Treating Skin Ulcers on Fish
Treating Skin Ulcers on Fish
Written by Saturday, 30 January 2010 00:00
| Article Index |
|---|
| Treating Skin Ulcers on Fish |
| Page 2: Severe Ulcers |
| All Pages |
Most of us observe religiously the golden rule in fish keeping: "avoid adding new fish (plants etc) to your tank without quarantining them first and keep your water and filters clean". Coupled with a good diet, we feel this should keep our fish disease free. In most cases this is true and we avoid serious or fatal fish diseases. But what happens when it is not?
Generally speaking diseases that affect fish have three possible causes: parasites, bacteria and / or viruses. The golden rule indicated mainly regards parasites. (1) These cannot "develop" in a tank; they can only get introduced. Bacteria and viruses, on the other hand, exist in a tank in that they come with its inhabitants. As is the case with people, a number of bacteria and other pathogens exist on fish. Generally speaking, provided these are in a certain state of equilibrium the fish is healthy. When this equilibrium is disturbed the already existing bacteria or viruses may adversely affect the health of one or more fish. (2)
A number of factors can affect the equilibrium indicated - change in the tank maintenance routine is only one of them. Fights among tankmates, stress, poor or inadequate aquarium maintenance, overstocking etc are just some of these factors. We will also include ageing in this list; this is also a change which can affect the ability of the immune system of a fish to fight pathogens and maintain a healthy equilibrium.
It is difficult to predict how the change of equilibrium will affect fish - and if all the tank inhabitants will have (the same) symptoms or any symptoms at all, when it comes to that. In a way it is easier to notice that something is not right when more than one fish (or even all the fish) are "not quite right". The difficulty in spotting disease and administering correct and timely treatment is when only one fish seems to be affected. Most hobbyists will take their time to try and identify what the underlying reason for the disease is while also expecting the fish to get "back on its fins", as it were, without medication. This can, on certain occasions, prove fatal for the affected fish.
One such case is the case with ulcers. "Ulcers are open sores on the body surface. Ulcers are typically pink-red in colour, often with a whitish border comprising dead skin tissue. Some ulcers are shallow (superficial) but severe ones may extend down to the fish's underlying muscle layers and occasionally the internal organs. The presence of one or more ulcers on fish is a sign of disease and requires prompt action." (3)
It is difficult to diagnose the cause of ulceration of a particular fish. Ulcers can be caused by bacteria, skin parasites and even viruses. (4) In some cases a wound caused by a fight, scraping on tank furniture or netting will get infected and develop into a skin ulcer. Chemicals have also being identified as a cause of ulceration on fish (for example exposure to high levels of ammonia or nitrite or high/low pH). Fish can also be susceptible if their normal defences are compromised by stress. (5)
Regardless of the cause, however, it is important to treat particular ulcers as quickly as possible for a number of reasons, namely:
- ulcers do spread so unless treated immediately they may cause significant damage to a fish
- if untreated for a period of time the fish may develop secondary infections
- timely treatment is more likely to indicate the possibility of a more severe, underlying infection, possibly the cause of the ulcer, which can subsequently be also treated successfully.
A popular remedy used in cases of skin wounds (including ulcers) and bacterial infections is Melafix. Melafix is a herbal remedy based on tea-tree oil (extract from the leaves of Melaleuca alternifolia) which has strong antibacterial and healing properties. It is excellent as a general antibacterial agent however we have tried it on a number of occasions and we have found it is not quite effective on severe cases of fish ulcers except (possibly) if applied locally on the wound (which we have not tried). What we have found to be extremely effective in a variety of cases is TAP Aqua Gel. (6) We have used it time and time again with excellent results. Below we will present some case studies and the treatment we applied, together with the results we got.
We will start with one of George's favourite fish, Mr Superior. Mr Superior is an L114 (Pseudacanthicus cf leopardus), a very healthy male, approximately 5 years old, well established in his tank and breeding. Following a number of successful spawnings the fish got challenged by another male for his cave. As he was guarding eggs at the time, Mr Superior did not move out of his cave. The challenger started literally chewing his back end until George interfered and removed him. A couple of days later the fish had developed an extremely large ulcer (starting from the caudal fin and ending half way up his dorsal fin) which was, in addition, fungused. We took photos of the fish while we were treating him back to health:
The treatment was as follows:
- we removed the fish from the tank and kept him firmly in a non-fluffy towel which was previously dipped in aquarium water and wrung well,
- we dried the wound dabbing it very gently with a sterile piece of surgical gauze,
- we applied enough Aqua Gel to cover the wound and a bit of the surrounding area entirely,
- we blew lightly on the Aqua Gel to help it gel, leaving the fish out of the water for a minute and
- We carefully released the fish back in the tank.
