Need info and support for rabbit experiencing painful gas

I posted this thread several months ago: http://www.rabbitsonline.net/showthread.php?t=87152 and you guys helped me so much, and I'm hoping for some more advice. My bunny no longer gets any veggies or fruits (as they were the suspected cause of his gas attacks). His diet is unlimited 50/50 timothy and orchard grass, and he gets 2 tablespoons of Oxbow essentials adult rabbit food every day. He's middle aged and around 5 1/2 pounds.

To be clear, he is my therapy pet and I am with him all day- I don't work and I am very in tune with any shifts in his personality or behaviour. He's been doing excellent these past few months. He has even more energy and personality, he's eating more hay, he's pooping even more, doing more binky's, doing more flops, is more curious and playful, etc. I've been giving him a lot more exercise too now that his energy has increased and overall, I though he was doing great and I was starting to believe that he might never get sick again. I did notice yesterday that he had pooped a bit less than normal, but there is the odd day where he does poop a bit less where he seems fine, so I didn't worry too much.

Last night, he had another gas episode. He got his dinner, gobbled up his timothy pellets, and suddenly, within a minute or two, he was having another attack. An attack always looks like this:
-very sudden onset, from 0 to 10 very quickly
-breaths rapidly
-keeps moving and shifting every few seconds, trying to find relief, presses his stomach to the floor
-his stomach feels like really soft pizza dough and is really malleable- on a normal day, it's firmer.
-sometimes he grinds his teeth
-after the worst of it passes, his ears feel a bit cold and I give him something warm to lie on (probably from the shock)

In the past, without any medicine and just me massaging his belly (which seemed to help him a little), an episode took about 4 hours to pass fully, before his breathing slowed to normal and he could get comfortable again. Sometime I would hear him pass a bit of gas, he would start to nibble on his hay, and a little later, he would become VERY interested in the critical care I would offer him- gobbling it up voluntarily. His poops would be very small for a couple of days after, and wouldn't be up to his regular volume for several days. He would start eating hay again only a few hours after feeling better, and would work back up to his normal hay eating after 1-3 days.

This time, I gave him 0.5 ml of metacam right away, and then about 15 minutes later I gave him .5ml of simethicone (it was a 25 mg suspension, so I opted to give him less at first). Within about 5 minutes of giving him the simethicone, he started to look better, and after 10 minutes, he miraculously seemed back to normal. I believe I heard him pass a bit of gas. the whole episode from beginning to end was maybe about 30 minutes. He almost immediately resumed eating his hay and drinking his water, and he had a small bowel movement shortly thereafter (with small pellets) so I opted not to use critical care. I just gave him his breakfast pellets and he ate them no problem. I'm so glad I had these tools on hand to make him feel better so quickly, but at the same time, I'm so torn about what to do with his treatment in the future.

I think cutting the veg out has been very beneficial and has him eating more hay, but now I'm wondering whether the veg did contribute to his previous attacks (all of which happened shortly after eating veg), or if there's something scarier going on. This time, it happened after he ate his oxbow pellets. Maybe he wolfs them down so quickly, he swallows air? Maybe there's an ingredient in the pellets that doesn't agree with him? I know there are a lot of rabbit owners who don't like soy in their rabbit's feed because it can cause foul urine. I did do some research on the internet, and found a lot of articles that suggested that soy is not fully digestible for dogs and cats and other pets and can cause a lot of digestive problems, some of the same problems we seen in humans with soy sensitivity, and gas is the major side effect. Oxbow essential's has soybean hulls and soybean meal and the 2nd and 3rd ingredient.

This is where I'm so conflicted. These are my options right now:
-try altering his diet again to see if it helps. Oxbow organic has rabbit pellets that contain more hay and no soy and they are available locally.
-get him on a daily dose of rantadine to see if it helps. I am aware of the benefits of rantadine for a rabbit that is chronically suffering, but my rabbit seems in top shape between episodes, and he recovers so fast. Right now I see this as a good option in case he gets worse
-get him an x-ray, urine test and/ or ultrasound. The vet will have to sedate him and that really scares me. It will also be incredibly costly.
-take him for a second opinion with another vet. I recently found another vet in the next city who works only with small pets and has a great reputation. My current vet has small animal experience but runs a vet for all pets and he wasn't familiar with Teddy's condition. He kept saying it could be treated like GI stasis, but I have cared for rabbits with GI stasis, and this is not even close to the same, even though it might be causing trouble in the same area. He's the expert, but he didn't leave me feeling confident.

A note: my bunny is terrible at being handled. He gets incredibly stressed and I limit his handling as much as possible. After I take him to the vet or to get his nails trimmed, he puts on a bit of a protest after and likes to refuse his hay and food for several hours. I am always worried about the benefits of handling him over the toll it may take on him.

Right now, I'm leaning towards altering his diet, which is undoubtedly the most simple least-anxiety inducing option, and then setting a consultation with the new vet I found once I feel my bunny is fully recovered.
at the last vet visit a few months ago:
-his teeth looked good
-his weight looked good
-his coat looked good (I groom him daily)
-his stomach felt good, he was a normal temperature and his anus was clean
-his diet was okayed for having enough fiber

Does anyone have any advice or suggestions? Do you disagree with me? Does anyone else have a rabbit that experiences something similar, and if so, what have you done? Thank you, guys.

