Worms, coccidia, and other parasites cause discomfort and potential intestinal scarring over time. Issues like fly strike can cause pain and infection.

• Poison/toxic substances: Eating certain houseplants, desiccant moisture-absorbing packets, medication, and exposure to common household pesticides, herbicides, paint, and cleaning products are all potential culprits.

• Dehydration: Bunnies need constant access to plenty of clean water in a bowl in a temperature-controlled environment. When bunnies are dehydrated, their guts lack the lubrication to move food through their systems. Extreme temperatures (heat and cold) can contribute to dehydration.

• Stress: Bunnies are sensitive, perceptive creatures. Outdoor housing, cages/hutches, traveling, moving, the death of a bunny bond-mate, and rehoming can all cause excessive duress. Bunnies need to have ample indoor, safe, climate-controlled space and stability in order to thrive.

What to do:

• Contact your vet ASAP! As with most signs of rabbit illness, if you suspect something is wrong, contact your veterinarian. Know where the nearest emergency exotic veterinary office is located, and find a rabbit-savvy vet you trust for ongoing and urgent care. Many “regular" veterinarians do not have the experience needed to care for rabbits. The bunny will likely need x-rays, prescription medications, and subcutaneous fluids that are only available from a vet. 

• Feed Sherwood Recovery Rx Food or Oxbow Critical Care so that the bunny’s GI tract is not empty. “Force feeding”, also known as “syringe feeding” is not fun for anyone, but it saves lives. Keep these products on hand, storing any open items in the freezer, and try to gradually feed small amounts of food. If you do not have recovery food, blend pellets with water in a food processor. Use 1 part recovery food powder mixed with 2-3 parts warm water. Depending on the size of the bunny, rabbits usually need to be syringe-fed about 8-15 cc of liquified food every few hours. You may need two people to help, and/or to put the rabbit in a “bunny burrito” so that they cannot escape. Insert the tip of the syringe into the side pocket space behind the front incisors and squeeze gently sideways to avoid squirting food down the trachea (windpipe). Give only 1-2 cc at a time, allowing the bunny time to gradually chew and swallow. 

• Use liquid simethicone often referred to as “baby gas drops”. This medicine for human infants is available over-the-counter in the baby section of most major grocery stores and pharmacies, and is considered “safe” for home use with rabbits. Simethicone works by lubricating the GI tract so that food and fur can move out. It can make stool look dark and shiny, but it helps alleviate some of the gas. Bunnies can take 1-2 cc of baby simethicone (20mg/ml suspension) as often as every hour for the first three doses, then 1 cc every three to eight hours thereafter until their appetite and stool return to normal.

• Practice your “bunny burrito” technique. Carefully place the bunny on a towel and hold onto them with one hand so they can’t run away, slip one edge of the towel under the bunny’s chin, then fold each side of the towel around the bunny’s neck until both ends of the towel meet behind their ears, almost as if making the bunny a bib with the towel. With your non-dominant hand, grip the two ends of the towel that are folded over behind the head. Then fold the bottom of the towel underneath the bunny’s bum so that the bunny cannot try to wiggle back out of the burrito. A proper bunny burrito keeps the bunny relatively immobile and in a safe position to ingest food and medicine. The bunny’s head and ears are outside the towel burrito, and this will allow you to gradually squeeze the syringe food and medicine into the side pocket of the bunny’s mouth.

• Keep your bunny as comfortable as possible while you wait. Be sure your rabbit has a clean litter box, fresh hay and pellets, warmth, soft surfaces, and a calm environment. Try to gently massage the gut starting from the upper abdomen down to the bunny’s bum. Keeping the bum elevated while massaging in the direction of the bunny’s head to their rear end can be helpful. Monitor the bunny to see if they need to be kept warmer than usual. Your presence as the bunny’s protector and caregiver and your voice will often be a source of comfort and safety.

• Watch out for the negative feedback loop of GI Stasis. As stasis continues, it can compound problems and make a bad situation even worse. In an empty, immobile gut, bad bacteria in the gut can grow. Sugars and starches can further ferment, creating more gas and discomfort, and making bunnies feel “full”. The bacteria and fermentation can lead to painful bloating and potential kidney and/or liver damage. As the bunny gets colder/hotter, the bunny reduces physical activity, and the stasis gets worse, so the bunny cannot comfortably move around. A cold bunny may not move around enough and will get colder as a result, so keeping the bunny warm is important. GI stasis can create a problematic cycle that must be interrupted. This is why it’s crucial to know your bunny well and act quickly when something seems “off”. 

Preventing GI Stasis:

• Know your bunny. Keeping bunnies indoors around humans helps us monitor their behavior and notice potential problems as soon as they occur.

• Provide unlimited fresh hay and water at all times. It’s all about the high-quality fiber and hydration! Drinking clean water from a bowl is helpful, as is carefully introducing any new foods.

