Gastrointestinal Hypomotility Syndrome
Gastrointestinal hypomotility — also known as GI stasis — is diagnosed based on clinical history and common signs 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 an 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. GI stasis occurs when muscular contractions within the stomach and intestines slow down or stop (called ileus), and the normal beneficial bacteria and microorganisms that make up the gut microbiome become imbalanced. This imbalance is also known as dysbiosis.
While this condition is most commonly seen in rabbits, it can also affect guinea pigs, chinchillas, and other herbivores. Contributing factors include inappropriate diet (very common), dehydration, stress, and other underlying health issues that may lead to decreased appetite. The lack of GI movement typically causes food material in the stomach to dehydrate, creating a partial or complete obstruction as the dry mass cannot move from the stomach to the small intestines. If left untreated, this condition can lead to severe illness and even death. The underlying cause must always be addressed as part of treatment.
Symptoms
- Lethargy and decreased activity
- Signs of pain — teeth grinding, hunched posture, hiding more than usual, difficulty getting comfortable, abdominal stretching, or pressing the abdomen to the ground
- Reduced appetite — animals may slow down or completely stop eating, and some will refuse their favorite treats
- Changes in feces — fecal output may significantly decrease, appear smaller or harder, or be absent entirely
Diagnosis
GI stasis 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 severity, determine the best treatment plan, and rule out other medical conditions. Because GI stasis is always secondary to another disease, a full medical workup is necessary whenever appropriate.
Treatment
Treatment focuses on symptomatic care, addressing any underlying causes, and making necessary long-term dietary changes. Recovery varies — some pets improve quickly while others may take several days to over a week to fully recover. Mild cases can often be managed with outpatient care, 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 GI motility
- Pain relief: management of abdominal pain is essential for comfort and recovery
- Pro-motility medications: drugs used to stimulate peristalsis of the GI tract — use is considered 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 — many pets die because of force feeding too soon. If the stomach is full of dehydrated contents and peristalsis is absent, feeding too early is dangerous and oral medications given at this stage are generally ineffective
- Simethicone or infant gas drops: only useful when gas is present in the stomach, which is less common since gas is usually lower in the GI tract — use is considered controversial
Prevention
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 the majority of your pet’s diet — hay is high in fiber, ensures proper digestion, and reduces the risk of dental disease. A high-quality 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 when hay is regularly offered.
Fruit and carrots should be avoided or offered only as rare treats. Most commercial rabbit treats should also be avoided as they have no nutritional value. Ensuring your pet gets adequate exercise, has access to a water bowl in addition to or instead of a bottle, and is in good body condition will also go a long way toward preventing GI hypomotility syndrome.
