Extended Use of Subpalpebral Lavage Systems for Treatment of Keratitis in a Harbor Seal (Phoca vitulina)
Abstract
A wild neonatal male harbor seal having discharge from the left eye was collected by the Northeast Marine Animal Lifeline and brought to the
New England Aquarium (NEA) for treatment. Ocular examination revealed left corneal ulceration and bilateral keratitis. Topical antibiotics and anti-inflammatory
medications were administered. However, ocular disease remained uncontrolled after six weeks and it became increasingly difficult to medicate the animal. The seal
exhibited severe diffuse corneal edema and appeared quite painful, persistently squinting and closing its eyes.
The seal was sedated and anesthetized six weeks post-presentation to NEA. A subpalpebral lavage system used for horses was placed for each eye
and sutured to the skin of the seal's forehead. Cytologic evaluation of the corneas showed mild neutrophilic inflammation of unknown etiology. No aerobic or
anaerobic bacteria were cultured from the corneas. A fungal culture revealed a Candida sp.
Following recovery from anesthesia, a regimen of topical ophthalmic medications including ciprofloxacin, fluconazole, atropine, ocufen, and
serum was delivered through each lavage system 3-4 times daily. The seal was also receiving oral baytril (22 mg BID) and metronidazole (125 mg BID). Initially,
the seal was kept out of the rehabilitation pool, then it was allowed supervised swims with other rehabilitating wild seals. The seal did not try to remove the
lavage systems, and it was not disturbed by other seals. Eventually, the seal was allowed access to the pool at all times (day and night), receiving eye
medications when it hauled out for feedings.
Over the next several weeks, the seal underwent anesthesia for additional corneal debridements. The subpalpebral lavage systems remained in
place for 16 weeks, during which time the ocular lesions slowly healed. Staff members closely monitored the lavage systems. Sutures holding the lavage system to
the forehead required replacement fairly frequently. Suture replacement was quickly accomplished without the need for sedation.
The subpalpebral lavage systems were removed under sedation. The seal was released to the wild approximately six months after arrival at the
NEA. It has been tracked via satellite tag.
Acknowledgements
Thanks to Connie Merigo, Andrea Osborne, Bob Cooper, Greg Early, Andy Stamper, Peter Merrill, Greg Jakish, and NEA volunteers for assistance
with this case.