Surgical removal of an undifferentiated abdominal sarcoma from a koi carp (Cyprinus carpio)

LIQUID NITROGEN CRYOSURGERY FOR CUTANEOUS AND OCULAR NEOPLASMS IN KOI (CYPRINUS CARPIO) AND GOLDFISH (CARASSIUS AURATUS): EIGHT CASES (2018-2019)

Cryosurgery, also known as cryotherapy and cryoablation, is a promising surgical technique that employs highly localized freezing to destroy damaged and diseased tissue, including benign and malignant neoplasms. This procedure has been reported in the treatment of chromatophoromas, fibromas, and peripheral nerve sheath tumors in piscine patients. This study presents eight clinical cases of cryosurgery on cyprinid pet fish for a wide array of neoplastic masses, including chromatophoromas, squamous cell carcinoma, and sarcomas that were diagnosed by histopathology. Surgical excision of external masses, liquid nitrogen cryotherapy, injectable medications (meloxicam and danofloxacin), and topical medical-grade honey were applied to the patients after biopsy sampling. Five out of seven cutaneous cases and two out of three ocular cases had complete resolution without recurrence for at least three months posttreatment. Treatment was unsuccessful for two of the cutaneous cases in which the cutaneous masses were extremely invasive, resulting in severe ulceration and deep invasion into the coelomic cavity. One of the ocular cases involved a corneal mass that did not change in size and had no complications after treatments, suggesting that the treatment might be useful in limiting growth. The effectiveness of cryotherapy appears to correlate with the tumor type, as well as the stage and progression of tumor invasion.

INTRAVENOUS CONTRAST-ENHANCED COMPUTED TOMOGRAPHY IN ADULT KOI (CYPRINUS CARPIO)

IV iodinated contrast is undocumented in koi (Cyprinus carpio). IV contrast-enhanced computed tomography (CT) provides detailed imaging of the vascular structures and parenchymal organs. The goals of this study were to (1) document feasibility of IV contrast into the caudal vein, (2) determine distribution of contrast media and conspicuity of organs, (3) evaluate for differences in contrast uptake with two different doses of IV contrast, and (4) evaluate for contraindications of IV iodinated contrast in a small cohort of fish. Thirty adult koi were split into three groups (n = 10) in a prospective interrupted time series design with nonequivalent groups, receiving 480 mg iodine per kg (mg I/kg), 800 mg I/kg, and saline. Contrast doses were selected based on the range of doses used in other species. Half of the fish given IV contrast (n = 10) were imaged with CT. Physical exams, blood smears, and biochemistries were performed on all fish. Half of the fish in each group were euthanized 24 h after injection and the other half two weeks later. Necropsies and histopathology were performed to evaluate pathology associated with contrast. For the CT examinations, precontrast, immediate postcontrast, and 5-m delayed postcontrast CT scans were obtained. Contrast in coelomic organs and circulatory system was measured using Hounsfield units. The caudal kidney was the most contrast-enhancing organ. Both doses produced good vascular enhancement and similar distribution. The delayed postcontrast scans showed repeatable parenchymal enhancement of organs. No mortality was encountered. No abnormalities were detected on blood smears, necropsies, or histopathology. Results suggest IV contrast administration is feasible, both contrast doses provided valuable anatomical information in the study with CT of coelomic organs, and no contraindications of contrast administration were detected.

USE OF TOPICAL TREATMENTS AND EFFECTS OF WATER TEMPERATURE ON WOUND HEALING IN COMMON CARP (CYPRINUS CARPIO)

Skin lesions are frequently diagnosed in fish medicine. Although systemic fish treatments exist, little is known about the efficacy of topical drugs on fish skin lesions. This study aimed to investigate the efficacy of medical-grade honey and silver sulfadiazine on skin lesions using common carp (Cyprinus carpio) as a model. Additionally, the effect of temperature on the wound healing process was evaluated. Punch biopsies were generated on six fish per treatment group under anesthesia. Treatment groups received one of the following topical medications after wounding: Dr. Nordyke's Wound Honey, MicroLyte Ag Vet, or SilvaSorb Gel. Nontreated positive control groups were similarly wounded but did not receive topical treatment. Fish were housed at 10°C to 13°C or 18°C to 21°C for 29 days. Macroscopic evaluation and image collection of wounds were performed on days 0, 4, 8, 12, 21, and 29 after wounding to compare changes in wound areas and inflammation over time. On day 29, tissue samples were collected for histologic analysis. From day 12 after wounding onward, wounds in positive controls maintained at 18°C to 21°C were significantly smaller (days 12, 21, and 29: P < 0.0001) compared with positive controls kept at 10°C to 13°C. There was an overall improvement in macroscopic appearance in honey-treated groups compared with positive controls on day 12 after wounding at 18°C to 21°C (P = 0.001), whereas with the use of Microlyte and Silvasorb, wounds had increased inflammation grades (P < 0.0001 and P < 0.0001, respectively) with enlarged wound areas (P < 0.0001 and P < 0.001, respectively) in comparison with positive controls on day 12 after wounding at 18°C to 21°C. This study suggests that topical use of medical-grade honey produces positive effects on wound healing in the carp model and higher water temperatures enhance the effects, whereas the use of silver sulfadiazine and lower water temperatures delays or worsens the wound healing process.

