Persistant Syphilis (vent disease)

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honeybunnylovesthumper

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Hi everyone,

Im really hoping you can help! Im from Wokingham, UK and came across your site a few months ago when my rabbit was showing signs of infection again after a round of penicillin. She's now had3 courses of the drug, seemginly clearing up after each then a week to two weeks later after the last injection, her nose and vent start developing the now familiar crusts. Im at a loss and just have no more money for injections, my parents are currently footing the bill and im dreading telling them i need another £100 (about 150$ i think). I am welcoming any knowledge on persistant cases of syphilis please

- female blue miniature lop (honey)
- 2 years 8 months
- spayed
-Poops fine, but pee is slightly red (understandably)
using litterbox as normal (same as other rabbit)
seems perky enough as always, although over the last few months she has been spending more and more time in her sleeping compartment throughout the day (they have a very very large hutch with a very large (x4) grassy pen with tunnels and mounds :) which shewould usually boundaround in the mornings )

NOTE: she lives with a male (thumper) who does not show hardly any signs of infection until the last visit when the vet found a teeny legion on his bits. The vet is assuming that thumper might be a silent carrier and reinfecting honey

-she has beenseeing the vet on and offsince she was about 1. Mainly it was because she used to get eye infections because of her facial structure. I would need to get her tear ducts flushed approx every 6 months as she would have running eyes and a slightly running nose (not enough for snuffles). She was therefore givenantibiotics in liquid and cream form for when these symptoms would flare up.

About a year ago honey started showing symptoms of crusts on her nose with little tufs of fur matted onto them. When taken to the vet she said that it was possibly syphilis, but given her previous medical issues, more likely just to be sore from her runny nose - at which point we scheduled another flush with antibiotics which cleared things up for a short while. A month or so later she was getting persistant eye infections (not so much of the nose running now tho) and eventually after more antibiotics before christmas last year honey took a turn for the worst.

Seemingly overnight she would not move from her hutch she contracted mites, looked scrawny and her nose was a mess. her vent was very swollen and she had been tearing at the fur in the surrounding area because of the mites. This was over the course of the weekend. When the vets were open (it was christmas) i managed to get her an appointment with the same vet that suggested it may be syphilis before. We started the first round of penicillin that week. The vet suggested that as thumper was not showing any signs of disease, it would be very very rare that he was infected so we treated honey only. First round was 3 shots (1 a week) and topical cream for the nose and spot on for mites (both rabbits). that cleared things up, until 2 weeks later when symptoms showed again - another round of penecillin 4 shots (1 a week). Cleared for a month, then symptoms again.

This time we treated both thumper and honey as a teeny legion had been found on his genitals. Honey did one week on her own, then both had 1 injection for the next 3 weeks.

Everything seemed to again be cleared up, her eye was a little weepy on the last injection and the vet said the penecillin would clear it up (and i also used an eye cream daily).

Its two weeks later and i noticed a small legion forming on her nose, checked her vent and sure enough - infection again. Slightly swolen, red and puss starting to come out.

Im at a loss! The injections are so expensive over here - even though i get a nurse to do it for free (i just pay for the penecillin) - especially as i need to give it to two animals. Please help! any suggestions would be so very helpful.


Other info:
- Diet - SuperRabbit excel dwarf pellets, plently of hay (with dandilions and herbs), cale or cabbage in evening and small amounts of either apple, carrot or pear. Lots of grass from their 'pen'.homegrown mint or parsely as another little treatduring the day sometimes
Appetite is absolutely fine.
- movement - no problems with movement.

-Possibly leaves from honeysuckle that would make her sick, but very unlikely she can get to them

- She is kept outdoors with Thumper in a very large pen running down the side of our garden. The hutch has a cover for the open section which is put down everynight.
 
Hi,

Just happened to stop into the forum during a wildlife break and saw your post. I suspect your problem is related to an inappropriate treatment protocol. All penicillin is not created equally. Which version are you using, what is the concentration of the drug and what is the weight of your rabbit? In the US, we use a form called Bicillin or Pen G. It actually contains two drugs....Procaine and Benzathine. Most vets use only the Procaine version (and if I remember correctly, Benzathine is not available in the UK). The problem with Procaine is that it is purged from the body rather quickly. The Procaine also starts to work faster. The Benzathine is much slower to reach working levels but stays in the body longer. If you are using Procaine only, the dosing protocol being used is totally insufficient to deal with any infection. I now dose Penicillin every day (safe only as an injectable) and when I use Convenia (a cephalosporin) I inject it every other day.

