Ringworm?? (caution: pictures of sick rabbit)

[seashore]

Hello,

One of our black Rex does developed what we thought was ringworm two weeks ago, and treated it with clotrimazole. It started in a ring of bare skin with fur in the middle on the back of her neck, then a second circle developed, then a patch at the base of an ear. At this point we realised the clotrimazole wasn't touching it and moved to an ointment made from coconut oil, tea tree and kawakawa, both of which are strongly antibacterial and antifungal, which worked better than clotrimazole in the past for a similar issue. It has prevented any further circles forming, but she's spread the ointment halfway down her back and it's fairly strong so she's not looking her best at the moment! We've also tried Betadine, she won't stand for having it sprayed on but is find with us dabbing her with a paper towel soaked in it and squeezing it out of that. Must have felt good as she has been licking us in thanks (cue the soap....)
It has now gone hard and scaly on the back of her neck, and we discovered just now that there is a line of this scaly skin all round under her chin and dewlap. We can't treat under there, and she won't stop licking it.

My question is - is this ringworm, or something else? Do we need to consult a vet? Or just time and continue the cycle of tea tree & kawakawa, Betadine, and/or clotrimazole?

Her appetite has dropped off a bit but we found when we brought her in tonight that she wanted to drink warm water, not the usual tap cold (it's summer here), lapped up an enormous volume of it and tucked into her pellets with gusto so maybe it's a loss of appetite due to lack of hydration.

 

[Bunnies4me]

More to this bun, she's my rabbit also.

We have dosed her with Ivermectin a week ago, and that's done seemingly nothing. Obviously she's in isolation, but she's bright and happy, there's no change in mood - except that's she become more affectionate and docile, which makes it easier to treat.
We were seeing some results from using the oil and tea tree and Kawakawa ointment, until I skipped a dose a few nights ago as I had been scratched, and wisdom was to avoid anointing her to prevent myself contracting ringworm through my open scratches. Next morning her skin had gone scaly in the original place, which in my past experience is often when a ringworm infection is at its height (we had ringworm last year in another doe, as mentioned above.). This seems to me to be a second round of the infection in the same place all over again. She doesn't seem to be scratching it excessively, but does clean it a lot and I fear she may be reinfecting herself in doing so. The bits in her fur don't move and when they come out it is hard scaly skin, so obviously not mites.
The skin underneath almost half her back is red and aggravated, and goes a lot further than just the area that has lost the fur.

I had been hoping to breed her shortly, but that's obviously not going to happen now.

Side note - vets here often come to the breeders for advice, so I'm sceptical about how much help they can offer.

 

[seashore]

Urgently need help here... @Alaska Satin @judymac @ladysown @eco2pia and any other resident experts!!

This doe is booked in with the vet but no appointment available until Wednesday. She has now started nibbling her shoulders raw... Literally chewing off unaffected skin since she can't get her teeth on the parts that are clearly itchy. We Betadined the raw area but she immediately started nibbling off another layer of skin and fur next to it. The ringworm (at least we are 90% sure it's ringworm) has made her skin all crusty behind her ears and between chin and dewlap.

Is there anything we can do to prevent her pulling skin off these unaffected areas? Very concerned that once raw, they are likely to get infected.
Help!!!

 

[chaoskittiez]

bunny sweater? Or a recovery suit? She’s a cute little thing.

 

[ladysown]

are you sure that's ringworm and not something else fungal or possibly mange?

To keep her from nibbling you may need to wrap a stuffed sock around her neck.

 

[seashore]

are you sure that's ringworm and not something else fungal or possibly mange?

To keep her from nibbling you may need to wrap a stuffed sock around her neck.

No, we're not sure! However it definitely started in rings, which were treated and nearly healed when it suddenly went into a second larger, non-ringed outbreak per the pictures.
OK, we'll give the sock idea a go. She's a serial cleaner so may or may not work.

 

[seashore]

bunny sweater? Or a recovery suit? She’s a cute little thing.

She would have the greatest fun unravelling a sweater, but we did consider a recovery suit. We'll try the sock idea first.

 

[Alaska Satin]

No, we're not sure! However it definitely started in rings, which were treated and nearly healed when it suddenly went into a second larger, non-ringed outbreak per the pictures.
OK, we'll give the sock idea a go. She's a serial cleaner so may or may not work.

I've never dealt with anything that looks like this in rabbits, but it looks like what I've seen in other species as a combination of fungal infection and secondary (and possibly tertiary) bacterial infection. The fact that neither ivermectin nor clotrimazole helped her makes me doubt it's purely fungal, as does the pattern of rings nearly healing and then the rise of a different pattern of pathology.

You might try one more med, fenbedazole (aka Safeguard), which has ranked right up there with ivermectin in its ability to help with mystery issues in my barn.

One of the problems here, though, is that all these drugs have almost certainly messed up her gut biome, which compromises her immune system at the moment she really needs it to be up and functioning. As a support measure, I'd be giving her Benebac or some other probiotic for herbivores during this time, as well as encouraging her to eat as much high-quality grass hay as possible. You might also see if she'll eat garlic (tiny amount), oregano and/or thyme. All three of these have antibacterial properties but should not disrupt the rabbit's gut. Basil is also an antimicrobial and can help in pain control. Chamomile, echinacea, dandelion and goldenseal are also helpful anti-inflammatories and immune boosters.

I'd be cautious about a sweater or sock or anything else that will contribute to a warm, moist environment especially around her neck and dewlap, as that will encourage both bacterial and fungal growth. It would be good to keep her from further aggravating her skin and spreading and/or ingesting pathogens, but watch very carefully that things don't get worse underneath the covered area.

