A Very Wet Patient

I had to scoop out a dead goldfish from the aquarium in my bedroom this morning. Bummer. It always happens after I "splurge" and buy a dozen or so feeder fish (you know, the 9 or 10 cent ones sold as food for bigger fish.) Who knows what diseases they carry, how old they are, how they have been handled, etc. They weren't meant to live long. Still, I hate finding them floating in the corner of my tank-I feel like I failed them in some way. I guess I was thinking of them as rescue fish, like getting last chance critters from the pound or something.

Keeping fish as pets goes back thousands of years, raised to a fine art by the ancient Chinese and later Japanese people. They were the ones who developed the goldfish in all its forms and colors by selectively breeding from close relatives of the common Crucian carp. The Paradise fish (Macropodus opercularis) was probably the first tropical fish to be kept in home aquariums in Europe in the 1600's, being able to survive in unheated normal room temperature waters. The first heated aquaria were done so with candles below slate bottoms. It wasn't until the early part of the 1900's that fish keeping became really popular, due to the construction of public aquaria. Most species kept are freshwater fish since they do not require the use of a great deal of specialized equipment or investment in the more expensive fish than do the more spectacular saltwater varieties. The fish can provide emotional, educational, and recreational outlets that can range from simple enjoyment to dedicated breeding and competition in highly organized shows. Properly cared for, many species are long-lived and can provide years of enjoyment. I just happen to like the back ground "white noise" of the bubbles in my bedroom when I sleep!

Fish medicine is often practiced as a "herd health" issue. If an individual sick in a tank is sick, it may be sacrificed to do testing or even an autopsy for the sake of the rest of the fish in the group. This is particularly true in the case of the huge fish "farms," where preventive medicine is an economic situation. But some people pay incredible amounts of money for individual fish and can develop bonds with them as any pet lover can. In these cases, sick fish need to be handled as any ill pet would. We don't see many pet fish as patients-there are far more experienced fish doctors than me. It isn't a simple thing to take a sick fish to the veterinarian. The stress of being netted, transported, examined and then returned to the aquarium may well exacerbate the problem and even result in the death of the fish. Few fish owners want to pay for a home vist from their veterinarian. Most fish are just cheaper to replace. Therefore, most people try over-the-counter remedies from the pet store, only calling their veterinarian if two or three of these OTC treatments have not worked for them or if surgery may be needed.

That was the situation with a gorgeous silver and gold Koi that I saw the first year our hospital opened. I don't remember if she had a name, but I remember that the owner had spent over $1500 for her as a younger fish, and estimated she was worth double that at the time he called me to see her. The fish had a large mass or growth on the side of her neck close to her gills. Even though the problem was pretty obvious, I took a thorough history, tested the water of the pond and briefly looked over the other fish in the pond for similar symptoms. She was the only fish with an offending mass, and it didn't appear to be affecting her in any adverse way. Her weight seemed fine, (I palpated over her ribs to assess muscle mass) she ate readily, and her gills moved normally.

Her owner was most concerned that this mass was impinging on internal structures, or soon would with as fast as it had come up on this fish. The only way to really know for sure would be to "look" inside her. I thought a radiograph would be helpful-but putting a fish on an x-ray table didn't sound like a good idea. I decided to experiment by herding her to the shallow end of the pond, placing a ziplock baggie over a small x-ray cassette and sliding the cassette under the fish-right in the water. I was worried how the water would affect the films-so took some with the fish balanced on top of the covered cassettes (very quickly and gently). I took several exposures at different settings since I was away from the hospital and thus wouldn't be able to develop them and see any problems until I got back. We got several very nice quality films-our radiologist was very impressed when I told him how they were exposed!

The radiographs told us that the mass was encapsulated and localized to the area we could see. There was very little mass tissue below the skin. The owner asked me if I could remove it. I told him I had never done fish surgery but had coincidentally just read an article about general anesthesia in fish (it is funny how things like that happen, isn't it?) He asked me to give it a go, and since I love surgery, readily agreed. We used an injectable anesthetic, but instead of trying to find a vein under that thick, scaley skin (I didn't even know where you would find one-so much for my fish anatomy!) we dripped the drug onto her gills throughout the procedure. We also ensured that her body stayed wet by wrapping her in a very thin, water-soaked towel. I dissected out the mass fairly easily-closing the wound left behind was another story. It was large and required some dissection of surrounding tissues and some fancy sutures that didn't pull through the skin, relieved the tension and closed the "dead space." It looked OK when all was done and the fish recovered in that shallow end of her pond with no problems. We took the sutures out about 2 weeks later and it looked great! Not to brag or anything, but I sure was impressed how well the incision had healed with very minimal scarring. You know, we often use fish oils on skin to minimize scars on human skin-this fish had a constant supply of her own oils. That sure did the trick!

That very cool owner moved out of state a few months later. He had a company that specializes in relocating pond fish ship his collection and all of them, my patient included, made it to their new home just fine. It was my pleasure to spend a little time talking to a veterinarian in their new town to introduce my patients and ensure continued care. I haven't heard from them since, but I won't soon forget my experience with that very wet patient.

Peace,
DrReneigh