Cynops Orientalis with Eye Affliction

One of my Co's has recently developed a problem with its left eye. Heres the history:

Several weeks ago I moved both of my male Co's to their permanent 10 gallon tank after spending the last several months in quarantine. Within about a week of being in their new home I noticed both newts squinting their eyes or just keeping them closed almost all the time. This lasted for maybe about 2 weeks, and during this time the newt that I am still concerned about was shedding frequently and having difficulty shedding. Both animals continued to eat during this time, though activity decreased and they hid a lot. That has now stopped, and both animals are eating well, active (for a newt) and not squinting or keeping their eyes closed for long periods of time. But, the larger of the two males seems to have suffered trauma or disease to its left eye. There is a white film covering the entire eye, and at one spot (corner of the eye closest to the neck, "caudal" eye?) the white film is opaque. I am suspicious that the animal may be blind in that eye (or have severely limited vision), as it seems to turn its head to the right when it is interested in something. Can newts develop cataracts? Or perhaps when it was having difficulty shedding layers of unshed skin remained on the eye and that is what I am now seeing? I do not think the animal is in pain because it doesn't squint anymore and it is eating well, ate just this morning in fact. And there is no swelling around the eye that I can see so I don't think it could be a glaucoma or anything.

This is the set up:
The permanent tank has floating elodea/anacharis, some java fern, and wood that I collected from a stream and autoclaved before putting in the tank. Temps are 65F, and my water chemistry is all within normal parameters. No substrate, just a bare bottom tank. I keep a fluorescent light above the tank for the plants.

Here are some very poor pictures of the afflicted newt that I took this morning while they were eating their bloodworms (sorry they are so bad, I am no photographer!):





Anyone have any ideas? I am not too concerned as I think the newt still has good quality of life, but I am very curious. I also would like to be able to get rid of the film if that is possible.

Hi Heather,

It's difficult to say without seeing the eye - I would certainly get the newt to a vet for proper evaluation. If it's over the entire eye surface that suggests a conjunctivitis, which topical treatments might well be able to help. Cataracts involve the lens/lens capsule only and not the whole eye.

One thought though; is the fluorescent light new? There have been problems in reptiles with certain brands of "full-spectrum" lighting causing eye problems, and the pattern described would fit very much with a light issue, reducing as it "burns in". Other significant possibilities would include other environmental factors (possibly something irritant or infectious in the water) given the history. But as I say, a vet who can actually examine the animal will be in a much better position to evaluate it.

I hope you can get him sorted out.

Thank you very much, Bruce. The whole eye is affected, but is worse in one patch. The light is new, but I think the newts may have been squinting prior to the light strip change. I do have an exotics vet in town and I think I will see what I can do about getting an appointment. I very much appreciate your input.

Heather - I had sort of a similar experience with one of my tigers. The eye became swollen and for lack of a better word 'gunky'. We went to an exotic vet, and as Bruce suggested, the diagnosis was conjunctivitis...apparently secondary to a piece of substrate which had been introduced into the eye or a nip from a tank mate, in that there was also an ocular abrasion. This situation was readily treated with twice a day flushing with sterile amphibian ringer's solution and twice daily application of sterile ophthalmic Neosporin for two weeks. I am happy to report that the issue is completely resolved. Good luck with your little guy.

Thanks Jan. To me the eye does not look like it is producing any discharge, but because the newt is in an aquatic environment and the eye is so small maybe I am missing any other symptom's. But it does look similar to corneal ulcerations I have seen, but those all seemed to be painful and I just don't think this animal is eliciting much pain because it is no longer squinting and is eating well. I do not have to work Tuesday so I was originally planning on taking it to the exotics vet, but now a family member needs to borrow my car. Do you think using amphibian ringers and the opthalmic Neosporin without a diagnosis would be too risky?

Heather, take this for what little it may be worth as I am not a vet. Until you can get to your exotic vet for evalulation of the eye, in my opinion, administering ocular flush with sterile amphibian ringer's solution would pose minimal risk. Assuming (which is always risky) that it is a bacterial conjunctivitis, applying sterile ophthalmic Neosporin ointment would also appear to be of limited risk. The risk here being that the infecting organism(s) is/are not bacterial or if so, not sensitive to the antibiotics (which, however, can only be determined by culture and sensitivity). We did not do a C&S on my tiger's eye. Both of these supportive treatments in the short term would not appear to present substantial risk.

