I’m posting this in hopes that any experienced rabbit owners here can guide me or make any suggestions. Ok, so over three months ago now my doe (which is now 7 months old) was diagnosed with rabbit syphilis. The vet prescribed antibiotics (azithromycin) to be given for 10 days. Fast forward it wasn’t getting better so she gave her almost four rounds of it to take, each time for 10 days. Finally it seemed to have gotten better and she was scheduled for her spay (FINALLY) At this point I was frustrated because the spay surgery had been rescheduled twice. The spay was rescheduled yesterday AGAIN because the vet noticed the syphilis was back right before taking her into surgery. I am so frustrated because not only is the azithromycin expensive and hard to get my doe to take but it’s NOT getting rid of it! This will be the fifth bottle she will be taking. Has anyone else dealt with this issue? What did your vet prescribe? Any help would be greatly appreciated.
Rabbit syphilis (AGAIN)
- Thread starter Yaya8a
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dogwoodblossoms
Well-Known Member
Has she been given a penicillin (Pen-G) injection?
My rabbit had syphilis as well and after two injections of penicillin was clear.
My rabbit had syphilis as well and after two injections of penicillin was clear.
When the vet first diagnosed it she told me they usually do injections (I’m assuming it’s the Pen G you’re talking about) but due to COVID she said they were not readily available at the moment. Instead she went with the azithromycin to be given orally. She told me it would work just as well, but after several weeks of it coming and going I’m starting to think it’s not working as well as she said it would. Not only that but it is becoming really costly, and if it’s not helping my bunny feel better it becomes even more frustrating. This time she wants to treat for a total of 6 weeks. I also have a 4 month old buck which has no signs of active lesions & I keep separated since he isn’t neutered yet, which I figured would be good to treat as well just in case. The vet said it wasn’t necessary until I saw active lesions on him as well. At this point I’m thinking what if he has it too and it’s just going back and forth between rabbits even though they aren’t in direct contact. Did the injections get rid of the syphilis for good in your rabbit? Or has it came back after even with treatment? She told me syphilis is not curable and will always remain in my rabbits body. That it would flare up with stress or changes in her environment
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Your vet is absolutely incorrect in saying your buck wouldn't need syphilis treatment because he didn't show any outward indicators. Rabbits can be carriers even with no signs externally. If he had any direct contact with your doe, he could have contracted it, or if you've handled one rabbit than the other without washing, there could be a slight possibility of transmission. And if they have had any physical contact at all since she's been on treatment, then he could have reinfected her, and that's why she isn't getting better. That is, if syphilis is actually what's going on here and not some other illness.
If they haven't had any direct contact and you've washed in between handling rabbits since she's been on treatment, then it's very unlikely he could have contracted it and you're looking at some other reason this isn't clearing up.
First to consider would be if the bacteria is resistant to this antibiotic and that's why it's not working. There have been treatment failures(in people) using azithromycin due to bacteria resistance. So I wonder if this is what's going on here. If so, then you need to talk to your vet about trying a different antibiotic. If your vet can get a hold of pen g procaine/benzathine for injection, that's the usual rabbit syphilis treatment and is very effective. Normally you would see significant improvement the first week after the first injection. If your vet can't get a hold of pen g then chloramphenicol might be another option(requires special handling).
https://wabbitwiki.com/wiki/Rabbit_syphilis
The other possibility is that your rabbit doesn't have rabbit syphilis at all, but it's something else. What physical indicators did your rabbit first show that pointed to her having syphilis? What indicators has she continued to have and has now ,that point to her still having it? Has your vet confirmed anything through tests?
Next thing I would like to address is how knowledgeable your vet is. The fact that your vet is saying that your other rabbit couldn't have rabbit syphilis because he didn't show any signs of lesions, and especially with your vet saying rabbit syphilis isn't curable, this makes me believe your vet isn't very knowledgeable about rabbits. Rabbit syphilis is absolutely curable when the right treatment is given. It will be completely cured and will not reemerge at a later time, unless a rabbit becomes reinfected from another rabbit that's a carrier.
