One of the scariest parts of being a rabbit caretaker is when our pet rabbits get sick. Rabbits have a knack for hiding their illnesses, which means they often goes unnoticed until the rabbit is very sick. This is especially true for the unfortunately common illness known as GI Stasis (Gastrointestinal Stasis). One night your rabbit seems perfectly healthy, but by the time you wake up, they need to be rushed to the emergency clinic.
GI Stasis is a sudden illness that can be fatal for rabbits within a 24 hour period of time. If you notice common symptoms, such as not pooping or eating, bring your rabbit to an emergency veterinary clinic as soon as possible. The best way to prevent GI Stasis is to make sure your rabbits have a hay-based diet with plenty of time for exercise.
Since GI Stasis is one of the most common illnesses that our pet rabbits suffer from, it’s important to be aware of the symptoms so we can get them the help they need in time. There is also a lot we can do as caretakers to prevent GI Stasis and keep our rabbits healthy for the long term. If there is anything I can impress on you with this article, I wish for you to take the symptoms seriously. If you get your rabbit medical help early, then they can make a full recovery.
What is GI Stasis?
GI Stasis (also called Ileus), is a dangerous gut condition in rabbits. This illness is characterized by a slow down of the rabbit’s digestive tract. As the gut comes to a halt, the rabbit will stop eating and producing fecal pellets. Their body and vital organs will begin to shut down, and it is likely that the rabbit will die unless they receive emergency medical attention.
Otherwise healthy rabbits can quickly end up with a serious case of GI Stasis. An external stressor may cause their digestive tract to slow down a little. The food and hair that has already been ingested can then become impacted in the stomach or intestines, further exacerbating the problem.
However, if you can get your rabbit to a veterinarian quickly, then they can give your rabbit medication to break down any blockages and mobilize the digestive tract. If detected early enough, rabbits can recover from GI Stasis.
Symptoms of GI Stasis
To help your rabbit recover from GI Stasis, you need to be able to detect it as early as possible. Familiarize yourself with the symptoms so that you know when to seek out emergency veterinary care. Some symptoms can also appear a number of days ahead of time, so if you notice less urgent signs, you can monitor your rabbit and schedule an appointment with their regular vet.
The symptom you are likely to notice first is a rabbit who is normally obsessed with food but is suddenly not eating. They have no interest in pellets, hay, or even treats and leafy greens. If you notice this behavior, think back to when you last saw your rabbit eat anything.
If your rabbit has not eaten for more than 10 hours, this is an emergency and your rabbit should be brought to the vet immediately. Even if it’s only been 4 or 5 hours, it’s a good idea to get in contact with a vet to try to get an appointment scheduled for the same day.
To help me monitor my rabbits’ eating habits, I try to space out the food I give them during the day. I’ll give them pellets and replenish their hay first thing in the morning. In the early evening I’ll give them their yummy leafy greens, then I’ll give them a little treat right before bed. This lets me check in on them at least three times a day to make sure that they have healthy appetites.
A lack of pooping is another emergency symptom that should never be taken lightly. Rabbits poop a lot, so if you clean out the litter box in the morning you would expect to see a lot of fecal pellets when you come home at the end of the day.
If your rabbit has not pooped for more than 10 hours, treat it as an emergency and get your rabbit to the vet immediately. Even if it’s only been 4 or 5 hours, it’s a good idea to get in contact with a vet to try to get an appointment scheduled for the same day.
While you don’t have to do a full cleanout of the rabbit’s litter box every day, it’s a good idea to at least scoop out the majority of the poop inside. This will help you to monitor the types of poop your rabbit is giving you (are they too small, merged together?). You’ll also have a better idea of how much your rabbit typically poops in a day. If it suddenly seems to be less than usual, you can monitor your rabbit and check for other signs of illness.
Lack of energy
Another common symptom that is harder to detect is a lack of energy. If your rabbit is simply sitting in one place or occasionally moving to a different place to sit for a while, then they might be ill. This is especially something to be concerned about if your rabbit is usually very active.
