Sunday, 31 August 2014

GI (Gastrointestinal) Stasis

What is GI stasis?
GI stasis (aka ileus) is a condition in which a bunny's gut slows down or stops completely. GI stasis is often fatal within days if no treatment is offered to the bunny.

Symptoms of GI stasis:

Note: Not all of the below symptoms may be present in a bunny having GI stasis. But if you notice any symptoms, even just one of them, presenting itself in your bunny, it's a situation you need to take action of.

1. No appetite
  • The bunny does not eat or only consumes a few strands of hay throughout half the day. He/she has no interest in pellets, veggies, fruits or other usual foods.

2. Not producing poop
  • The bunny does not produce poop at all for a few hours or more.

3. Producing very small and/or misshapen poop
Definition of 'small poop': 1/2 or smaller the size of normal poop is considered small.
  • Little amount of poop is produced, and majority of the produced poop are small and/or misshapen.

    Difference between normal poop and small poop.


    Difference between normal poop and small and/or misshapen poop

    4. Producing sticky poop OR poop produced sticks to bum bunny's bum
    • The little amount of poop produced are covered in a mucus-like substance.
      OR
    • As the bunny hops, you would see two or more poop hanging underneath the fur of the bunny's bum, near the genital area.
      OR 
    • The little amount of poop produced sticks together. (Like two peas glued together horizontally.)
      Above: abnormal poop. Below: normal poop (Photo from Guide to bunny poop)

      Note: Sticky poop or mucus-covered poop are not to be confused with cecotropes, which is something really normal and essential that needs to be consumed by a healthy bunny everyday. Bunnies usually consume their cecotropes directly from their anus, but sometimes they miss out some.
      Difference between cecotropes and normal poop.

    5. Lethargic (=Tired and lack energy)
    • Although normal, healthy bunnies do use a lot of time relaxing and resting, a sick bunny:
      • has a particular lethargic look in his/her eyes.
      • would not do other bunny activities (eg: eat hay, grooming, hopping to another spot to rest) for a few hours or more.
      • would rest in a ball-like or hunched up position, at the same spot (usually a corner), for an hour or more.

        Note: resting ball-like is one of the normal resting positions, but notice: a sick bunny would rest like this for an hour or more, and not changing to other positions or doing any other bunny activities.
        Dutchie resting like ball, but he got up and begged for treats after 5 minutes.
    6. Bloating
    • The bunny's stomach/intestinal area would feel hard and bouncy due to a build-up of gas. A normal bunny's stomach feels soft and a little jiggly.

      Before you bring your bunny to a vet, you can try the following treatment first, as travelling adds stress to a bunny.

      Treatments for GI stasis
      The key to successful treatment is to get food, especially fibre, into the bunny's gut so that it can move efficiently again.

      1. Hay
      How-to (i) - Give unlimited Timothy hay
      1. Purchase a packet of Timothy hay immediately if you have not previously.
      2. Place a handful of the hay in front of your bunny. If he/she finishes the given amount, place more.

        Oxbow Timothy hay
      • Why this helps?
        Timothy hay provides fibre for a bunny's gut to move efficiently. In a proper bunny's diet, Timothy hay makes up 70%. 

      How-to (ii) - Feeding strand by strand
      1. Pick a fresh strand from your Timothy hay packet.
      2. Wiggle it near your bunny's mouth. You can also very gently, insert a small part of the hay strand into the corner of your bunny's mouth.
      3. If your bunny eats the strand of hay, pick up another fresh strand. Repeat feeding your bunny like this.
      4. Do not become impatient. If you give your bunny five or six strands of hay at one go, he/she may lose interest.
      • Why this helps?
        The hay helps the gut move efficiently again, and your actions gives encouragement to the bunny.

      How-to (iii) - Trying other types of hay
      1. If your bunny refuses to eat Timothy hay, try purchasing other types of hay. 
      2. Other than Timothy hay, Oxbow offers a variety of high-fibre grass hay such as: Orchard grass, Organic Meadow hay, Oat hay and Botanical hay.

        Oxbow Orchard Grass

        Oxbow Oat hay

        Oxbow Botanical Hay
      • Why this helps?
        The types of hay suggested each have a different texture and flavour, and so may stimulate your bunny to eat them. Hay provides the fibre needed for the bunny's gut to move smoothly. Timothy hay should also be available at all times along with these types of hay.

        2. Fresh vegetables
        Note: purchase organic vegetables if possible. If vegetables purchased are not organic, they must be washed thoroughly to remove pesticides.

