very good info on gut stasis and other digestive issues

~cut and pasted from a web bunny group I belong to~

Often when a rabbit has a gastrointestinal (GI) disorder, the owner will immediately assume "stasis," or what is more properly called gastrointestinal hypomotility. I believe this is because for the past 10-15 years or so there has been a lot of emphasis on GI hypomotility by many rabbit organizations and others in the rabbit community.

However, there are many other intestinal disorders as well, some with similar symptoms, and it is critical that the rabbit caretaker learn to distinguish among them. In the Special Care book I did with Kathy Smith, we included a chart on pages 86 and 87 in order to make it easier for rabbit caretakers to compare signs/symptoms of the various digestive ailments. But for those who do not have the book, here is a summary of some different gastrointestinal disorders:

Acute bloat. If a rabbit owner does not learn to recognize the signs of any other rabbit GI problem, they need to learn this one because untreated the rabbit will most probably die within 12-24 hours. Signs: ABRUPT cessation of fecal pellets (rabbit will produce NO fecal pellets), tight, bloated abdomen that feels like a drum ( or a doughy one if there has been a rupture), refusal to eat and drink, signs of extreme pain (sits hunched in corner, grinds teeth), low body temperature (below 99 F), rapid heart rate and respiration. There is a RAPID ONSET – rabbit may have been absolutely fine minutes or hours ago and then suddenly near collapse. If you see these signs you must act very fast to save your rabbit – get the rabbit to a vet immediately. In acute bloat, as opposed to hypomotility (stasis), gas and liquids can often be seen in radiographs distending the stomach and upper small intestine (in hypomotility the gas pattern is often in pockets throughout the gut). In acute bloat, the pressure of the gas will press on organs, causing extreme pain, and the stomach may actually rupture. .

Although very rarely acute bloat may occur for no apparent reason or after eating an excessive amount of spoiled vegetables, most often acute bloat is the result of a functional or complete blockage of the pylorus or intestine. The rabbit may consume an item such as a dried pea or bean without chewing, which obstructs the pylorus, or the rabbit may consume too lignified fiber, such as wood, which can cause a functional blockage. Tumors, abscesses, and a twisted intestine (more common in older rabbits or those suffering from mobility problems) can also create blockages. If the blockage is a total blockage, the rabbit's only hope is IMMEDIATE surgical intervention by a skilled vet. If the blockage is functional, the rabbit can sometimes be saved by providing supportive care (fluids, reglan, antibiotics, simethicone, critical care, olive oil in pumpkin or other food that can be syringed, warming the rabbit if temp is low, pain medication, etc.)

Severe GI hypomotility. Signs of severe hypomotility may progress to those of acute bloat if the condition is not treated in its earlier stages and the GI tract becomes impacted with time, creating a functional obstruction. A difference from the signs of acute bloat is that in most cases, fecal pellets will have been decreasing in size and amount over time and then cease altogether. Appetite may have been decreasing slowly and will suddenly become very depressed. Signs of pain may have been apparent before but will suddenly increase. Body temperature may be below normal. Treatment is usually as for the functional blockage described under acute bloat.

Non-obstructive GI hypomotility. Fecal pellets gradually decrease in size and number. Rabbit eats and drinks, but not as much as before, and may be less active than before (or in some cases may drink more than before). Abdomen may become slightly distended, increasing as time passes, but painful gas tens to accumulate in pockets, rather than throughout the entire gut. Body temperature may be normal or below normal. These are the early stages of GI hypomotility (commonly called stasis). The condition needs to be treated before it progresses to the more dangerous stage listed above. It may help to encourage exercise and hay consumption (or give foods such as Critical Care if the rabbit refuses to eat on his own), along with olive oil in a food such as canned pumpkin. Some vets may prescribe reglan and antibiotics. Gently warm rabbit if body temp is low. Questran may help also, but since it absorbs water, should not be given unless additional fluids are given as well.

Impacted cecum. A rabbit with an impacted cecum will often look lopsided as the impacted cecum swells out from only one side of the body. In some cases the owner will see no hard feces, but will notice mucous without diarrhea. Cecal impaction may be caused by stress and pain, consumption of an item such as clumping cat litter, or consumption of too much long fiber. Fluids are critical in the treatment of an impacted cecum. Some vets may prescribe a motility drug and/or antibiotics. Probiotics may also help restore the balance of the cecal microflora. 

Intestinal dysbiosis. The term "dysbiosis" means an imbalance, and this condition is caused by an imbalance of the "good" and "bad" microflora in the rabbit gut. Signs may include watery diarrhea, mucoid diarrhea, pain, lethargy, low body temperature, and chock. It may cause GI hypomotility or be a result of GI hypomotility, or be brought on by a course of antibiotics, a bad diet, stress, or other factors. Care will often include fluids, antibiotics, probiotics, motility drugs, and/or pain medication. See a veterinarian, with intestinal dysbiosis, like acute bloat, it is IMPERATIVE to get veterinary care immediately to save the rabbit.

"Poopy Butt." This condition is NOT true diarrhea, but very soft feces that become squished on the rabbits' perineal (genital-anal) area. As I noted in a previous post, this can occur either from soft fecal pellets or unconsumed cecotrophs. If it is a result of soft fecal pellets, the cause may be too much of a fresh food, especially a green, the rabbit is sensitive to, or a bad diet including too high a proportion of simple carbs such as sugar. If caused by cecotrophs, the reason may be age or infirmity if the rabbit is unable to reach the cecotrophs to consume them, or it may occur if the rabbit receives a concentrate food such as pellets and does not need to consume all cecotrophs. A hay-only diet may cause the symptoms to leave, but a hay-only diet is not nutritionally adequate over the long term and will lead to many other problems, possibly including an impacted cecum.

Lucile Moore, PhD
The previous information was compiled from various veterinary books, scientific journal articles, and personal correspondence with veterinarians experienced in rabbit medicine. However, symptoms can vary depending upon the age and health of the rabbit. Always consult a veterinarian if your rabbit is ill. 
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