How do I diagnose and treat GI stasis in a rabbit that has stopped eating?

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Rabbit gastrointestinal (GI) stasis is a clinical syndrome requiring urgent intervention — hypothermia at presentation (rectal temperature ≤ 36.6°C 97.9°F) is the single strongest negative prognostic indicator, associated with a 5-fold increased risk of death or euthanasia. 2 --- Diagnosis begins with ruling out obstruction before treating for stasis. The most common presenting complaints are hyporexia or anorexia, lethargy, and decreased fecal output — a nonspecific triad that also characterizes GI obstruction, appendicitis, and liver lobe torsion. 79 A diagnosis of nonspecific system involvement is made in more than 30% of rabbit GI presentations, reflecting the breadth of the differential. 7 GI stasis without overt obstruction is confirmed by abdominal radiography or ultrasonography; ultrasonography has limited utility in rabbits with GI stasis due to interference from excessive cecal and intestinal gas. 26 The key radiographic distinction between stasis and obstruction is critical before initiating promotility therapy. In obstruction, the stomach is distended with fluid/homogenous soft tissue opacity and a dorsal gas cap; mean blood glucose of 444 mg/dL (24.7 mmol/L) has been associated with GI obstruction in rabbits with anorexia. 3 Serial abdominal radiographs can be used to assess response to medical therapy — a reduction in gastric size with appearance of new small intestinal gas dilation, followed by cecal gas dilation, is suggestive of aboral passage of an obstruction. 12 --- Stabilization takes priority over diagnostics in the decompensated rabbit. Dehydration is frequently masked in rabbits because water is absorbed from the GI tract into the vascular space, preventing the expected rise in packed cell volume. 1 Decreased food intake rapidly precipitates hepatic lipidosis, which further suppresses appetite and accelerates the downward spiral. 1 Active warming is required for any hypothermic rabbit. 12 Medical management of GI stasis centers on IV crystall