        How-to:
        1. Offer 1/2 cup of vegetables to your bunny. Wet the vegetables slightly with clean, drinking water.
        2. You can pat the vegetables light against the bunny's mouth to encourage eating if he/she doesn't seem to show great enthusiasm.
        3. Wait for approximately 2 hours before giving another 1/2 cup of vegetables. This is to avoid the bunny becoming overfull. During this period, offer your bunny Timothy hay as mentioned above.
        4. If your bunny begins to eat Timothy hay enthusiastically after eating the vegetables, excellent! Offer up to 1½ cup of vegetables for every 2lb your bunny weights for that day.
        5. If your bunny does not eat the Timothy hay, continue offering 1/2 cup of vegetables at a few more times at regular intervals throughout the remainder of the day.
          (As a reminder, Timothy hay must be available at all times. Remember to also wait for a couple of hours before giving another serving of vegetables!)
        6. Safe types of vegetables: 
          • Baby bok choy
          • Bok choy
          • Cabbage
          • Chinese Sharp Spinach [aka 'Yin Choy (sharp leaves)']
          • Chye Sym
          • Kangkong (aka 'water spinach')
          • Kale
        • Why this helps?
          Vegetables consists of fibre (though much lesser than hay) and increases the bunny's water intake. Along with fibre, water helps the gut to move smoothly. Also, as vegetables are delicious, they help soothe and boost the discomforted bunny's mood.

        3. Fresh herbs
        Note: If the herbs you purchase are not organic, remember to wash them thoroughly to remove pesticides.

        How-to: 
        1. Offer 1/8 cup of herbs to your bunny. Wet the herbs slightly with clean, drinking water.
        2. You can pat the herbs lightly against your bunny's mouth to encourage him/her to eat.
        3. You can also try gently inserting a small part of the herb's stem into the corner of your bunny's mouth.
        4. Safe types of herbs:
          • basil
          • mint
          • cilantro
          • parsley
        • Why this helps?
          Herbs have a pungent smell and may help stimulate your bunny to eat.

        4. Fruit juices
        Notes:
        - if your bunny is eating hay and vegetables as mentioned above, ignore this treatment.
        - juices should be freshly-made at home. DO NOT purchase juice in cans or cartons at supermarkets; those have added preservatives and are high in sugar.
        -  fruit juices should be made using a juicer (the juice and pulp are separated). DO NOT use a smoothie maker. 
        - fruits should be wash thoroughly before juicing to remove pesticides.
        - DO NOT add sugar/salt or any other additional substances into the juice.
        - water used to dilute juices should be clean, drinking water. DO NOT use tap water or any other water you would not drink. 

        How-to:

        1. After making the fruit juice, add some water to dilute it. This is to increase the amount of water drunk.
        2. The ratio of water to fruit juice should be 1 : 1/2.
        3. The final amount of fruit juice given to your bunny should be about 1/4 cup.
        4. Safe types of fruits to use for juicing:
          • apple
          • carrot
          • tomato
          • watermelon
        • Why this helps?
          Bunnies in GI stasis may not want to drink tasteless water, so fruit juices are good in this situation to help hydrate the bunny. Water helps the gut to move smoothly again; its function is the same during constipation in humans.

          Note: throughout a single day, give the 1/4 cup of juice 2 - 3 times only, as even when diluted they still contain sugar.

        5. Exercise
        How-to: 
        1. Allow your bunny to explore new rooms in your house he/she has never been before.
        2. In addition, you can let your bunny outdoors (=garden) more often.
        3. The bunny should be supervised at all times.
        • Why this helps?
          When a bunny hops and moves about, the gut is encouraged to move too. The treatment's logic is the same for humans with constipation.  Also, the new environment serves as a distraction, diverting the bunny's attention away from the discomfort and boosting the bunny's mood.

        6. *Ear TTouches
        The Tellington TTouch is a safe, gentle bodywork comprised of circular touches and subtle body lifts.

        How-to:
        1. Start on one side of the ear and lightly sandwich it between your thumb and index fingers. 
        2. If your bunny has upright ears, slide your fingers from the base of the ear up and off the ear's edge. For a lop rabbit, use downward or lateral slides. Work the entire ear this way.
        3. To get an idea of the amount of pressure, touch the skin on your eyelid and push it in a circle. 
        4. You can watch this video to see how it's done (1:27):
        • Why this helps?
          Working with ears stimulates acupressure points linked to the stomach intestines, respiration and other areas vital to recovery, so it is an effective way to help support a rabbit with GI problems.

          *I read this from the House Rabbit Society's website. You can read the full article here: Tellington TTouch for a Happy and Healthy Rabbit

          As well as encouraging my bunny to eat in the case of mild stasis, I would do the TTouch on their ears. I would repeat this every hour or so. Each session lasts about 5 minutes. I've found the TTouch method to be an excellent complementary treatment.