Implications of comparative ventral body wall histology on selection of abdominal surgical approach and closure in 12 species of fish

A ventral midline surgical approach for fish celiotomy is commonly performed in veterinary clinical medicine and research, although the relevant ventral body wall anatomy of many fish species is not well documented. Histological evaluation of tissue samples from the ventral body wall of 12 fish species was performed to provide a reference for surgical approach and closure decisions. The width between muscle bundles running parallel to the long axis and total thickness of tissue layers varied among species. An appreciable space between longitudinal muscles of the ventral body wall and a lack of muscle, vessels and nerves on midline in all species examined supports recommendations of ventral midline incisions to spare important structures. Dense connective tissue consistent with an aponeurosis between musculature along the ventral body wall was not observed in any species evaluated. Connective tissue was concentrated within the dermis of all species evaluated, with an additional layer of collagen along the coelomic membrane in Russian sturgeon Acipenser gueldenstaedtii, koi Cyprinus carpio, goldfish Carassius auratus, black drum Pogonias cromis, black seabass Centropristis striata, tomtate Haemulon aurolineatum and scup Stenotomus caprinus. A sufficiently wide space on ventral midline for practical targeting during the surgical approach is present in A. gueldenstaedtii, C. carpio, striped bass Morone saxatilis, H. aurolineatum, P. cromis, rainbow trout Oncorhynchus mykiss and brown trout Salmo trutta. Sand perch Diplectrum formosum, C. auratus, S. caprinus, grey triggerfish Balistes capriscus and black sea bass Centropristis striata have a negligible space between longitudinal muscles on midline. The variation in ventral body wall structure observed in this study helps inform surgical decision making for celiotomy incision and closure in these species.

Histological and immunohistochemical characterization of 17 gonadal tumours in koi carp (Cyprinus carpio koi)

Reports on abdominal tumours in koi carp are scarce and most are from the gonads. Their histological diagnosis is challenging due to the occurrence of mixed populations of neoplastic cells and the few availability of cross-reactive antibodies in fish tissues. The present study aims to provide a histopathological characterization of seventeen gonadal tumours, enriched by a wide antibody panel (vimentin, CD117, placental alkaline phosphatase-PLAP, AE1/AE3 cytokeratin, E-cadherin, proliferating cell nuclear antigen-PCNA, müllerian-inhibiting substance-MIS, GATA4 and Inhibin-α) applied on whole and tissue microarray (TMA) sections. Abdominal enlargement was associated with tumours filling 30%-80% of the abdominal cavity; frequently, the gonads had been completely replaced by neoplastic tissue. Twelve cases were characterized as sex cord-stromal tumours (SCSTs), three as germ cell tumours (GCTs), one as mixed germ cell sex cord-stromal tumour (MGCSCST) and one as carcinoma. By immunohistochemistry, PLAP enabled confirmation of GCTs, ovarian carcinoma and the objective identification of a further cell component in 8 out of the 12 SCSTs that were reclassified as mixed tumours. The use of an immunohistochemical panel can help in refining the histological diagnosis, but the morphological diagnosis still represents the main tool for the characterization of these tumours in koi carp.

INTRAVENOUS IOPAMIDOL PHARMACOKINETICS IN COMMON CARP (CYPRINUS CARPIO)

