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Dr. B.
Dr. B., Veterinarian
Category: Pet
Satisfied Customers: 6053
Experience:  I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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Hello Doctor: Several months ago you gave me advise/help with

Resolved Question:

Hello Doctor:
Several months ago you gave me advise/help with my goldfish having a lump on its head.
It's an 80 gallon outdoor above ground pond.
This morning we noticed the lump seems to have dropped off.
Is this a good thing or a bad thing?
I have a new picture to upload, if you send me the instructions.
Thanks,
Howard
Submitted: 1 year ago.
Category: Pet
Expert:  Dr. B. replied 1 year ago.
Good evening,

I would be keen to see a photo if possible. To post the photo, you can either use the wee paper clip on the tool bar or you can post them on a 3rd party site (ie Flickr, Photobucket, etc) and paste the web address here.

Otherwise, have you noticed any ulceration, redness, or inflammation of the skin in this area since it dropped off?

How is the fish otherwise?

Customer: replied 1 year ago.

I am having trouble attaching the picture .... Please bear with me while I find out what the problem is.


Thanks,

Expert:  Dr. B. replied 1 year ago.
No worries. Smile

Dr. B.
Customer: replied 1 year ago.

Hello ... Were you able to see the picture?


The fish seems to be acting normal ...

Expert:  Dr. B. replied 1 year ago.
Hi again,

We have success.Smile
Now looking at the edges of the ulceration, it does appear that the mass has sloughed from the head without the influence of any external factors (ie trauma, tearing, etc). And this is something that can arise with these types of masses. This happens when the mass becomes too big for the blood supply supporting its growth. And when there is too little blood, we can see the tissue become devitalized and it then will slough.

In this case, the mass's sloughing is neither good or bad in itself. In some cases, the mass may not regrow (though they can have scarring) but often they do. Where this situation can become concerning (or bad) is when we have open lesion (red/raw/etc) that is at risk of infection by secondary agents (often Aeromonas).

In this situation, you might consider supporting this fish with Melafix to aid healing. You can also use a water probiotic like Koizyme to discourage Aeromonas population within the water. As well, supportive measures like maintaining high water quality, keeping water temperatures in the high 70's to low 80's, and even using a low dose of aquarium salt (ie 0.1%) to encourage healing would be beneficial here. While doing this, you do want to keep a close eye for any cotton/fuzzy material or inflammation/red streaking around this ulcer, as these can be hints of bacterial infection and a red flag that antibiotic cover (ie kanamycin/doxycycline) would then also be indicated.

Overall, this is not an uncommon result of a lymphocystis mass outgrowing its blood supply. As long as the resultant lesion is not open or raw, I would advise supportive care to encourage healing. But if you do see any raw areas on the lesion or any hints of bacteria preying upon it, then we'd want to consider starting antibiotics against opportunistic bacterial agents.

All the best,
Dr. B.
Customer: replied 1 year ago.

Thank you ... I guess it's a bit of good news.


Just before contacting you we went to the fish store and got some amoxocollin - Aquafish brand - and we added 9 capsules to the water.


We also replaced about 30% of the water supply.


Would the Amoxocillin be good therapy?


Is this lession still herpes related? It means the other babies in the tank are also infected, right?


I've heard of something called "hole in the head" ... Have you heard of this?


Doctor, again, thanks for your help.


Howard

Expert:  Dr. B. replied 1 year ago.
You are very welcome.

The lesion will be indirectly related to the herpes virus, in the sense that the original mass was likely a viral induced proliferation of tissue. And if it was viral induced, then any other fish in the tank will be at risk of being carriers of the virus as well.

In regards to 'hole in the head' (hexamitiasis), it is always a consideration since koi can be vulnerable to that agent. That said, it would be less likely here with this fish's history. If it hadn't had a mass previously, then we'd need to consider it as a differential. But with the historical mass present in this area, we'd be less likely to see hexamita induce what you are seeing.

Now I must say that Amoxicillin would not be my choice here. Amoxicillin is an antibiotic that targets gram positive bacteria and the vast majority of bacteria that target the external tissues of the fish are gram negative. Now while it would always be ideal for a swab of the lesion to be taken for bacterial culture, this is often not an option. And if it is not possible, then we do tend to use broad spectrum antibiotics that will target the common gram negative bacteria that would likely to be blame. As I noted before, a combination treatment of kanamycin/minocycline would be a good choice. But if that was not an option, then my second choice would be erythromycin (plain Maracyn) or tetracycline, used along with minocycline (your Maracyn-Two). Or if you were to treat this fish via injectable antibiotics, then Baytril (enrofloxacin) would be our usual choice.

