What is GI Stasis?

Gastrointestinal stasis (also called ileus) is when a rabbit's digestive system slows down or stops completely. This is the #1 killer of pet rabbits and can progress from subtle symptoms to death within 24-48 hours if left untreated.

The rabbit's digestive system is designed for near-constant food intake. When it stops, gas builds up, causing excruciating pain. The pain causes the rabbit to stop eating, which worsens the stasis. This creates a deadly cycle that requires immediate intervention.

Rabbit health care

Recognizing the Signs

Early Warning Signs (Act NOW):

  • No fecal pellets for 6-12 hours
  • Small, dry, or misshapen poops
  • Reduced appetite or picky eating
  • Less active than normal
  • Hunched posture
  • Teeth grinding (sign of pain)

Critical Emergency Signs (VET IMMEDIATELY):

  • No eating for 12+ hours
  • No poops for 12+ hours
  • Bloated, hard abdomen
  • Severe lethargy or lying flat
  • Cold ears/extremities
  • Labored breathing
  • Unresponsive or unable to stand

The Triple Threat Protocol

This evidence-based protocol uses three medications working synergistically to break the stasis cycle. Many rabbit-savvy vets use this approach for home treatment of mild-to-moderate cases, always with veterinary guidance.

1. Meloxicam (Pain Management) 💊

Why it's critical: Pain causes rabbits to stop eating. No medication works if the rabbit is in pain. Meloxicam is an NSAID that reduces inflammation and pain in the GI tract.

Dosage: 0.3-0.5 mg/kg every 12-24 hours

  • For a 2kg (4.4 lb) rabbit: 0.6-1.0 mg per dose
  • Using 1.5mg/ml suspension: 0.4-0.67 ml per dose

Administration: Give orally with syringe. Can be given with or without food (though your rabbit likely isn't eating). Start this FIRST before gut motility drugs.

Duration: Continue for 3-5 days even after symptoms resolve.

2. Metoclopramide (Gut Motility Stimulant) 💚

Why it works: Metoclopramide (Reglan) stimulates smooth muscle contractions in the upper GI tract, helping move gas and food through the system.

Dosage: 0.5-1.0 mg/kg every 6-8 hours

  • For a 2kg rabbit: 1.0-2.0 mg per dose
  • Using 1mg/ml solution: 1.0-2.0 ml per dose

Administration: Give orally 15-30 minutes AFTER pain medication. Never give on an empty stomach without pain control first.

Important: Do NOT use if you suspect a complete blockage (foreign object obstruction). Can cause intestinal rupture if there's a physical blockage.

3. Cisapride (Powerful Gut Motility Drug) 🚀

The game-changer: Cisapride is often considered the "gold standard" for rabbit GI stasis. It's more powerful than Metoclopramide and works throughout the entire GI tract.

Dosage: 0.5 mg/kg every 8-12 hours

  • For a 2kg rabbit: 1.0 mg per dose
  • Typically requires compounding pharmacy

Why it's hard to get: Cisapride was withdrawn from human use due to cardiac side effects. However, it remains safe and highly effective for rabbits. You'll need a vet prescription and a compounding pharmacy.

Pro tip: Keep compounded Cisapride on hand if you're a rabbit owner. It has a shelf life of 60-90 days refrigerated. Having it available can save your rabbit's life at 2 AM when vets are closed.

Complete Treatment Protocol Timeline

⏰
Hour 0 - IMMEDIATELY

1. Remove all pellets (hay only available)
2. Give Meloxicam (pain medication)
3. Call your exotic vet for guidance

⏰
Hour 0.5 (30 minutes later)

1. Give Metoclopramide or Cisapride
2. Start gentle belly massage (circular motions, 5-10 minutes)
3. Offer favorite fresh herbs (cilantro, parsley)

⏰
Hour 1-2

1. Encourage movement (gentle exercise)
2. Offer water via syringe if not drinking
3. Monitor for poops (photograph any changes)

⏰
Hour 4-6

1. Repeat motility medication
2. If no improvement, begin assisted feeding (Critical Care)
3. Continue monitoring temperature and behavior

⏰
Hour 8-12

1. Repeat all medications on schedule
2. If NO poops by 12 hours → EMERGENCY VET
3. If improving (small poops, nibbling hay) → Continue protocol

Supportive Care Essentials

Hydration

Dehydration worsens stasis. If your rabbit isn't drinking, give water via syringe every 2-3 hours. Offer 10-20 ml at a time, slowly. You can also give subcutaneous fluids if trained by your vet.

Critical Care (Assisted Feeding)

After 6-8 hours without eating, begin syringe-feeding Oxbow Critical Care. Start with 10-15 ml every 3-4 hours and gradually increase to 50-60 ml per feeding as gut function returns. Mix to a smooth, pudding-like consistency.

Simethicone for Gas

Infant gas drops (simethicone) can help break up gas bubbles. Give 1-2 ml every 3-4 hours. This is safe and can provide significant relief while waiting for gut motility to return.

Warmth

Rabbits in stasis often can't regulate body temperature. Provide a heating pad (on LOW, wrapped in towels) or warm water bottle. Keep ambient temperature around 70-75°F.

When to Go to Emergency Vet

Go immediately if:

  • No poops for 12+ hours despite treatment
  • Abdomen is very bloated/hard
  • Labored breathing or mouth breathing
  • Body temperature below 100°F (normal: 101-103°F)
  • Complete lack of response to medications
  • Seizures or inability to stand
  • Blue-tinged gums or ears

Prevention is Everything

The best treatment for GI stasis is never getting it. Here's how to minimize risk:

  • Unlimited hay: 80-90% of diet should be grass hay
  • Limited pellets: 1/4 cup per 5 lbs body weight daily
  • Daily greens: 2 cups mixed greens per 5 lbs body weight
  • Fresh water: Change daily, provide multiple sources
  • Exercise: Minimum 3-4 hours daily out of cage
  • Stress reduction: Minimize changes, loud noises, other pets
  • Regular vet checks: Every 6 months for early detection

Medications to Keep On Hand

Smart rabbit owners maintain an emergency GI stasis kit:

  • Meloxicam (0.5 or 1.5 mg/ml suspension) - Get from vet
  • Cisapride (compounded) - Requires prescription
  • Metoclopramide - Prescription or vet-dispensed
  • Simethicone drops (infant gas drops) - Over-the-counter
  • Oxbow Critical Care - Pet store or online
  • 1ml feeding syringes - Pet store or online
  • Pediatric electrolyte solution - Pharmacy

💡 Pro Tip: Ask your vet to prescribe "just in case" medications before you need them. Having Meloxicam and Cisapride on hand can literally save your rabbit's life on a weekend or holiday when vets are unavailable.