This procedure, done properly, can be a lifesaver. The enema can stimulate a static gastrointesinal tract into movement within a few minutes of administration, and can be used alone or in conjunction with GI motility drugs such as cisapride or metoclopramide.

As with any medical procedure on your rabbit, do not try this without consulting your rabbit-savvy veterinarian .

You will need:

• a bowl for water
• water-based gel lubricant
• gauze or terrycloth washcloth to mop up leakage
• infant ear bulb syringe, preferably one that looks like this:
  

  The bulb pictured is white, soft plastic, and holds about one ounce (~ 30mL). Importantly, it has small flanges that act as a stop guard for safety. Less expensive ear bulbs lack this built-in safety feature. If you can't find the white safety bulb at your local drug store, do a Google image search for one that looks like it, and you should be able to find a source. (It's a good idea to buy a bulb like this before you need it.)

For a video tutorial on how to administer a rabbit enema, see:

Step-by-step instructions:

1. Fill a clean bowl with freshtap water at the appropriate temperature (see below).
A tiny bit of simethicone or water-based lubricant gel can be added, if you wish, but it is not essential.
IMPORTANT NOTE ABOUT ENEMA WATER TEMPERATURE: The appropriate temperature of the enema water depends on the condition and temperature of the rabbit. Normal rabbit body temperature ranges from 101^oF - 103^oF, depending on the rabbit's health and emotional state. Consult this excellent video to learn how to safely take your rabbit's temperature.

As always, consult your rabbit-savvy veterinarian about the appropriate temperature of the water to be used before you attempt the enema procedure, but here are some general rules.

• For a hypothermic rabbit, use normal body temperature water: 101^oF - 103^oF.
• For a rabbit whose body temperature is normal, use body temperature water, or slightly cooler.
• For a hyperthermic rabbit, use water slightly cooler than body temperature (95^oF - 100^oF) can be used. (DANGER: an enema that is too cold can cause life-threatening complications. ALWAYS consult your veterinarian.)

To accurately determine the water temperature, use a rectal thermometer.

2. Dip the tip of the enema bulb into the water and draw up water until the bulb seems full.

3. Invert the bulb so the tip is facing upwards. Squeeze until water just starts to come out. Then, while still holding the bulb squeezed inwards, dip the tip back in the bowl and draw up more water until the bulb is full. This removes the air bubble at the top of the syringe so you won't be introducting air into your rabbit's rectum.

4. Lubricate the bulb tip generously with water-based gel lubricant. (In a pinch, coconut oil or other vegetable oil will do.)

5. Place the bunny on a secure surface covered with soft toweling or other comfortable, traction-providing material.

6. Using proper handling technique to support the back and neck, gently pick up the bunny and invert her so she is in "cradle" position, head resting in the crook of your left elbow (if you're right handed; opposite if you're left-handed). The toweling will provide a soft cushion for her back.

7. Locate the anus. Gently press the prepuce to pull back the furry skin and reveal the urogenital opening and anus. The anus is the more caudal opening, farther towards the tail end of the bunny. Unlike the urogenital opening, the anus is muscular, and will usually "wink" at you when you touch it.

8. Carefully and gently, insert the lubricated tip of the syringe no deeper than about 1/2" (~1.5cm). If it doesn't slide in easily, gently tilt the tip in different directions, probing very slightly until it slides in comfortably. It may help, while you're probing, to squeeze a bit of water into the rectum to help "blaze the trail". There may be poop stuck in there, and a little squirt of water will sometimes provide enough lubrication to open the rectal path.

NEVER FORCE THE TIP! Keep patiently changing position of the tip, probing and squirting just a little, until you feel the water flow without resistance.

9. Using very gentle pressure, slowly express the water into the rectum. NEVER force anything. If you feel resistance, move the tip around gently until the water flows easily. The contents of an entire 1oz/30cc bulb will usually fit into the rectum of even a fairly small rabbit (2lb/1kg), but use good judgment. Insufficient water will not have the desired effect, but you don't want to overdo.

10. If you are doing this correctly, any excess water will start to "fountain" back out around the inserted bulb tip when the rectum is full.

11. Withdraw the syringe tip while keeping your thumb and forefinger in a very mild pinch grip on either side of the anus. As the tip emerges, gently close the anus with your thumb and forefinger. Hold the anus closed for about 10--15 seconds, to keep your hard-won enema water where it belongs, in the rectum.

12. Continue to hold bun on her back for about a 45-60 seconds. Carefully elevating the bunny's back end will allow gravity to help move the water backwards up the GI tract, and will help prevent the water from just squirting out when you're done. As always, properly support the back and neck while you move the bunny.

13. Carefully roll the bunny back onto her feet. It can be helpful to lift the bunny's back end again, but be sure to support the back and neck to prevent injury.

14. Mop up leakage around the bunny's anus with your clean gauze or washcloth. Bunny's comfort is of paramount importance, and a wet bum is no fun.

A few extra pointers:

• The enema can be repeated every four to six hours.

• The colon absorbs water. If your veteterinarian has directed you to give your ailing bunny subcutaneous fluids as part of her therapy, be sure to consult with your vet to determine whether any adjustments need to be made to fluid dosages.

• If a bunny is extremely agitated by your efforts to administer the enema, STOP. Don't risk injury or extreme stress to a bunny, which can make things worse.

• If you cannot find a syringe with safety flanges, it's wise to make a small mark on the bulb tip about 1/2" (1.5cm) from the end, so you don't push it in too far.