GI Stasis/Ileus weekly/bi-weekly

Hello everyone,

This is my first post and the reason I've registered here is to write this post, because I want to know other people's opinion from different countries.

I'm a bit lost here, don't know what to do:

I have two sterilized bunnies (a female and a male both of them are around 3-4 years old). The female is a dwarf lionhead bunny.
The female one has GI stasis on a weekly/bi-weekly basis since 2019 august.
So now we have a motherload of paper regarding vet examinations due to this.

Feeding:
Hay ( I mix 2-3 types together), water. Pelletts in the morning and in the evening. Nothing more. No fruit or any other kind of vegetables, not even a tiny bit.

They are 24/7 roaming inside the living room without being locked inside the cage. There are no plants or any kind of stuff they can accidentally eat.

We had both of them examined by multiple doctors (Male = excellent condition) and one of the doctors came to a verdict that something is not right with her gut because when she touched just a tiny bit the bunny would immediately "move away ". We did an ultrasound examination on her and found that there is a gut thickening.
So we went back to the doctor and she recommended to feed quamatel mini tablets 2x a day (1/8 of the actual tablet). (assuming that this is only an inflame and not a tumor)
So I fed her 2x a day by wrapping the tablet inside a basil leaf. From this point on I would say that the symptoms for the GI stasis (if this gut thickening was the root cause) should happen at a constantly decreasing rate…..but no. We did a checkup on her gut with ultrasound again 4 weeks ago= they weren't able to observe the thickening anymore. 2 weeks ago I took her back to the vet (due to annual RHD2 injection) and she examined it= the bunny is in excellent condition, even when touching her guts she no longer "moves away".

And yet, 2 days ago= ileus….she is right now in the hospital and I'm waiting on her to recover. This was the worst one so far. They even considered performing a surgery.

I'm really convinced that:
-This is a tumor and they just failed to locate it via ultrasound the 2nd time.
-Something else is amiss here that we fail to detect

Facts:
-Multiple doctors (qualified bunny/exotic vets) examined her (at least 3)
-We don't have any other pets
-We even set up security cameras so we can check precisely when was the last time they ate
-The way we were able to detect that something is wrong is that she didn't accept the pellets when offered
-The problem comes really suddenly: 30 mins ago she actually accepted the pellett, 30 mins. later not.
-I groom them on a daily basis with furminator, and I also had the female's mane cut so she doesn't eat that much fur. Sometimes the grooming lasts 30 mins per bunny, some days only 5 minutes (depending on the amount of fur they are shedding)
-Feeding wise: the hay is on the ground, they don't even have to take it out from a feeder. Water wise: using a mortar bowl.

Any ideas? Please ask anything, and feel free to tell me that I'm wrong, doing something wrong. My main purpose with the post is to have a healthy bunny.

Thank you!

I would look to get some input from Jenny (@JBun ) on this one. (She's our health moderator.)
I know there have been rabbits that simply could not tolerate pellets. Any pellets at all and they get GI stress. Others have problems if they get more than just a tablespoon per day. ...Just wondering if this could be at least part of the problem.

How big is the mortar bowl? I would be sure there is at least one 20 oz bowl per rabbit.

The bowl is not even close to 20 oz (approx. 600ml, right?). Per day/per rabbit? Isn't that a bit too much? I mean more water wouldn't hurt of course, worst case they don't drink it, but our rabbits both barely drink 20 oz per day together.

(They didn't drink 20 oz together even when we used the so popular cage attached water bottle. I think we added the mortar bowl in 2019 march-april or so. We still have the cage attached bottle as well, just in case they want to use that as well, but they dont use it.)

(Of course, we check on the water supply like every 2-3 hours and when we see it's empty we refill it)
(also we keep it clean so no algaes and such)

But I will surely swap it for a bigger one!

Also, might be worth trying going without pellets for a month.

Thank you!

If she is feeling unwell soon after eating pellets, I would highly suspect them as the culprit. I had a similar experience with a rabbit. He was new and came down with GI stasis. He had just started to recover after 3 weeks, when it happened again, and again. I soon noticed and realized, that it was after he started eating pellets again that he started to get sick again. I put him on a hay and select leafy green diet, and he never had stasis again.

