by Dr. Scott J. Stahl, Pender Veterinary Clinic, Fairfax, Va. 

      Anorexia, or  loss of appetite, is a commonly seen problem for rabbits in my practice. It is important to remember that anorexia is a clinical sign of many potential diseases in rabbits, but is not a disease itself.  Anorexia can be a very serious condition in rabbits. Like horses, rabbits are grazers because their intestines require constant fuel to keep their organ systems healthy. Several days of not eating can be life-threatening. One of the most common reasons for rabbits to stop eating is "hairballs" or gastrointestinal stasis. I will discuss the clinical signs, diagnosis and treatment of gastrointestinal stasis in this article.

Gastrointestinal Stasis (Hairballs)
      The ingestion of large amounts of shedding hair while grooming can result in a slowing down (stasis) of ingesta through a rabbit's intestinal tract. The hair sometimes can form a hairball and actually blocks the intestine, but more commonly the hair mixes with the food and slows down its passage, causing a sludging of the gastrointestinal contents.
      Rabbits tend to become uncomfortable with the stasis and may stop eating and drinking. This worsens the situation (because of the loss of even more fluid from the intestinal tract) and intestinal movement may stop. Remember, rabbits do not have the ability to vomit so once they eat something it has to move through the entire gastrointestinal system.

Clinical Signs:

• Heavy shed
• Fewer or no stools
• Smaller stools, or with lots of obvious hair present
• Not drinking
• Depression and lethargy. The rabbit often sits hunched up in its litter box.
• Gurgling sounds from the gastrointestinal tract.

Diagnosis:

• Palpating (feeling) gas in the intestinal tract.
• Palpating firm mass in the stomach, but no formed stool in the distal colon.
• X-rays can be helpful, but most of the time rabbits have a distinctly full stomach and a hairball may be hard to view.

      It is often difficult to make a definite diagnosis, so we often try to rule out other diseases, and watch for positive response to therapy.

Treatment:
      The most important part of the treatment is to correct the dehydration and sludging of the gastrointestinal material. This is accomplished by giving intravenous fluid (in the more severe cases) or subcutaneous (under the skin) fluid in combination with oral fluid. Sometimes oral fluid alone (pineapple juice, Pedialyte or Gatorade therapy at home) is enough to get things moving.
      Other forms of treatment include laxatives, such as cat hairball medication (a mineral oil-based paste) to help lubricate the system, and intestinal stimulants, such as metacloprimide, or cisapride, to increase regular intestinal muscle contraction and motility.

Prevention:
      Prevention is always the best medicine in rabbits. The most important factors in preventing gastrointestinal stasis are:

1. Keeping rabbits on a high fiber diet by

• Feeding limited amounts of rabbit chow (about 1/8 of a cup for a 2 to 3 pounds rabbit)
• The rabbit chow should have a crude fiber content in excess of 17%
• Feeding free choice timothy (grass) hay
• Feeding dark green, leafy vegetables

2. Regular removal of shedding hair from the rabbit to prevent ingestion. Any hair not physically removed will probably be ingested when the bunny grooms itself. Shedding hair can also be removed by brushing, plucking or using sticky lint rollers. Some bunnies even tolerate being vacuumed!

3. Using laxatives such as cat hairball medicine several times weekly, or when the rabbit is having a heavy shed. Also, pineapple or papaya juice or papaya enzyme tablets are recommended. These fruits contain an enzyme known as papain that is supposed to digest hair. Their ability to do this in the rabbit's intestinal system is uncertain and controversial, but the fluid may be helpful in loosening up the sludging. The juice should always be fresh or frozen, as the enzyme is not active in canned products. Also juices tend to high in sugar and should be diluted 50:50 with water.

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