In this post, we will discuss common leopard gecko illnesses and diseases, their causes and tips for treatments. By reading some symptoms and descriptions, you might diagnose your leopard gecko at home. But while we will provide you with some advice on first aid or initial treatment, always see your reptile vet for professional advice. Each leopard gecko is different and needs specialized care.
Leopard geckos are hardy reptiles that adapt to different conditions, but they can still become sick. Beginner owners might make mistakes with husbandry and care, but it is fine as everyone is learning!
You might also notice some problems or strange behavior in adopted leopard geckos. These might be the signs of poor care and even abuse.
Calcium deficiency and Metabolic Bone Disease (MBD) in leopard geckos
What causes calcium deficiency or MBD in leopard geckos?
Leopard geckos might develop calcium deficiency if they don’t get enough calcium with food. This includes feeding insects that have not been gut-loaded or dusted.
Most owners skip using a full-spectrum lighting that emits UVA and UVB light spectrum to produce vitamin D3 in the skin. Vitamin D3 is required to absorb calcium, so proper gut-loading and dusting of insects is essential. You need to make up for the lack of UVB lamps in the enclosure.
Another reason for developing hypocalcemia, or calcium deficiency, is over supplementation with phosphorus. In the diet and supplement post we have discussed how important Ca:P ratio is in leopard gecko’s diet.
You should supplement your leopard gecko with twice as much calcium than phosphorus (2:1). Too much phosphorus in the diet binds calcium and removes it from the body.
What are symptoms of calcium deficiency/MBD in leopard geckos?
Note the crooked spine and soft legs. He is having a trouble lifting itself up – this is severe MBD
Classic signs of MBD in leopard geckos are tiredness, weakness, soft bones, lack of movement and sometimes tail thinning. Your leopard gecko might also start having problems with catching the prey when hunting – a result of bad coordination.
One of the notable signs that your leopard gecko has calcium deficiency is crooked legs. Always make sure to check your leopard gecko’s limbs and how he is walking on them.
If you can see that your leopard gecko’s limbs look soft, weak and without the clearly strong and round knees, then it might be MBD. Leopard gecko will also have trouble lifting its body, and will be touching the ground with its belly when walking or even dragging. Limbs might also break and become swollen.
At late stages, leopard gecko will be twitching when you handle it. Calcium is very important for sending nerve impulses. It might also develop a crooked spine and legs. In severe cases, leopard gecko’s jaw becomes soft and seems to be ‘hanging’. These changes are often irreversible.
Note how leopard gecko with MBD can’t lift its body – legs look rubbery
How to treat a leopard gecko with calcium deficiency?
You can help treat your leopard gecko at early stages of the disease. The problem is, soft bones are also easy to break. 
Many leopard geckos with MBD break their bones (and develop swollen limbs). If you notice any changes in behavior, problems with catching food of softness in bones, start the treatment immediately.
Offer gut-loaded insects, dust the food with calcium + vitamin D3 like this and provide a pure source of calcium (grated cuttlebone) in the vivarium at at times. If you have been using supplements, try to switch to a different brand. You can also introduce a low UVB lamp (such as 5.0 fluorescent full-spectrum bulb).
The best idea is to take your leopard gecko to the vet if you have an opportunity. It could potentially be a parasitic infection and blood tests are required. Also, take your leopard gecko the vet if supplementation doesn’t help at early stages. Read our supplementation guide here.
At late stages, it is impossible to reverse the changes. Broken spine and bones often indicate late stage of the disease. Leopard gecko that is too sick will need injections to survive.
Mouth rot and stomatitis in leopard geckos
Mouth rot or stomatitis is an inflammation of gums and is painful to leopard geckos.
What causes stomatitis in leopard geckos?
Stomatitis can result from poor terrarium hygiene, lack of lighting and fighting with other geckos in the same tank.
Weak immune system can contribute to the inflammation.
What are symptoms of stomatitis in leopard geckos?
This is the early stage of stomatitis
Symptoms of stomatitis include red and swollen lips and gums, presence of pus on the gums and lethargy. Leopard gecko might also refuse food because its mouth is very painful. Mouth secretions, swelling and excess salivation are also common.
How to treat stomatitis in leopard geckos?
