Please help!! Salamander with "lesions" not getting better

[Starry]

Hi all,
So my salamander was in to the exotics vet a couple months ago because he had a big black spot on his back and smaller black spots that came off whenever he shed and then grew right back. The vet put him on Baytril and that seems to have gotten better. While on the Baytril he developed a new problem..a big lesion/ulcer type thing under his jaw and smaller lesions along his body and ventral side of his body. The vet put him on Silver Sulfadiazene cream 3-4X a day and suggested to clean the tank less frequently and use distilled water when I did clean it. It seemed to improve drastically until a couple days ago I found a new sore on the bottom of his foot that is so nasty you can see some bone. The lesions along his sides are back as well as under his jaw and now around his vent. I've been putting the Silver cream on again but I'm very worried as he's not nearly as active and alert as usual (he is still eating well).
Does anyone have any idea what is causing this and what should I do for him? Much appreciated!

 

[Jennewt]

Just so we can follow the story, here is a link to your previous post with photos
http://www.caudata.org/forum/f46-be...k-spot-other-tiny-ones-all-over-his-body.html
When a salamander just spontaneously develops ulcers, it's a bad sign about the animal's health in general. It suggests that the animal is under (or has been under in the past) some sort of serious stress or exposure to pathogens that it has not encountered before.

What kind of setup are you using during this treatment period? I would recommend damp paper towels changed daily. Regarding his regular tank, distilled water isn't going to make any difference, and may in fact make things worse (distilled water can be stressful to amphibians). The photos you posted previously look like his setup is wet gravel, but if this is still the case it is something I wouldn't recommend at all.

 

[Starry]

Thanks for the reply. The vet said the same thing about the previous setup of the tank, so I got rid of the gravel and he is now on moist paper towels with a water dish and a cave to hide in and that's it. I was cleaning the tank several times a week while he was on the Baytril and the black spots seemed to clear up but then he developed the ulcer type things so the vet suggested I was overcleaning and perhaps the chlorine in the water was irritating his skin. I cut down on the cleanings and things improved a lot until just a few days ago when it cropped up again.
She called tonight and said to stop the Silver Sulfadiazene cream and restart the Baytril and to get some substrate for him to burrow into that will keep the tank less moist but he will still have his water dish. I had mentioned what I had seen on here, that perhaps it's a combo of being too moist and stress from a not so "natural" habitat for the last couple of months (not to mention trips to the vet and putting cream on him a few times a day)
What do you think? Do you have any other suggestions??

 

[Jan]

Assure you are using an appropritate substrate: Caudata Culture Species Entry - Tiger salamander

Keep him in the coolest area of your home and away from other stressors e.g., lights, and noise...and do not handle him unless it is necessary for treatment.

Be careful of using an overly dry substrate as tigers are dependant on some moisture for their skin - you do not want him to dry out.

Let's keep the thread on Starry in one place (here) instead of posting on 2 threads [http://www.caudata.org/forum/f46-be...7579-tiny-black-spots-tiger-salamanders.html]. This will avoid disjointed information.

 

[Jennewt]

I am actually fairly impressed by the good advice you are getting from your vet. I agree that you want to avoid chlorine in the water, and you want to keep the sal less-moist. Bottled spring water or dechlorinated tap water would both be better choice than distilled though.

I would hesitate to put the salamander back into a diggable substrate until the ulcers and lesions resolve. Soil or bark type substrates always stick to their skin to some extent, and this can't be good when there is a lesion present. I would stick to using the paper towels for now, but be sure to change them daily, and be sure they are just moist, not soaking wet.

 

[Jan]

Although my first recommendation for a terrestrial sal with skin manifestations/ulcers is always to place the animal on moistened paper toweling, my thought on this case was different. This tiger has been maintained (unfortunately) in an aquatic environment. Therefore pathogens present may be more amenable to growth in a water environment. Along those lines of consideration, changing the environment to the drier side may assist with inhibiting pathogen growth if it is dependent on moisture. Perhaps the vet was tracking along this line of thought as well. I have also seen reports of observation that caudates tend to move to land and drier areas when ill. A moisture gradient in the enclosure would allow the tiger to decide where it prefers.

