Small intestinal obstruction in pet rabbits is often due to trichobezoars with gastric distension. Medical management, including gastric decompression, fluid therapy, and intravenous lidocaine, is increasingly reported, though no standardized protocols exist. Gastric decompression is considered useful but technically challenging, with limited published descriptions of sedation, analgesia, tube choice, or complications. A 2-year-old spayed rabbit presented with acute lethargy, inappetence, and weakness. Examination and radiographs suggested intestinal obstruction. Sedated with midazolam, it underwent orogastric decompression via a 14-Fr Foley catheter, yielding 130 mL of fluid and gas. The rabbit bit the tube and ingested ~13 cm. Radiographs confirmed the foreign body, but endoscopic retrieval failed, and the patient was referred for surgery. Premedication included midazolam, buprenorphine, dexmedetomidine, and ketamine; induction was achieved with propofol, followed by lidocaine bolus and CRI. A ventral midline incision and gastrotomy allowed removal of the tube. The stomach was closed with 3-0 poliglecaprone 25, and suspected trichobezoar material was milked to the cecum. Closure and recovery were uneventful. The rabbit lived 12 additional months, dying of unrelated causes.