Neonatal Conjunctivitis in Dogs

Conjunctivitis is an infection of the conjunctiva, the mucous membrane that lines the inner eyelid and covers the front of the eye itself. When this condition affects puppies, it is known as neonatal conjunctivitis, and symptoms generally develop within the first ten to fourteen days. If left untreated, this disorder can cause ulceration and scarring to the eye itself that may lead to blindness. Puppies that have developed this disorder but have not yet opened their eyes will need to have their eyes opened manually for treatment, but this should be done by a professional as mishandling this procedure can have lifelong consequences for the puppy.

Neonatal conjunctivitis is a condition that occurs when a newborn puppy contracts an infection in the eye, usually contracted from their mother during the birthing process.

Symptoms of neonatal conjunctivitis can typically be seen quite early after the puppies are born as the actual infection occurs most often during the birthing process itself. Indications that your puppy or puppies have contracted an infection in the eyes can include: 

• Blindness
• Discharge from the eyes
• Excessive blinking
• Eyelids bulge outwards
• Eyelids sticking together
• Incomplete opening of eyes
• Red eyes
• Rupture of cornea
• Swollen eyelids
• Ulcerations on the eyes

Types

Conjunctivitis, both neonatal and otherwise, can come in many forms, although the symptoms and effects are all quite similar. The main categories of infection include: 

Bacterial - This type of infection is the most common cause of neonatal conjunctivitis in dogs, and is most often associated with a variety of the Staphylococcus bacterium 

Foreign body - Although a foreign body may frequently trigger eyes that are swollen and red in an adult dog, this would be an extremely rare cause of neonatal conjunctivitis as most incidents occur before the eyes open to allow foreign bodies into the eye. 

Fungal - Conjunctiva also provides an optimal breeding ground for fungal infections, and these are also capable of causing uncomfortable and possibly dangerous reactions in the eyes that they infest 

Viral - Viral illnesses are also capable of instigating conjunctivitis in puppies as well as in adult dogs; the most frequently seen viruses that infect eyes and cause conjunctivitis include canine distemper and hepatitis (although these are more likely to affect adult dogs, a dam with these illnesses may pass them on to one or more puppies, which may trigger conjunctivitis)

Neonatal conjunctivitis is generally caused by the transmission of bacteria or viruses from the dam to the puppy during the birthing process. In newborns, the infection is trapped behind the sealed eyelids and can cause damage to the tear glands, reducing the protective lubrication. This can leave neonates at an increased risk for infection and scarring of the eye due to the inability of the infection to be flushed from the eye unassisted. Puppies who are afflicted with ankyloblepharon, a condition in which the opening of the eyelids is delayed due to being fused together, are more likely to develop conjunctivitis.

Both the affected puppy or puppies and the mother will require a physical examination to ensure that they are generally healthy and standard diagnostic tests including a biochemical profile, complete blood count (CBC), and a urinalysis will also be completed on the dam to determine if any systemic infections are present in the blood. The swelling of the puppy’s eyes will be evaluated, and any pus will be cultured as will secretions from within the dam’s vagina. These cultures will help the veterinarian determine not only that an infection is present, but which microorganism is responsible for the swelling and discharge. Certain necessary diagnostic tests and actions, such as the visual examination of the cornea itself and Fluorescein staining of the eye to check the presence of ulcerations on the cat’s cornea, will typically need to be delayed until the eyelids are able to be opened manually to give the examining vet access to the corneas.

Eyelids that are still fused will need to be opened manually to drain the infection from under the lids. In many cases, your veterinarian will be able to accomplish this by gently pulling them apart by hand when the puppies are seven days old or older. The eyelids belonging to puppies that are less than seven days old will generally need to be surgically sliced to allow the fluid to drain from the eye. Once the eyelids are open, the next step will typically be to thoroughly rinse the pus and discharge from the eyes using a warm saline solution, then making a cursory evaluation of the health of the cornea. If the puppy is under five weeks of age their eyes may still appear clouded due to the normal development pattern of canine eyes. A topical antibiotic will be placed on the eyes at this time as well, in order to fight any current bacterial infections and prevent future ones.

Any topical medications that are prescribed by your veterinarian will need to be applied to the eyes several times per day until the infection has cleared and warm compresses will generally be required to prevent the eyelids from sticking together. In many cases, particularly those with very young puppies, you will need to administer artificial tears as well since puppies do not develop the ability to create their own tears until their eyes open naturally, which typically happens at around one to two weeks old. Once the puppies begin to produce their own tears, the artificial tears will no longer be needed.