The Myths About "Hairballs"

A common killer of domestic rabbits

One of the most preventable of health problems in your rabbitry is the occurrence of impacted digestive tracks common to domesticated rabbits. Like cats, rabbits are meticulous groomers; a habit that subjects them to ingesting large amounts of hair into their digestive system particularly during times of molting. Unlike cats, rabbits are not capable of vomiting. All the hair ingested by the rabbit must pass through the length of the gastrointestinal track (GIT). If the rabbit is suffering from an impaired digestive system due to improper diet this hair can collect in the stomach and effectually block elimination, a condition that can lead to certain death.

As apposed to common belief, the hairball is not the primarily problem but is only the symptom of a much more critical underlying problem involving the diet the rabbit is being fed. This condition is well explained in an article posted on the House Rabbit Society web site entitled Sluggish Motility in the Gastrointestinal Track written by Susan Brown, DVM.

In her article Dr. Susan Brown states her frustration over the perpetuation of the myths about "hairballs". She would prefer that people stop using the term "hairballs" and replace it with "stomach/cecal impaction due to reduced GIT motility". She states that it is important to understand that impaction is not a cause of disease but rather is the result of underlying GIT problems that are 99% preventable with an appropriate diet.

Dr Brown emphasizes the importance of supplying sufficient quantities of fiber in your rabbit’s diet. The higher the percentages of fiber in the diet the faster will the contents of food and hair flow through the digestive track. When fiber is low or nonexistent in the rabbits diet the passage of food and hair will slow down and becomes sluggish affecting how quickly the stomach empties. When this condition becomes more severe the rabbit will slow or stop eating and drinking probably because the feeling of fullness in the stomach decreases the stimulation or desire to eat. The lack of food and water entering into the digestive system further slows down the process and causes the contents in the stomach and intestinal track to become further compacted and dehydration of the contents begins. The hair the rabbit has ingested during normal grooming is mixed in with the food particles and the liquid contents of the stomach. Once the rabbit has completely stop eating and drinking this mass will dehydrate. The larger particles in the stomach are left behind which includes the hair that gradually becomes a solid mass completely blocking any further movement of food through the digestive system. The stools from the rabbit will become smaller in size and fewer in number until eventually they will stop all together. Without treatment to relive the problem the rabbit will loose weight and become less active and will eventually die a slow death of starvation and dehydration.

In her article Susan Brown discusses how proper quantities of leafy greens and timothy in the diet will prevent the occurrence of hair balls and the critical condition she calls Sluggish Motility in the Gastrointestinal Track, (GIT). Dr. Brown suggests that the condition call Hair Balls is in reality a symptom brought on by the lack of proper amounts of fiber in the animals diet which results in GIT disease.

This is not to suggest that proper grooming and brushing of the animal to remove excess amounts of loose hair from the body of the rabbit is not important. What is evident in Dr. Brown’s article is that the condition called hair balls is an opportunistic health problem that is aggravated by a sluggish movement of food and digested hair through the gastrointestinal track. Wild rabbits live active lives eating a diet rich in fiber and greens which greatly reduces any chance of developing GIT disease. Domestic caged rabbits live in a totally artificial sedentary environment where access to a normal high fiber diet is often absent. Restrictions placed on domestic rabbits that inhibit what would normally be a highly active life style in the wild further impedes the normal digestive process. Diet and life style then become the root cause of GIT disease or what is often misnamed as "hair balls".

Signs of trouble:

Gastrointestinal track disease usually has a rabid onset and if left untreated will quickly progress in severity. Unless Treatment is begun in the early stages the rabbit’s health can become so seriously impaired that chances for survival will fade. Listed below are obvious warning symptoms in the normal order of occurrence that are indicative of gastrointestinal problems.

Stools strung together resembling a string of pearls. A rabbit that is ingesting an excessive amount of hair will produce stools that hang together on strands of hair that have the appearance similar to that of a string of pearls, often hanging down below the bottom of the cage floor. This condition is often the first indication that a problem exists. Grooming and brushing the rabbit to remove loose hair will help to eliminate this obvious problem but diet also needs to be addressed. It is important to keep in mind that hair contributes to the problem but is not the root cause of gastrointestinal blockage. Even wild rabbits are meticulous groomers with little evidence of gastrointestinal problems.

A sudden change in eating habits. There has been a noticeable decline in the rabbit’s normal food intake over a relatively short time. There may also be a decline in normal water intake. As the condition worsens drinking and eating may stop together. Unless the rabbit shows signs of some other abnormality, GIT disease should be suspected and treatment begun immediately with the offering of large amounts of leafy greens and access to unlimited amounts of grass hay. Food pellets can be removed as the rabbit will probably not be interested in eating them.

