GI Stasis Recovery

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ReggieBush

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Hello everyone,
I recently had to rush little Reggie Bush to the vet because she (yes, it's a she....we named her before knowing the sex) stopped eating and was very lethargic. She hadn't eaten in about 30 hours so I knew something was wrong. To make a long story short, she was diagnosed with GI Statis and was put on medication consisting of Metoclopramide (GI mobility), Cisapride (GI mobility and appetite stimulant), pain meds and finally an antibiotic. We had to force feed her for a day, and amazingly she is recovering from this. She is eating on her own and almost acting the same...the problem is that she isn't pooping near her normal rate (which is a lot). Has anyone else gone through this before and is the lack of poop normal? I have read that it can take a few days. She has been on her meds since Sunday morning, so almost a full 3 days. Please let me know if anyone else has experienced this! It's very stressful, and Reggie seems fairly normal.....she just isn't producing the typical farmers field of crap. Her poops are somewhat wet or they are small and somewhat hard. Any help would be appreciated. She is still on the meds of 2 more days.
 
It can take a few days for the poop to get back to normal. As long as she is eating and some poop is coming out, the levels should get back to normal as her appetite gets back to normal, but that can also depend on what caused the stasis in the first place, and what kind of diet she is getting now. A few causes of stasis are molting and ingesting too much fur, diet too high in carbs and sugars, low fiber in the diet, gas from certain veggies, stress, dehydration, dental problems, and other health problems. So figuring out what the cause was will affect her recovery. If it is diet related, then the diet needs to be adjusted to aid in the recovery and prevent it from reoccurring. If a health problem is the cause, then that needs to be addressed or recovery may not happen. To help get the poop back to normal, feeding lots of grass hay and non cruciferous dark leafy greens(stop if the poop gets mushy), can help a lot. Reducing pellets or stopping pellets for the time being, may also be needed. In addition, you may need to add in a probiotic like benebac or probios, to offset the effects of the antibiotic. I'm curious if the vet mentioned why antibiotics were being prescribed? Sometimes the addition of antibiotics(when not specifically needed) can further disrupt the bacterial imbalance of the gut, which is part of why the stasis is occurring in the first place. These links provide a good explanation of stasis and the meds typically used to correct it.

http://www.bio.miami.edu/hare/ileus.html
http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=484#.UZ8FPbx7LTo.twitter
 
Agreed with above. Probiotics are very helpful in getting buns back to normal, along with wet greens of the non-gassy variety (not cabbage, broccoli, collards, kale, related veggies) if she's used to them, and lots of hay. I'd go buy a new thing of hay if she's not eating a lot, and buy all the different kinds your pet store sells. The variety will encourage her to eat more hay, which is always a good thing. My guys especially like oat hay, which is a bit coarser and has a different flavor (I'm told, haven't tried it myself!) that they like. Adding dried herbs and rose petals to the hay is also fine--but stay away from hay with sweet stuff like dried carrots or papaya added. The nicer hays may be more expensive, but I've never spent more on hay in a year than I've spent in a single episode of GI stasis at the vet's!

It can take several days for the gut to get going again. It can be a week or more before they are back to normal.

I am surprised your vet prescribed both cisapride and metoclopramide. That isn't usually done--typically they only give one at a time. They act in different parts of the GI tract more or less. Cisapride is less commonly used, I think, because it acts more on the stomach and upper GI and has some serious potential side effects.
 
Just want to thank Tonyshuman and JBun for the response. I'm going to cut down the meds at this point and let nature run it's course. Reggie is eating as per usual and acting almost the same....I was just worried where all of her poops went. I'm basically at the mercy of the vet and what she prescribed, so I appreciate the input. Once Reggie is full speed I'll post a photo of her blinky's in your honor! Much appreciated!
 
It is not a good idea to cut down on the meds (although given TonysHuman's comment about cisapride, it might be ok to cut back on that). Rabbits can relapse very quickly and the meds are there to keep them on the right track. I once cut out the meds a week after starting them (on the vet's instructions) and my rabbit relapsed that evening and died the next day. After 30 hours not eating, it will take a while for her to get back to normal, and usually it is recommended to continue the motility meds for at least a week after back to normal pooping (which my vet at the time didn't know). Nature, in the case of stasis, often needs a helping hand! Make sure she is staying well-hydrated and eating lots of hay.
 
It is not a good idea to cut down on the meds (although given TonysHuman's comment about cisapride, it might be ok to cut back on that). Rabbits can relapse very quickly and the meds are there to keep them on the right track. I once cut out the meds a week after starting them (on the vet's instructions) and my rabbit relapsed that evening and died the next day. After 30 hours not eating, it will take a while for her to get back to normal, and usually it is recommended to continue the motility meds for at least a week after back to normal pooping (which my vet at the time didn't know). Nature, in the case of stasis, often needs a helping hand! Make sure she is staying well-hydrated and eating lots of hay.