We repeated the same once more two days later. Following this we kept observing the fish that appeared to be nicely healing (the fungus and the redness disappeared and the skin started reappearing) so we decided to avoid stressing the fish any further by taking him out for a further application and let him heal by himself. A month later there was no sign of the wound and the fish had resumed normal activity.
Before looking at the next case study it is worth making some comments on the treatment indicated:
The fish can be left in the net when netted out of the tank. However this may be a bit messy because the fish is bound to jerk its body around and as a result it is difficult to apply the gel locally, where required. You may end up with gel all over the floor, in the tank water and so on. You may try to keep the fish in place using your hands but in the case of the pseudacanth this was not such a good idea as these fish are spiny and can cause pain when they hit you abruptly.
If you decide to keep the fish in the net make sure the net is the right size for the fish, i.e. it is neither too small nor too big. If the net is too small the fish will eventually find itself on the floor (there is bound to be a moment when you are concentrating on the application and setting of the gel when your patient will do the mega-leap) and may be further hurt or injured. If the net is too big the fish will be turning sides inside the net and that will make the application and setting of the gel impossible.
If you keep the fish in the net it helps if you rest the frame of the net on a bucket (we use clean buckets from aquarium products such as foods, salt etc). For smaller nets you can use the mouth of a jar or any other suitable small container (this depends on the size of the net). This way you have both hands available to apply the tap and control the whole situation, if need be (trying to apply the gel with one hand and holding a jerking fish in a net in the other can be somewhat of a juggling act). For added comfort for your fish you can fill the bucket or container, which you use to rest your net, with aquarium water. This allows the fish to breath, at least from one side. A word of caution: we have found this to be quite a good trick with fish that get particularly stressed when netted however you must be prepared for a good soaking in case the fish moves or jerks while in the water. An added disadvantage of this method is that, depending on where the wound is, the water may dampen the gel before it sets, in which case you need to repeat the whole procedure (drying, application, setting). Finally you cannot fill the bucket with water when the ulcer is across the body of a fish or if you are treating two ulcers, one on each side of the fish.
If you are treating a small fish it is best to leave it in the net and hold its body gently but firmly from outside the net. Make sure your hands are clean and wet (wash them first, then dip them in tank water). You can tip frame of the net backwards (so that it falls around your hand) to avoid it interfering with the treatment. You can then apply the gel using your other hand, blow on it lightly and release the fish in the tank. The whole process of application - drying should not take more than two minutes.
Using a towel gives you much better control which is a bonus with bigger or difficult to hold fish, particularly if you have not tried local applications on fish previously (after a couple of times you will be an expert, it is a very easy thing to do). In this case chose a non-fluffy, clean, as less absorbent as you possibly have, towel. Fluffy or extra absorbent towels are bound to cause damage to the slime coat of the fish and this should be avoided to the extent possible. For this reason it is also best to dip the towel in a bit of aquarium water prior to using it for holding the fish (take a bit of water from the tank in a container, then dip the towel and your hands in it).
Prior to drying the wound carry out a visual inspection. Look for foreign material such as splinters of wood, sand etc. If anything appears to have pierced the skin of the fish work gently around it - once the fish is back in the tank you must contact a vet to remove it. Loose scales or sand can be removed gently if you poor slowly over them some aquarium water and tap them off with a piece of gauze. In more serious cases, e.g. to remove dead, contaminated or adherent tissue which may promote infection and impede healing vets perform a procedure called debriding. This is a specialized procedure and may involve anaesthetizing the fish. In most cases this will not be required. However, just to be on the safe side, to determine the seriousness of the ulcer you are treating take a couple of good quality photos of the wound to examine in peace later.