If your rabbit is typically active and bouncing off the walls, it will be easier to notice this change in behavior. However, many rabbits mellow out as they age. Rabbits also tend to be less active in the afternoon than in the morning and evening. You’ll need to make the comparison to your own rabbit’s typical energy levels and use the other symptoms on this list to determine if your rabbit is ill.
A hunched posture is a common position that rabbits take when they are not feeling well because of GI Stasis. In this posture the rabbit may look like they are trying to sit in a loaf, but they keep their weight on their front paws to prevent their belly from pressing into the ground painfully.
The rabbit will also typically have squinted eyes, which is often a sign of pain. Some rabbits will loudly grate their teeth together as well. This is different from the soft teeth grinding sound that rabbits make when they are purring, and is instead a sign of discomfort. It’s as if the rabbit is gritting their teeth in pain.
Loud stomach gurgles or none at all
A healthy rabbit’s stomach will make some amount of gurgling sounds when you place your ear close to their stomach. This is normal and nothing to worry about. However, if you notice very loud gurgling that can be heard from across the room, that can be a sign of gas painfully moving around the rabbit’s stomach or intestines.
Alternatively, if you hear no sounds at all coming from your rabbits stomach, even when placing your ear directly next to them, that is a sign that the digestive tract has completely stopped and your rabbit needs medical attention. Look for other signs of illness in your rabbit, such as not eating or pooping and get your rabbit to a vet.
Unusual behavior for your rabbit
If something just seems off about your rabbit’s behavior, it’s a good idea to get them checked out. You know your rabbits personality better than anyone else, so only you can be the judge of what is considered unusual.
This is because rabbits have the instinct to hide any illnesses and weaknesses. In the wild this would help to prevent them from being picked off by a predator, but as pets it means that it’s very difficult to tell when a rabbit is sick. Sometimes a big change in their habits or personality is the first clue you’ll get.
Some examples would be a rabbit who is typically very friendly, suddenly becoming aggressive. Or a rabbit sitting for hours in the litter box when that’s not a place they usually choose to stay.
Mushy or unformed cecotropes
Cecotropes are the second type of poop that rabbits produce. Usually the rabbit will eat these directly from their anus because they are healthy for rabbits to reingest, but you might occasionally see a tiny grape-like cluster of squishy poops that your rabbit left behind.
If your rabbit’s digestive system is out of balance, it can affect the way these cecotropes are formed. Instead of getting a tight cluster of cecotropes, you’ll find they are lumpy with a more clay-like texture.
This is an early sign that the digestive system is unbalanced and often leads to symptoms of GI Stasis. It’s important to make an appointment with your vet to detect any underlying conditions and get your rabbit onto a healthier diet.
Small or double poops
Other signs you may start to notice before your rabbit has any serious symptoms of GI Stasis include small poops or double poops that have merged together. Finding a few of these in the litter box every day is common and nothing to worry about. However, when the average size of the fecal pellets has drastically decreased, or there are more double and triple poops than the normal healthy pellets, you’ll want to seek the advice of a veterinarian to prevent GI Stasis before it gets more serious.
Causes of GI Stasis
GI Stasis can be an illness in and of itself, or it can be the result of another underlying health condition. That’s why it’s so common among rabbits. Just about any kind of stress or pain can lead to an episode of GI Stasis. In many cases this means we won’t truly know what caused your rabbit to go into stasis, but we can make some educated guesses based on the many potential causes.
An unhealthy diet
The main cause of GI Stasis in rabbits is an unhealthy diet that is lacking in fiber. Rabbits need to be eating a lot of grass-based hay (such as timothy hay) to keep their digestion moving at a healthy pace. This means that the majority of their diet should be hay.
Pellets, on the other hand, should only be a small part of the rabbit’s overall diet. You only want to give your rabbit about a tablespoon of pellets per pound of body weight. This means for a 4 pound rabbit, you only want to give them ¼ cup of pellets per day.
