Rabbit with GI stasis? Now has diarrhea

Question
Dear Dr. Krempels,  I have a 5 year old mixed breed rabbit (maybe some flemish giant?) who lives in the barn in a large run, but often comes inside to play and has an outdoor play pen in summer.  His diet consists of unlimited grass hay, unlimited MannaPro pellet, unlimited water that does not freeze (heated water bottle,) and occasional veggie treats (rarely, if ever any fruit.)  On Sat morning, he did not come out of his house to greet me (but it was below zero here) and I noticed his water consumption was lower than normal.  I coaxed him out, gave him a good look over and everything seemed fine.  I left the carrot peels I had for him and later that evening he had eaten them all, drank some water and seemed fine.  The next morning, again, he did not come out to greet me, but I could find no signs of a problem.  That evening, when I picked him up, I immediately felt that his belly was bloated and he had not eaten all day.  I brought him in the house (of course it is Sunday night) and upon massaging his belly could feel all the gas.  The only thing I had to help him was Mylanta and I eventually gave him some hoping to give him some kind of relief.  I gave him water with a syringe (he is very used to being handled and took it well.)  The next day, I took him to the vet who gave him some fluids and confirmed that there was no blockage.  I offered him a variety of greens and the only thing he would eat was Romaine lettuce, but at least it was something.  No poop now for over 24 hours.  He actually drank quite a bit of water on his own.  Yesterday he would not eat at all and I made a mash of some pellets and Hay Stretcher (essentially pelleted grass hay)and gave him small amounts of that with as much water as possible.  His belly seems more tender when I massage it now.  He has been getting Baby Simethicone liquid suspension regularly.  In the evenings, he likes to cuddle with me and the only place he seems really comfortable is lying in my arms on the couch.  In the cage he seems uncomfortable.  Maybe he likes the warmth of my body, but he sleeps quite soundly with me.  Last night, he ate a few sprigs of mint.  After feeding him some of the mash, he was laying in my arms and I could tell he was having pain because his breathing became shallow and he was grinding his teeth a bit.  Then a bunch of watery diarrhea erupted.  After cleaning everything up, he slept the sleep of the dead in my arms for about 2 hours.  When he woke up, he started licking some of the dried mash that I missed on my shirt.  Since he seemed hungry, I offered him a variety of greens, mostly kale and herbs, but he would not eat.  He would only eat the mash, but did so off of a spoon, I did not need to force him.  This morning, there was some more watery stool under the cage.  I am going to take a sample to my vet to test for parasites, but I am very concerned over the diarrhea.  Is this part of the process?  He has eaten mostly liquefied food for days.  This morning he nibbled on a small piece of kale and ate another mint sprig (his favorite.)  This is in addition to the water and food that I force fed (seems harsh because he really takes it readily, not really forcing.)  My vet opens at 3 and it's likely he will want to give him more fluids sub-q. But should I expect to see diarrhea before he forms stool pellets again?  Or am I right to be alarmed over this?  This morning I double checked to see if I had missed any diarrhea in his cage when I brought him in on Sunday, but I did not see any signs of loose stool or small hard pellets.  Plus his butt was clean when I brought him in.  He has not been back to his regular cage as I felt he doesn't need to battle the cold on top of being sick.  He is used to being in the house (the dog is his best friend) so I hope this is not an added stress.  I have never been through this before, but I am losing hope for my bunny after seeing the diarrhea. I would give anything to see him recover, even if it takes a long time.  Thanks for any advice you can offer.

Answer
Dear Alison,

To get you the best information to get your bunny well in a hurry, I will send you these three articles:

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

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

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

To find a good, rabbit-savvy vet, use the list linked here:

http://www.rabbit.org/vets

But please read those articles above.  They may really help you turn this around.

Dana