Thank you for the additional information.
I am glad that you are not seeing of those more sinister signs I had inquired after. Now even though you do not do so routinely, I would suggest that checking the water parameters would be prudent to make sure that nitrogenous waste products are not having any negative effects on him. And if you were to periodically monitor the water parameters, you will see nitrogenous waste level trends that may lead to you modifying your water change schedule (potentially more often but potentially less so depending on the rate of waste accumulation). In a way, monitoring the water parameters is similar to checking a general health profile blood panel on our terrestrial species (though less invasive to the fish) and can just give us information about their general health (since fish in poorer water conditions will be much more prone to stress and disease).
Now as the vet you work for noted, the signs he is showing are quite suspicious to swim bladder disease . As I am sure you can appreciate, the fancy goldfish like fantails will be more prone to issues with the swim bladder (though not as prone as the severely modified ornamental breeds). This is because as we have bred animals for certain traits, we often end up changing other things (not always for the better) as well. This is the case for English bulldogs who are prone to under development of their airways and smooshed noses, and it is the same way with our fancy goldfish and their 'runty' compressed swim bladders. If you look at the image link below, you will be able to appreciate the deviation in swim bladder development we have caused in this type of fish (fan tails are B). And I am sure you will appreciate that with this smaller swim bladder, these fish are more prone to buoyancy problems, both is there is an issue in the swim bladder or issues outside compressing it. (You can appreciate this HERE. )
In regards XXXXX XXXXX non-congential differentials for swim bladder disease in
fish, we can see it for a variety of reasons. This includes idiopathic cases, trauma, infection (focal abscesses in or around the swim bladder), constipation, and even tumour growth in the swim bladder. Essentially we must consider conditions that would cause distension of the swim bladder from within as well as differentials that would compress the swim bladder.
As I noted, not all causes of swim bladder issues with be untreatable. If constipation is playing a role here, then we can sometimes restore normal fecal
output and rebalance the pressures on the swim bladder by treating the fish
with fibrous vegetables Typically, people will use shelled peas but you can
also try spinach, cucumber, or even Daphnea from the pet store as
'laxative/clearing' agents. The reason we use these is because we are
attempting to clear them out, in the hopes that increased material in the gut
had been the cause for swim bladder compression.
As well, if we are trying to rule out GI distension as a reason for compression, do pay mind to the water temperature, as colder water (below 55 degrees F/14 degrees C) can impede active gut movement. Ideally, we want this tank to be around 65-70 degrees F to ensure we have appropriate gut transit.
If you try this and don't see improvement within a few days of treatment, then
you'd need to consider that those other causes of swim bladder disease
could be influencing what you are seeing. And if that were the case, then you
could consider having an xray to help rule out some of those differentials. Fish
radiography is something you will be able to perform at your practice provided
your fish is not massive. If he is an averaged sized fantail, then you can
place him (along with an adequate amount of water of course) into a ziploc bag.
This can then be placed on the xray plate so that you can get a quick picture.
If he is a stressy fish, clove oil can be used to help sedate him a wee bit (or
you could do a proper fish anesthesia with MS-222, though I do suspect your
practice will not have this on hand).
Alternatively, some vets will be equipped to sample the contents of the swim bladder. This can then be cultured for infectious causes and examined under the microscope to uncover the nature of the material extracted. Depending on the findings, an appropriate course of treatment can be initiated and an overall prognosis appreciated.
Overall, his signs are suggestive of swim bladder disease. Therefore, I would
advise the above approach for him. While doing so, do monitor his fecal production (since mucoid white feces can suggest internal GI flagellates) and do consider checking the water parameters to make sure they are as they should be. And if you are struggling to settle his signs, then it is possible to xray him or even get a sample via needle aspiration/drainage to aid your diagnosis and approach to addressing this swim bladder issue.
I hope this information is helpful.
Please do let me know if you have any further questions.
If you have no further questions, feedback is greatly appreciated.
All the best,
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