Urgent Severe bunny constipation

Question

Angel House Rabbit soc   Hi Dana.  I am sending you an xray so I can get your opinion.  I am a volunteer with the NMHRS and have asked you questions before and have complete faith in your answers and knowledge.  This bunny is from a local sanctuary.  I took it in because it was not well.  It is all skin and bones.  Her belly felt solid as a rock though and was quite enlarged.  My local vet took xrays and said she was severely constipated so much so that he thought it could take months to get her all cleared out.  She had a huge clump of poop stuck to her bottom that was preventing her from pooping on her own but once we got her cleaned up she is pooping on her own. I have had to give her more butt baths though to keep her clean from poopy butt.  They are not very large poops but they are plentiful.  We started her out on a liquid diet only including Critical Care and Angels mush.  We have added greens.  My concern was he did not want her to have hay because he said it would only pack in more dry matter and add to the waste already backed up in her.  Wouldn't the hay help though with all its fiber?  I have NEVER heard of not feeding hay to a bunny under ANY circumstance.  Let me know what you think after viewing the xray.  I am giving her hay (I'm a terrible patient) but she refuses to eat it anyway.  I have tried timothy, alfalfa and Oat and she just wont eat it.  But she does eat her critical care and mush all on her own and not by syringe.  Any tips thoughts or ideas would be helpful.  The sanctuary was not a good place for her and she has scars from other rabbits bites I believe.  That could be why she was so malnourished and has strange eating habits. Let me know if you have trouble viewing the xray. Thank you

Answer
Hi, Victoria

Sorry for the delay.  My house got struck by lightning just when I came back on as an "expert" and I didn't even realize I had questions pending.  (Fortunately, bunnies all okay.)

That is the worst impacted GI tract I've ever seen.  Not sure I disagree with the vets about the hay in this case.  I think it's more important to *hydrate the heck* out of her.  Oral liquids.  ENEMA.  SubQ fluids.  I suspect she got this way from having insufficient liquids available, and it may, indeed, take weeks to hydrate everything so it breaks up and starts to move through.  Hay will complicate things.

I would give her VERY wet Critical Care, but concentrate on hydration.  If you don't know how to do an enema, there are instructions here:

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

Enemas can work *wonders* to hydrate the lower GI, and if you do it once a day, things will start to move.  The enema actually appears to stimulate GI motility.

I hope this helps.  Bless you for taking care of this poor little bunny.

Please let me know how it goes, if you have time.  And if you have further questions, please write directly to me at dana@miami.edu as I've had to put myself on break from AllExperts for the moment.

Hope all goes well.

Dana