I had tried several times after this to see if I could reintroduce pellets into his diet, very slowly and gradually using multiple kinds and every time he would start to show signs of discomfort(eye squinting, belly pressing, constantly shifting positions) with even the smallest amount(less than half a tsp.) probably within a half hour after he ate them. So I stopped the pellets and stuck with hay and leafy greens. Sugary/starchy foods would cause the same problem, so he never got those either. He had always been fed pellets in his previous home, but I think that first bout with stasis damaged his digestive tract causing megacolon type symptoms after that(which would worsen when I tried putting pellets back in his diet) and that's why he could no longer have pellets or starchy foods without it making him sick.

Other possibilities are that she is sensitive to one of the hays she is getting. Or if the hay has gone bad(mold) or the water source is contaminated in some way. Though if it was bad hay or water, more than likely your other rabbit would be showing signs of having problems as well. Then there is always the possibility of some sort of digestive problem that the vet isn't seeing on xrays.

Ampee said:

The bowl is not even close to 20 oz (approx. 600ml, right?). Per day/per rabbit? Isn't that a bit too much?

(They didn't drink 20 oz together even when we used the so popular cage attached water bottle. I think we added the mortar bowl in 2019 march-april or so. We still have the cage attached bottle as well, just in case they want to use that as well, but they dont use it.)

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Rabbits tend to drink less water when they have to work at it as they do if it is in a bottle. They tend do drink more from a bowl. The more water, the better! I would definitely try larger bowls then. One of my rabbits would easily drink that much every day. My current one will only drink a quarter of it on some days and then overnight he'll suddenly drink it all. Better they have it and not need it then the other way around.

So they let her out of the hospital on monday.
She got better until now. This morning we saw she didn't eat during the night. We fed her Meloxy pain killers and now she is a bit better….

What should I do? I'm completley lost.

Have you got some critical care to start syringe feeding to keep her going until you see the vet again? Oxbow make a good powder mix that you can reconstitute in water and syringe feed and I have saved a couple of buns from complete stasis with it. Are their any vegetables that this rabbit particularly likes? Ones that aren't too gassy? Maybe a little safe, fresh grass. Hand picked, not mown. Try for rye grass, as low in calcium and protein, but high in fibre. If you want to also increase water intact....good way is to also sprinkle a bit of water on some fresh greens and that way they get some extra water too.

The anti inflammatory pain killers (it sounds like what that is) should help....but I highly recommend intervening if you can and try syringe feeding the critical care as well.
Gentle tummy rubs are good too, though as you said before she may not allow this. It is a thing that a lot of buns have to learn to get used to. Some never do.
Please keep us updated.

I have been going through this for over 7 years now with my BB. Very frequent anorexia and bellyache. We have had all possible tests apart from exploratory surgery which I would only allow if it was a matter of life and death. We had two CT scans, ultrasound, etc. and we still don't know what the cause is. A few years ago she had an 8 week course of Baytril in case there was some infection - the vet had seen a similar case where it was decided to do exploratory surgery and infection was found, that bunny was cured by the 8 week course of Baytril. No such luck for my BB.
Are you very sure your bunnies are not ingesting any non-food items such as cardboard or mats?
Here is my suggestion: keep her on hay only (try to add a couple more varieties), possibly add some dried forage, for at least 2 weeks. Then add one new food (in very small quantities) , wait two weeks before you introduce another new food and keep a food diary so you have a chance of finding out what triggers it. I suggest you try fresh herbs as new foods, easier to digest than veg.
It's really important to catch it early when they start bellyaching. Give painkiller, gut stimulants and simethicone and gently massage belly. Most of the time this works for us. If we cannot get her to eat after 3-4 hours we take her to the vet/emergency vet.
As mentioned above it could be the pellets. My first bunny ended up having a pellet free diet (after being hospitalised 3 times in one year) because my intuition (this was many years before Google) was that his illness was due to the dried food. He never got ill again after I stopped the pellets.
Best of luck! I know how stressful this is. Let us know how you are getting on?

Thank you so much for replying!!

She is still holding out this "betterness", and it's due to the Meloxy I think (Meloxy= the painkiller). She has eaten since very genereously and also accepted oxbow digestive support as well. 5 minutes ago she made her first big pile of poo since the morning so now I'm a bit reliefed. (They look perfectly shaped and not that tiny)

Since she is back from the hospital we have been force feeding her 2x a day (morning, night) with Oxbow CC (Banana flavor). Also the hospital gave us an antibiotic that we have to give her 2x for a week, after feeding her the nightly antibiotics we wait 3-4 hours and we give her BioLapis (probiotic).