Koi carp (Cyprinus carpio), a variety of common carp, has gained popularity as an ornamental fish worldwide. Their high monetary and sentimental value has necessitated the development of antemortem diagnostic options. Contrast-enhanced computed tomography (CT) scanning with intravenous iopamidol has been shown to be safe and diagnostically effective at a minimum dose of 480 mg iodine (I)/kg in koi. The purpose of this study was to evaluate the pharmacokinetic parameters of this dose of iopamidol, as well as excretory mechanisms specific to fish, using common carp as a model. Blood, posterior kidney, gill, and bile were collected, necessitating sacrificial sampling. Thirty-five adult fish were randomly divided into six sampling groups. Five sampling groups (n = 6/group) received 480 mg I/kg; the control group (n = 5) received an equivalent volume of saline. The iopamidol groups were sampled at the following time points postinjection: 5 min, 1 hr, 6 hr, 24 hr, and 48 hr. The control group was sampled at 48 hr. Concentrations of iopamidol were determined using liquid chromatography tandem mass spectrometry; noncompartmental analysis was used to calculate pharmacokinetic parameters. Total clearance (3.04 ml/hr per kilogram) was slower, the volume of distribution smaller (79.92 ml/ kg), and the elimination half-life (20.39 hr) prolonged compared to similar studies in mammals. The time-concentration profiles of kidney and gill were similar; these organs appear to be responsible for the majority of iopamidol excretion. However, that of bile was much different, showing slower, low-level accumulation with time, suggesting that in fish, multiple organ systems play a role in elimination beyond just the kidney. In particular, they may rely more heavily upon biliary excretion, which thus far has been noted only in mammals with renal impairment. Further research is warranted to investigate if the slower elimination allows diagnostic CT images to be acquired at different time points postinjection.

Evidence-Based Advances in Aquatic Animal Medicine

Fish and aquatic invertebrates deserve evidence-based medicine. Pharmacologic information is available; most pharmacokinetic studies are derived from the aquaculture industry and extrapolated to ornamental fish. Conversely, advanced diagnostics and information regarding diseases affecting only ornamental fish and invertebrates require more peer-reviewed experimental studies; the examples of carp edema virus, sea star wasting disease, seahorse nutrition, and gas bubble disease of fish under human care are discussed. Antinociception is also a controversial topic of growing interest in aquatic animal medicine. This article summarizes information regarding new topics of interest in companion fish and invertebrates and highlights some future avenues for research.

Fish Oncology: Diseases, Diagnostics, and Therapeutics

The scientific literature contains a wealth of information concerning spontaneous fish neoplasms, although ornamental fish oncology is still in its infancy. The occurrence of fish neoplasms has often been associated with oncogenic viruses and environmental insults, making them useful markers for environmental contaminants. The use of fish, including zebrafish, as models of human carcinogenesis has been developed and knowledge gained from these models may also be applied to ornamental fish, although more studies are required. This review summarizes information available about fish oncology pertaining to veterinary clinicians.

A veterinary guide to the fish gastrointestinal tract

For veterinarians to better understand aquatic animal health, the most basic veterinary foundation begins with understanding piscine anatomy and physiology. General observations of fish behavior, anatomy, and food apprehension can provide more valuable diagnostic information than advanced laboratory testing alone. This article highlights anatomic differences of fish species occupying different environmental niches, using a case to show the use of modern veterinary diagnostics, and introduces additional topics in piscine gastroenterology related to toxins, nutrition, probiotics, and infectious diseases.

Diagnostic techniques and treatments for internal disorders of Koi (Cyprinus carpio)

The most common problems that occur in koi involve external pathogens and environmental conditions. Techniques for external fish examination and water quality analysis have been well described in the veterinary literature. However, there are also some internal disorders of koi, such as gas bladder abnormalities affecting the fish's buoyancy, neoplasia, egg binding (roe retention), and spinal disorders that can be diagnosed with common veterinary medical procedures. Diagnostic techniques along with available treatments for these disorders are presented in this article.

Geriatric veterinary care for fish patients

There is little evidence-based research and scientific literature available for providing geriatric care for fish patients. Fish can have tremendous longevity. Although the average life span for most fish species can be only a few days to weeks for the beginning hobbyist, it is becoming more common for clients to have animals for several decades with the advent and continued development of improved life-support systems, husbandry, water quality additives, and fish nutrition. This article discusses fish longevity for several popular species, addresses environmental quality issues for geriatric patients, and provides information on the most common challenges, from a veterinary perspective, to maintain fish over the years.

Surgical removal of an ovarian tumour in a koi carp (Cyprinus carpio)

Ultrasonography, radiography and exploratory coeliotomy were used to diagnose and treat a large intracoelomic neoplasm from a female koi carp (Cyprinus carpio) presented for abdominal enlargement of several months duration. Feed was withheld for 1 week immediately prior to surgery and the fish was sedated with isoeugenol (AQUI-S) at a dose rate of 10 mL/L to facilitate diagnostic imaging techniques. Surgical anaesthesia was induced by adding tricaine (MS-222) 50 mg/L to the water and an exploratory coeliotomy and tumour removal was performed. The fish was allowed to recover in fresh water at 18 degrees C and salt was added slowly to the water over a period of 1 hour to a concentration of 5 g/L This concentration was maintained in a recovery pond for 1 week postoperatively. Enrofloxacin was administered intramuscularly (10 mg/kg) immediately, 3 days and 1 week postoperatively. A diagnosis of undifferentiated ovarian carcinoma was made on the basis of the histological appearance of the neoplasm and immunohistochemical staining.

