Motility Disorders - Some essential facts

• A rabbit not eating will develop hypomotility

• Reduced gut movements will cause anorexia

• Gastric stasis causes dehydration and impaction of the normal contents

• Dehydration of gut contents decreases gut activity

• Ileus is painful, causing the rabbit to appear hunched and grind its teeth

• Faecal output is low or stops

• Ileus can be either obstructive or non-obstructive – it’s essential you identify the clinical signs and differentiate between the two.

- Obstructive ileus happens quickly, with the animal becoming dehydrated and critical within hours. On x-ray you may find fluid and gas cranial to the obstruction.

- Non-obstructive ileus starts and progresses slowly over a few days. There is a slow reduction in faecal size and output. As symptoms progress, the entire gastrointestinal tract fills with gas, which is clearly visible on x-ray.

Some of the commonest triggers for the motility disorder are:

1. Lack of fibre – we have a great article on the importance to fibre . So often pet owners get diet completely wrong, and are tempted to feed concentrated treats and the dreaded muesli, forgetting all about fibre. Remember, grass and hay is essential.

2. Failure to eat –badly worn and overgrown teeth or illness will make the rabbit unwilling or unable to eat. This will inevitably trigger stasis.

3. Dehydration – check they are actually drinking. Gut stasis itself will cause dehydration

4. Stress, of which some of the more common one include:

• Predators – cats and dogs in particular

• Dominant rabbits – whilst rabbits are social animals and like to be together, it can sometimes be a problem if one of the rabbits is over dominant, causing stress to the others;

• Introducing a new pet rabbit into the social group

• Changes in diet – always recommend good quality fresh hay. It helps to ask the, owner what foods they are feeding and ask them to bring some in for the rabbit when staying in the clinic

• Transport – be aware that visits to the surgery can sometimes put the rabbit under additional stress

5. Pain – many conditions will cause pain, including dental problems, abscesses, skin conditions and uveitis. Don’t forget to use post-op analgesia.

6. Post-surgical adhesions – be ever so careful when handling internal organs during a routine rabbit spay. Inappropriate handling can sometimes cause adhesions, resulting in pain.

7. Foreign bodies – always look out for these, as they need to be dealt with urgently. Check the common sites – pylorus, proximal duodenum and ileo-caecocolic region. Common foreign bodies include dried food and hair, carpet, rubber and plastic. Not all are visible on x-ray.

Treatment of non-obstructive ileus

A typical treatment plan would include the following;

• If possible hospitalise the rabbit away from cats and dogs as predator sounds may contribute to the problem

• Fluid therapy – aim to restore and then maintain the fluid balance with intravenous fluids. A typical fluid rate would be 100mls/kg/day.

• Analgesia – buprenorphine, butorphanol and meloxicam are frequently used.

• Motility regulators such as metoclopramide, cisapride and cimetidine

• Intensive care feeding to provide calories and fibre – commercially available high fibre herbivore recovery diets, Always offer hay.

• Exercise will stimulate GI motility, so always encourage the nursing team to allow the rabbit some free time to move about

Treatment of obstructive ileus

• This is a true surgical emergency

• Stabilise the patient first

• Good surgical technique is required. Use the appropriate suture materials and handle the gut as little as possible to reduce the chance of adhesions

• Post-surgical adhesions can be reduced by using verapamil

Don’t forget;

• Post op-pain relief

• Fluids

• Nutritional support- a proactive nursing team will work wonders

This article is just the tip of the iceberg when it comes to discussing gut stasis in rabbits. Our Burgess vet Club team will bring you more in future publications. Don’t forget to tell your colleagues about our clinical updates.