Abstract
Primary lipid keratopathy refers to lipid infiltration into the cornea that occurs in the absence
of underlying ocular pathology, and is associated with disorders of lipid metabolism. Lesions of primary lipid
keratopathy consist of hazy or crystalline to dense white corneal opacities that occur initially at the limbus and
advance towards the central cornea as the disease progresses .1,2,4 Several cases of lipid keratopathy in
anurans have been reported in the literature; however, the causes and risk factors associated with the disease in these
species remain obscure.3,5,6 The purpose of this study was to further identify susceptible species of
amphibians and reptiles, and factors predisposing to the development of the disease. A survey of 28 North American zoos
was conducted and retrospective and current cases at the Toronto Zoo were reviewed.
In the survey, fourteen zoos reported a total of 28 cases of lipid keratopathy in the following
species of anurans: Litoria caerulea, Litoria aurea, Osteopilus septentrionalis, Agalychnis callidryas, Hyla
arenicolor, Hyla eximia, Dyscophus antongilli, Kaloula pulehra, Ceratophrys ornata, Scaphiopus couchii and Bufo
gutattus.
At the Toronto Zoo, all five adult female White's tree frogs (Litoria caerulea) previously
held in the collection had high serum cholesterol and developed lipid keratopathy, while three male conspecifics were
unaffected and had low serum cholesterol (Table 1). The diet consisted of crickets three times weekly and pinkies once
weekly. Currently, the zoo houses three females that are fed crickets three times weekly and pinkies once monthly and
have low serum cholesterol (Table 1). One of these females has lipid keratopathy. Values from unaffected captive New
Guinea tree frogs, fed crickets three times weekly and pinkies once weekly, are presented for comparison (Table 1).
Four out of five female Colorado river toads (Bufo alvarius) previously in the collection had
lipid keratopathy. There are currently 6 females in the collection, two of which have lipid keratopathy. The diet has
always consisted of crickets fed three times weekly and pinkies once weekly. Both affected and unaffected females have
high mean serum cholesterol (Table 1). Serum cholesterol determinations repeated over several years revealed wide
fluctuations within individuals. Serum cholesterol values for three female Marine toads (Bufo marinus), fed the
same diet, are presented for comparison (Table 1).
The findings in this review of retrospective and current cases are consistent with the literature in
that lipid keratopathy appears to be primarily a disease of older female frogs of certain species. The disease is more
frequent in females that have high serum cholesterol. Although the literature suggests the feeding of pinkies as a
cause,3,6 some species fed pinkies maintain low serum cholesterol and are not predisposed to lipid
keratopathy. As part of a larger study investigating the cause of lipid keratopathy in Cuban tree frogs, we have induced
the disease in female frogs fed only crickets. In these animals, both female and male frogs developed elevated serum
cholesterol in captivity, compared to wild conspecifics. Captive females affected with lipid keratopathy had
significantly higher serum cholesterol values than unaffected captive females.
Lipid keratopathy in reptiles has not been described in the literature. In the survey, four plumed
basilisks (Basilisk plumifrons), two speckled Cape tortoises (Homopus signatus) and one Madagascan day
gecko (Phelsuma madagascariensis) were identified as having lipid keratopathy. At the Toronto Zoo, there have been
two cases of primary lipid keratopathy in female plumed basilisks, and one in a female green water dragon
(Physignathus cocincinus). Their diet consists of crickets three times weekly and pinkies and mealworms once
weekly. The green water dragons are also fed mixed vegetables once weekly. Repeated cholesterol determinations on several
animals in the collection revealed high serum cholesterol in most individuals of both sexes (Table 2). This appears to
indicate that either high serum cholesterol is normal in both sexes of these species, or both sexes have problems with
lipid metabolism in captivity. Because all basilisks and water dragons had high serum cholesterol, no association can be
made with the presence of lipid keratopathy.
Table 1. Serum cholesterol values and signalment of anurans at Toronto Zoo.