Using a piece of sterile surgical gauze to dry and clean the ulcer prior to applying the Aqua Gel is the best way to ensure you will not add more bacteria to an already infected wound. Discard the towel (or gauze) immediately after use. Patting the wound dry is essential to remove any debris from the surface and allow the medication to be absorbed deeply into the infected tissue.
Keeping the fish firmly in place pump enough Aqua Gel on the fish to cover the wound; lightly spread, if required, using your fingers. Blow a couple of times over the Aqua Gel; this will make it set quicker. After a minute release the fish gently back in the tank, away from the pump exit or areas with high water movement (this will dissolve the Aqua Gel). If applied correctly, the Aqua Gel will be clearly visible on the wound for some hours.
Do not worry if some Aqua Gel gets into your Aquarium water. The water will get cloudy and may be a bit foamy on the surface but that will not harm your fish.
The second case was slightly different. Our friend and fellow aquarist Panos Philipakopoulos contacted us to say he has noticed a rather sizeable sore on the lower lip of his male Paratilapia sp. 'Andapa'. The sore did not respond to Melafix treatment, so we advised the use of Aqua Gel. The similarities with the previous case were that there were no new introductions to the tank and that the tank maintenance routine was steady and good. The difference was that the fish could not have been attacked by a tankmate (he is living in a dedicated tank with his female) so the reasons for the development of the ulcer were unknown to us. Hence the treatment was slightly different. In particular, Panos:
- did a large water change (80%) and cleaned his filter and substrate prior to the treatment,
- applied Aqua Gel locally on the wound 3 times (once every two days). Prior to each application he took photos of the wound so we could monitor if the fish responded to the treatment or not,
- added 3ppt of aquarium salt to the water over two days (1,5 ppt daily),
- completed the Aqua Gel application 10 days after he started (once every two days x 3 times and once after 3 days) and the salt treatment 3 weeks later (50% water change at the end of the third week and 50% water change at the end of the fourth week without addition of salt).
The fish responded well to the treatment and 4 weeks later the ulcer had disappeared. Hobbyists who can read Greek will enjoy Panos' article: Γνώση και ένστικτο. For the benefit of those who cannot read Greek we have included below some of the photos of Panos's P. sp. 'Andapa' during and after treatment:
All in all, Panos applied Aqua Gel on the fish four times (once every two days) and kept the aquarium salt in the water for one month. It is worth mentioning why we advised this variation of the treatment in this case. Unlike the case of Mr Superior we did not know the cause of the ulcer. Panos was suspecting (as he told us later) that the fish may have burnt himself on the heater but this was just stipulation. We have not seen the tank so it was likely that there was some bacterial bloom, which eventually led to the ulcer. This is easy to happen. We therefore advised a full water change and complete tank maintenance. It is something we always do when unsure of the reasons for a disease outbreak - get the tank thoroughly cleaned prior to applying treatment. It will not harm the fish (if unnecessary) but it will certainly help them in most cases. In Panos's case there was one added reason: the tank had been previously treated with Melafix and mixing two medications in the water is never a good idea, except if it is known that these are fully compatible. As this was not the case on this occasion it was necessary to ensure there were no significant traces of Melafix in the water prior to applying the new treatment.
The active ingredients in Aqua Gel fight the local infection; the gel shields the wound from the water temporarily so that the former does not get infected further. We were concerned about the depth of this wound (the jaw bone of the fish was bare of flesh at one point) so we advised local application of the medication four times to prevent the open wound to get infected again, until it was sufficiently healed. You will notice in the second photo that the redness (indicating a bacterial infection) had gone right down; it is possible that local application of a waterproof gel or paste (such as Vaseline) would also do, just to ensure that the wound was not coming in direct contact with the possibly infected water. However, there seemed to be no reason to change the treatment particularly since aquatic medications of this kind also have agents to promote healing, which was an added extra.
Ulcers can upset the water balance of a fish by adversely affecting the waterproof layers of the skin. Though this was a relatively small ulcer it was a deep one and we did not know much about the cause of it or the general condition of the fish. More specifically, it was difficult to say if this was an isolated ulcer or the first of others to appear. We advised the addition of salt in the water to support the osmoregulatory system of the fish thereby reducing the stress levels its body had to go through and allowing it to convalesce faster. Salt has antiseptic and fungicidal properties which is an added extra when one is dealing with open wounds.
| Next > |
|---|