To treat stomatitis, start cleaning and sanitizing the vivarium and accessories more often (weekly for accessories and cage and daily for bowls and removing feces).
Remove the loose substrate if you can as it will be easier to clean. Remove uneaten food and faces as soon as you can spot them. Also, increase the temperature in the vivarium by 5-10 degrees to help your loepard gecko fight off the infection.
Apart from cleaning the cage, wipe leopard gecko’s mouth and gums with Betadine antiseptic. Remove any pus if there is any. Apply some antibiotic ointment (Neomycin) on the skin in small quantities, but not on gums.
Keep cleaning the mouth and the cage until leopard gecko gets better. Show your leopard gecko to the vet because he or she will probably administer antibiotics to clear the infection.
Substrate ingestion and gut impaction in leopard geckos
Why causes gut impaction in leopard geckos?
Leopard geckos that are kept on sand, gravel or bark chippings are all at risk of gut impaction. The problem is, leopard geckos, especially babies, are very likely to ingest the substrate. One of the most popular substrates that causes impaction is sand. Some reasons of gut impaction are:
- Calcium or other nutrient deficiency in leopard geckos. Those geckos that are deficient in calcium will ingest the sand/loose substrate. Don’t be tricked that sand containing calcium is healthy – it is not and can still cause impaction.
- Curiosity and unintentional ingestion by hatchling and baby leopard geckos. Baby leopard geckos are still learning to hunt and can unintentionally ingest sand/loose substrate. They might also get interested in sand and try it. Hatchlings and babies up to 5 months old must be kept only on paper towels.
- Unintentional ingestion if the food is laying directly on sand. Always put your leopard gecko’s food in the bowl or feed it with tongs.
- Sometimes even healthy leopard geckos might ingest sand or other loose substrate when you change it from the different type of substrate, or of different color. They might lick or try it to familiarize themselves with new surroundings.
- Gravid, or pregnant leopard geckos might eat some sand when their ovaries become activated.
more on impaction…
As you can see, using loose substrate for your leopard gecko’s tank is risky. The worst offenders are sand, pebbles and cork. Some leopard geckos that ingest small amounts of sand or other loose substrate are able to pass it well without becoming impacted.
If your leopard gecko has ingested sand, make sure to give it lots of water. Otherwise, the sand inside the leopard gecko’s guts will become very hard and cause impaction.
If you suspect that your leopard gecko has ingested some sand, start the treatment immediately. A leopard gecko that has ingested sand will have symptoms of a puffy stomach, constipation, bad appetite, lethargy.
You will be often able to see the mass in the stomach or feel it with fingers. Be careful – a female might be actually gravid rather than impacted. Take your leopard gecko to the vet for an X-Ray which can show any sand or other loose substrate that is causing impaction (but not bark).
Start giving your leopard gecko 3-4 drops of vegetable oil or petroleum jelly. After giving the oil or petroleum jelly, make a warm bath for your gecko.
Ideal leopard gecko bath temperature is around 82-88 degrees Fahrenheit (27.7-31.1 Celsius). With leopard gecko in a bath, massage its lower part of the belly gently. Repeat until the situation gets better.
Healthy leopard gecko’s poop should be soft, but not runny. It should be medium-dark to dark in color and have a white-yellowing excretion, which is uric acid. Leopard geckos preserve water by only excreting uric acid instead of urine.
Sometimes you might also notice cricket or other insect waste that has not been fully digested – wings etc. On this picture on the right you can see abnormal feces. Leopard gecko had sand and pebbles in the tank, which he ingested.
If your leopard gecko has a diarrhea, it is a big sign of parasites and infections such as Cryptosporidiosis and Coccidia. You need to collect the feces in a plastic bag and take them to the vet for a fecal examination.
Read more about best and worst substrates for a leopard gecko’s tank here.
Eye problems in leopard geckos
Notice a problematic shedding in this leopard gecko that caused eyelid swelling.
Leopard geckos might occasionally get small particles in their eyes. If your leopard gecko has something in its eye, it be squinting or unable to open an eye fully. These small particles can be sand or other loose substrate. That is one of the reasons not to use loose substrate such as sand.
Sometimes, leopard geckos might have a problematic shedding and the skin might get stuck around and on top of an eye. The eyelid might become swollen and red.