        6. Praise and encouragement
        How-to: 
        1. Praise your bunny if you notice he/she eats hay or drunk water.
        2. Pet your bunny and sit by his/her side more often during this period. Talk softly, say reassuring words.
        3. If your bunny is bonded to another bunny, DO NOT separate them. GI stasis is not contagious.
        • Why this helps?
          Praise boosts their mood! Living with bunnies for years taught me that they recognise human language too. They know when you're praising them.

          Mental support from fellow bunny companions is also important, that is why to not separate bonded bunnies.

        7. Oxbow Critical Care
        Note: if your bunny is eating vegetables and hay as mentioned above, ignore this treatment completely.


        Oxbow Critical Care, in short, is a powder made from Timothy hay and other nutrients. It has an appetizing smell and may stimulate a bunny in GI stasis to eat it. It is mixed with water to create a muddy-like mixture

        Oxbow Critical Care and how it looks like
        Critical Care is now available in Anise and Apple-Banana flavour as well.

        How-to (i) - Offering using a spoon:
        Use a shallow spoon. If a spoon's depth is deep, it would difficult for your bunny to eat it.
        1. You can watch the below video on how to prepare Critical Care properly.



        How-to (ii) - Force-feeding using a syringe:
        Reminder note: if your bunny is eating vegetables and hay as mentioned above, ignore this treatment completely! Force-feeding should only be used when the bunny does not want to eat anything at all by him/herself. 

        Firstly, I strongly advise that if a recommended vet is in your area (scroll down to the end of this article - links are provided), visit the vet first before attempting the force-feeding method. Force-feeding is a stressful event to both bunny and human. During the vet visit, ask your vet to demonstrate the force-feeding method.
        1. Use a 1 ml syringe. DO NOT use a 3 ml or larger syringe; the Critical Care will become quite impossible to squirt out later.

        2. You can watch the below video on how to draw up Critical Care using a syringe.


        Knowing the symptoms and treatments, it is also important to understand the causes of GI stasis. After all, prevention is better than cure!


        Causes of GI stasis
        1. Improper diet
        • Lacking of high-fibre Timothy hay
          • A bunny's gut would not move efficiently if he/she does not eat hay. This is the most common cause of GI stasis (and unfortunately, death due to GI stasis) in bunnies if the owner does not offer unlimited Timothy hay, due to insufficient understanding of a bunny's diet.
        • Insufficient water intake
          • Even if a bunny eats hay, his/her gut would not move efficiently if he/she does not drink enough water. That is why a bunny's diet should contain vegetables.
        • Consuming too much high-sugar foods
          • Fruits, commercial treats, and colourful (=not plain-brown) pellets are all high in sugar. Giving an excess of these encourages the growth of bad bacteria in your bunny's gut.

        2. Stress
        • If your bunny is new to your home, he/she may become stressed due to:
          • living in a new and unfamiliar environment
          • you touching or petting him/her too much
          • you gawking at him/her too often
          • loud noises or sounds
        • If your bunny has been at your home for a while, he/she may become stressed due to:
          • being moved into a new environment
          • property (e.g: food bowl, cage) moved to another location
          • a new object/animal present in your house
          • less attention from you
          • loud noises or sounds
          • loss of a companion
        • A bunny may also become stressed and go into stasis due to other underlying diseases that is causing pain. If you suspect this, bring your bunny to a vet for a checkup.

        3. Consumption of unsuitable food
        • If the food you given is safe according to articles you've read, that particular food may be unsuitable for your bunny. For example, dill isn't suitable for Jippie, although it is generally a safe bunny herb.

        4. Accidental consumption of household objects
        • Sometimes, bunnies chew and consume things that aren't food. Several examples are: wire, remote control buttons and plastic-made objects.

        5. Lack of exercise
        • Bunnies cooped up in cages almost 24/7 are considered to be lacking exercise. Unable to hop about much, the gut will not be efficient.
        • Being locked in a cage for long hours also causes a bunny to become stress.

        Lastly are the signs of recovery. These signs tell you whether or not the treatments suggested worked!


        Signs of Improvement and Recovery
        1. Regaining appetite
        • The bunny starts to eat hay at regular intervals.
        • The bunny shows interest in treats and other foods as usual.

        2. Producing poop
        • Poop produced indicates that the gut is moving - certainly a good sign.
        • Poop produced at first may be: small, abnormally shaped, or a little sticky.
          Continue treatments and observe your bunny. The poop should return to their normal size after a day.

        3. Becoming active
        • The bunny's eyes light up and return to their usual cheekiness glow.
        • The bunny hops around often and goes about with normal bunny activities (eg: grooming, eating hay) as usual.

        I hope that the home treatments suggested above helps your bunny, if he/she is currently in stasis.

        However, if your bunny does not show any sign of recovery after a day (or if you feel the need), a vet-visit is advised.

        Recommended Vets
        Recommended Vets in Malaysia
        Recommended Vets in Singapore
        Recommended Vets (international) 

        First published on 15/10/2011

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