The potential risks of diagnosing rabbits with GI stasis

A non-eating or anorexic rabbit, a common exotic animal emergency observed by exotic specialists, is often labeled as gastrointestinal (GI) stasis. However, this term can be very detrimental to the rabbit’s wellbeing.

In an interview with dvm360, Lauren Thielen, DVM, DABVP (Avian Practice), talked about one the main takeaways from her lecture Exotic Animal Emergencies: Where to Start and What to Expect, presented at the Southwest Veterinary Symposium in Fort Worth, Texas. Thielen explained that the term ‘GI stasis’ implies that there is no underlying cause to an anorexic rabbit’s behavior, because GI stasis is assumed to be the condition itself.

Yet, as Thielen explains, a rabbit that is not eating can be caused by a number of underlying health issues—from dental disease, to metabolic problems or liver lobe torsion—and labeling a non-eating rabbit’s condition ‘GI stasis’ can deter the necessary testing needed to find the true cause of this behavior.

Below is a partial transcript:

Lauren Thielen, DVM, DABVP (Avian Practice): So, I think the most common exotic animal emergency that people see is the non-eating rabbit. And you know, I've been doing this for over a decade, and when I first started even working with an exotic specialist, we had this term called GI stasis, which basically meant the rabbit [is] not eating and the rabbit [is] not pooping. And this GI stasis syndrome just happens to rabbits, and it's just something that we just have to be aware of, and we have to just try to fix it when it happens.

And then the more and more I work with rabbits, and the more and more research that we're understanding is that that's a horrible name for what's happening. Yes, the GI tract is… slowing down, and it's not having that peristalsis like it once was, but the main thing I want to teach these… practitioners at this lecture, is that GI stasis is inappropriately named because when you take something and you just name it some kind of syndrome, the syndrome implies that there's not an underlying cause to what's happening.

And so, you know, the anorexic rabbit is one of the most common reasons it presents to the ER, but it doesn't happen just because it's a rabbit. It happens for other causes. …Maybe there's dental disease going on. Maybe there's some kind of metabolic problem, like something wrong with the liver or the kidneys.

Fascinatingly enough, within the past, I mean, definitely decade, but I would say even the past 5 years, us as an exotic animal community, we've been diagnosing these high percentages of liver lobe torsions in rabbits. And so basically what happens is the liver, like one of the lobes—there's many lobes in the rabbit's liver—but one of the lobes, usually the caudate, twists on itself and then, you can imagine what happens if an organ torses in your abdomen— it causes a lot of pain, and sometimes it even bleeds. And so, you know these liver lobe torsions usually require surgery or very aggressive medical management, but it's weird, because sometimes these rabbits look… mostly fine, like you would think an animal that had this, like, big organ damage happened to be like sitting there dying and just really, really sad, but they kind of just look like they're quiet and they're not eating—that's why the mom brought them in—but they're just… not as [visibly] sick as you would think.

And so I think… the plan a lot of vets would have done in the past is like, oh, well we'll just give [the rabbit] some [subcutaneous] fluids, and we'll just feed it some critical care formula via syringe and we'll send it home, and hopefully it gets better. But if you're not doing that blood work, if you're not doing imaging, if you're not doing that diagnostic workup, because you're thinking, this is a syndrome, then you're missing the ball.