Can you not space out when he gets his pellets or give them to him in a treat ball? Again, spaced out?
I think it explains itself when it happened right after he ate the pellets.

That would be a simple solution wouldn't it? I would love if that turns out to be the case.

I will try scattering them around his cage more than I already do to make him work for it a bit more, or even feed him by hand. He gets two tablespoons total every day and it's already divided into four mini meals throughout the day. I've tried treat balls and I haven't yet found one he hasn't tried to eat- he's attracted to rubber and plastic materials and will eat them if given the chance.

I agree that it seems pretty obvious it was the pellets this time that were the cause. I would only resort to the vet if I couldn't identify the cause and there might be some other issue going on that needed investigating, and/or if the gas drops and other attempts to help relieve the pain didn't help, if it didn't resolve in a few more hours, and you end up needing more heavy duty pain meds and possible stomach decompression from the vet. Since you are pretty sure it's the pellets, and the gas drops helped, you know at this point what you need to work on to try and prevent it from reoccurring.

He definitely could have inhaled too much air with them because of inhaling them so quickly. If you can slow down how quickly he eats them and he still has another episode, you could try reducing pellet amounts and see if a reduced portion makes any difference.

The other possibility is the pellets themselves are causing too much upset, if this keeps reoccurring on a regular basis, right after he eats his pellets, even with slowing down his eating of them. If they are a brand new bag, it could be there is a problem with this particular batch. Or if not a new bag, it could be your bun is just becoming sensitive to something in the pellets. I had that problem and ended up just having to take my rabbit completely off of processed pellet food, so now she only gets hay, leafy greens, and forage. Though trying a different type of pellet with another formulation could make a difference for your bun, but only if it's the pellet ingredients and not the inhaling too quickly part that is causing the issue.

Thanks for the suggestions and support!
My anxiety wants me to think I'm not doing enough if I don't take him to the vet, but especially for a bunny that gets stressed when handled, it isn't always the best option.

Even though it looks like the pellets caused it, I wonder why, after each incident, his poops temporarily get smaller in size? It seems the longer the episode, the longer it takes him to recover fully, and this time, he was fully recovered in 24 hours, at which point his poops resumed their normal size as well. I suppose that could just be his body's response to the stress of it.

I found a bag of Oxbow organics yesterday and started the transition process that day. I tried him on this food last year and he didn't have any reaction to it then (and now that I think about it, while he was eating it, he didn't have a single episode), so I'm wondering if I can transition him onto it much quicker than is recommended, maybe in 10 days instead of 3 weeks? I want to get him off Oxbow essentials ASAP in case it's the source of the problem.

We have a shallow box filled with strips of newspaper, and we put pellets in it, mix around the paper, and then Pippi has to hunt to find her food. That might help prevent him from eating too quickly too. I really hope he feels better soon. <3

We put our male's food in wooden 'boxes' and puzzles (he has to flip one top open, slide another, open many drawers of another, etc. to slow him down). It's completely untreated wood, so it's safe for him to chew (and he does).

Since your rabbit is prone to GI issues, I'd suggest transitioning very slowly rather than more rapidly. Even food that is better, if not his usual, can cause GI upset- so I would go with the 3 weeks personally.

We had a rabbit who seems to have random tummy issues, especially the older he gets. We found out that he sometimes has a bout of bladder sludge, likely caused by him being so sedentary, so our very rabbit savvy vet gave us a few things to use that work - metoclopromide and metacam. He takes the metacam these days for arthritis anyways, so he always gets a low dose, but we can increase it if he has issues. The metoclopromide is only used if we notice that he is having a hard time with his poo, especially if we see strings of pearls, or those poos that are all connected by fur passing through his system. The other thing, that he hates, is that we regularly exercise him. So, once a day, or often more than that, we *make* him come out of his big cage and run around for 10-15 minutes. This has really helped cut down on these episodes as well. He has only had to have antibiotics once for the bladder sludge (which turned into an infection). Nothing else we can really do about it. He's older, set in his ways, and even though we have tried to cut back on his pellets (which might be the other culprit of his sludge because he is so stubborn and will only eat a certain cheap kind), we would rather just deal with the episodes one at a time....and if they ever increased, we would take action on the pellets. As far as veggies, plain baby romaine should not cause gas, at least as far as our rabbit savvy vet has said, and I have to wonder if that could help with making sure that things are moving since it has a lot of water in it, but hay is really the best to keeping things moving usually. Does your rabbit have any issues with molting when he has these gas pains? Or does he groom a lot and have a lot of fur?

In my opinion, if you can get your rabbit in with the vet who has the most experience with small animals, and especially if they work with a lot of rabbits, then I think that would be the next step. A really good rabbit savvy vet would have a better idea at what could be the problem or potential things to try. I would not keep going to the current vet unless that is the only option you have...from your previous post, they do not seem like a rabbit savvy vet. But that is just my opinion.....and I can only speak for my own experiences. Rabbits are an animal that we can never learn enough about!!!