Diane R said:

I have been going through this for over 7 years now with my BB. Very frequent anorexia and bellyache. We have had all possible tests apart from exploratory surgery which I would only allow if it was a matter of life and death. We had two CT scans, ultrasound, etc. and we still don't know what the cause is. A few years ago she had an 8 week course of Baytril in case there was some infection - the vet had seen a similar case where it was decided to do exploratory surgery and infection was found, that bunny was cured by the 8 week course of Baytril. No such luck for my BB.
Are you very sure your bunnies are not ingesting any non-food items such as cardboard or mats?
Here is my suggestion: keep her on hay only (try to add a couple more varieties), possibly add some dried forage, for at least 2 weeks. Then add one new food (in very small quantities) , wait two weeks before you introduce another new food and keep a food diary so you have a chance of finding out what triggers it. I suggest you try fresh herbs as new foods, easier to digest than veg.
It's really important to catch it early when they start bellyaching. Give painkiller, gut stimulants and simethicone and gently massage belly. Most of the time this works for us. If we cannot get her to eat after 3-4 hours we take her to the vet/emergency vet.
As mentioned above it could be the pellets. My first bunny ended up having a pellet free diet (after being hospitalised 3 times in one year) because my intuition (this was many years before Google) was that his illness was due to the dried food. He never got ill again after I stopped the pellets.
Best of luck! I know how stressful this is. Let us know how you are getting on?

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I'm 99 percent sure she doesn't eat any non food stuff. The only thing she could eat is the cage they have for litter (she chews on it sometimes) and the pillow/carpet.

Ampee said:

I'm 99 percent sure she doesn't eat any non food stuff. The only thing she could eat is the cage they have for litter (she chews on it sometimes) and the pillow/carpet.

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Good she seems to be recovering. If she is eating by herself I would not force feed - far too stressful and stress hinders recovery. Why is she on antibiotics? What is the litter she eats? Any non-food item, especially stuff like carpet fibres can cause these issues. Perhaps you should put her in a large, safe pen when you can't watch her.

Ampee said:

I'm 99 percent sure she doesn't eat any non food stuff. The only thing she could eat is the cage they have for litter (she chews on it sometimes, its plastic) and the pillow/carpet.

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Diane R said:

Good she seems to be recovering. If she is eating by herself I would not force feed - far too stressful and stress hinders recovery. Why is she on antibiotics? What is the litter she eats? Any non-food item, especially stuff like carpet fibres can cause these issues. Perhaps you should put her in a large, safe pen when you can't watch her.

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After this GI stasis, some kind of bacteria can overpopulate and to prevent that they prescribed the antibiotics.
She just flopped minutes ago

Probiotics are great. Great u are syringe feeding. Glad she is not eating any non food stuff. Keep us posted.

She is worse again. Even with Meloxy painkiller.

Ampee said:

She is worse again. Even with Meloxy painkiller.

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So sorry to hear that. I don't understand why, when she was eating well, they told you to syringe feed her. I also don't understand why they haven't given you any gut stimulants to give at home. Are you taking her back to the vet? Poor bunny and poor you!

Gut stimultant? what's that? I tried giving oxbow digestive, yesterday she accepted that, now she won't.
We just forced fed her and also gave her Meloxy and espumisam (this takes care of the gases if she has any)
I don't know whether I should take her back to the hospital, they would keep her in for sure and on Sunday you can't even call them about your bunny.

Ampee said:

Gut stimultant? what's that? I tried giving oxbow digestive, yesterday she accepted that, now she won't.
We just forced fed her and also gave her Meloxy and espumisam (this takes care of the gases if she has any)
I don't know whether I should take her back to the hospital, they would keep her in for sure and on Sunday you can't even call them about your bunny.

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Gut stimulant gets the gut working again. Here we use ranitidine, emeprid, cisapride. How is she apart from not eating? Does she run around at all? Movement might help. Can you hear gut sounds when you press your ear on the side under the ribcage? Maybe give her some peace for a couple of hours and see if she will eat anything then and then decide whether to go back to the hospital? So stressful!

Not really, she is just lying right now and that's it.
Yesterday evening she flopped like 2x times and 6 hours later in the morning she was unwell again. This same stuff happened yesterday morning as well, she was unwell but afternoon she got better. But not today….

Sometimes they flop when they are in pain. It is so frustrating not knowing what's going on. As she has had painkiller and some food, I would leave her for a couple of hours at least. If she is no better then and still won't take any food I would think about going to the hospital again as there is clearly something going on. Could they do a CT scan? If she does perk up and eats a reasonable amount of hay I would stop the force feeding. Has she done any droppings today?