Neonatal Ophthalmia in Dogs

Eye infection with inflammation of the conjunctiva (also called pink eye or red eye) is a common condition in dogs. Newborn puppies are especially prone to developing conjunctivitis at about two weeks of age, shortly before or shortly after their eyes first open. Bacteria acquired from the mother during the birth process spreads to the eye which is unable to properly flush itself at that age. As the bacteria reproduce and grow in numbers, the eye becomes infected and swollen, often exuding a thick purulent discharge. Most conditions are treatable if caught early, but delayed treatment can result in complications and even vision loss.

Newborn dogs sometimes develop an eye infection during the first few weeks of life, before their eyes are fully open. Bacteria multiply behind the eyelid causing infection, swollen eyelids, and discharge of pus. In veterinary terms, this is called Neonatal Conjunctivitis or Neonatal Ophthalmia.

It’s crucial to treat neonatal conjunctivitis early, so take your puppy to see a veterinarian immediately if you notice any of the following symptoms:

• Eyes are swollen or bulging before they open
• Discharge of mucus or pus as the eyes start to open
• Eyelids crusted over with discharge
• Eyelids glued together by discharge
• Red or watery eyes
• Generally poor health and failure to thrive

Types

Conjunctivitis in dogs is divided into several types. Most neonatal conjunctivitis falls into the category of purulent conjunctivitis. Occasionally other conditions can sometimes be mistaken for conjunctivitis.

• Serous conjunctivitis - characterized by redness, itching or clear discharge; often caused by an allergic reaction or an infection from a foreign body.
• Follicular (mucoid) conjunctivitis - characterized by rough patches on the eye and discharge of mucus; caused by inflammation of the mucosal follicles in response to an infection or a foreign body.
• Purulent conjunctivitis - characterized by the discharge of pus, crusted eyelids and inflamed conjunctiva; usually related to a bacterial infection; common strains include streptococcus or staphylococcus. This type of conjunctivitis should always be treated by a veterinarian.
• Chronic conjunctivitis - recurring conjunctivitis that does not respond to treatment.
• Dry eye (keratoconjunctivitis sicca) - a serious condition in which the tear glands fail to produce sufficiently. Since it causes either dry or watery eyes, it can sometimes be confused with conjunctivitis. Middle aged to older dogs are usually affected so this should not be a cause of neonatal ophthalmia.

The vast majority of eye infections in newborn dogs are caused by bacteria from the mother which is acquired during the birth process. Since a puppy’s eyes normally take 10-14 days to open, the bacteria will not be flushed out of the eye and have ample opportunity to proliferate.

• Ankyloblepharon, a condition in which the eyelids are partially fused together, can increase the likelihood of neonatal infection.
• Puppies born in the same litter often develop similar infections.
• More serious systemic bacterial infections or sepsis can sometimes cause or contribute to neonatal conjunctivitis.
• Congenital eye conditions can occasionally lead to similar symptoms e.g. entropion or ectopic cilia.

Neonatal conjunctivitis can usually be diagnosed based on the symptoms and the time of onset. Describe the puppy’s symptoms to your veterinarian and arrange an office visit at the earliest possible time. The veterinarian will be able to analyze the condition by observing the symptoms and will most likely prescribe treatment such as eye drops. If the condition is not responsive to treatment, a bacterial culture test may be required for further analysis.

Any obvious symptoms like eye swelling and discharge are crucial to making an accurate diagnosis. Additional factors like the age or the puppy, the degree to which its eyes are opened, and the health of other members of the litter can also be important. The overall health and demeanor of the puppy can also help to indicate if there is a problem.

The most important and immediate treatment will be to fully open the puppy’s eyelids and flush out the bacteria. With puppies at least a week old, the eyelids may be able to be gently pried apart. If the puppy is still very young, or if there is a genetic abnormality and the lids are partially fused, the veterinarian will need to use a surgical instrument to separate them.

Once the eyelids are open, the veterinarian will clean out the accumulated discharge and prescribe antibiotic drops or ointment. Most likely this medication will need to be applied several times a day. Young puppies do not always produce adequate tears, so artificial tears may also need to be prescribed to prevent the cornea from drying out and causing further complications. Any medication containing corticosteroids is absolutely contraindicated as it will inhibit the eye’s natural ability to flush and can cause bacteria to proliferate.

If the discharge continues and the eyelids become stuck together again, they will need to be re-separated and cleaned. Most infections will clear up with antibiotic treatment. If the infection fails to respond to treatment, another office visit, and further testing will be required.

Most puppies with neonatal eye infection make a complete recovery with no reoccurrence or complications. If treatment is delayed, however, or the condition is left untreated, it can damage the cornea and cause vision impairment or blindness and these conditions will need to be managed.

The overall health of the puppy can also be a contributing factor in recovery, so it’s important to maintain adequate feeding and nutrition. This may include hand feeding if the mother is absent, or ensuring that the puppy isn’t pushed aside by stronger siblings at feeding time. It’s also important to ensure that other siblings are treated if they exhibit any symptoms to prevent cross-infection.