Species |
n |
Sex |
Age (yr) |
Cholesterola |
Lipid
keratopathyb |
White's tree frog (historic) |
5 |
f |
7-12 |
34.1 (8.5-55.0) |
+ |
White's tree frog (historic) |
2 |
m |
5,18 |
1.4, 2.9 |
- |
White's tree frog (current) |
3 |
f |
at least 2-5 |
< 0.9, 2.8, 5.2 |
1+, 2- |
New Guinea tree frog |
3 |
f |
2-4 |
3.0, 3.8, 20.8 |
- |
New Guinea tree frog |
3 |
m |
2-4 |
1.6, 2.4, 2.6 |
- |
Colorado river toad |
6 |
f |
at least 13 |
18.2 (<0.9-67.7) |
+ |
Colorado river toad |
5 |
f |
at least 8 |
12.6 (3.1-24.5) |
- |
Marine toad |
3 |
f |
9 |
< 0.9, < 0.9, 3.0 |
- |
a. Values are expressed in mmol/L. The value is presented as a mean (range) if the number ofindividuals
sampled exceeded three. Otherwise, the values for each individual are separated by commas. Several of the means include
multiple determinations at different times on individual frogs. 0.9 mmol/L is the limit of detection of the cholesterol
assay.
b. Unless otherwise stated, a (+) or (B) indicates whether all animals in the group had, or did not have lipid
keratopathy.
Table 2. Serum cholesterol values and signalment for reptiles at the Toronto Zoo.
Species |
n |
Sex |
Age (yr) |
Cholesterola |
Lipid
keratopathyb |
Plumed basilisk |
2 |
f |
4, 6.5 |
46.8, 51.5 |
+ |
Plumed basilisk |
1 |
f |
at least 4.5 |
33.6 |
+ |
Plumed basilisk |
3 |
m |
at least 2 |
26.6, 31.8, 50.0 |
- |
Green water dragon |
1 |
f |
11 |
30.2 |
+ |
Green water dragon |
3 |
f |
approx. 5 |
16.0, 17.3, 30.6 |
- |
Green water dragon |
3 |
m |
5-15 |
13.6, 18.4, 23.3 |
- |
a. Values are expressed in mmol/L. Most of the serum cholesterol values for individuals are averages of
two or three determinations made in that individual over a period of years.
b. A (+) or (B) indicates whether all animals in the group had, or did not have, lipid keratopathy.
Acknowledgments
We thank the respondents of the lipid keratopathy survey. We also thank past Toronto Zoo resident
Karrie Rose for historic serum cholesterol determinations. We are grateful to the keepers of the Toronto Zoo Animal
Health Unit for assistance with the care and feeding of the Cuban tree frogs. The Toronto Zoo Foundation and Association
of Reptile and Amphibian Veterinarians provided financial support. This work was completed as partial fulfillment of a
Doctor of Veterinary Science graduate degree by the senior author.
References
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Surv. Ophthal. 36: 1-22.
2. Bron AJ. 1989. Corneal changes in the dislipoproteinemias. Cornea 8: 135-140.
3. Carpenter JL, A Bacharach Jr., DM Albert, SJ Vainsi, MA Goldstein. 1986. Xanthomatous
keratitis, disseminated xanthomatosis, and atherosclerosis in Cuban tree frogs. Vet. Pathol. 23: 337-339.
4. Crispin SM, KC Barnett. 1983. Dystrophy, degeneration and infiltration of the canine
cornea. J. Small Anim. Pract. 24: 63-83.
5. Dziezyc J, NJ Millichamp. 1989. Lipid keratopathy in frogs. In: Proceedings of the
Third International Colloquium on Pathology of Reptiles and Amphibians, pp. 95-96.
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xanthomatosis, and hypercholesterolemia in Cuban tree frogs (Osteopilus septentrionalis). J. Zoo Wildl.
Med. 21: 99-104.