Gastrointestinal hypomotility or GI stasis is diagnosed based on clinical history and the common clinical manifestations including reduced to absent appetite, reduced to absent fecal output, abdominal discomfort, and lethargy. It is ALWAYS SECONDARY to an UNDERLYING CAUSE such as illness, pain, stress, or inappropriate diet that negatively impacts GI motility. 

What is Gastrointestinal Hypomotility Syndrome?

In a healthy small herbivore, the stomach and intestines should always be moving, a function known as peristalsis.  Gastrointestinal stasis occurs when muscular contractions and movement within the stomach and intestines slow down or even stop (called ileus), and normal beneficial bacteria and microorganisms (the microbiome) become imbalanced.  This imbalance is also known as dysbiosis. While this condition is most seen in rabbits, it can also affect guinea pigs, chinchillas, and other herbivores. Various factors contribute to the development of GI stasis, including inappropriate diet (very common), dehydration, stress or other underlying health issues that may lead to anorexia. The lack of GI movement typically results in dehydration of food material in the stomach, causing a partial or completed obstruction as the dry mass of GI contents cannot move from the stomach to the small intestines. This leads to the clinical signs recognized by pet owners. If left untreated, this condition can lead to severe illness and even death. The underlying issue must also be addressed.

What are the symptoms to look for? 

Symptoms of GI hypomotility syndrome can include: 

• Lethargy and decreased activity
• Signs of pain: teeth grinding, hunched posture, hiding more, difficulty getting comfortable, abdominal stretching, and, in some cases, rabbits will press their abdomen to the ground. 
• Reduced appetite: animals will slow down or completely stop eating, some may refuse their favorite treats 
• Changes in feces: some animal’s fecal output will significantly decrease or appear smaller, harder, or absent

How is GI stasis diagnosed? 

This syndrome can be diagnosed by your veterinarian based on a physical exam, history, and presenting clinical signs. Additional diagnostics, such as bloodwork and radiographs, are often necessary to assess the severity and determine the best treatment plan. These are also needed to rule out other medical conditions. Because GI stasis is always secondary to another disease, it is necessary pets receive a full medical workup whenever appropriate.

How is GI stasis treated? 

Treatment will focus on symptomatic care, addressing any underlying causes, and making any needed dietary changes long term. Recovery can vary as some pets show improvement quickly, while others may take several days to over a week to fully recover. In mild cases, outpatient care is warranted and usually sufficient, while more severe cases require hospitalization and more aggressive medical management. 

Treatment options include:

• Fluid therapy: to combat dehydration and electrolyte imbalances and help restore motility
• Pain relief: the management of abdominal pain is essential for comfort and recovery 
• Pro motility medications: drugs used to stimulate peristalsis of the GI tract. Use is controversial.
• Assist feeding: Since pets in stasis often have little to no appetite, syringe feeding a liquid or gruel diet is crucial to support and stimulate the GI tract. It is important to know when to start feeding as many pets die because of force feeding too soon. If the stomach is full of dehydrated contents and there is absent peristalsis it is dangerous to feed too soon and generally a waste to give oral medications.
• Simethicone or infant gas drops: these are only useful when gas is in the stomach which is much less common as gas is usually lower in the GI tract. Use is controversial.

How to prevent or minimize GI stasis? 

Feeding a balanced diet at home is the most effective way to prevent severe GI stasis. A variety of high-quality hay should make up most of your pet’s diet, since hay is high in fiber. This ensures proper digestion and also reduces the risk of dental disease. A high-quality rabbit pellet should be fed in moderation based on your pet’s weight. Over supplementation of non-hay food items can result in fiber deficiency and dysbiosis, even if hay is regularly being offered. The feeding of fruit and carrots should be avoided or only fed as rare treats. We also recommend avoiding most commercial rabbit treats as these are junk food with no nutritional value. Ensuring your rabbit gets enough exercise, has access to a water bowl in addition or instead of a bottle, and is in a good body condition will also go a long way to preventing GI hypomotility syndrome.