T.gigas evanescens Eye Disorder Diagnosis

[Kbell31]

Please comment. Attached are pictures.
My Merauke has been having on again off again issues with her left eye. She has been to the vet, twice. I am seeing a trend in gigas eye issues lately and the diagnosis doesnt seem to be nailed down.
The first vet visit I was told to put preservative free dry eye drops in her eye daily. This protocol did not seem to help, though it did not seem to worsen it either.
The symptoms are: yellowish crust around the eye, inflamed third eyelid, indented eye in socket.
Her temps/humidity- Day 68-74F cool side, 78-81F hot, basking rock 97F.Night 65-68F. Humidity 55%. She is on aspen, eats 1x/2wks a mixture of blue buffalo cat food, snails or chicken with a mix of vegetables, peppers,mushrooms,mustard greens, radishes and some type of squash. She eats fruit in between feedings, a few blueberries here and there, apple, mango, etc. I dust/spray a calcium w/out D3 supplement every other feeding and do a vitamin supplement 1x/mnth.
After a warm soak her eye will nearly completely recover to normal. Then in a matter of a day or two it will start to exhibit symptoms again.
I have always maintained good husbandry with her and I am saddened this is occurring.
The second vet visit I was told to switch bedding so I did a full tank cleaning yesturday and have replaced the aspen with carefresh bedding. I have not used this before.
I was given two medications, a liquid antibiotic labeled SMZ liquid-to give .5 ml every 12 hrs. for 7-10 days and an eye ointment, labeled Neomycin and Polymycin B Sulfates and Dexamethasone to be instilled in the eye once every 12 hrs for 5-7 days. .
The vet would like to get a culture of the eye some time next week.

And so the story goes we are leaving on vacation. Tomorrow. The vet said to atleast get her started on the antibiotics and continue when we get back in 5 days. I have attached photos, I would appreciate ideas, comments on the medications if anyone has experience with them and maybe some encouragement.
Thank you.

[Susann]

I really don't think anybody here will be able to help you with a diagnosis either.
I don't want to make you feel discouraged, but if it is the same thing many of us have struggled with, then we can tell you that we've never gotten a diagnosis either.
We've used drops, and ointments, we've soaked, we've wiped, we've dried, we've medicated. There would sometimes be improvements that lasted through a shed or two.
I don't want to make you feel like it's useless for you to try all those things, I just want to let you know ahead of time that it's not because you're not doing a good enough job IF you don't see improvement.

The only thing that made Joey better for longer than a shed or two was the injections I told you about.

Now, Joey passed away before I figured out the MistKing. And none of my other sick skinks were anywhere near as "inflamed" as Joey was before I installed the MistKing that seems to have stopped the progression.

I really don't mean this as discouragement, for you or anybody else who may be seeing eye symptoms, but I'm going to post some pictures of Joey's eyes, in case you recognize that it does not look similar at all. I obviously don't have pictures of all the stages of his progression as a lot of the time I didn't even want to take pictures at all.

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I wish I could tell you that the MistKing would fix, or even help, your girl.... I don't know. But if you do find something that seems to work, please let us know.
Will you have someone looking in on her while you guys are gone?
I almost find it a little odd that your vet would tell you to give her a couple doses of the medication if she won't be getting it for the next 5 days.... I don't know if there's any way for her to keep getting the medication while you are gone?

[Kbell31]

Im sorry about Joey Susann.
My mother will be checking in on her everyday, but I am not sure she would be successful in administering the meds. It takes two people, one to hold her while the other doses. She may be able to do the eye ointment herself and she said would try.
Of course we would be leaving now for vacation, I will be worrying the entire time.
Your pictures in my opinion do look similar, and she is rubbing her eye a lot as well. I was hoping someone had heard of these medicines and would have chimed in on their safety records. The diagnosis was just a long shot.
I too was suprised the vet wanted to start the meds now before we left. Honestly I only did one dose of the antibiotics yesturday, and today the ointment only. I dont feel comfortable leaving her after trying something new, if she were to have a bad reaction to it, no one would be here to monitor her.
Im going to continue to update and Susann I will show my vet these discussions and your success with the mistking when we get back. Unfortunately this seems it will be more serious than I had anticipated and I dont want to take it lightly.

[Lea]

There is a possibility of greater antibiotic resistance when the bacteria is subjected to higher temperatures, or thermal stress, (Alejandra Rodríguez-Verdugo, Brandon S Gaut and Olivier Tenaillon. Evolution of Escherichia coli rifampicin resistance in an antibiotic-free environment during thermal stress. BMC Evolutionary Biology).


It's not a widely documented fact, but given that you are away for a few days and cannot administer medications, it may be beneficial to reduce your high end temperatures by a few degrees to perhaps decrease the possibility of your skink developing resistance. It may also reduce the rate at which the antibiotics are metabolised, increasing the half life, therefore increasing the time where the antibiotic is at an effective or active level. I know there are articles supporting a slowed metabolic rate, but I don't have any articles to link you, sorry. If El Lobo comes by, he may be able to help with articles.