This condition may be due to other diseases, non-infective such as corneal disease or keratitis, etc. These various rule-outs will require exam by ophthalmoscope or slit lamp and potentially would require the use of dyes, etc., depending on what the vet observes.

Other thoughts that come to mind:
- You indicated that the eye problem developed within a week of the newt being placed in a new environment. The problem had not occured in the quarantine environment where the newts had been maintained for several months. I would consider placing the newts back into an environment that mimics the quarantine environment. Some ocular conditions can be caused by the environment and nutrional factors.
- You indicated that the lights are new. As an interesting side point, some keratitis in amphibians has been associated with prolonged exposure to UV light - with progression the corneal surface can be affected (not suggesting this, just mentioning it).
- Might you want to isolate the newt from his tankmate in the event that the condition is infectious?

Hope you can see your vet in the near future. Please keep us abreast of the outcome.

Thank you so much. Hopefully I can get him to a vet within the week.

Just an Update

To those of you who are interested, the newt subject of this thread is doing well. About 10 days ago I noticed the eye looking less cloudy/opaque. The eye has continued to make improvements and is almost back to normal. Around the periphery of the eye there is still white, but other than that the rest of the eye looks normal. I regret that I never had a chance to take the little guy to the vet - do to another pet emergency that same week that required a big portion of my animal budget in vet bills, this little guy was unfortunately neglected. I consider the newt and myself very lucky that the condition did not worsen and become severely infected. Because of this incident, though, I have put aside a bit of my savings for just such a situation in the future. Now that I have recovered financially, I am still a little tempted to take the newt to my exotics vet to see if I could get a diagnosis (I am very curious what they think it may have been) but because the condition is so much improved I wonder of they could tell me anything.

Anyway, thanks to all who wrote suggestions and offered encouragement, I very much appreciated it.

Heather

Heather, so nice to hear that the eye has improved. Just out of curiousity, did the eye spontaneously improve or did you empirically treat or change environmental conditions?

Jan, I am embarrassed to say that I did not do anything to help the newt recover except do more frequent water changes to help keep the water "cleaner". I had the best intentions of doing the amphibian ringers but just never set aside enough time to do it. Thats why I feel I and the newt are so lucky he has recovered so well.

Update Number Two

Well, the condition re-occurred but luckily this time I could consult a vet. He told me that the cloudiness was likely due to some sort of trauma that caused fluid to collect under the cornea, and the diagnosis is bacterial conjunctivitis. No fluorescene (spelling?) was performed to check for an ulcer (can they even do that in amphibs? I know its done all the time in dogs and cats to check for corneal ulcers). So don't know if there is an ulcer but decided to use an opthalmic med that did not include a steroid just to be safe. What's been prescribed is Tobramycin 0.3%. I have yet to use the medication, though, because...well, I wanted to check with you guys first. The doctor was nice and all and this exotic hospital does see a good many snakes, ferrets, turtles, etc, but I don't think they see/treat too may amphibians and caudates in particular.The front desk gave me a caresheet when I checked in about amphibian care but it didn't say one thing about newts! I don't think this guy had ever treated a newt before and I know I should trust him but I wanted to make sure that Tobramycin is safe for use in newts. He prescribed one drop per eye BID for 10 days. Should I proceed with said medication, or call them back and ask if I could try something else? They also had B.N.P but only in an ointment and the Tobramycin is a solution. Thanks all,

Heather

jewett said:

Well, the condition re-occurred but luckily this time I could consult a vet. He told me that the cloudiness was likely due to some sort of trauma that caused fluid to collect under the cornea, and the diagnosis is bacterial conjunctivitis. No fluorescene (spelling?) was performed to check for an ulcer (can they even do that in amphibs? I know its done all the time in dogs and cats to check for corneal ulcers). So don't know if there is an ulcer but decided to use an opthalmic med that did not include a steroid just to be safe. What's been prescribed is Tobramycin 0.3%. I have yet to use the medication, though, because...well, I wanted to check with you guys first. The doctor was nice and all and this exotic hospital does see a good many snakes, ferrets, turtles, etc, but I don't think they see/treat too may amphibians and caudates in particular.The front desk gave me a caresheet when I checked in about amphibian care but it didn't say one thing about newts! I don't think this guy had ever treated a newt before and I know I should trust him but I wanted to make sure that Tobramycin is safe for use in newts. He prescribed one drop per eye BID for 10 days. Should I proceed with said medication, or call them back and ask if I could try something else? They also had B.N.P but only in an ointment and the Tobramycin is a solution. Thanks all,