All the best,
Dr. B.
Customer: replied 1 year ago.

Thank you so much Doctor.


I suppose I can get the Melafix, Koizyme and kanamycin/doxycycline at my pet store?


I will have the instructions for the dosage, right?


Again Doctor, you have been great !!!!!


Just respond to this so that I can do the rating ....


Thank you, XXXXX XXXXX thank you,


Howard

Expert:  Dr. B. replied 1 year ago.
Hi again,

Availability of each can vary by pet store, so it is a case of checking with your local pet stores to see if the do carry these. If they do not, many can order them in for you. If you are struggling, then it would be a case of finding a site online (example). In regards XXXXX XXXXX it will be depend on the strength of the product you get but the directions and dose will be on the label in any case.

All the best & a lovely evening to you,
Dr. B.
Dr. B., Veterinarian
Category: Pet
Satisfied Customers: 6053
Experience: I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
Dr. B. and 5 other Pet Specialists are ready to help you
Customer: replied 1 year ago.

Hello Doctor:


Have new issue with the fish in question.

Expert:  Dr. B. replied 1 year ago.
Good evening,

Do let me know what is going on and I am happy to do all I can to assist.

All the best,
Dr. B.
Customer: replied 1 year ago.

Hello:


A black area is now showing in the place where the white part is.


I would love to send you a picture, if you give me a site to send it to.


Thanks,

Customer: replied 1 year ago.

Here's the link to the two new pictures. Please look at the ones with today's date in the title.


 


http://s1316.photobucket.com/user/hacorlando/media/Fish-PM-June2113011_zpsb767e9a7.jpg.html?sort=3&o=0


 


Thanks,

Expert:  Dr. B. replied 1 year ago.
Hi again,

I have looked over the photo. Its a wee bit hard to get a real feel for the lesion's texture with it being taken at an angle but is an interesting change you are seeing.

Can you tell me if your water parameters (especially ammonia) are normal?

Does the black lesion appear raised, fluffy, firm, or scab like?

From what I see, this is a dark lesion in the crater of the previous scarring?

How is otherwise? Appetite? Activity?
Customer: replied 1 year ago.

Hello and thanks for the answer.


First off, should I start a new thread, for payment purposes? Now that you have the history, this seems to be the correct thing to do.


I will also try to download a better picture, but the lesion seems to be inside the previous one. It is smooth and a bit raised.


We just changed about 30% of the water. The nitrate is around 5-10, in the safe zone. The nitrite is about .5, in the "caution zone". Water is hard, but this has always been our case. It's about 125-150. Alkalinity and Ph are both normal.


Just noticed the lesion today. Just added Maracyn (Erythromycin) this morning.

Customer: replied 1 year ago.

Just uploaded two new pictures. In answer to your other questions, he's acting quite normal. Eats healthy, swims with others as usual. No changes in behavior.


 


http://s1316.photobucket.com/user/hacorlando/library/?sort=3&page=1


 


 

Expert:  Dr. B. replied 1 year ago.
You are very welcome.

The website does prefer if 'new questions' are opened as such (for their numbers/processing/payments/etc). If you do want to list it as a new question, just put 'nekovet' at the start of the question and it will be left open for me to comment. (There should also be an option to request me specifically.

If possible, it would be ideal to get another photo looking straight down +/- macro to allow me to fully appreciate the texture/identity to this lesions.

As well, I am glad you have checked the water and are addressing it. But how was ammonia (I'd be concerned its up if the nitrites are as well).

Look forward to hearing back from you,
Dr. B.
Expert:  Dr. B. replied 1 year ago.
I see the new photos now (think we tried posting our posts at the same time).
If you want to open this as a new question, then I will keep an eye peeled.

Otherwise, the new photos appear to show that the 'ulcerative' nature of the original lesion has filled in. Is that what you are seeing?

Cheers,
Dr. B.
Customer: replied 1 year ago.

Just started a new chain.


Unfortunately I cannot check the ammonia with my testing kit, but can take a water sample to my local pet store for checking.


The old lesion, which looked like white scar tissue, seems to now be filling with the new black matter and that appears to be under a very thin layer of skin?


Thanks,

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