Treats should also be kept to a minimum. A high amount of sugary foods can easily cause an imbalance in the rabbit’s gut, which can subsequently lead to digestive issues, such as GI Stasis.
To learn more about how to give your rabbit a healthy diet, visit Rabbit Diet 101.
Other injuries or illnesses
GI Stasis can also be caused by any number of other illnesses and injuries. Pain or distress from other disorders can end up causing the rabbit’s digestive system to slow down, which snowballs into a serious case of gastrointestinal stasis as particles get impacted in the stomach and intestines.
If you have a rabbit who frequently requires medical attention because of GI Stasis, they may have an underlying health condition that needs to be diagnosed. Conditions such as overgrown teeth, urinary tract infections (UTI’s), or even a buildup of gas can be causes of GI Stasis and will need to be addressed to help prevent GI Stasis in the future.
Stress or anxiety
Prolonged stress or anxiety can also be the cause of GI Stasis. The fear that rabbits feel can also affect their digestive system and cause it to slow down. Rabbits who are anxious and stressed will also eat less in some cases, which can cause the symptoms of GI Stasis to get worse since they are not eating as much to help keep their system moving.
Drinking plenty of water keeps a rabbit’s digestive system moving more easily through the stomach and small intestines. It can prevent the food and hair particles from clumping together and forming a blockage if the digestive tract slows down. It’s important to make sure your rabbit is drinking enough water to have a healthy gut.
Most of the time, your rabbit will be able to maintain their own hydration as long as they have water available. It’s a good idea to provide a large bowl instead of a water bottle, since this is an easier and more natural way for rabbits to drink.
An intestinal blockage is not usually the cause of GI Stasis unless your rabbit eats something they should not. However this often happens as a result of the gut slowing down, causing the condition of the rabbit to decline rapidly.
Hairballs, which were previously thought to be a major cause of GI Stasis, are in this category and happen more as a result and very rarely cause a blockage on their own. However, since excess fur in the digestive system can cause an impact after the gut has begun slowing down for a different reason, it’s a good idea to brush your rabbit regularly to try to prevent a potential blockage.
Rabbits who are obese have a higher chance of developing GI Stasis. Often obesity is a result of an unhealthy diet or a sedentary lifestyle, both of which can add to an imbalanced and slow moving gut. If your rabbit is overweight or obese, talk to your veterinarian about how to help them lose weight in a healthy way.
For more information on obesity in rabbits, read my article on Helping Obese Rabbits Lose weight.
Some rabbits simply have bad genetics when it comes to digestive health, making them more prone to getting GI Stasis. Lop rabbits and albino rabbits tend to be more likely to have digestive issues. This is possibly due to more in-breeding when these breeds and colors of rabbits were first produced.
There is also a link between white spotted rabbits (with the english spotted gene) and digestive health. The fewer spots and whiter the rabbit is, the more likely that they will be prone to severe episodes of gastrointestinal stasis. Common breeds that are affected by this gene are Hotots, Rhinelanders, Checkered Giants, and English Spotted rabbits. However other breeds and mixed breed rabbits can also have this spotted pattern gene.
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What to do if you believe your rabbit has GI Stasis
If you believe your rabbit has GI Stasis, you should give your veterinarian a call to get them medical attention as soon as possible. Remember, if your rabbit hasn’t been eating or pooping for more than 10 hours, you should treat it as a medical emergency.
If you notice some of the more subtle symptoms, such as smaller poops or some unusual behaviors, you may have more time to make an appointment with your veterinarian. Keep monitoring your rabbit’s condition and make sure to bring them in for a checkup so your doctor can look for underlying health conditions and help make sure your rabbit has a healthy diet.
Immediate at-home actions to take
If you believe your rabbit is developing GI Stasis, there are a couple actions you can take to help you determine the extent of their condition. These are steps you can take if you notice your rabbit is behaving strangely, but you’re not sure what the cause is.