• Limit starchy and sugary foods. Even a tiny bit of banana, carrot, apple, or other fruit can cause problems. Make sure bunnies are not eating cereal, crackers, bread, raisins, or other tempting foods that children may drop on the floor or leave behind. Bunny-safe fresh greens are a nice treat, as are high-fiber pellets and dried willow leaves or apple branches.

• House your bunny indoors with access to at least 16 square feet of space on one level at all times, or 20+ square feet for bonded pairs. There are too many risks associated with outdoor housing including temperature extremes, fear-causing predators, and insects/parasites. Small cages, hutches, and enclosures do not allow bunnies to move around freely, and physical movement also keeps their internal systems moving properly. The larger the bun(s), the more space they need at all times. 

• Bunny-proof your space. Problems can be caused when your rabbit can chew and potentially ingest harmful household items such as carpet, paint, and electrical cords. They can also get injured while trying to leap out of enclosures or when squeezing through pet gates.

• Clean the bunny’s litter box often. Daily spot cleaning and frequent checks help you learn your bunny’s normal defecation and urination patterns. It’s easier to see that the bunny has not used the litter box recently when it’s always kept clean.

• Build a stasis emergency kit. Keep flavorless baby gas drops (simethicone), Sherwood Recovery Food or Oxbow Critical Care, feeding syringes (1-10ml) for feeding, and a bunny-safe heating pad on hand. For higher risk bunnies, some vets will prescribe a small amount of Metacam/Meloxicam and Reglan/Metoclopramide to keep on hand for emergencies.

• Know your vet and schedule regular wellness checkups. An annual checkup is a good idea to monitor common trouble areas such as teeth. Establishing care with a trusted, rabbit-savvy vet will make it more likely that your bunny can be seen quickly when health issues arise. Start talking with your vet about GI stasis during regular checkups. They may be able to help you create a “stasis emergency kit”. Bring sample poops in a plastic bag marked with the date/time they were found as these are useful for vets to examine. Consider regular preventive measures such as bunny-safe probiotics and dietary supplements.

• Cultivate healthy gut biomes. Many baby bunnies are separated from their mamas far too early. Helping bunnies nurse from mama for the first 8 weeks of their lives helps them develop healthy gut flora early in life. Please do not buy rabbits less than 6 weeks old from a breeder as the babies need to stay with mama.

• Find a bunny sitter you trust and plan ahead. If you're headed out of town, make sure someone is checking on your bunny every 12 hours (at least twice per day) and provide them with a list of emergency contacts if you are not reachable. 

• Groom your rabbit frequently. Preventing excess fur from entering the bunny’s GI tract is key since rabbits cannot vomit or spit up hairballs. Consider dietary supplements if you have a long-haired rabbit and/or a bonded pair who groom each other often. Even if bunnies don’t enjoy it, grooming is a necessary part of keeping them healthy.

*** This guide is for educational purposes only. It is not intended to diagnose or treat medical problems in rabbits. Please see a veterinarian for medical care if you have concerns about your bunny’s health.

Sources: 

Thanks to Lori B, Victoria M, Tracy C, Olivia E, and Mary Anne L for sharing their experiences and recommendations! 

“Guidelines for the Management of Gastrointestinal Stasis in Rabbits”, University of New South Wales, 2020.

Krempels, Dana M. “GastroIntestinal Stasis, The Silent Killer.” GastroIntestinal Stasis: The Silent Killer, 2005, www.bio.miami.edu/hare/ileus.html. See also https://rabbit.org/gastrointestinal-stasis-the-silent-killer-2/.

“Ileus: Care Information.” Vet Help Direct, 13 Apr. 2020, vethelpdirect.com/pet-health-library/condition-rabbit-ileus-gut-stasis/.

Special Bunny, “Gas & Stasis.” Accessed 2021. https://www.specialbunny.org/gas-stasis/

MediRabbit, “Differential Diagnosis for Ileus in Rabbits”. Accessed 2021. http://www.medirabbit.com/EN/GI_diseases/Differential/generalities_ileus.htm

MediRabbit, “Normal and Abnormal Fecal and Cecal Feces of Rabbits”. Accessed 2021. http://www.medirabbit.com/EN/GI_diseases/drop/Drp_en.htm

Oglesbee, Barbara L., and Jeffrey R. Jenkins. “Gastrointestinal Diseases.” Edited by Katherine E. Quesenberry and James W. Carpenter, Ferrets, Rabbits, and Rodents, U.S. National Library of Medicine, 2012. www.ncbi.nlm.nih.gov/pmc/articles/PMC7152107/

Scottish Government. “Pet Rabbit Welfare Guidance”, 2018, https://www.gov.scot/publications/pet-rabbit-welfare-guidance/pages/1/