Medirabbit: rabbit syphilis
https://rabbit.org/vet-listings/
Just FYI if you ever have to use azithromycin(or any other medications), you can request your vet call in a prescription to a human pharmacy(cheaper than getting it from the vet) or an online animal pharmacy. Also if you use a prescription discount service, it can reduce the cost as well. I used goodrx and got my prescription of azithromycin from walmart. Two 30ml bottles was only about $24.
If they haven't had any direct contact and you've washed in between handling rabbits since she's been on treatment, then it's very unlikely he could have contracted it and you're looking at some other reason this isn't clearing up.
First to consider would be if the bacteria is resistant to this antibiotic and that's why it's not working. There have been treatment failures(in people) using azithromycin due to bacteria resistance. So I wonder if this is what's going on here. If so, then you need to talk to your vet about trying a different antibiotic. If your vet can get a hold of pen g procaine/benzathine for injection, that's the usual rabbit syphilis treatment and is very effective. Normally you would see significant improvement the first week after the first injection. If your vet can't get a hold of pen g then chloramphenicol might be another option(requires special handling).
https://wabbitwiki.com/wiki/Rabbit_syphilis
The other possibility is that your rabbit doesn't have rabbit syphilis at all, but it's something else. What physical indicators did your rabbit first show that pointed to her having syphilis? What indicators has she continued to have and has now ,that point to her still having it? Has your vet confirmed anything through tests?
Next thing I would like to address is how knowledgeable your vet is. The fact that your vet is saying that your other rabbit couldn't have rabbit syphilis because he didn't show any signs of lesions, and especially with your vet saying rabbit syphilis isn't curable, this makes me believe your vet isn't very knowledgeable about rabbits. Rabbit syphilis is absolutely curable when the right treatment is given. It will be completely cured and will not reemerge at a later time, unless a rabbit becomes reinfected from another rabbit that's a carrier.
Medirabbit: rabbit syphilis
https://rabbit.org/vet-listings/
Just FYI if you ever have to use azithromycin(or any other medications), you can request your vet call in a prescription to a human pharmacy(cheaper than getting it from the vet) or an online animal pharmacy. Also if you use a prescription discount service, it can reduce the cost as well. I used goodrx and got my prescription of azithromycin from walmart. Two 30ml bottles was only about $24.
Thank you for responding! & yes, I immediately took it as a red flag When they told me that it was not necessary to treat my buck. Since this has been going for so long once it cleared up and there were no active lesions they told me that contact between rabbits should be fine. So yes, in the time frame between ending treatment and now my rabbits do have contact through the grids. Since I’m having them be side by side a few hours a day in complete different pens for future bonding purposes. Which is why I brought up also treating the buck.
As far as symptoms I had originally taken her in for possible ear mites and during the exam they found yellow crusting in the mouth area. I was shown the area and I could see what they were talking about. They also examined the genital area and they said that seemed to be lesion free. Which I kind of found odd? Since I’ve read syphilis is also in the genital area and can then infect mouth, eyes, face etc… they didn’t perform any additional exams and just went with syphilis. It was then the whole ordeal with the azithromycin began. After 4 weeks of treatment I was told it got better and spay could be done. Another month went by and spay day came around and now I was told she has yellow crusting around the mouth area AGAIN & spay cannot be done.
Aside from the yellow crusting in the mouth my doe eats, drinks, and has complete normal activity. No other obvious symptoms going on. I wasn’t aware that I could buy the antibiotic online. The vet is charging me $50 a bottle good for only 10 days
& she has to have a 6 week treatment this time around. As you can imagine that is adding up quickly! And not helping my rabbit 
I am seriously considering taking her elsewhere but with Covid all the exotic vets are so overwhelmed with bookings. They have very few appointments. Now that you are telling me that is curable if it even is syphilis, it is really making me question their knowledge as well.
Is the crusting inside the mouth or are there any lesions at the corners of the mouth? If so, could you take a clear close up photo and post it here. Then you could at least get our opinion of some possibilities.
If you can find a different vet to go to, I would strongly recommend that you do that. I almost wonder if your vet is completely misdiagnosing your rabbit, if your rabbit even actually has an issue at all if there are no visible outward indicators that you can see. If there actually is crusting/lesions, then a different possible cause is a fungal infection. Lesions around the mouth can have a very similar look to syphilis.
