Neutering/Spaying - The neutering/spaying of rabbits is of utmost importance. Altered rabbits are healthier and live longer than unaltered rabbits. The risk of reproductive cancers (ovarian, uterine, mammarian) for an unspayed female rabbit is virtually eliminated by spaying your female rabbit. Your neutered male rabbit will live longer as well, given that he won't be tempted to fight with other animals (rabbits, cats, etc.) due to his sexual aggression. Uterine adenocarcinoma is a malignant cancer that can affect female rabbits over two years of age. The best prevention for this disease is to remove the reproductive organs (ovaries and uterus) in a surgical procedure commonly called a spay. The procedure can be performed in females over four months of age. Spaying a rabbit also prevents pregnancy and can help control some aggressive behavior. Male rabbits can also develop disease of the reproductive organs (the testicles) but with much less frequency than females. However, some male rabbits have a tendency to become aggressive in their “adolescent” years (8-18 months of age) and can also start spraying urine outside the toilet area to mark their territory. Surgical removal of the testicles, called castration, can control these behaviors if it is done before the behavior occurs or shortly thereafter.

Loss of Appetite - Rabbits are little eating machines and if you note that your pet has changed his/her eating habits, there is cause for concern. The most common reason a rabbit stops eating is in response to pain somewhere in the body. The rule of thumb regarding the seriousness of the loss of appetite is as follows:
• Loss of appetite but otherwise acting normal should be investigated within 48 hours.
Some rabbits may go through a slow down and then pick up again in a day. The key here is that the rabbit is still active and alert is still be producing stools.
• Loss of appetite accompanied by obvious lethargy or depression should be considered an emergency and should be investigated immediately. This can be a sign of an intestinal obstruction or toxin ingestion. Another important sign is that no stools are being produced.

Diarrhea - True diarrhea, where all the stool being passed is purely liquid, is very rare in the rabbit. More commonly we see a situation where the rabbit has both normal and soft pudding-like stools in the toilet area. This is not diarrhea, but a problem with GI motility usually caused by an inappropriate diet. If you should notice true diarrhea in your pet, you should consider it an emergency situation and consult your veterinarian immediately.

GI Stasis
Rabbits produce two types of pellets: fecal pellets (left in the litterbox) and cecotropes (soft, pungent, normally shaped like a cluster of grapes and reingested by the rabbit to obtain essential nutrients). Liquid or mushy cecotropes are usually caused by an imbalance of the normal bacterial and fungal flora of the cecum (the bunny's intestinal "fermentation vat"). The floral imbalance can be caused by a number of factors, such as the wrong antibiotic (oral penicillins can be deadly to rabbits for this reason!) or a diet too rich in digestible carbohydrates and too low in crude fiber. It also can be caused by a slowing of the normal peristaltic muscular contractions which push food and liquids through the intestines. The slowdown or cessation of peristalsis of the intestine is known as gastrointestinal (GI) stasis or ileus.

What Causes GI Stasis: A rabbit's intestine can become static for a variety of reasons, including (1) stress, (2) dehydration, (3) pain from another underlying disorder or illness (such as gas, molar spurs, bladder problems or infection) (4) an intestinal blockage or, most commonly, (5) insufficient dietary crude fiber (which is why unlimited grass hay is so essential in the rabbit diet). Left untreated, the slowdown or complete cessation of normal intestinal movement (peristalsis) can result in a painful death, in a relatively short period of time. If your rabbit stops eating or producing feces for 12 hours or more, you should consider the condition an EMERGENCY. GET YOUR BUNNY TO A RABBIT-SAVVY VETERINARIAN IMMEDIATELY.

An intestinal slowdown can cause ingested hair and food to lodge anywhere along the GI tract, creating a blockage. Also, because the cecum is not emptying quickly enough, harmful bacteria such as Clostridium spp. (related to the ones that cause botulism and tetanus) can proliferate, their numbers overwhelming those of the normal, beneficial bacteria and fungi in the cecum. Once this overgrowth occurs, gas emitted by the bacteria can cause extreme pain. Some Clostridium species produce deadly exotoxins. It is the liver's job to detoxify these harmful poisons, at a terrible cost to that all-important organ. Often, the ultimate cause of death from GI stasis is damage to the liver.

How Can GI Stasis be detected: Symptoms of GI stasis include very small (or no) fecal pellets, sometimes clinging to the bunny's bottom. In some cases, very small fecal pellets will be encased in clear or yellowish mucus. This indicates a potentially serious problem (enteritis, an inflammation of the intestinal lining) which must be treated as an emergency. With GI stasis, the normal, quiet gurgling of the healthy intestine is replaced either by very loud, violent gurgles (gas blorping around painfully!) or a desolate silence. The bunny may become lethargic, have no appetite and may hunch in a ball, loudly crunching his teeth in pain. Too often, a rabbit suffering from GI stasis is diagnosed as having a "hairball." In reality, an apparent hairball usually is a result of GI stasis--not the cause. A vet who has not palpated many rabbit abdomens may be unfamiliar with the normal, sometimes doughy feel of the healthy rabbit stomach. A doughy stomach is cause for concern only when accompanied by an empty lower GI and symptoms of abdominal discomfort.

Like those of most herbivores, the stomach and intestines of a healthy rabbit are never empty. A rabbit may eat relatively normal amounts of food, almost up to the time the GI shuts down. Because of this, the stomach may retain a large bolus of food when stasis occurs. Unlike the typical cat hairball, which usually consists completely of hair, the mass misdiagnosed as a "hairball" in a rabbit is usually composed mostly of food held together by hair and mucus. Unless it is allowed to dehydrate into an impassable mass, this bolus of ingested material can be slowly broken down with enzyme supplements and plenty of oral fluids. However, treating a mass this way without addressing the problem of GI stasis will generally be unproductive.

If you suspect that your bunny is experiencing GI stasis, you must take him/her to your rabbit-experienced veterinarian without delay. Tell the vet your suspicions. S/he will probably listen for normal intestinal sounds and palpate the bunny's abdomen. The vet also may wish to take radiographs (x-rays) to see whether the various parts of the digestive tract contain normal ingested matter, feces or foreign objects--or are empty and gassy. The appearance of the digestive tract will help the vet determine whether there is an obstruction and, if so, where it is located.

If a true intestinal obstruction (almost always accompanied by severe bloating and acute pain) is present, the use of intestinal motility drugs (described later) could make the situation worse by pushing it into a narrow area where it completely obstructs the intestine, resulting in intestinal rupture. However, if the mass is not causing a complete blockage, it is best to consider medical alternatives to surgery. A gastrotomy--surgical opening of the stomach--may be performed to remove an obstruction, but rabbits who undergo this procedure have an abysmally low survival rate. It is very difficult to get a rabbit's intestines moving normally again post-operatively. Those who survive the surgery itself often succumb a few days later to peritonitis or other complications, even when under the care of the most practiced, skillful rabbit surgeon. Surgery on the rabbit GI tract should be considered only as a last resort.

GI Stasis can be successfully treated if your vet has determined that there is no intestinal obstruction. There are several treatments s/he may wish to use to help your bunny in distress. As always, do not perform any of these procedures or try to administer any of these medicines without the supervision of a veterinarian experienced with rabbit disorders and treatments.

Treatments