I personally would make a radical change in the treatment protocol. I suspect the dosing is too small (in the amount of drug being used) and frequency is too wide.....once a week is very old school and insufficient. Comes from years ago when Penicillin was starting to be used as an injectable treatment. While each situation is different, I have injected massive doses of Penicillin every day for certain conditions. Hope this helps.

Randy
 
Wow thanks randy - that does really help :)

I was beginning to suspect the dosage was insufficient. The vet was careful to use the same brand each time, but i have to admit i don't know what type was being used. When i previously looked on these forums for solutions i did notice that people were injecting their rabbits on a daily rather than weekly basis, but put this down to a difference in the drugs being used.

I know that here in the UK penicillin used in rabbits is still in the experimental phase as the vet has confirmed there is very little research available in the UK. The vet in question specialises in small animals so i have trusted her opinion. Perhaps they are just behind the times because we are far from the research in the US.

Anyway this is a very vaild point and must be the answer - i will possibly take honey to another vets and see if they have more experience in dealing with syphilis in rabbits. I will takealong a copy of your reply so they can also look into it before moving forward.
As far as weight and dosage is concerned, i know that this is in correlation according to the vet... (but how much i can trust this now i dont know).

oh also - how long do you continue daily doses for?
Thanks again randy :)

 
Most drugs that are safe to use in rabbits are not yet licensed for use in them here yet. Most drugs, like the penicillins, are used offlicence, but a decent rabbit savvy will know the dosage and be able to prescribe accordingly.

I wonder if maybe your vet is not that great with rabbits? Plenty of vets in the UK are behind the times in terms of rabbit knowledge, and whilst they might be great with other species, they can lack with rabbits.
 
Hey flash - yes i am beginning to suspect you are right. I honestly thought this vet was up to date as she specialised in small animals and was fairly young so should have been relatively up to date with recent teachings:(

I think i really will look for another vet, which is annoying considering this one is only at the top of my road! very handy for emergencies.

If anyone from the UK knows of a good rabbit specialist in Berkshire, UK i would be very very grateful
 
wierdly enough i just noticed my vets (kynoch) listed in the virst forum link... Nick Tremlet the vet mentioned is the dog specialist there. Now im confused!
 
Thanks again flashy - i have had a look at the links you gave me and they have been really helpful. I was a bit confused to find my vets mentioned in the recommended forum, given my situation - they are also RCVS accredited small animal surgery (second link).
I have looked into this further and noticed that they have another branch not so far away in harmans water where they have a vet who specialises inparticular in Rabbit medicine and surgery, so I think i will give them a call. That way all the records will be easily transferred and they can get further info from the original vet very easily.

Thanks all for your help, I will call on Monday and ask the vet specialist to call me in between appointments and see what he sais. Wish me luck!

I will let you all know what he sais in regards to treatment recommendations. Hopefully poor little honey will feel better again soon.
 
It's a bit odd with the differences in meds in various countries. I have had the opportunities to work with vets in the US, Canada, UK, Australia, Far East and Mexico. I use drugs that makes most vets cringe. Many vets have had very little, if any, training on exotics....in the US anyway. I still find vets using the antique of reference manuals....The Merck Manual. That is scary. Vets are sometimes limited by veterinary malpractice laws as well as practice policies. I work with vets enough that I know they are "behind the eight ball" in many cases with exotics and avian issues. And I have had to scramble in some situations to decipher the pharmacology of a particular drug to see if will be safe and effective.

Many vets in the US are still stuck in the "Village of Yesteryear" and still rely on drugs such as Baytril and Sulfatrim. When you fully understand what the drugs do....and how they interact with that specialized hind gut fermentation digestive system in a rabbit....it is possible to use drugs long considered "unsafe"....and use them safely and effectively. We are just beginning to get a new breed of vets that will work "outside the box"....but it will take time to make a major impact.

My time is somewhat limited since it's the high season for wildlife rescues here.....got a call about a six foot tall Black Bear today....but if your vet will contact me directly....I will consult with her regarding appropriate Penicillin dosing....she just needs to know that I am not a vet. If she is willing, I will give you my personal e-mail address so she can get in touch with me.

And far as time....I dose for at least 5 days after resolution of symtoms assuming no collateral issues from the drugs.

