What can cause RGIS?

​​RGIS is a syndrome that occurs secondary to your rabbit not ​feeling well. This means that any factor or condition that is ​causing your rabbit to feel unwell, stressed, scared, upset (or ​a combination of above) can subsequently trigger a RGIS ​event. Inappropriate diet can also contribute to RGIS, as this ​can demote gut motility and create adverse health risks. Such ​examples include:

• Sources of stress (changes to their environment, ​presence of predator animals like cats and dogs, loud ​noises)
  
• Sources of pain (dental disease, arthritis, intestinal ​blockage, ear infections, injury)
  
• Underlying disease (cancer, uterine cancer/disease, ​bladder sludge, kidney disease, obesity, etc.)
  
• Feeding excessive quantities of high sugar foods like ​carrots, apples, banana
  
• Insufficient fibre content
  
• High carbohydrate foods such as ‘cereal mix’ pellets
  
• Combination of the above
  

How is RGIS treated?

First, the primary aim is to stabilise the rabbit. This involves administering pain relief, and correcting dehydration. It is also a good idea to do a blood test, to obtain baseline health values and check blood sugar and dehydration levels.

Once the rabbit is more stable, treatment may involve sedation to take X-rays of the abdomen. This gives us more information as to what may be going on in the gastrointestinal system, as well as making sure there is no intestinal blockage.

If a blockage is suspected, this may be relieved with aggressive medical therapy or emergency surgery. Once a blockage has been ruled out, the rabbit will require supportive care including prokinetic medication (medication to promote gut movement) and syringe feeding every 2-4 hours. It may take hours or even days to get a rabbit eating and pooping normally again.

What happens next?

Once a rabbit recovers from a RGIS event, it is recommended to ​investigate what caused the event in the first place. In order to ​do this, some or all of the following tests may be ​recommended:

Full blood tests

• This checks general organ function and looks at how the ​immune system is performing
  

Urine tests

• This looks at kidney function, as well as checks for ​underlying bladder or uterine issues
  

Sedation for oral examination and imaging

• This provides information as to the rabbit’s oral and dental ​health. While the mouth can be examined consciously with ​an otoscope, this examination is usually limited due to the ​rabbit’s tongue and chewing movements – sedation allows ​for thorough examination without patient interference.
  
• Imaging via X-rays or CT scanning is the best way to look ​for any signs of retrograde (backwards) growth of the teeth ​and signs of dental abscesses.
  
• X-rays may reveal signs of arthritis, abnormal growths, heart ​disease, or bladder sludge.
  
• CT scanning is the most optimal diagnostic tool for rabbits. ​It enables us to check the whole rabbit (including internal ​organ systems) for any abnormality, and only requires ​sedation for a very short period of time.
  

How can we prevent RGIS?

As RGIS can be a potentially life-threatening event, it is important ​to try to prevent it from occurring. While not always possible to ​eliminate such triggers, we can minimise and manage them, for ​example:

• Minimise stress, and be prepared when it comes to stressful ​events for your rabbit.
  
• Feeding your rabbit an appropriate diet.
  
• Seeking veterinary advice as soon as possible if you notice ​any changes or concerns with your rabbit.
  

If your rabbit has a history of RGIS, it is important to investigate ​the cause - this will provide your rabbit the best chance of ​preventing it in the future.