For veterinary professionals
October 2026
The rabbit comes back for the third time with dandruff down the back. It had selamectin a month ago, and the month before that. The family is frustrated, and honestly, so are we. Skin disease makes up a large share of rabbit visits, ectoparasites are a big part of it, and the drug many of us were taught to reach for first doesn't always do the job. These are things we encounter in practice all the time, and here are some options to consider.
Many rabbit skin problems are secondary. Obesity is very common in pet rabbits, and obesity, osteoarthritis, spondylosis and dental disease all limit grooming. A rabbit that can't reach its back will accumulate scale and parasites there. So the full physical exam comes before the skin tests, and "mites that keep coming back" is often a sign of a rabbit that can't groom.
For diagnostics, clear acetate tape cytology is the workhorse for dry, scaly lesions, and an impression smear suits moist ones. Rabbit skin is thin, so use a dull blade or a scraping spatula for scrapes. Sarcoptes and Demodex are rare in the United States. A trichogram helps separate barbering from dermatophytosis.
Cheyletiella parasitovorax, the "walking dandruff" mite, is common in my practice. Look for broken hairs, scale and patchy alopecia, with variable pruritus. Tape cytology usually finds it, and the hooked mouthparts are distinctive. It's zoonotic, so let the family know if they've noticed itchy spots of their own.
Psoroptes cuniculi, the ear mite, produces thick, layered crusts on the inner pinna that are hard to mistake, though atypical cases on the perineum and feet have been reported. Do not pull the crusts. It's painful and causes bleeding. Treat the mite and the crusts will fall out on their own. Severe cases deserve analgesia and sometimes systemic antimicrobials. Tetanus has been reported in association with P. cuniculi, which is worth mentioning to families.
Leporacarus gibbus, the fur mite, is considered commensal by some because many rabbits carry it without signs. Others are pruritic, and it's potentially zoonotic, so I identify and treat it.
Fleas in US rabbits are Ctenocephalides felis, usually picked up from a heavily infested household. Treat every pet in the home. Cuterebra is more common in rabbits housed outdoors and is removed as in cats, with analgesia afterward.
Cheyletiella females and eggs can survive off the host for up to about ten days. Dosing selamectin every two to four weeks leaves a gap for reinfestation, and in my practice that's exactly where I see failures. If you use selamectin, I recommend 20 mg/kg every 7 days for at least three doses, and additional doses are often needed.
I've largely moved to fluralaner, based on the growing rabbit literature and my own results. Options that have worked include an oral product compounded in-clinic where legally allowed, the topical fluralaner product, or the topical fluralaner/moxidectin product, in each case dosed at 25 mg/kg of fluralaner.
In my experience a dose lasts about two months in rabbits. That's a clinical observation, not a pharmacokinetic result, because rabbit PK data don't exist yet. Controlled data are starting to appear, though. A 2026 trial in naturally infested rabbits found that single oral doses of fluralaner, afoxolaner or sarolaner cleared P. cuniculi within the first week, without adverse effects (Machado et al.). Isoxazolines are off-label in rabbits, so document the conversation and consent.
Treat in-contact rabbits and other pets, and clean the environment. Recheck cytology rather than assuming cure. Don't bathe rabbits: the risk of hypothermia and the difficulty of drying the coat outweigh any benefit. And if the rabbit can't groom, find out why. Back pain, dental disease and obesity often sit behind recurrent parasites.
If you have a rabbit with mites that won't clear, or you'd like to talk through using fluralaner, reach out to Nashville's rabbit specialist. Dr. Logan Kopp, DABVP (Exotic Companion Mammal Practice), sees referrals at Priest Lake Veterinary Hospital, (615) 361-4646. Referral details are on the referring veterinarians page.
This content is for educational purposes for veterinary professionals. It doesn't establish a VCPR or replace clinical judgment for an individual patient. Drug use and doses should be checked against current references and adjusted for each case.