I know this doesn't directly assist you with the undetermined eye problem, but it's a sort of get by solution to cope with being away. I don't suppose you can take your skink with you, or you can rearrange your holiday to help better the outcome?

[El Lobo]

There are not many pharmacokinetic studies available for reptiles and in particular BTS. A precautionary approach seems to be the consensus in maintaining POTZ (preferred optimum temperature zone) by supplying enough heat to allow the reptile to achieve and maintain PBT (preferred body temperature) during treatment.

Link below to veterinary formulary book pp109-110.

http://books.google.com.au/books?id=WIT ... es&f=false

An article I posted a couple of years ago.
viewtopic.php?f=19&t=17735&p=369597&hilit=pharmacokinetic#p369597

[Scotts1au]

Unfortunately I have a bit of experience in treating bacterial infections with Easterns and adopted the philosophy that antibiotics were affective as a supportive therapy but really the bluey needs to do the work. In this case the symptoms do look familiar - fair to say seen on this site over the years many times, particularly from WC animals. Kat had the same problem with her little one Nemo who eventually died despite probably the most intensive attempt to save a blueys that I've seen.

My suspicison at the time was a resident infection of some sort but something possibly endemic where these guys live. Visible symptoms on mucous membranes around the mouth and eyes are typical of of a systemic and resident infection that treating the eyes alone won't fix. I think that there are enough indicators that antibiotics help at least in the short term but haven't to date killed off whatever it is causing the problem - close but no cigar. Staph aureas is an example of a bug that can get into the bones and mucosal linings and be very difficult to eradicate - and you may need to talk to the vet about whether a protocol for treatment might be best along the lines of what one might use for something like oesteomyelitis. It is worth asking the question of your vet.

BTW I know I go against some of the others on this site but I have had good sucess in maintaining blueys at higher temperatures -at or around 33C continuously during periods of illness.

[hurricanejen]

Offering a higher range of temps for them to seek out while ill can help immensely, but be cautious about keeping the whole cage warm while you're gone. Great advice here already from the 'big guys'

What kind of bedding are you keeping her on? It looked to me from the pics like pine shavings, although I know aspen is sometimes cut in a similar way. I've seen pine cause nasty skin problems with snakes and lizards kept on it. Since she is experiencing eye issues, it may be beneficial to take her off a bedding that is at all dusty - maybe use reptibark/orchid bark for a while? I'd say cypress, but the sharp edges may also irritate the eyes.

My only other contribution is to try different things - as Susann noted, if there is no improvement then something isn't working yet. Reptiles are extremely good at seeking out conditions that help them to improve, including cooler temps sometimes as needed, or more humidity, etc. Offer her as wide a range of options to choose from as possible while you're gone, and when you come back keep a diary of where you see her within the cage and what condition her eye is in during different times of day. From there you can figure out if you should increase temps, humidity, or decrease them as needed.

Good luck, keep us posted!

-Jen

[Kbell31]

I have always had her on aspen, never pine. I changed it out to carefresh now though. We will try that for awhile.
I am back from vacation and Indah is in the middle of shedding, ornery and hiding most of the day. I offered her food this afternoon but she only ate a few bites and then went and hid again. Her eye looked pretty good to my suprise. I didnt start up the antibiotics yet or ointment. I think I will begin the consecutive treatment after she is done shedding, mostly because she just hides during this time anyways and I would rather not mess about with her when that is going on. I will keep updating. And thank you to everyone who responded.

[xxmonitorlizardxx]

Blueberry had eye problems that looked almost exactly like, and the eye would look much better after shedding. When I took him to the vet, the vet prescribed some antibacterial lubricant/ointment. I unfortunately don't remember what it was called. The vet also mentioned increasing the humidity.

[Kbell31]

The ointment I have is an antibacterial/steroid combo. Its called Neomycin and Polymcin..sound similar?

[ScooterBTS]

My blue tongue has the same problem. I have tried the Mist-king without success, and im going to try Vit-a, calcium with d3, and antiobiotics shots. This disease sucks, I always have problems with reptiles. I had a chameleon that lived liked 2 years and then died. My bearded dragon had mbd and died, and now my blue tongue has a nasty unknown disease. I just hope these shots work

[Lea]

My blue tongue has the same problem. I have tried the Mist-king without success, and im going to try Vit-a, calcium with d3, and antiobiotics shots. This disease sucks, I always have problems with reptiles. I had a chameleon that lived liked 2 years and then died. My bearded dragon had mbd and died, and now my blue tongue has a nasty unknown disease. I just hope these shots work

I think you should exercise great caution if ever contemplating another reptile. You may have undiagnosed husbandry issues that could be contributing to your high morbidity rate. I'm not targeting your care specifically and I'm sure you are endeavouring to deliver a high quality care environment, but it could do you well to get right back to basics, overhaul your enclosure and look closely at all areas of husbandry. There unfortunately might be something that's wasn't picked up with your chameleon that has rolled over and influenced the well being of the other reptiles. This could be as well as the eye condition, although the eye condition could be the only outward sign of illness, there might be something underlying that has caused your animal to be predisposed to this problem.