The treat test
The treat test is a very simple check I perform with my rabbits. I simply get out my rabbits favorite treat and see if they’ll come running up to me for it. There are three different results that will cause me to take different actions:
- The rabbit comes running up to me for a treat. This is the best case scenario. Whatever was causing the rabbit to act strangely, they are likely feeling okay now. I will still monitor their behavior, but am not too worried.
- The rabbit will hesitantly take the treat from me. This gives me cause for concern, but may mean it’s not a complete emergency yet. I’ll look for other signs of illness and see if my rabbit feels better after a dose of simethicone. Give the vet a call and make an appointment while continuing to monitor their behavior and health.
- The rabbit will not eat their favorite treat. This is when I’m very worried and it’s time to make an appointment with the vet as soon as possible, especially if it’s been going on for a number of hours or an unknown amount of time (starting overnight).
Keep your rabbit warm
If the next available vet appointment is not for a number of hours, one thing you can do at home in the meantime is keep your rabbit warm. When GI Stasis starts to cause the body to shut down, it also lowers the rabbit’s body temperature which, in turn, makes it more difficult for the rabbit to recover.
To keep your rabbit warm, place them next to a heating pad or hot water bottle. Wrap these heating implements in a towel to prevent burning the rabbit. You can also wrap your rabbit in a towel or hold them close to you to warm them up with your body heat.
Simethicone/Baby gas drops
The symptoms of GI Stasis are very similar to the symptoms that rabbits get when they have a gas buildup. In fact a gas buildup can lead to an episode of GI Stasis. In these cases, the gas can be released by using baby gas drops (also called simethicone).
You only want to give this to your rabbit if you notice the symptoms early on. For example, if you know that your rabbit was happily eating when you fed them in the morning, but an hour later you notice signs of GI Stasis. If it’s been a longer period of time, then don’t wait. Get your rabbit immediate medical attention.
If they are still in good condition (they ate and pooped fairly recently) you can try giving simethicone:
- Give your rabbit 1ml of simethicone every hour for 3 hours. It should help them to pass any gas that is trapped in their system.
- if your rabbit doesn’t improve then make an emergency vet appointment.
Is it okay to give your rabbit pineapple juice?
An old home remedy that has been used to treat GI Stasis in rabbits is watered down pineapple juice. The idea is that the enzymes in the pineapple juice will break down the particles that are impacting the digestive tract. However, this has been largely debunked since studies have shown that the acidic environment in a rabbit’s stomach prevents the pineapple juice from having any effect.
If there is any potential advantage to giving a rabbit pineapple juice, it’s that the flavor may help rabbits to stay better hydrated which can help them recover. Adding just a couple drops to their water bowl, might make the rabbit more likely to drink more.
However, I want to be clear that this is not veterinary approved advice. Any positive effects of pineapple juice on GI Stasis have no medical basis. On top of that the high sugar content of pineapple juice could potentially be detrimental to the rabbits health, causing an increased imbalance of the bacteria in the rabbit’s gut.
It’s better to try to get a rabbit to stay hydrated in other ways. Offer them leafy greens that have just been recently washed. You also want to make sure they have ready access to a bowl of water.
What to expect at the veterinary office
Once you bring your rabbit to the veterinary office, make sure to tell them the condition of your rabbit. You could say you suspect they have GI Stasis or that you haven’t seen them eat or poop for a number of hours. The staff should recognize it as an emergency and work with you to give your rabbit the care and attention they need.
The emergency veterinary clinic may let you accompany your rabbit, but often you’ll have to stay in a waiting room while your rabbit is cared for. During this time the staff will do some or all of the following:
- Take your rabbit’s vitals to determine if your rabbit is hypothermic.
- Give your rabbit X-rays to determine the extent of the problem.
- Give your rabbit an IV of fluids to keep them hydrated and give them essential electrolytes.
- Give your rabbit stimulants for their digestive system (such as cisapride or reglan).
- Give your rabbit pain relief medication.
In most cases, the rabbit will be able to recover with these steps. The sooner you can get them the care they need, the more likely they are to make a quick recovery.