Heather

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This is a 'touchy' situation - I try not to second guess vets, but rather have pertinent discussions. Some thoughts:

• Aminoglycosides (tobramycin, gentacmicin, amikacin) are fairly toxic compounds in humans and other species when given systemically. In amphibians, semi-permeable skin would allow for some systemic absorption (presumably) when administered topically. I know nothing about the species you keep other than it is quite a small animal.
• The tobramycin product is a solution and in an aquatic animal I would wonder how much contact time the medication would have with the eye during the dosing period. A second thought would be that the med would dissipate into the water – not sure if the resulting aquatic concentration would be meaningful but hypothetically it could be…i.e., increased exposure to a toxic compound in the animal’s environment.
• If C & S wasn’t performed (I assume it wasn’t) then tobramycin is being used empirically. If this is the case, I might wonder if NBP ophthalmic (which is fairly safe in newts/sals) wouldn’t be a reasonable first choice, reserving tob if NPB is ineffective. Additionally, the ointment vehicle may provide greater contact time on the ocular surface during the dosing period.

I tend to be conservative. I think we still have much to learn about medication in caudates.

Thanks so much, Jan. You are right, no culture and sensitivity was done. I think I would like to go with the ointment, then, and will call the vet back. BNP and NBP are one and the same I take it? I hope I can manage to apply ointment to the afflicted eye without wasting too much!
And I am thinking that I will be keeping the animal on damp paper towels while it is being treated. I am sure the antibiotic would mess with my biological filter in my tank, and think that the ointment will just wash off anyway without having time to work if the animal is placed back in the water even several minutes after treatment.
Thanks again,
Heather

jewett said:

Thanks so much, Jan. You are right, no culture and sensitivity was done. I think I would like to go with the ointment, then, and will call the vet back. BNP and NBP are one and the same I take it? I hope I can manage to apply ointment to the afflicted eye without wasting too much!
And I am thinking that I will be keeping the animal on damp paper towels while it is being treated. I am sure the antibiotic would mess with my biological filter in my tank, and think that the ointment will just wash off anyway without having time to work if the animal is placed back in the water even several minutes after treatment.
Thanks again,
Heather

Click to expand...

The abbreviation is for the same triple antibiotic formulation - generically; neomycin, polymixin and bacitracin (sold by several generic pharma mnfs) with the brand name product being Neosporin sterile ophthalmic ointment. It is a fairly broad-spectrum antibiotic product. I think you will find that you don't waste much. The delivery end of the tube is very narrow and easy to control to produce a tiny 'glob'. Just try to keep the animal's head as still as possible when dosing - don't want further trauma from the metal delivery tube. When dosing my tiger's eye for conjunctivitis (much larger animal, however) I found it to be an easy process....and in our case, an effective treatment.

When speaking with the vet, I might just explain my thoughts and ask him/her if this approach has any merit. There may be a reason tob specifically was selected but perhaps not. In any event, I would try not to alienate the vet ...there aren't that many exotics around.

I would be interested if anyone else has had experiences with aminoglycosides in caudates - anyone?

Thanks again, Jan - you are so knowledgeable and helpful! I will contact the vet and see about getting a new 'script.

Recently one of my newts also seems to be closing his/her eyes. I really doubt that that he is sleeping. Does anyone else have this problem? What can I do?

The other newt in the tank is completely normal.

Gingrich, what makes you really doubt the newt in question is sleeping? I do find my animals occasionally resting quietly with their eyes have closed, so it may be possible your animal is simply resting as well. Other than closed eyes do you notice any other odd behavior or symptoms? What species do you keep? At what temperature do you keep your tank, and how do you have it set up?