Medirabbit: fungal dermatitis
But if you decide to stick with this vet or absolutely can't find another vet to go to, then I would suggest to either bring up switching antibiotics if possible. But if not, then insist on your vet calling in the prescription to walmart, etc, get a discount code from goodrx, etc, then pick up a much cheaper prescription that way. They come in 15ml and 30ml bottles of 200mg/per 5ml. Do you know the concentration of the suspension you're currently using, what amount are you giving per day, and what's your rabbits weight?
Before bringing up calling in a prescription with your vet, call around and find a place that has it in stock and find out the size of the bottles they stock, so you have all of this when you tell your vet you want the scrip called in. And be insistent. Some vets will push back because they make so much money from you buying the prescription from them. But you have every right to request your vet call in the prescription somewhere, and they have no right to refuse you doing this.
If you can find a different vet to go to, I would strongly recommend that you do that. I almost wonder if your vet is completely misdiagnosing your rabbit, if your rabbit even actually has an issue at all if there are no visible outward indicators that you can see. If there actually is crusting/lesions, then a different possible cause is a fungal infection. Lesions around the mouth can have a very similar look to syphilis.
Medirabbit: fungal dermatitis
But if you decide to stick with this vet or absolutely can't find another vet to go to, then I would suggest to either bring up switching antibiotics if possible. But if not, then insist on your vet calling in the prescription to walmart, etc, get a discount code from goodrx, etc, then pick up a much cheaper prescription that way. They come in 15ml and 30ml bottles of 200mg/per 5ml. Do you know the concentration of the suspension you're currently using, what amount are you giving per day, and what's your rabbits weight?
Before bringing up calling in a prescription with your vet, call around and find a place that has it in stock and find out the size of the bottles they stock, so you have all of this when you tell your vet you want the scrip called in. And be insistent. Some vets will push back because they make so much money from you buying the prescription from them. But you have every right to request your vet call in the prescription somewhere, and they have no right to refuse you doing this.
The yellow crusting and lesions are mainly on the outside of the mouth. & the lesions seem to be mostly in the corners of the mouth. I’ve taken some pictures as best as I can without stressing her even further. They are from the sides and corners of her mouth and then from the front. I’ve circled in red where you can see the visible crusting. I don’t think it’s THAT bad? But you can definitely see it. The vet said there was no lesions or crusting in the genital area. & yes I’m highly leaning on a second opinion. I’m going to call a few other vets and fingers crossed they have something soon. If I cannot get her in to see someone else I’m going to have to stick with this one for now but I will definitely mention about calling in the meds elsewhere. My rabbit weighs 4.65lbs and I was told to give her 1.6 ML of the azithromycin once a day. I’ve also included a pic of the bottle so you can see it. This is costing $50 a bottle. Do you think it could be something else that is fungal as you mentioned? Once again thank you for all of your input! I appreciate it.
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And it's not just food residue or staining? Then if not, to me that looks more fungal, at least from what I can see. It's hard to get a good look at it in the photos. With syphilis, I would expect to see more whitish and thicker crusting than occurs with a fungal infection. And the fact that you've seen little to no improvement while she's been on antibiotics, makes me suspect fungal dermatitis even more.
$50 for a 15ml bottle is insane! I was getting 60ml for $24. But if I'm wrong and this actually is syphilis, then if you can't switch antibiotics and once you can get it cheaper from a pharmacy, you may want to ask about trying a higher dose. Your rabbit is right at the lower 30mg/kg dose. For my rabbit with a persistent infection, the lower dose just ended up with the infection coming back once the antibiotic was stopped. So it was upped to the higher 50mg/kg dose, for a longer period, which did end up getting rid of the infection.
$50 for a 15ml bottle is insane! I was getting 60ml for $24. But if I'm wrong and this actually is syphilis, then if you can't switch antibiotics and once you can get it cheaper from a pharmacy, you may want to ask about trying a higher dose. Your rabbit is right at the lower 30mg/kg dose. For my rabbit with a persistent infection, the lower dose just ended up with the infection coming back once the antibiotic was stopped. So it was upped to the higher 50mg/kg dose, for a longer period, which did end up getting rid of the infection.