To help your leopard gecko remove any foreign objects from the eye, wash it with wet cotton pad. You can also use reptile eye rinse like this to remove any particles and disinfect the eye. If there is any retained shed skin, moisten the skin and rub it off gently, or use tweezers to carefully remove the skin.
Other reasons for eye problems are scratches or injuries caused by terrarium furniture or other cage mates. Vitamin A and E deficiencies (eye and skin vitamins) will cause eye problems, too.
If your leopard gecko’s eye or eyes don’t open at all, there might be pus behind the eyelid. Visit you vet immediately for professional help. Don’t attempt to remove it yourself as you can damage the eye.
Respiratory infection in leopard geckos
Your leopard gecko might develop a respiratory infection, but it is very unlikely in good terrarium setups. Even though leopard geckos are hardy, they might develop a respiratory infection in a very cold (under 75 degrees F) or overly humid enclosure.
This might also happen if you are using a substrate that crumbles too much, leaving lots of dust particles that leopard gecko breaths in (such as alfalfa). Weak immune system due to cold temperatures can also be a reason.
Symptoms of respiratory infection are wheezing, hard breathing, bubbles on the nose, heavy breathing with an open mouth and gaping. In severe cases, it might have nose discharge.
To help treat you leopard gecko’s respiratory infection, increase the temperature in the terrarium by 10 degrees F (to 85-88 F). Also, you can wash leopard gecko’s nose with warm camomile tea solution. If symptoms don’t disappear within 5 days, take your leopard gecko to the vet.
Egg binding in leopard geckos
This leopard gecko is gravid (pregnant)
Female leopard gecko carrying eggs might not be able to lay them and become egg-bound. There are few reasons for this:
- The first one is lack of calcium in her body. Calcium is essential for gravid leopard geckos as it helps to form the eggs and contract the smooth muscle that is pushing the eggs in the oviducts.
- Internal issues – such as broken pelvis, tumors and so on.
- She is not happy with the egg laying site or it is not present at all so she doesn’t want to lay them.
To prevent egg-binding in a leopard gecko, make sure you gut-load and dust her food with calcium daily, and other multivitamins and minerals once a week.
Also, start making a nesting site (egg laying site) around 10 days after mating. You will be able to see her carrying eggs – hold a bright light near her and you will see 1 or often 2 round eggs in the middle sides of her belly.
If you are not sure about your leopard gecko being gravid, take her to the vet to perform an X-Ray – it will show the eggs in the pelvis. Please note that leopard geckos might lay eggs without mating with a male – but the eggs will be infertile.
If your leopard gecko can’t pass the eggs, a vet will remove the eggs surgically or give your leopard gecko some calcium and hormone injections.
Tail rot in leopard geckos
Leopard gecko’s tail tip might start looking dry, black and skinnier than the rest of the tail. One of the reasons of tail tip thinning and rot is a problematic shedding on the tail or being bitten by cage mates.
Retained skin constricts the blood flow and causes necrosis (dying) of the tail tip. If any skin is stuck to the wound, give your leopard gecko a bath and remove the skin gently with tweezers or by rubbing.
In the case of black and dry tail, you must make sure that the necrosis doesn’t spread higher in the tail.
If the tail tip is very dry and is almost falling, then you don’t need to do anything.
Otherwise, it is usually advisable to cut off the tail tip that might cause spreading of necrosis. Visit your vet who will be able to make the right decision.
If you do this at home, make sure to control the bleeding (if any) and apply antibiotic ointment on the tail tip. You should always wait before cutting the tail tip – if it is a dry necrosis, it is likely to drop off itself.
Broken bones or wounds in leopard geckos
Leopard gecko might get injuries by other leopard geckos if they live in groups. Cage mates might scratch and bite each other.
Sometimes, leopard geckos get injured from using hot rocks or abrasive tank accessories. Minor cuts and injuries can be treated at home – use antibiotic ointment for the wound and remove any loose substrate that might stick to it.
Leopard gecko might break the bones that are soft or weak. Take your leopard gecko to the vet if it has broken any bones.
The vet will perform an X-Ray to see the real picture. Leopard geckos with calcium deficiency are more likely to break bones. If you notice your leopard gecko not being able to balance on higher structures, bring them lower.