Usually cat preparations can be used on rabbits, so you might try an antifungal medicated shampoo for cats, although I strongly suspect that fungus is not her only problem. I would normally be be a little hesitant about shampooing because her skin is so offended, but it sounds like you really need to do something as it's escalating. Maybe do a spot wash and see how she tolerates it.

I agree with your suspicion about many/most vets not being all that clued into rabbit care (although it sounds like yours are at least honest if they confer with breeders), but if you're willing to go that route, it might be worthwhile to get in contact with one that might give you a prescription for enrofloxacin, sulphadiazine or sulfamethoxazole or some other rabbit-safe antibiotic. A vet that would do a culture to identify bacterial infection would be ideal, since that would guide you in the choice of antibiotic. I have found that unless the vet is interested, this kind of thing is prohibitively expensive, so I try all the other approaches, and if I can't pull the rabbit out of it, I put them down humanely. I also would not breed this rabbit, as even if she makes it through this, she seems to have tendencies toward problems I wouldn't want to perpetuate in my herd.

 

[seashore]

You might try one more med, fenbedazole (aka Safeguard), which has ranked right up there with ivermectin in its ability to help with mystery issues in my barn.

Safeguard isn't available in NZ. We can get Panacur 100 but only in a 1L bottle for $150 (USD $100). We have considered buying a 1L and decanting it into smaller bottles and selling 900ml previously; maybe we'd better do that.
The only other option is in a horse wormer paste along with ivermectin and praziquantel.

As a support measure, I'd be giving her Benebac or some other probiotic for herbivores during this time

Bene-Bac is also not available! The options here seem to be either a dog/cat probiotic, or an enormous sized bottle for a horse. Would Critical Care help? We have that on hand.

You might also see if she'll eat garlic (tiny amount), oregano and/or thyme. All three of these have antibacterial properties but should not disrupt the rabbit's gut. Basil is also an antimicrobial and can help in pain control. Chamomile, echinacea, dandelion and goldenseal are also helpful anti-inflammatories and immune boosters.

We have all of these except goldenseal she will be stoked, absolutely loves her greens. Will raid the garden!

Point taken about a neck sock causing moist areas. We will monitor this closely.

After reading an article from the UK National Angora Club on homeopathics for rabbits we researched and found that Bacillinum 200c is recommended for ringworm on organic farms here. We only have 30c in the meds drawer but gave her 3 drops of this on a leaf last night. Can't harm and might help!
She is drinking plenty of water and eating hay and greens (we are in process of ripping out the corn and runner beans, so the rabbits are getting the leaves and vines), not much pellets but not off her feed completely.

 

[seashore]

You might try one more med, fenbedazole (aka Safeguard), which has ranked right up there with ivermectin in its ability to help with mystery issues in my barn.

Good news, another breeder in the area kindly gave us about 30ml of Panacur and we have dosed her. Fingers crossed!
She's gobbled down Critical Care, water, hay, dandelion greens and herbs though less interested in pellets than before, however is looking a bit brighter eyed and acting perky. Lower pellet desire is fairly normal as she greatly prefers anything fresh over pellets usually. But she won't stop licking the crusty parts and has now developed these crusts all around her mouth
66 hours till the vet visit... counting down. Could go either way between now and then.

 

[Bunnies4me]

The original patch that had the first outbreak in ringworm is starting to regrow fur and doesn't have any of these crusty / dead skin patches, but is new skin and healthy. Sort of indicates that we probably won the battle with the original ringworm, and what we are battling now is not ringworm - or the rest of the area would have responded to the ringworm cream, which it hasn't.

 

[StilFarminCA84]

Good news, another breeder in the area kindly gave us about 30ml of Panacur and we have dosed her. Fingers crossed!
She's gobbled down Critical Care, water, hay, dandelion greens and herbs though less interested in pellets than before, however is looking a bit brighter eyed and acting perky. Lower pellet desire is fairly normal as she greatly prefers anything fresh over pellets usually. But she won't stop licking the crusty parts and has now developed these crusts all around her mouth
66 hours till the vet visit... counting down. Could go either way between now and then.

How much did you give her? And how much does she weigh? Was it paste? Was it horse paste or rabbit panacur paste? Or are they the same? If horse paste version what did that amount look like visually? Need help with my poor bunny

 

[Bunnies4me]

How much did you give her? And how much does she weigh? Was it paste? Was it horse paste or rabbit panacur paste? Or are they the same? If horse paste version what did that amount look like visually? Need help with my poor bunny

Panacur was the sheep and goat liquid - I'll have to look at the bottle, wrote the dose on it, think it's about 0.6 or 0.9ml. Ivermectin was the horse paste one, about the size of half a small green pea. I eventually took her to the vet and got an antibiotic, she's fully recovered now and is ready for breeding again

The thing that I have learnt is this:
Strawberry leaves - bacterial infection
Comfrey - fungal infection

If you have suspected ringworm in your rabbit, I would highly recommend going to your local chemist and getting some cream, the active ingredient needs to be Terbinafine Hydrochloride 10 mg/g. There's a lot of other creams out there, but that one really works, gets on top of it within about a week. The other creams I tried had no effect and was just a waste of time, don't bother trying any with active ingredient that is clotramazole etc, they must only work on humans.

Would you like to share images of your sick rabbit?

 

[seashore]

How much did you give her? And how much does she weigh? Was it paste? Was it horse paste or rabbit panacur paste? Or are they the same? If horse paste version what did that amount look like visually? Need help with my poor bunny

In addition to what @Bunnies4me said above - note that our rabbit didn't get better until we got an antibiotic from the vet. She has now made a full recovery.