Refusal to eat. The rabbit may show an increased interest in chewing at the wood surfaces in the cage or chewing paper materials on the bottom of the cage. These can be indications that the rabbit is craving a source of fiber. When this activity is combined with a refusal to eat their normal food an underlying reason needs to be investigated. GIT diseases should always be suspected. Refusal to eat can be indicative of a blocked digestive system and is cause for alarm. If treatment has not already begun, now is the time to begin offering large amounts of leafy greens and access to unlimited amounts of grass hay.

A decrease in the size and number of stools. A decrease in the size of the stools combined with a decrease in the number of stools that would be expected from an otherwise healthy rabbit indicates a possible gastrointestinal blockage. This symptom appears later in the development of the disease and will usually follow the cessation of eating and drinking. A decrease in stool production should always be a cause for alarm. If this symptom does not reverse within a period of two or three days of offering greens and hay or should other more severe symptoms arise the services of a veterinarian should be obtained without delay.

Lethargic behavior. The rabbit may appear listless and may crowd into a corner of the cage while demonstrating little interest to outside stimulus. This behavior will often appear in the later stages of GIT disease and should again be a serious cause for alarm. At this point the condition of the rabbit is in serious decline and without immediate intervention by a veterinarian survival will be in doubt.

A continuing weight loss. Because the rabbit will have stopped eating weight loss will be rapid as starvation will have set in. Dehydration will also be in strong evidence. The longer the rabbit goes without eating, the more dehydrated and impacted the material in the stomach and cecum will become and the less the rabbit will feel like eating. Another danger is the formation of dangerous toxins in the digestive system due to the altered growths of certain bacteria which will cause death. Even at this late point rehydration may still be possible under the care of a veterinarian.

Hair may appear dry and dull. In the last stages of GIT disease the general appearance of the rabbit’s fur will sharply decline and appear dry, dull and lifeless. The rabbit will appear alarmingly thin and generally unhealthy. In advanced stages of the disease the foot pads will be dry to the touch and show signs of cracking or splitting and the nose and lips may feel dry to the touch. These are all signs of severe dehydration. At this point death is imminent either from dehydration or starvation or toxic poisoning.


Prevention and Treatment:


Dr. Brown states in her article that over 50% of the rabbits she has seen with this condition will take care of it themselves when they are given large amounts of leafy greens to eat. "Most of the cases of stomach impaction I have seen have been rabbits on a primary pellet diet and have had little or no access to greens or hay. They are craving fiber and fluids and the leafy greens can be just the ticket. In addition we give all these patients good quality grass hay. We completely remove pellets from the diet (rabbits usually won't eat pellets when they are ill anyway). Whatever treatment is used, one can expect stools to be produced within three days. It is rarely necessary to perform surgery for this condition."

When the condition is more advanced the services of a veterinarian will be needed. Rehydration is often necessary to save the rabbit’s life and to soften the contents of the stomach in an effort to restart the system and promote elimination of the contents from the digestive system. Even in mild cases a veterinarian should be consulted to aid in eliminating possible contributing health problems.

Hair is not the only culprit:

"Other causes of GIT disease in the rabbit include partial or complete blockages of the intestine with foreign material (often carpet fibers), post-surgical adhesions, intestinal parasites, toxins (such as lead) and other systemic disease." Dr. Brown goes on to state the importance of having your rabbit thoroughly examined by your veterinarian prior to instituting any treatment plan.

Ideas on how GIT disease can be prevented:

Dr. Brown explains in her article that prevention is not really difficult. She states that providing a diet high in indigestible fiber is vitally important. Foods singled out as good sources of high fiber content included grass hay, namely oat, timothy and Bermuda grass as being especially beneficial. Grass hay is lower in calcium, protein and calories than legume hay such as alfalfa. It should be noted that excess amounts of protein and starch can be particularly detrimental to the rabbit’s health by promoting the growth of certain types of microorganisms that under the right circumstances and produce toxic poisoning. Dr. Brown suggests that grass hay should be provided 24 hours a day to the rabbit. Dark leafy greens are recommended for their fiber content, high moisture content and nutritious value; all of which aids in keeping the digestive track moving normally. It is recommended that at least 3 different types of greens be added to the diet to provide a variety of nutrients and tastes. Dandelion greens, mustard greens, romaine, carrot tops and parsley were among the items mentioned specifically. For domestic rabbits unaccustomed to such a diet it is recommended that grass hay be added first over a one or two week period. The hay can then be followed up gradually with the addition of greens. There is little likelihood that the new diet will cause any significant digestive upset for your rabbit, but by adding the new items in moderation there will be time for your rabbit to make the adjustment with less chance of adverse effects.

For further information on this and other important subjects of interest, please visit the House Rabbit Society web site at


In memory of Maggie Mae

May the innocent not suffer the ignorance of their caregivers.

John W. Jones

Copyright March 2006 All rights reserved

Verlannahill Rabbitry