Gastric bloat in a rabbit is a true emergency. When a non-pregnant rabbit’s abdomen becomes acutely distended and the rabbit becomes critically weak, the rabbit must be immediately rushed to a veterinarian knowledgeable about rabbit diseases. 

The pain associated with bloat, the build-up of toxins in the bloated stomach, and the internal pressure on other abdominal organs and blood-flow can become a life-threatening event within one to two hours.

This condition is drastically different from gastrointestinal (GI) stasis. In GI stasis, the rabbit’s stomach may be slightly enlarged, but not severely distended and painful. GI stasis generally happens over several days, whereas bloat occurs over several minutes to hours.

What can cause gastric bloat in rabbits?

Rabbits develop a bloated stomach due to a complete “outflow obstruction” (a blockage) from the stomach to the duodenum, the first section of the small intestines. This obstruction generally occurs at the pylorus, which is the small, muscular pathway leading from the stomach into the duodenum.

The most common blockage is an accumulation of hair, mucus, and ingested items (ingesta). Once the outflow of ingesta is blocked, fluid and gas begin to build up in the stomach, causing pain and discomfort. As the fluid continues to build inside the stomach, bacteria cause a build-up of toxins as well.

Foreign body ingestion (e.g., plastic, carpet fiber, bedding, cloth, and cat litter) can also cause a gastric blockage that may lead to gastric bloat. Although rarely seen in rabbits, cancer of the stomach or small intestines may cause an obstruction of the GI tract that causes the stomach to bloat.

How will my veterinarian diagnose gastric bloat ?

Your veterinarian will start by asking you questions about your rabbit's signs and behavior, and then will perform a complete physical examination on your rabbit. They will do tests such as X-rays (radiographs) and bloodwork to evaluate your rabbit's overall health.

Rabbits with gastric bloat have a very bloated abdomen and appear very uncomfortable. They generally are hunched up or lying on their side, and their abdomen is tender when palpated. X-rays of the abdomen are critical to diagnose gastric bloat. Your veterinarian may need to administer a sedative and pain medication before taking the X-rays to keep your rabbit from going into shock. The X-rays will reveal a severely distended stomach with a large amount of fluid filling the entire volume of the stomach and a pocket of gas noted in the center of the fluid.

"Rabbits with gastric bloat have a very bloated abdomen and appear very uncomfortable."

Bloodwork may reveal dehydration and altered kidney values if blood flow to the abdominal organs has been compromised by the severely distended stomach. Blood glucose levels are generally very elevated in rabbits with a true gastric obstruction that leads to gastric bloat.

Rectal temperatures are generally below normal for rabbits with gastric bloat. Normal rectal temperature for a healthy rabbit is 100.4°F-103.8°F (8.0°C-39.9°C). 

How will my veterinarian treat gastric bloat?

Once your veterinarian confirms that your rabbit has GI stasis and determines the underlying reason your rabbit has stopped eating, they will recommend supportive care. Depending on the rabbit’s condition, hospitalization may be recommended.

Therapy for gastric bloat may include any or all of the following:

• IV catheter and IV fluid therapy to correct the dehydration
• Midazolam (a sedative to ease anxiety and stress)
• Analgesics (pain-relieving medication)
• Stomach suction to extract the fluid, gas and, hopefully, the hair-based obstruction
• Gastric surgery may be recommended for the most critical cases, but the outcomes for a complete and successful recovery are fair to poor even in the hands of the most experienced exotic veterinary surgeon
• Motility-modifying medications to enhance movement of ingesta through the stomach and intestinal tract (these medications can only be used once the patient has begun having bowel movements)
• Anti-inflammatory medications to help with stomach pain
• Critical Care or Herbivore Care once the patient is no longer bloated and is willing to be syringe fed

What can I do to keep my rabbit from getting gastric bloat?

The best way to prevent gastric bloat is to feed your rabbit a high-fiber, hay-based diet with supplemental vegetables, a small amount of pellets, and limited amounts of fruit (as fruit is high in carbohydrates). The high fiber in hay stimulates normal intestinal motility. Brushing your rabbit daily to twice a week during shedding season will decrease the amount of hair that the rabbit can ingest when it grooms itself.

Allow your rabbit lots of supervised out-of-cage time to encourage physical exercise that promotes normal gut motility. Prevent your rabbit from chewing on rugs, towels, or other materials that may cause a true, life-threatening physical obstruction in your rabbit's GI tract. Never allow your rabbit access to cat litter.

Finally, watch your rabbit carefully at home for signs such as decreased appetite, reduced stool formation, or any other abnormal behaviors and have them checked immediately by your veterinarian if any of these signs occur. A rabbit that is not eating can progress rapidly from just feeling poorly to developing a life-threatening illness in a matter of hours.