Very big problem with Rabbits nails

Question
QUESTION: Hello, I am at a loss at to what is happening with my bunny, and my exotic vet, along with one of his very experienced exotic counselors, is also clueless.

I have to give you a bit of background. I bought Shelby (the bunny in question) on a farm in Connecticut. She was a baby (maybe 2 months old). This was this past June. In a few months, she ended up coming down with what was later diagnosed as Syphilis. Before the diagnosis, we gave a half-course of Baytril (because it was;t working, and then did bloods to diagnose), and then she was put on weekly Penicillin (or some form of Penicillin that they give bunnies) for four weeks. The Syphilis cleared up fully.

After this, she got Giardia, but I put her on Kocci-Free and it cleared up.

Now, her newest and biggest problem is her nails. One day, when I found some blood in her cage, I picked her up to check her over, and found that all of her nails on her back feet were missing. They would get slightly better and begin growing in after some care, and then get bad again. I removed anything I thought was a threat and that she might have caught them in and ripped them out, but it got worse. Then I found blood again, and found two of her toes very swollen and infected-looking and one had a large open wound with dead skin around on the tip of the toe. I took her to the vet (all of this happened within a week and a half), he checked for ringworm and it was negative,and the vet put her on a higher dose of Baytril for 20 days (she is on day 6 right now), as well as Virbac cream. I still see no real improvement, and I feel like we are missing something here.

The toe looks really bad and even the rest of the ones that aren't open are very dry and crusty and the nail is very brittle looking. Could it be some other Fungus they didn't think of? I just started her on Booster from Harrison's as well as ordered grapefruit seed extract to try and put in her water and on her nails (because they say it is a great antifungal).

But I really need help. I am afraid that if something doesn't get better soon she will have to get the toe amputated, and I might not be able to keep her because her bills in the past 4 months have already gone over $1100.

Thanks,
Kate

ANSWER: Hi Kate,

A couple of questions for you, were her toenails very long or had they been kept trimmed?  Nails over 1/2" in length are prone to catching on the cage wire and being torn out.  Since the nails grow very close to the bones of the toe, a torn toenail can quickly cause an infection in the bone of the toe which can be very difficult to treat.  Also, did all 4 nails on the back foot fall out at the same time or at different times?  Does she have a solid pine board or plastic riser that she can sit on to get off of the wire?  Sore hocks can be very common especially in larger breeds that are kept on the wire 24/7 (open bleeding wounds on the feet that can get infected).  If you could at all post a picture that would be very helpful to me in trying to figure out what's going on with your poor girl.  On a side note, make sure you're giving her a teaspoon of plain yogurt a couple of times a day with a medicine dropper as the Baytril (even if it's given in injectable form) can really cause problems with the bacterial balance of a bunny's gut if they don't have some probiotics to replenish it.  Looking forward to getting a little more info from you so we can hopefully solve this problem!  Blessings, Lori

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second pic of bad one  
First nail (bad one)   QUESTION: Lori, thank you so much for such a speedy response. Shelby did not have long nails before this happened. I did trim them, and she does not have a wire floor. She currently is on cardboard that is on my floor with a folded bedsheet covering it. I also do not have high carpets she could get stuck on.

All of the nails broke off at what it looks like the same, or roughly the same time, and I forgot to mention that one of them (the last one on the outside of the back foot) is missing the first knuckle, and has healed. I am guessing that she chews them when I am not looking, because they will heal up, and then I find the nail's quick re-opened (and the nail is still a nub, almost level with the nailbed, so completely impossible for it to be broken off again at this point). I forgot to mention also, that during her (i believe 2nd or 3rd) penicillin vaccination, the doc noticed two of them broken. He figured they got caught, They started to get better so I stopped monitoring. Then shortly after we finished with the penicillin and the Syphilis cleared up, I made this discovery. It should also be mentioned that he did a full blood work last week and said all is normal. Could it be that the penicillin did something to her system that is responsible for this?

Right now, she is on benebac, so her tummy is holding up alright. I give her bene-bac every day in the morning with her meal, an hour or two before giving the antibiotics.

I have uploaded three pics, which I am attaching. They are not that great so I am not sure if they will help. It is hard to really understand what you are seeing. They are all three different nails. The first and second pictures are the one nail that is a swollen with a bad open wound. The next two are examples of how all the rest look with the exception of the one now missing. (correction, it will only let me upload two, so I will send next two in next e-mail)

So you know, the front nails are perfectly normal looking.

So sorry for such lengthy questions, but I am so desperate for help for my little girl. She is just a baby and has suffered a lot and I just want her to be able to live as a normal bunny free of pain.

Thanks so very much for your time and effort.

Kate

ANSWER: Hi Kate,

I'm sorry for the delay in getting back to you, but I've been consulting a few of my breeder friends over this one.  A rabbit judge that I know used to work as a vet tech, and while she only saw something like this once it turned out to be a fungal infection in the patient's toes.  She recommended soaking it in iodine a few times a day for at least a couple of weeks even if symptoms appear to improve.  She said they can be difficult to treat because the fungus can get quite a ways up into the bone, but she also mentioned that your vet may be able to do a swab and get a more accurate diagnosis.  The use of antibiotics for her other ailments could be contributing to fungal growth because the medicine would kill off the good bacteria that keeps the fungus under control along with the bad bacteria that is making her sick.  I hope you're able to get her through this without too many more vet bills, and finally be able to enjoy your pet rather than spending so much time trying to get her better.  Best wishes!

---------- FOLLOW-UP ----------

QUESTION: Thanks so much for all that effort and research on your part. Would you suggest that I stop with the antibiotics? I am only scared that the toe with the big open wound and swelling will get worse, but maybe not with the iodine. Should the iodine be full strength or diluted? I will be taking her to a new vet that is more rabbit savvy, and I am very certain now that it is one of the species of ringworm that doesn't flouresce, because I now have a ringworm like trash on my neck. I also ordered get a wound care spray and hopefully the new vet can finally diagnose her and make her better. Hope to hear back soon so I can start the iodine, i just want to know if it should be full strength.

Answer
Don't use full-strength tincture of iodine, it's way too harsh.  Use either Povidine or Betadine as they are still very effective but a little more "tame".  Blot the iodine on the toe 3x day, but don't saturate it because you don't want bunny licking too much of it off.  Hopefully your new vet can give you a little more insight into what's going on.  Not many of my breeder friends have heard of this problem, so it's definitely a little on the unusual side!  Good luck:)