Gut motility/gas in stomach

Question
QUESTION: I have a 5 year old German lop who over the last 2 years has become very prone to GI stasis/bloat.  This is now happening on average every 2 months.  Usually he stops eating and becomes subdued and after various trips to the vets my procedure is now to give him fibreplex together with biolapis and recovery powder mixed with baby food until he start to eat again.  I also give him a small dose of metacam.  The last time this happened (about 4 weeks ago) he didn't stop eating straight away which was unusual but he was clearly in pain as he was grinding his teeth and drooling significantly (also new symptoms).  At that time he also took what I can only describe as mini "stomach convulsions" whereby his stomach would almost take a mini jump forward. This had also never happened before.  I took him to the vet and they advised me to follow my usual course of action in addition to them giving him an injection to stimulate his gut.  He was also given zantac which did seem to help significantly.  Following the vet's advice did work but it took longer than usual for him to revert to his usual self.  He is still on zantac.  The vet had him on 0.6 mls 2 or 3 times a day while his stomach was bloated.  They have advised that I keep him on zantac long term and I have been continuing to give him this twice a day.  They have also advised that I reduce this preferably to about 0.25 mls per day.  I have tried to do this but each time I reduce the dose below 0.5 mls he starts to grind his teeth again and his stomach bloats up.  The vets now think he may have small stomach ulcers and I should just keep going with the zantac.  The vets have been very helpful but I am concerned about how to address this issue long term as they haven't suggested doing anything to heal these ulcers or even establish that this is the problem.  I should be so grateful to receive any suggestions that you may have.  Thank you in advance for your help.

ANSWER: Dear Elizabeth,

Please read:

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

Also, while the triggers of GI stasis/ileus are not *always* the same as the things that cause mushy poop, you might find the following information useful.  Your bunny may be suffering from chronic cecal dysbiosis, which--left untreated--can develop into full-blown ileus in some cases.  Cecal dysbiosis is fully explained here:

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

The problem isn't usually dietary, but it could have something to do with his diet, if he's getting the wrong type of food.  Please check that here:

www.bio.miami.edu/hare/diet.html

Possibly the second most common cause of this problem is probably pain/stress from dental disorders, such as molar spurs or dental abscess.  Please read:

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

You will need an experienced rabbit vet to help you, and you can find one via the Vet Referral Listings linked here:

www.rabbit.org/vets

If your bunny is truly getting very gassy and bloated, then I also will ask:  What is the shape and condition of his fecal and his cecal pellets?  Has he ever produced large, abnormally shaped fecal pellets that seem "rubbery" or not as friable as normal pellets? This is associated with poor innervation of the intestine, and can be a congenital problem. It is most often seen in white rabbits with dark markings along the back, but can occur in fully pigmented rabbits, as well.

Since your bunny is 5 years old, though, my prime suspect is molar spurs causing enough chronic pain/stress to elicit that constant GI slowdown that will result in gas and then feeds on itself to make the problem worse and worse.  Have a really experienced rabbit vet check his molars and get them in order.  If they are the trigger of his GI problems, then filing them smooth will help him resolve this problem for good.

Hope this helps.

Dana


---------- FOLLOW-UP ----------

QUESTION: Thank you very much for your advice.  I have been reading the suggested literature over the last couple of days with great interest.  I am unsure about the best course of action.  My bunny shares a hutch with a 5 year old mini lop who eats the same food and hay and she (fingers crossed!) is unaffected by gut motility problems.  They are both fed a good quality hay and vet recommended pellets so I assume that is it not a dietary problem.  They no longer get rabbit treats as my german lop has been neutered and puts on weight very easily.  Neither bunny likes fruit and will refuse it if offered.  Their diet is therefore very plain but of good quality.  The last time my bunny was unwell (which was the first time I heard him grind his teeth and noticed he was drooling significantly) I was actually convinced it was a tooth problem as my mini lop has had to have molar spurs filed down in the past and she had had both drooling and grinding symptoms.  The vet however did check his teeth and said that they were absolutely fine which puzzled me as I was so sure it was his teeth.  I know my vet is not a rabbit specialist but I do feel that she is very competent when checking my bunny. I am however considering asking her for a referral to a rabbit specialist just to have his teeth checked.  You asked me about my bunny's droppings.  Both types seem fine although he does seem to produce too many caecotrophs and sometimes these can be a bit unformed (i.e. not always in a grape-like cluster but a bit squishier).  I asked my vet about this and she advised that this may be caused by too high an intake of food pellets and not enough hay.  His fecal pellets are always the same although when he bloats up he stops producing fecal pellets quite quickly.  I do wonder if you have any opinion on why the zantac doesn't seem to work when used at the recommended long term lower level?  This weekend my bunny has again been quite bad with drooling and tooth grinding (even whilst still on 0.55 ml zantac syrup twice a day).  He is still eating however.  Although zantac does seem to help it doesn't seem to prevent whatever is wrong flaring up even at the 0.55 dose.  The only thing that seems to help is giving him a small dose of metacam together with very gentle tummy rubs and putting a bunny heat pad in with him to get him over it.  I do have to say that I don't like giving my bunny metacam on a regular basis but it seems to be necessary at the moment to stop his tooth grinding.  Any further advice you can offer would be very valued.  Kind Regards.

Answer
Dear Elizabeth,

I agree with you that this really sounds like a dental problem.  The drooling and picky eating are a dead giveaway.  Some rabbits are extremely sensitive, and will have GI problems triggered by even a very small buccal spur (these form on the upper molars and are sometimes very hard to see).

I hope your vet will give you a referral to a really experienced rabbit vet.  I don't know where you are in the UK, but if you really want the very best rabbit dental expert, it might be worth a drive or ride to Harrogate to see Dr. Frances Harcourt-Brown:

http://www.any-uk-vet.co.uk/harcourt-brown/index.htm

I hope this helps.

Dana