Abstract
Cyclosporine (CSA) implants are commonly used to help control Equine Recurrent Uveitis.2 These implants have also been used in pinnipeds to control otariid keratopathy, a common ophthalmological problem affecting sea lions and fur seals. Since cataracts are also very common in pinnipeds,1 cyclosporine implants have been commonly surgically implanted immediately following lensectomy or at a prior anesthetic event in order to address this concurrent problem.
A 22 year old male neutered California sea lion with a history of otariid keratopathy was sedated in December of 2011, for placement of subjunctival cyclosporine implants (Lux Bio Sciences Jersey City, NJ) OU. Ultrasound evaluation was also performed on the eyes to confirm the presence of cataracts. At this time, it was determined that the animal had mature cataracts in both eyes, but lensectomy was not performed. Following implantation with CSA, all medications used prior to implants were continued: 0.3% Tacrolimus OU TID, 50 mg Doxycyline PO BID, 50 mg Tramadol PO BID, 3 tablets Large Breed Dasuquin (Nutramax Laboratories Edgewood, MD), and 6 capsules Eye Sea (Animal Necessity New York, NY). Photographs were taken to evaluate the keratitis in both eyes and trainers noted a mild improvement in the animal's vision. The clinical improvement noted was that the animal's eyes were open almost constantly following placement of the implants.
After several months, it was decided to perform bilateral lensectomies on this animal to improve quality of life and prevent possible lens luxation. Two weeks prior to surgery, corneal ulceration was noted OS. Treatment with oral and topical antimicrobials were initiated. In October 2012, bilateral lensectomies were performed. During surgery, bilateral conjunctival biopsies were taken to evaluate cyclosporine levels. A second set of CSA implants were placed, and corneal cultures and cytology were performed. Cytology of the left cornea revealed numerous buds and hyphae. Appropriate oral and topical anti-inflammatory, antibacterial and antifungal medications were initiated. Following surgery, significant improvement was observed by the trainers in regards to vision. Photographs were taken weekly to evaluate corneal healing.
Acknowledgements
The authors thank the staff and trainers at Gulf World Marine Park for the excellent care they provide to all the animals. We would also like to thank Drs. Michael Walsh and James Bailey for their knowledge and expertise during all of the pinniped surgeries that have occurred at Gulf World Marine Park.
* Presenting author
Literature Cited
1. Colitz CM, Saville WJ, Renner MS, McBain JF, Reidarson TH, Schmitt TL, Nolan EC, Dugan SJ, Knightly F, Rodriguez MM, Mejia-Fava JC, Osborn SD, Clough PL, Collins SP, Osborn BA, Terrell K. 2010 Risk factors associated with cataracts and lens luxations in captive pinnipeds in the United States and the Bahamas. JAVMA 237:429–436.
2. Gilger B, Malok, E, Stewart, T, Horohov D, Ashton P, Smith T, Jaffe GJ, Allen JB. 2000. Effect of an intravitreal cyclosporine implant on experimental uveitis in horses. Vet. Immunol. Immunopathol. 76:239–55.