The veterinary office may want to keep the rabbit overnight for observation to make sure they make a full recovery, but in many cases your rabbit can go home with you after a few hours. You’ll be sent home with medication and instructions to help make sure your rabbit makes a full recovery.
Aftercare for your rabbit
Once your rabbit is home with you, you’ll want to make sure to keep them warm and comfortable. You’ll want to avoid handling your rabbit as much as possible, since that can be stressful for them, but petting is often appreciated.
You’ll also want to be ready for at least a week of medication regime. Usually the veterinarian will prescribe a gut motility medication along with a pain medication. These will need to be administered to your rabbit every 8 or 12 hours. Follow your veterinarian’s instructions for the correct dosage and time intervals for your rabbit.
On top of these medications, you will likely also be instructed to feed your rabbit some Critical Care until they are eating normally again. Critical Care is a powder based formula that can be mixed with water and syringe fed to a sick rabbit. Usually the rabbit will be able to eat their regular food within a few days, but it may take longer, so be sure to observe your rabbit and ask your veterinarian for advice if you are ever unsure of what to do.
These medications and the Critical Care will have to be syringe fed to your rabbit. To administer the medications:
- Put your rabbit into a burrito. Use a towel to securely wrap your rabbit up so they can’t squirm away while you give them the medication.
- Wrap your arm around the rabbit and place your hand over their head. This will hold your rabbit securely next to your body and prevent them from bucking their head away from the syringe.
- Pull back the lip and insert the syringe behind the front teeth. Try to get the syringe far enough inside the mouth so your rabbit will swallow it, and not just let it dribble out in front of them.
When giving your rabbit larger amounts, make sure to give them only 1mL of the medication or Critical Care at a time. This will give them time to chew and swallow.
How to prevent GI Stasis
Since GI Stasis has so many different causes, it’s impossible to completely prevent a rabbit from getting this illness. However, there is still a lot you can do to make GI Stasis less likely. By taking preventative measures and catching the signs of illness early, you make it much less likely that your rabbit will succumb to this deadly condition.
Preventative steps you can take include:
- A healthy diet. Most bouts of GI Stasis in rabbits are caused by an unhealthy and unbalanced diet. By making sure your rabbit has unlimited hay available (such as timothy hay) with only small amounts of pellets and treats, you can help keep their gut healthy. Learn more about a healthy rabbit diet.
- Exercise. Movement and activity can prevent your rabbit’s gut from slowing down and keep it healthy. Find out ways you can encourage your rabbit to get more exercise.
- Regular veterinary exams. Annual health exams can help you to catch signs of an underlying health condition early, before it become a serious health risk.
- Encourage hydration. Make sure your rabbit has constant access to water (from a bowl). You can also give them other ways to get water, such as from leafy greens that have just been washed.
- Reduce stress. Try to reduce the amount of stress in your rabbit’s life. Make sure they have enough socialization and avoid putting them into scary situations. Learn how to reduce stress for your rabbit.
- Hanspeter W. Steinmetz, Dr.med.vet., MSc; Marcus Clauss, PD, Dr.med.vet., DECVCN. “Gastrointestinal Stasis in Rabbits and Rodents.” World Small Animal Veterinary Association World Congress Proceedings. 2010. https://www.vin.com/apputil/content/defaultadv1.aspx?id=4516368&pid=11310.
- House Rabbit Society. “Practical Nutrition.” Youtube. Commentary by Susan Smith Ph.D. Nov. 7, 2014, https://www.youtube.com/watch?v=91mSv1PqyY4&feature=youtu.be.
- Krempels, Dana, Ph.D. “Gastrointestinal Stasis: The Silent Killer.” House Rabbit Society, Feb. 10, 2013, rabbit.org/gastrointestinal-stasis-the-silent-killer-2.
- Logsdon, Cat. “GI Stasis.” Zooh Corner Rabbit Rescue. March 2014. http://www.mybunny.org/info/gi-stasis.
- Varga, M. Textbook of Rabbit Medicine 2nd ed., p. 317. Ossining, NY: Butterworth Heinemann Elsevier, 2014