The downside is the ulcerated area potentially collecting solids from the substrate or additional substrate pathogens. However, if Baytril baths are being used, this will rinse the area.

It is tough to make these treatment calls as so much of what we do is not data driven but empiric and based on anecdotes.

Perhaps I misunderstood, but as I read the first post, distilled water was recommended to clean the tank, not use on the salamander directly?

Just some other thoughts.

 

[Starry]

Yes, his vet is really good and so far everything she has done has helped in some way and made sense to do. I guess the trouble is that he's a salamander not a cat or dog so it's difficult to always know what things are going wrong and how to fix them.
He's getting the Baytril in injected crickets, not in a bath...do you think this would be a problem if he did go into substrate with his lesions? I guess my concern is that they may be partially due to stress of having a pretty unnatural habitat of paper towels, a cave, and a dish for 2 months now. Would it be best to use the substrate so he could burrow and be less stressed and then keep an eye on the lesions to make sure they don't get irritated with the soil? Or should I continue with the paper towels only make them just barely moist? I feel terrible for having him in the previous environment of rocks and water for the past few years but was always alert, healthy and friendly so I assumed he liked it a lot. I had no idea it could possibly lead to these problems.
As for the distilled water...the vet recommended just using plain tap water and leaving it to sit out for a couple of days so that it becomes dechlorinated so that's what I've been doing. I don't really want to use drops to remove the chlorine because I want to minimize the chemicals.
The good thing is that he is off the Silver Sulfadiazene cream so I don't have to handle him and dab stuff on him 4 times a day. He can just get his meds through eating the crickets which I don't think is too stressing!
Sooo...yes or no to using substrate or stay with paper towels but less damp?? What do you all think?

 

[Jennewt]

Substrate is a difficult choice in this case. Maybe someone else will have an opinion.

Regarding chlorine, I've done some experiments using a test kit (the kind sold for swimming pools). I find that letting water sit out overnight is not enough to get rid of the chlorine effectively. And yes, my water does have only chlorine, not chloramine. Dissipation at cool temperature is much slower than you'd expect, with water in a bucket a week later still having very significant amounts of chlorine. So be cautious about this issue.

 

[Starry]

Oh, good to know...I was leaving the water sit for about a week or 2 but it sounds like that's not enough. I'll mention it to his vet and see what her take is on what to do. Thanks!

 

[Jan]

Yes, his vet is really good and so far everything she has done has helped in some way and made sense to do. I guess the trouble is that he's a salamander not a cat or dog so it's difficult to always know what things are going wrong and how to fix them.
He's getting the Baytril in injected crickets, not in a bath...do you think this would be a problem if he did go into substrate with his lesions? I guess my concern is that they may be partially due to stress of having a pretty unnatural habitat of paper towels, a cave, and a dish for 2 months now. Would it be best to use the substrate so he could burrow and be less stressed and then keep an eye on the lesions to make sure they don't get irritated with the soil? Or should I continue with the paper towels only make them just barely moist? I feel terrible for having him in the previous environment of rocks and water for the past few years but was always alert, healthy and friendly so I assumed he liked it a lot. I had no idea it could possibly lead to these problems.
As for the distilled water...the vet recommended just using plain tap water and leaving it to sit out for a couple of days so that it becomes dechlorinated so that's what I've been doing. I don't really want to use drops to remove the chlorine because I want to minimize the chemicals.
The good thing is that he is off the Silver Sulfadiazene cream so I don't have to handle him and dab stuff on him 4 times a day. He can just get his meds through eating the crickets which I don't think is too stressing!
Sooo...yes or no to using substrate or stay with paper towels but less damp?? What do you all think?