Randy
 
Wow! thank you so much Randy :)

I will call the vets on Monday, as per my last post I have found that one of their other branches slightly further away has a vet that specialises in rabbit medicine so I will ask him to call me inbetween appointments - at which point I will mention all the info you have given me and your offer of help (which is very very generousconsidering you are dealing with black bears at the same time!).

I have also checked the credentials of the vet that treated honey and although she specialises in small animals and furries, im not sure she has knowledge specifically about rabbits. Anyway hopefully between her, the rabbit vet and yourself we can work out a plan of action that will help Honey and cure this once and for all.

I just feel so bad for her being sick all the time, she's such a character I just wish I could wave a magic wand.I want to see her bouncing around, digging andbeing her inquisitve, cheeky self again.

Thanks again Randy (and bear)




 
I want to add another possibility that it may not actually be syphillis. I agree that a more aggressive treatment protocol and the correct concentration of penicillin may be the reason the treatment is not working, but there could be another cause. Some fungal infections and sarcoptic mange occasionally look like syphillis, and this is something you may want to look into if a new, improved syphillis treatment protocol fails to give good results. Mange and fungal infections can also be diagnosed by looking at a skin scraping of the affected area. It's not nearly as likely, but it is still a possibility so I wanted to mention it. A final reminder is to make sure the environment is adequately disinfected at the end of treatment, for instance with a bleach wash.
 
thanks Claire - it is another possibility to present to the vet.

I think I might have to seperate them for a little while whilst honey undergoes another round of injections (keep her inside). Though it seems like added cruelty though keeping her away from Thumper and away from the sky and grass.

I will round up the vets and ask all of these questions, all of the information I've got on here is so helpful :)
 
I've checked honey again today and she has started to develop legions/scabs around the corners of her mouth - this has never happened before. I am really worried that it will prevent her from eating until i can get her to the vets tomorrow. She has just nibbled some mint leaves, so is eating at the moment (despite being miffed that I cleaned her bits up and poked around her face), should I call the emergency vet now? I am very worried that this may get much worse by tomorrow as this resurgence of symptoms seems to have come back so quickly and in a new part of the face...

Her nose has only a tiny scab on this time and I have put some topical cream I have handy (prescribed by vet for such occasions) - should I soak the crusts from around her mouth off like I used to do with her nose and use the cream?
The cream is actually Fucithalmic (vet) viscous eye drops incase she rubbed it into her eyes whilst cleaning, so I would imagine it would not be harmful if ingested but really can't be sure.
Any ideas to help her - even if it is just until I can get her to the vets tomorrow?
Also, her vent is looking very sore and pussy now and i am worried about flies getting to her - should I bring her inside?
Sorry, Im panicing a bit...
 
I would suggest getting her checked out today if you are worried about her stopping eating. Hopefully, at the least, some pain meds might be enough to keep her through. If I were near I could lend you some Metacam, unfortunately, I'm not close in the slightest.

In terms of separating them, try to avoid this if possible. They have both been exposed, and separating them can add additional stress, it can also make recovery harder. Could you bring them both in?
 
Yes, I do have avery largeindoor cage I can assemble which I bought for when they are sick, though it drive them nuts because its so much smaller than they are used to.

Honey is eating at the moment so I will intermittantly feed her grass (she likes it when i feed it to her even though she has loads of fresh grass in front of her!), she's such a greedy little thing I will know immediatelyif she has no appetite.I have calmed down a little now - it was just the shock of how quicly these legions seemed to develop - I only got the all clear from the vets two weeks ago.

I have also rumaged through the 'bunny cupboard' and found a couple of sachets ofBio-Lapis and syringesif I need to feed her during the night. Ifshe turns her nose up at her food later, I will call the vet. If she doesnt I will check on herin the night with syringeof green sludge at the ready.

I am a little worriedabout the stress factor though. Honey has never been affected by stress really (the cage she was in was attacked by a fox when she was younger and she ran into one of the chew proof tunnels I had hidden undergrounduntilI ran downstairs and shued the fox off - since then she has been brazen as anything, nothing scares her). However,my parents have adopted a dog which is due to arrive on Tuesday. We have already constructed a secondary gate and fence around their pen to keep him away just incase, but would this still be too stressful for her ?
 
I think the medication would be ok to put around her mouth as long as you don't use a huge amount.
 
