In this blog post, we have compiled the key takeaways from the session titled “Diagnosis and Treatment of Gastrointestinal Stasis/Obstruction in Rabbits – with Research Assistant Dr. Ebuderda Günay”, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Nutrition Ecosystem. We would like to thank our professor for the presentation.
Gastrointestinal Syndrome in Rabbits: A Silent Start, a Rapidly Growing Clinical Challenge
In exotic animal medicine, there are some diseases that are “very common, yet still not taken seriously enough.” Rabbit gastrointestinal syndrome (GI stasis/obstruction) is exactly such a condition. A quarter of the rabbits brought to clinics arrive with this complaint. Moreover, the problem usually doesn’t begin “all at once”; small factors such as improper feeding, dental problems, stress, and dehydration accumulate—and within 2–3 years, they can turn into a major clinical crisis.
Our speaker explained this syndrome clearly, starting from rabbit anatomy and moving through current treatment approaches. The main message of the talk was: “If a rabbit’s gut stops, everything stops. If you catch it early you can save it; if you are late, the race becomes much harder.”
A Rabbit Is Not a Rodent, but a Lagomorph: Everything Starts Here
To understand GI syndrome in rabbits, the first correct fact is:
A rabbit is not a rodent.
Rabbits belong to the lagomorph group, and their digestion differs significantly from rodents. This is why “rabbit feeds” sold on the same shelves as rodent feeds in pet shops can cause chronic problems. Rabbit digestion is built on: high fiber + intense fermentation.
When this system breaks down, the first thing to collapse rapidly is intestinal motility.
The Cecum Is the Heart of the Digestive System
When you look at a rabbit’s digestive system, the most striking feature is the enormous cecum:
- It makes up 40% of the total digestive system volume
- Fermentation happens here
- Energy comes largely from volatile fatty acids (acetate, butyrate, propionate)
- Vitamin K, B vitamins, and microbial protein synthesis occur here
If the cecal flora becomes disrupted (dysbiosis):
- gas forms,
- toxins increase,
- energy production decreases,
- intestinal sluggishness begins.
In other words, the main groundwork for GI syndrome is established in the cecum.
Rabbits Cannot Vomit: A Small Detail With Huge Clinical Consequences
Because of the strong cardiac sphincter at the stomach entrance, rabbits cannot vomit.
What does this mean?
- Preoperative fasting is often unnecessary.
- But if the stomach–intestinal tract becomes obstructed even once, the contents cannot move back out.
- A bloated stomach rapidly worsens the animal’s condition.
Also, because the stomach pH is very low (1–2):
- most standard probiotics die in the stomach,
- which is why probiotic use in rabbits is controversial.
Cecotrophs: “Normal Mistaken for Diarrhea” and Owner Misinterpretation
Rabbits produce two types of stool:
- Normal pellet feces (hard, like olive pits)
- Cecotrophs (soft, smelly, mucous; stick near the anus and are re-ingested)
Owners often mistake cecotrophs for diarrhea and panic, bringing the rabbit to the clinic. The veterinarian should ask: “Have you seen the hard pellet feces?”
If pellet feces are being produced, the rabbit does not have diarrhea. Most often the issue is diet + obesity + inability to eat cecotrophs.
Explaining this correctly prevents unnecessary antibiotics and stops the cycle of improper feeding.
Diet = The Number One Cause of This Syndrome
Perhaps the clearest message of the seminar was this: 85–90% of a rabbit’s diet must be hay.
The ideal ratio:
- 85% hay (alfalfa / grass hay, etc.)
- 10% leafy greens
- 5% pellet feed
Hay is essential not only for nutrition, but also for:
- wearing down teeth,
- intestinal motility,
- balancing cecal flora.
In diets high in carbohydrates and low in fiber:
- Clostridium species increase,
- toxins and gas are produced,
- digestive pain + appetite loss begin,
- the gut slows and eventually stops.