No, i really don’t think it’s food residue or staining. You can actually feel the small scabs on the corners of her mouth. They are more on the yellow side in color. And yes! I suspect that is what happened with my rabbit as well. She did the 4 week treatment and it went away but then we stopped the azithromycin and within a couple weeks it came back! Now we are back at square one
and yes, I’ve been paying $50 a bottle each time, it’s honestly a lot. I’ve already spent $200 worth of it only for them to tell me she needs an additional 6 more weeks totaling another $300. At least if I would for sure know it would get rid of it, it wouldn’t be so frustrating!
If you can't find another vet to get your rabbit into, I would suggest asking your current vet to test for a fungal infection, to rule it in or out. And the vet shouldn't just do this with a UV light test only. Some fungus doesn't show up this way.
A UV light? They didn’t even use that
they went off solely by the lesions. After doing just a visual exam they said they were almost certain it was syphilis.
John Wick
Well-Known Member
Admittedly I skimmed, but there is a PCR blood test for syphilis antibodies that can be run to better confirm the diagnosis.
Anecdotally, I personally as well as one other rabbit owner I know have had rabbits who have coinciding syphilis as well as ringworm, which intuitively can make sense since ringworm is more often contracted by younger rabbits and older rabbits, due to weak/compromised immune systems. A system fighting syphilis will be strained.
There are atypical cases of syphilis which only show symptoms around the mouth with no genital signs. My rabbit was one of them and other cases exist: MediRabbit
Re: the lesions being in and/or around the corners of the mouth query, I will mention that my rabbit's mouth crusting never went into the mouth, making his first vet rule out syphilis and we treated for ringworm (which he did indeed have). Eventually though, the ringworm was gone and what was now happening was syphilis symptoms. Unlike ringworm, the syphilis fur loss didn't spread nearly as far and it would not spread regardless if I put ringworm-related treatment on it or not (it was a whole routine and I just got lazy sometimes honestly ..). The syphilis treatment was 21 days of both azithromycin oral and daily penicillin shots. Since syphilis can be asymptomatic, just like with a URI or other infections I would not suggest stopping treatment until well after symptoms disappear.... All this to say, fungal and syphilis can coincide, come one after another, and vice versa in terms of symptom presentation.
I would discuss trying a fungal treatment. From my experience, Itraconazole (oral) can be used and/or Silva sulfadiazine (cream; topical) and/or clotrimazole (drops; topical). There should not be 'harm' in trying a fungal treatment to see if it helps.
Edit: here's a document I created in the past summarizing my rabbits particular timeline, treatment, and assessments around syphilis-ringworm: Loading Google Docs
Anecdotally, I personally as well as one other rabbit owner I know have had rabbits who have coinciding syphilis as well as ringworm, which intuitively can make sense since ringworm is more often contracted by younger rabbits and older rabbits, due to weak/compromised immune systems. A system fighting syphilis will be strained.
There are atypical cases of syphilis which only show symptoms around the mouth with no genital signs. My rabbit was one of them and other cases exist: MediRabbit
Re: the lesions being in and/or around the corners of the mouth query, I will mention that my rabbit's mouth crusting never went into the mouth, making his first vet rule out syphilis and we treated for ringworm (which he did indeed have). Eventually though, the ringworm was gone and what was now happening was syphilis symptoms. Unlike ringworm, the syphilis fur loss didn't spread nearly as far and it would not spread regardless if I put ringworm-related treatment on it or not (it was a whole routine and I just got lazy sometimes honestly ..). The syphilis treatment was 21 days of both azithromycin oral and daily penicillin shots. Since syphilis can be asymptomatic, just like with a URI or other infections I would not suggest stopping treatment until well after symptoms disappear.... All this to say, fungal and syphilis can coincide, come one after another, and vice versa in terms of symptom presentation.
I would discuss trying a fungal treatment. From my experience, Itraconazole (oral) can be used and/or Silva sulfadiazine (cream; topical) and/or clotrimazole (drops; topical). There should not be 'harm' in trying a fungal treatment to see if it helps.
Edit: here's a document I created in the past summarizing my rabbits particular timeline, treatment, and assessments around syphilis-ringworm: Loading Google Docs