A new dog that may be attacking the pen would be too stressful for any rabbit. Even a dog walking around for the 1st time is going to be scary . Is there any way that you can keep the dogs and rabbits separate?
 
OK, I've just spoken to the rabbit specialist from the other branch of my surgery. And he suggests, looking at her file, that honey is not actually suffering from syphilis!...

Given her past tear duct issues (from her teeth roots growing upwards) he suggests that this is probably a persistant bacterialinfection in her sinuses which has travelled to other parts of the body (i.e. vent - and now mouth as over the last day or so she has develped legions/crusts on the sides of her mouth also). It just annoyingly presents itself with the same symptoms as syphilis.

As we have already given honey a good dose of some of the strongest antibiotics out there, he sais that we should probably be pushing for control rather than cure as its clearly very unusual and strong. Which will mean they will need to put a little anesthetic on her nose and get a swab from the tissue deep inside her nose and do some detective work under the microscope. They will then try togrow the culture and test it on as many types of antibiotics as they can.

He also wants us to Xray her skull again as he belives this is not helped by her teeth problems (she is a particularly flat faced mini-lop - which although cute, comes with teeth issues as im sure you guys know). The roots grow up into the gum where the surrounding tissues swell and block the tear duct to the nasal pasages (the tears fluid then streaming out of the corner of the eye). This blockage is probably fueling the conditions for this bacterial infection to grow. He sais that he has some painkillers that we can give her that also change the way her teeth are growing, so they may help along with the classic treatment for bunny denistry.

He didnt have an appointment today so he has sent all the information accross to my usual branch for my vet, charlotte to look at. He said that he doestrust her judgement and he would have done little different and she can call him anytime to ask questions and is posting all his recommendations on honey's file. I managed to get an appointment with my vet Charlotte for a little later today as I couldnt wait till tomorrow.



Side note - (not about this case - but i hada tough night with thumper too!)

yesterday evening I noticed that honey wasnt really interested in her food and didnt touch her treats. I then noticed that thumper (the big agouti boy bunny) was laying in his sleeping compartment not really budging. Now thumper will run though a wall for his excel pellets, so I was really worried. I also noticed that there were not many 'offerings'in the litter tray I had changed earlier in the day - certainly none of thumpers.

After scouring the internet and forums I was worried it was stasis, so brought them both inside ourutility room so they can properly run around and chased him to keep him moving. I plonked him on a hot water bottle and have him belly rubs syringed him slightly warm water.Honey by this time was munching her way through the food happpy not to be disturbed, but thumper still refused everything about 1am I started force feeding him the bio-lapis I have to stimulate the gut and give him water, but by 2pm I was very worried about him. I phoned the emegency vets and luckly the guy was really helpful and suggested loads of things.

I decided to give it half an hour before bringing him in as he was intermittantly still cleaning himself a little and he has done this once before where he scares me by not eating then is absolutely fine the next second, the little drama queen (otherwise it would have been straight to the vets). He also suggested mashing up some excel pellets and syringe feeding him this.

After about 20 mins of feeding and getting covered in mushy green stuff thumper eventally started getting aggressive and trying to bite the syringe. I think at this point I managed to get a good doseage of mush down his throat and he remembered he loves it XD after one last stomach gurgle he went crazy biting syringe and chomping at the towel I held him in. At this point I decided to try his chomp on a digestive biscuit he had turned his nose up at earlier. Num num num numnum. yes we bit and chewed it! I have NEVER EVER been so happy to see any living creature eat in my life. From that moment on he was back to his old bullying ways, worrying honey, eating everything in sightand investigating. I reckon it must have been wind, but Im gonna take him along to the vets today just incase!
 
Well, you had a day yesterday, didn't you.

Do you know what caused Thumper's problems? Stasis (or heading for it) is secondary to something else, like eating something dodgy, stress, tooth problems, etc.

If it happens again and it might be gas, Dioralyte can be good for hydrating them, but more importantly, Infacol (which has the active ingrdident simethicone) is a baby gas med that is good for gas episodes.

Good luck with the vets today. I hope that what the other vet says can make a difference. It might be worth asking to have some pain medication on hand at all times so that if she ever needs it (or he does, for that matter), then you have it on hand. Any idea what anti biotics are going to be tried? Also, let us know what the x-ray shows up :) I hope the swab is useful for you too so that you can have the best shot at beating it.

I hope today is easier for you than yesterday.
 

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