Blackwell's Five-Minute Veterinary Consult: Reptile and Amphibian. Javier G. Nevarez

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Blackwell's Five-Minute Veterinary Consult: Reptile and Amphibian - Javier G. Nevarez

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DR, ed. Reptile Medicine and Surgery. 2nd ed. St. Louis, MO: Elsevier Saunders; 2006:862–864.

      2 Bennett, RA. Cloacal prolapse. In: Mader DR, ed. Reptile Medicine and Surgery. 2nd ed. St. Louis, MO: Elsevier Saunders; 2006:751–755.

      Author Rob L. Coke, DVM, DACZM, DABVP (Reptile & Amphibian), CVA

      Conjunctivitis

      

BASICS

      DEFINITION/OVERVIEW

      Conjunctivitis is defined as inflammation of the conjunctiva. In reptiles, conjunctivitis often presents concurrently with blepharedema, which is edema and swelling of the eyelids. In many cases, the blepharedema is severe enough to impede proper evaluation of the eye and hence identification of conjunctivitis. Blepharoconjunctivitis is a common presentation.

      ETIOLOGY/PATHOPHYSIOLOGY

       Conjunctivitis is most often caused by viral or bacterial infections.

       Other etiologies include fungal or parasitic infection, poor water quality, and environmental irritants or toxins.

       Trauma may also be a cause, especially in cases of unilateral conjunctivitis.

      SIGNALMENT/HISTORY

       There is no specific signalment for the occurrence of conjunctivitis.

       The main focus should be on obtaining a thorough history of the husbandry.

      CLINICAL PRESENTATION

       In addition to the conjunctivitis itself, chelonians often present with blepharedema, blepharospasm, and/or periocular swelling usually affecting both eyes and causing blepharoconjunctivitis.

       Animals may also present with anorexia, depression and lethargy due to either the systemic effects of the underlying etiology (e.g., herpes virus) or simply from their inability to see properly.

      RISK FACTORS

       Husbandry

       Poor cleanliness and hygiene of the enclosure can lead to increased environmental bacterial load, which can contribute to conjunctivitis.

       Poor water quality for aquatic chelonians causing high ammonia levels.

       Others

      N/A

DIAGNOSIS

      DIFFERENTIAL DIAGNOSIS

       Herpes virus

       Ranavirus

       Mycoplasmosis

       Chlamydiosis

       Toxin exposure (ammonia, aromatic oils from cedar chips)

       Trauma

       Parasitic (leeches or trematodes)

      DIAGNOSTICS

       A complete ophthalmic examination with the use of magnification by direct or indirect ophthalmoscopy including fluorescein test for corneal ulcers.

       Sampling of the conjunctiva for bacterial culture and sensitivity.

       PCR for herpes virus, ranavirus, Mycoplasma sp., or Chlamydia sp., according to other clinical signs and presentation.

      PATHOLOGICAL FINDINGS

       Blepharoconjunctivitis is a common presentation.

       Plaques or caseous material may be observed within the fornix or even covering the corneal surface.

       Mucopurulent discharge

TREATMENT

      APPROPRIATE HEALTH CARE

       Treatment will be based on the underlying etiology; anti‐inflammatories and analgesics should be considered in most cases.

       Treatment of viral infections is often unrewarding.

       Concurrent systemic and ophthalmic therapy is recommended for best response.

       Flushing and cleaning of the eyes is also necessary to remove any adhered material or plaques that may be harboring organisms.

       A solution of 1 part povidone iodine to 50 parts saline can be used.

       When blepharedema is present, a pipette tip, tomcat catheter, or intravenous catheter can be inserted between the eyelids to flush the eyes.

      NUTRITIONAL SUPPORT

       In cases of anorectic animals, force‐feeding with easily digestible proteins should be initiated.

       Direct feeding by stomach tubing can be performed in some species; placement of an esophagostomy tube should be considered for chronic management.

       Supportive fluid therapy should be provided.

      CLIENT EDUCATION/HUSBANDRY RECOMMENDATIONS

       Remove and isolate sick individuals and reduce stress by providing optimal living conditions and hygiene.

       Thorough cleaning of cage to reduce environmental load of infectious organisms.

       Ensure that quarantine protocols have been implemented for all new arrivals.

       Treatment compliance is key for response to therapy.

MEDICATIONS

      DRUG(S) OF CHOICE

       Systemic Therapy

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