Neoplasia in fishes

Similar to higher vertebrates, neoplasia is not an uncommon disease in fishes, which are the largest group of vertebrates. However,neoplasia in fishes is generally a benign condition with relatively few exceptions of malignant disease. The objective of this discussion is to provide an overview of neoplasia and the various neoplastic disease conditions in fishes according to organ system,including the few neoplasms of species that are familiar to the aquatic animal or exotic animal practitioner. The discussion also considers the various nonneoplastic lesions in fishes that may be confused with neoplasms, and treatment of neoplastic disease in fishes that is generally restricted to surgical intervention.

Evaluation of the tissue reactions in the skin and body wall of koi (Cyprinus carpio) to five suture materials

Five different suture materials (silk, monofilament nylon, polyglyconate, polyglactin 910, and chromic gut) were placed in the skin and body wall of 10 Doitsu (scaleless) koi (Cyprinus carpio). After seven days the sutures were retrieved from five of the fish in 5 mm and 6 mm punch biopsies, and after 14 days they were retrieved in the same way from the other five. The tissue reactions were evaluated by gross visual inspection and by histological examination. The total inflammatory reaction was graded on a scale from 0 (no inflammation) to 5 (severe inflammation). The synthetic suture materials generally induced a moderate inflammatory reaction that decreased after seven days. After 14 days the superficial reaction to monofilament nylon was substantial, and the tissue reactions to the organic suture materials were slightly greater than the reactions to the synthetics. The inflammatory response to silk was greater after 14 days than after seven, and chromic gut induced a moderately severe inflammatory response after seven days; the chromic gut sutures fell out before the biopsies were taken after 14 days. The organic materials induced intense inflammatory reactions which did not subside if the suture remained in the tissue.

Reproductive medicine in koi (Cyprinus carpio)

Each year more veterinarians are seeing ornamental fish patients and our knowledge of how to manage the pet fish patient is increasing at a rapid pace. A large percentage of these patients are nishikigoi (Cyprinus carpio) which are taxonomically an ornamental carp. In this country and in many parts of the world we refer to these fish as koi. Reproductive medicine problems are well documented in koi and a thorough knowledge of this subject will aid the fish practitioner in diagnosis and treatment.

Use of pneumocystoplasty for overinflation of the swim bladder in a goldfish

A Ryukin goldfish was evaluated because of a 6-month history of progressive abdominal distention and positive buoyancy. Overinflation of the swim bladder was diagnosed, and the fish was anesthetized with tricaine methanesulfonate. Archimedes' principle was used to determine the volume of swim bladder that was removed surgically. The caudal swim bladder was exteriorized through an abdominal incision and 2 surgical clips were placed across it to limit its size. After surgery, the fish remained in a state of negative buoyancy in sternal and lateral recumbency on the bottom of the tank. Sutures were removed 15 days after surgery, but the fish died 24 days after surgery. A full necropsy could not be performed because of autolysis of the tissues, but the surgical clips and the swim bladder appeared unremarkable. Pneumocystoplasty may be a viable treatment for this condition.

Surgical removal of a seminoma from a black sea bass

An adult black sea bass was examined because of abdominal distention and decreased appetite. A large abdominal swelling was evident and was firm on palpation. Differential diagnoses included neoplasia, abscess or granuloma, hematoma, or swim bladder abnormality. Diagnostic tests included survey radiography, positive-contrast radiography, and computed tomography. The sea bass was anesthetized with tricaine methanesulfonate. A ventral midline abdominal incision was made, and adhesions to the mass were gently dissected. The fish recovered without complications. Radiography was repeated 8 weeks after surgery, and there was no evidence of mass regrowth. To the authors' knowledge, this is the first report of a barium enema being performed in a fish. Although surgical procedures are performed more commonly on fish for research, a few reports of clinical surgical cases have been described. Our experience supports the conclusions of other reports that certain surgical procedures can be performed safely in fish.

Surgery in fish

Surgery in fish is feasible and practical for clinical and research applications. Certain adjustments in standard surgical procedures are necessary to accommodate piscine tissue handling, skin sensitivity, aqueous respiration, anatomic variations, and patient size. General considerations for fish surgery, including anesthesia, presurgical evaluation, equipment, suture selection, and surgical site preparation, have been presented here. Procedures described include celiotomy, enucleation, pseudobranchectomy, swim bladder surgery, gonadectomy, liver and kidney biopsy techniques, telemetry device implantation, and vascular catheterization.