Thanks! She is eating a tonne of food again! Her poops are smaller and somewhat hard, but at least stuff is coming out at this point...it's a mixed bag. The Vet gave 5 days of meds, so last night was the last dosage. I'll continue to monitor, but she is acting the same, eating a lot and getting water. I might have to cut back on the food to force her to eat more hay. I appreciate the concern and everyone's advice!

ddfd.JPG
 
I forgot to mention, her typical diet is Lettuce, Parsley and Cilantro....which she just loves. At night she will get a cup of dry pellets. She munches on the Timothy Hay when she wants and is provided ample Hay....it's just not her favorite.
 
Really glad to hear she's feeling better. She's a cute little bun!

I think part of the problem with her poop not getting back to normal, and possibly the reason for the stasis, is that she is probably getting too many pellets. I don't know her age and size, but she looks to be somewhere around 4 lbs maybe? If she is, typically a rabbit that size should get about 1/4-1/3 cup of pellets a day. If she is under 7 months old, she would get around a half cup. The general recommendation is 1/4-1/2 cup for every 6 lbs., but that can vary a bit too, depending on the metabolism of the rabbit. But getting a cup a day is quite a bit if she is that small. And it's also probably why she doesn't eat very much hay. If you were to reduce the pellet amount to at least a half a cup and provide unlimited hay, that should get her eating more of the hay. It should also get her poop looking a lot better and help prevent her from getting stasis again.
 
Thanks JBun. That photo is a little old, she is almost 4 and about 6 lbs at this point. I can try cutting down the pellets. It's strange because she has been in perfect health for a long while now, not one single issue (knock on wood). She has ample hay to chew on, and it a few locations. Typically when she is pooing/peeing she is chewing on a pile of hay that sits right beside the litter box. Today her poo's doubled in number and slightly bigger...so we are trending in the right direction it seems. Once again, I appreciate the feedback, this forum has been a knowledgeable and wonderfully calming experience! I've attached a recent photo of her so you can judge her size better.....she's let herself go a little.....just kidding. She gets plenty of exercise!

sds.JPG
 
Oh yeah, much bigger, haha. Cute picture! That's quite the balancing act :)

Even at 6 lbs. 1 cup is still quite a bit, unless she has a lot of trouble keeping weight on. 1/2-2/3 cup might be a better amount. With pellets, they really aren't supposed to be the bulk of a rabbits diet. They are mostly needed to provide the right balance of vitamins and minerals that a rabbit needs. So with my rabbits I shoot for the lowest amount that I can feed but still provide them with the proper nutrition and keep them at a good weight. The bulk of a rabbits diet should be mostly hay because of the way a rabbits digestive system works. They need the fiber from it to keep the digestive system moving well, and prevent things like slowdown and blockages. Hay also helps keep their teeth worn down to prevent spurs from developing. The general rule of thumb is that they need to be eating a pile of hay about the size of their body, each day.

At 4 she seems to be doing pretty well. I think with her suddenly getting stasis, I've found as my rabbits get older, their digestive system seems to get more sensitive. I've had to adjust diets as my rabbits age. Any time I see those really tiny fecal poop, I know that the rabbit isn't getting enough fiber. Luckily it's usually easily fixed.
 
Oh yeah, much bigger, haha. Cute picture! That's quite the balancing act :)

Even at 6 lbs. 1 cup is still quite a bit, unless she has a lot of trouble keeping weight on. 1/2-2/3 cup might be a better amount. With pellets, they really aren't supposed to be the bulk of a rabbits diet. They are mostly needed to provide the right balance of vitamins and minerals that a rabbit needs. So with my rabbits I shoot for the lowest amount that I can feed but still provide them with the proper nutrition and keep them at a good weight. The bulk of a rabbits diet should be mostly hay because of the way a rabbits digestive system works. They need the fiber from it to keep the digestive system moving well, and prevent things like slowdown and blockages. Hay also helps keep their teeth worn down to prevent spurs from developing. The general rule of thumb is that they need to be eating a pile of hay about the size of their body, each day.

At 4 she seems to be doing pretty well. I think with her suddenly getting stasis, I've found as my rabbits get older, their digestive system seems to get more sensitive. I've had to adjust diets as my rabbits age. Any time I see those really tiny fecal poop, I know that the rabbit isn't getting enough fiber. Luckily it's usually easily fixed.

More information that should help. Typically in the morning she gets 2 or 3 Romaine Lettuce hearts, a handful of cilantro and a handful of parsley....her treats are small baby carrots. From the sounds of it, I'll have to slowly cut back these greens and hope she eats more hay. I'm pretty sure she doesn't eat her body size of hay.
 