In practice, GI syndrome is often “the explosion of an animal that has been fed incorrectly for years.”
Risk Factors: Why the Syndrome Has No Single Cause
Rabbit GI syndrome is multifactorial:
- Fiber deficiency / improper diet
- Dental disease
- Stress and environmental changes
- Pain and other systemic diseases
- Dehydration
- Trichobezoar (hairball) accumulation
A critical point: Trichobezoars are not the cause—they are the result.
When gut motility slows, hair clumps together, forms a mass, and causes blockage. Saying “I saw a hairball, so that must be the problem” is incomplete — the true issue is the loss of motility.
GI Stasis or Obstruction? Making the Distinction Saves Lives
There are two main conditions:
- GI Stasis: motility slows/stops but there is no full blockage
- Obstruction: mechanical blockage exists (hairball, foreign body, etc.)
How to distinguish: Palpation + radiography.
On X-ray:
- In stasis, the stomach is dough-like, full, but gas–fluid levels are not clearly defined.
- In obstruction, the stomach becomes extremely enlarged, with clear gas + fluid levels. (The speaker describes this as a “boiled egg appearance.”)
Obstruction location is also classified:
- proximal (stomach exit)
- distal (end of small intestine)
- colon (very rare)
This classification guides treatment decisions.
Clinical Alarm Findings: When Does Prognosis Worsen?
- If body temperature drops below 36.6°C, mortality risk increases.
- Blood glucose above 300–360 mg/dl strongly indicates obstruction.
- Above 444 mg/dl is a critical threshold: prognosis becomes seriously worse.
Important note: High glucose in rabbits does not mean diabetes. Glucose rises sharply during stress and obstruction — it’s a metabolic alarm signal.
Updated Treatment Paradigm: Medical First, Surgery Second
Old approach: “Operate immediately.” New approach (2024–2025 literature): Start with aggressive medical therapy, and only proceed to surgery if there is no response.
Backbone of medical treatment:
- Rehydration: 100 ml/kg/day fluids (SC if needed, mostly IV)
- Pain control: meloxicam, butorphanol
- Gas relief: simethicone
- Force-feeding (to prevent hepatic lipidosis): Critical Care / Oxbow-type formulas
- Prokinetic support: metoclopramide (effect debated but can be used)
- Lidocaine / FLK protocol: lidocaine shown to greatly increase motility
- FLK (fentanyl-lidocaine-ketamine) is strong, but fentanyl access is difficult
- in practice, lidocaine + ketamine + opioid combinations are effective
Medical treatment success rates in many studies: 80–90%.
When Is Surgery Needed? And Why Is It Always Risky?
If after 24–48 hours of medical therapy:
- glucose does not decrease,
- X-rays show no progress,
- clinical improvement does not begin,
then surgery is considered.
But the reality of surgery is clear:
- average survival rate is around 47%
- if postoperative care is poor, this drops even further
That’s why the speaker emphasized this principle: “Advancing the blockage is better than cutting the intestines.” Whenever possible, pushing the mass into the stomach/cecum and emptying it from there is preferred.
Conclusion: Rabbit GI Syndrome Is a Battle of “Feeding + Motility”
This seminar reminded us of the most critical lesson in rabbit medicine: A rabbit’s intestines do not tolerate stopping.
No fiber → flora imbalance → increased gas → pain → motility stops → hairball forms → obstruction occurs.
If caught early, it can largely be resolved with medical treatment. If caught late, even surgery cannot guarantee success.
That’s why the simplest but most life-saving question in a rabbit patient is: “What does it eat, how much water does it drink, and what is its stool like?”
A veterinarian who interprets these answers correctly can stop this syndrome before it even begins.
We will continue sharing key insights from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, held under the sponsorship of the Kito Healthy Nutrition Ecosystem. See you in our next content that will contribute to your clinical practice.
For more information about Kito, you can visit www.kito.pet and follow our social media accounts. To contact us, you can email info@kito.pet.