My thought would be to go with what the vet is recommending. She has seen the animal, made assessments, provided medications and a plan that has helped and is in line with treatments commonly used in caudates. To help you understand, ask her why she is recommending substrate at this point vs. moistened paper towels...and discuss it with her. As I mentioned in the above post, there may be some rational to this. What has been being done has not produced a cure - perhaps the thought is that it is time to try a new approach and re-assess.

Thoughts on substrate - my goal would be to use something that would be as free as possible of contaminants and potential pathogens...I would not be inclined to use soil in this set-up. Bark or shredded bark can have sharp edges that have the potential to puncture the wounds - I personally would avoid these. If it were me choosing a substrate - I would go with coco-fiber blocks that need to be reconstituted. This provides a soft substrate and one might assume (risky to make assumptions), to be reasonably free of pathogens. I would change it out every 3 or so weeks (you want a clean environment) and spot clean every few days - no dead prey items should ever be left in the enclosure. Set up a moisture gradient with one side of the tank fairly dry and the other side moist - let the sal choose. The potential downside is that the fibers can sometimes stick to the sal's skin - you will have to see if this poses a problem or not....theoretically this might stimulate epithelial regranulation. Perhaps the vet can offer an opinion and on choice of substrates.

Chloramine is also a concern if your municipality uses this for water sanitation. This does not dissipate on standing or aging and must be chemically removed.

Regarding chlorine - it is regarded as something we want to eliminate - extremely important for aquatic caudates and generally advocated for terrestrial caudates as well. In this animal's case, there could be an argument for using chlorinated water. Chlorine kills a number of pathogens that antibacterials alone will not. Unless there is confidence that the infection is bacterial only, it may offer something. This has to be weighed against its potential negative effects, but I have found that terrestrial sals, tigers in specific, are tolerant of chlorine from tap water. I do not advocate its use routinely but in this case......just another thought.

Bottom line, I would go with the vet's recommendations. Please keep us informed as this progresses...these type of reports help all of us learn. It is so nice to see that you are vested in returning this animal to good health.

 

[Starry]

Thanks for the reply Jan, it helped a lot! I found what you said about the dirt helping with regranulation very interesting and it made sense. If we had a big open wound and just let it sit on wet paper towels it would probably take forever to heal up. I went and got a brick of substrate...now the big question is how do I go about baking it? The vet suggested this to kill off any possible nematodes or anything else that could hurt him further. Do I bake or reconstitute it first? She said 15-20 min at 200F?
I'm very worried about Iggy and hope the new substrate and being back on the Baytril helps...the lesion still looks incredibly nasty on his back foot (bones still showing) and now it looks like a smaller one is starting up on his front foot. I feel like crying every time I look.

 

[Jennewt]

I think you could bake it before or after reconstituting. 15-20 min sounds very short, the material might not get hot all the way through, so I checked the Amphib Medicine book - they say 200F for 30 minutes or more. Good luck to your sal!

 

[Starry]

Ok, I'll do just that, thanks!!

 

[Starry]

Just a quick update...
Iggy's looking a little better to me. The lesion on the bottom of his back foot looks much better (the flesh/skin has pretty much grown over the exposed bones). The small lesion that was starting on the bottom of his front foot is still there but I think it too looks a little better as does the rest of his skin in general. He also seems to have more energy and is lifting himself off the ground when he lunges for crickets which he had stopped doing for a while. He's still on his crickets injected with Baytril once a day which I think is helping but I really think the biggest improvement has been moving him from the moist paper towels to soft substrate that he can dig and burrow into. I don't want to get my hopes up to early but so far things are looking better for my little guy.
I think the original black spots were my fault from having the large rocks and water in his tank (probably built up bacteria over the years of not being able to thoroughly clean the rocks) which the Baytril cleared up and then the new lesions that developed were perhaps caused by the vet and I putting him onto moist paper towels for such a long time while he was in "quarantine."
Please let me know if you have any comments or suggestions for further helping him along!
Oh yes...he does have a little blister/pimple thing on his vent area that's new. I'm hoping it's nothing serious and will clear up in time.