Leafy greens are actually really good for stasis. The moisture and fiber helps a lot. The baby carrot could be cut out for now though, because of the sugars in it. But I definitely wouldn't cut back the greens. Greens are good :) Pellets would be the best thing to reduce the amounts on. Just to give you an idea of pellet amounts. I have a 5 lb Holland lop bonded with an 8 lb mini lop mix, and they share 1/2 cup of pellets each day. Now with that said, normally for two rabbits of their size they should get closer to 1-1 1/4 cup to share, but they both have low metabolisms and gain weight easily, so they are on a bit of a diet :). So for your rabbit being 6 lbs, 1/2 cup is probably just right. If you feel like she needs a little more than that, I wouldn't do any more than 2/3 cup. And just make sure with the decreased pellet amount that she is making up for it eating her hay. Then just keep an eye on her weight and body condition to make sure that she doesn't lose too much weight.
 
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Sometimes I feel that if she is having all of the greens (lettuce, parsley, cilantro) then she is getting full and not worrying about the hay. Do you think that's the case? The carrots are typically for treats because I have heard bad things about the sugar laced treats......she goes nuts for the carrots, it's adorable.
 
Actually as far as greens go, they are definitely not too filling. I had a baby bun that was 4 weeks old. She was maybe 4 oz, really tiny. But she was weaned too early and not properly, and didn't know how to eat pellets or drink from a dish. But she had been fed some green leaf lettuce when she was with her mom, and would eat that and pretty much only that. I ended up feeding that TINY baby bun a whole head of chopped up green leaf lettuce each day, along with a handful of cilantro. 10 days later and 10 heads of lettuce later, she finally started nibbling on pellets, and gradually started eating them and hay. Obviously feeding a baby rabbit only lettuce isn't a good idea, but it was a necessity at the time. She did pee a ton though, when she was getting all that lettuce. With greens it's mostly water. So if anything, feeding greens to your bun would more directly affect the amount of water she drinks. Pellets on the other hand, are a very condensed food. So they would easily be the cause she is getting filled up and not eating much hay.
 
Hello all,
Reggie seems to be doing great at this point, eating lots of food as I described above, the normal amount of hay and drinking water. Is it normal for her to have either diarrhea or wet/soft poop? I noticed it this morning on the floor and her butt was quite the mess. She would usually have these every couple of months, and I typically would cut back her 1 mini carrot a day treat, ensure she had enough water and enough hay. I'm still a little overly sensitive to her health at this point, and that's why I am asking. I have researched this plenty of times in the past.
 
I'm pretty sure it's not cecotropes, since I have seen those before....it's a little wetter and not shaped the same. I know the answer typically is "more hay", but I witnessed her eating a fair amount of hay the past few days. Should I just be cutting back on everything? She loves her lettuce, parsley, and cilantro.....I would probably have to force feed her the hay for a week until she realizes she's not getting anything else. Her spirits are good and she is running/jumping around. Any other solution?
 
Mushy poop isn't normal for them to have, and it's usually related to stasis problems. Parasites/bacteria can sometimes be the cause, but most often it has to do with the rabbits diet. Sometimes a rabbit can be sensitive to a particular vegetable, but most often it happens when a rabbit is getting too many carbs and sugars in the diet from treats and/or pellets. Some rabbits are just extra sensitive to these things. If you are seeing normal 'cocoa puff' fecal poop, then what you are most likely seeing are unformed or semi formed cecotropes. Parasites and specific bacteria excluded, what happens is the bacterial balance in the cecum is changed by a new food, or too many carbs and sugars. This overgrowth of harmful bacteria will continue and the problem will get worse if the diet isn't corrected, which can then lead to stasis. The way to correct it is basically by elimination to try and figure out the cause. Sugary and starchy treats are the easiest thing to eliminate first to see if that fixes it. Things like carrots, fruit, seeds, grains, and anything else sugary. If you don't start to see improvement in a few days to a week, you would need to try the next thing. Either the veggies or the pellets. If you haven't added any new veggies into the diet or increased amounts recently, then it's most likely the pellets that are going to be causing it. Were you able to reduce the pellets at all since she had her bout with stasis? That would probably be the best thing to try. I don't feed my rabbits sugary treats, so I know when my rabbits get any soft poop, it's most likely to do with the pellets. Once I reduce the pellets a little, it corrects the problem.

For some rabbits, once you correct the bacterial imbalance and get their poop back to normal, you may be able to reintroduce treats or increase the pellets again, but I've found with most of my rabbits that are sensitive and get soft poop, that they are always sensitive and have to stay on a no treat and/or reduced pellet diet in order to keep the soft poop from reoccurring.

The technical name for all of this is cecal dysbiosis. You can read about it in these links.

http://www.sawneeanimalclinic.com/downloads/chronic_intermittent_diarrhea_in_rabbits.pdf
http://www.veterinarypartner.com/Content.plx?P=A&A=3012
 
Thanks again. I was thinking of getting rid of the pellets all together. I assume with Lettuce, Parsley, Cilantro and Timothy Hay.....that the diet is fine and she wouldn't need anything more? I have reduced the amount of pellets, but this didn't help the consumption of hay.....it might just take time. If not, then I will minimize the amount of pellets to 1/3 of a cup. Are the pellets essential?
 

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