preventing recurring stasis - bunny currently healthy

Question
Hello Dr. Krempels, In 20 years of rabbit adopting, I've never seen this.  Our 3 y.o. girl has been in the ICU for stasis 3 times in 6 months.  Every time, the xrays show huge gas bubbles distending her stomach.  IV electrolytes + baytril, and oral cisapride + reglan bring her back to life, but we need to find a way to prevent this trauma!  Her diet - timothy hay, bunny basics T, cilantro, italian parsley - is consistent and both she and her partner are big eaters usually.  BTW, her companion's GI system is as normal as can be.  

We did blood work and urinalysis but our vet (house rabbit approved Louis Schwartz in Los Angeles) didn't find anything unusual.  Dr. Schwartz' online vet network suggested that she might have some type of infection, so she's in the miidle of a course of oral baytril now.

One thing we notice is that she produces a lot of cecotropes and doesn't eat them all, also her usual feces are usually small.  For a week after returning from the hospital, her poops are gorgeous textbook size and texture, but eventually they go back to the small size.  We wondered if she might have some nutrient deficiency that causes the sub-optimal poops and cecotropes, or maybe some bacteria imbalance in her gut.  We wonder if these poops/cecotropes could be related to the gas that appears to cause her statis.  Can you think of a way to test for this or can you recommend any supplements (yogurt??)?

 The research we've done indicates yarrow, nettles, prozyme powder, papaya, pineapple and  caraway are recommended to alleviate gas in rabbits.  Do you have an opinion on any of these?  

Thank you so much for everything you do for our beloved rabbit childern!!!

Susan

Answer
Dear Susan,

A bunny with chronic ileus is usually suffering from some source of pain or stress.  Dental problems are probably the most common cryptic trigger of ileus:

http://www.bio.miami.edu/hare/dental.html

Some rabbits are so sensitive to even small spurs that they spiral into ileus at the least little poke.  So I'd definitely ask the vet to check for spurs and file them smooth if there are any at all.  The upper arcade buccal spurs can be especially troubling, as they are sometimes hard to see and even harder to clip and file.  

When she does have an episode, there is no faster way to get her GI moving than with a careful enema, delivered with a pediatric ear syringe.  Just a bit of lukewarm water, lubricated tip, and about 30-35 cc into the rectum.  Don't insert the tip more than about 1/4-1/2 inch, and never force anything.  NO FRENCH CATHETERS!!  A shallow-delivery is safest and best, and you can control it better to allow the water to take the path of least resistant, thereby avoiding problems.

You can find more instructions for treating ileus here:

http://www.bio.miami.edu/hare/ileus.html

but I've seriously found that I need nothing more than enema any more.  It is nothing short of miraculous:  a couple of minutes after administration, the GI is bubbling away, and the poops come out nice and hydrated.

I hope this helps.

Dana