Broken bones will take months to heal and some changes might be irreversible. The vet will usually place a splint on the broken digit and you will need to be patient with the healing gecko.
Burns in leopard geckos
Your leopard gecko might burn itself if it has touched a hot bulb or used an overheated hot rock. Serious burns can also cause deep wounds requiring antibiotics. Apply some antibiotic ointment on the burn and take your leopard gecko to the vet in case of serious burns.
Prolapse in leopard geckos
Leopard geckos hemipenes are reproductive organs and they come out when mating, due to impaction or mechanical ‘popping’. Sometimes, the hemipenes might not go back in naturally and stay out. You must try your best to push them back in, or otherwise they will get inflamed and infected.
If there is no blood, place your leopard gecko on a wet towel and then prepare a sugar bath 2 times a day. Mix sugar and warm water, and give your leopard gecko a bath.
If it doesn’t go back in after a bath, try to gently push it in with a cotton bud. See your vet if it doesn’t go back in after few hours. On your way to the vet, apply some Vaseline on the hemipenes to prevent any inflammation.
Internal parasites in leopard geckos
Steam cleaners can sanitize a vivarium and other surfaces with an up to 200 degree pressured steam
Your leopard gecko, even if it a captive-bred one, can become infected with internal parasites. Parasites are usually passed with feces and through the water. There are different internal parasites, and all of them need different prescribed medicines for treatment.
To treat any parasitic infection in a leopard gecko, set up another temporary tank and move your gecko from one tank to another for cleaning.
How to treat parasitic infections?
Remove any loose substrate or carpet, and only use paper towels that you need to change once or twice a day. Remove accessories that are not important and clean other accessories once a day.
Change the water daily and if you see any feces – remove them immediately. Is it a good idea to wear gloves while doing it. And also, never use a kitchen sink for washing and cleaning leopard gecko’s furniture.
Another good way to clean leopard gecko’s cage without any chemicals is by using a steam cleaner. Choose a steam cleaner like this that heats the water to up to 200 degrees, as you need around 160-170 degree steam to kill most parasites.
Internal parasites can also cause gastroenteritis in leopard geckos, and the symptoms include weight loss, incomplete food digestion (seen in feces), watery and runny stools and poor feeding.
Coccidiosis
Coccidia are one the most common protozoa causing Coccidiosis. Symptoms of Coccidiosis in leopard geckos are lethargy, poor appetite and digestion and weakness. If the infection is not treated, leopard gecko becomes dehydrated and loses a lot of weight.
Your leopard gecko might not eat and be very weak.
Coccidiosis is considered a super infection because parasites pass with feces, so reinfection is very easy. Isolate a sick leopard gecko from other reptiles if you have any.
Treatment of Coccidiosis might take around a month or two, depending on how much effort you put in the treatment. A vet will be able to diagnose Coccidiosis after performing a stool test and will prescribe a medication to take every day or two.
Cryptosporidium, or Crypto
Cryptosporidiosis is considered one of the worst parasitic infections affecting reptiles. It is caused by protozoa
and causes a big range of symptoms. Few of these symptoms are diarrhea, significant weight loss, lethargy, poor appetite and thickening of intestines.
If untreated, a leopard gecko will become underweight, stop eating and die. Take your leopard gecko to the vet if your notice any of these symptoms for a fecal examination. Crypto is treated with anti-parasitic drugs.
Sometimes Crypto will cause a ‘Stick tail’ disease in leopard geckos – an extreme thinning of the tail, but it can also be caused by protozoa or bacteria.
Symptoms include a dramatic weight loss (tail will become stick-thin), diarrhea, a lot of hiding and poor feeding. Treatment will depend on the cause – if caused by Crypto, a chance of cure is smaller than if caused by bacteria or protozoa.
Flagellates, trichomonads, nematodes
Flagellates are parasites that cause common symptoms of a parasitic infection – watery stools and poor feeding. The infection is treated quite easily with metronidazole antibiotics. Trichomonads are also killed with antibiotics.
Nematodes are worms that live and multiply in leopard gecko’s intestines, causing weight loss and poor growth. It is diagnosed with fecal examination, and treatment is with wormers.