Elderly goldfish with tumour

[jntm]

I have a 15 year old goldfish (I don't know the breed - was bought for my daughter when she was little!).

About two months ago we noticed a small pea-sized orange lump near the end of its tail. This has grown quite rapidly into a lumpy shape - see photo (NB the 'other fish' in the photo is just a reflection).

Over the same period, the goldfish has lost its colour.

Since it is right at the end of the tail, it looks as if it ought to be easy to remove, but as the photo shows, there appear to be a couple of quite large blood vessels serving the growth.

Any suggestions?

 

[Joyler]

Im sorry, I don't know how to help...but he is beautiful! I hope someone can help you...

 

[dkpate]

That really is a beautiful goldfish!!! I hope JSoong will see this, he knows all about goldfish.
Good luck!

 

[jntm]

Many thanks for your nice comments on my now-not-very-gold goldfish! What a shame one can't tell it about its admirers!

Being now about 15, he/she (see how ignorant I am!) tends to take life very quietly, though still with a bit if a flick and somersault at feeding time!

 

[jsoong]

That is a beautiful fish.

I know how a vet would deal with this ... but I am not sure if this is doable in the home.

The fish will need to be anesthetized. FinQuel (MS-222 or Tricaine) is what a lot of home users / fish store / breeders use as an anesthetic. <This is actually a local anesthetic - fast Na channel blocker, you knock the fish out due to its toxic side effect.) Vets (like Dr Johnson of KoiVet.com) use "real" inhalation anesthetic (isoflurane is what he used for big procedures according to the website). An anesthetic agent is much more controllable & prob safer, but for a simple procedure like fin trimming, FinQuel is perfectly adequate. <You can prob get by with just a high salt solution - although the fish will merely be stunned, not anesthetized.>

Instructions on sedation:
Sedate with Finquel or Clove Oil
Note : overdose of any anesthetic will kill the fish .. there is a fine line between sedation & euthanasia ... esp. with clove oil.

Trimming the fin is relatively simple, but I am a bit wary of the big vessels going into the tumor. People do fin trimming for severe finrot & sometimes for lymphocytosis. There is not much bleeding with that. Although one account of a koi with fin trimmed required suturing.

If you decide to attempt the removal, you will need to be prepared to control any bleeding from those big vessels. Typically, a bit of pressure with a bit of gauze on the wound is all you need. But with big vessels, some kind of cautery (chemical or electrical) or suturing might be needed. Unless you are a medical type & have access to stuff (and some experience working on tissue), you do take a risk doing the procedure yourself.

 

[Joyler]

Wow! Great info!! Jntm, I hope this helps and that it gains it's health back!

 

[jntm]

Many thanks, jsoong - very helpful, if slightly scary, advice!

I did show the photo to the vet we normally take our cat to, and he looked very dubious and said: 'I wouldn't know how to anaesthetise a fish' - so veterinary advice doesn't look very promising. However your info has taken me a good few notches further on!

Any suggestions as to dosage and means of delivering the anaesthetic? I imagine you transfer the fish to a small tank of water, and put it in the water?

I'm not sure where I'd get Finquel, but salt and clove oil are clearly options.

I'll have a look at the website you mentioned.

Thanks!

 

[Dylan5359]

great advice!

-Dylan

 

[jsoong]

For FinQuel, you make up the proper concentration in a bucket. Transfer the fish to the bucket, wait till it is anesthetized. Then remove the fish to a wet towel for your operation. Afterward you transfer the fish to a bucket of clean water for recovery. <You may have to put fish back in Finquel if it starts to wake before you are done. There are links to pics & videos of fish surgery if you want to delve into that more deeply.>

The link has the dosage & dosing instructions.

For salt, I use 0.9% salt for fish that had been exposed to salt previously. <I use 0.5% for weak fish.> I put the fish in a bucket of the salt solution. Goldfish gets very docile in that level of salt. <Some will pass out totally, and you need to remove the fish to fresh water as soon as that happens.> I have only use salt for handling of the fish (examination, minor surface scrapes). You might be able to do a quick fin snip with that ... but your might not have enough time to do a lot if the bleeding is profuse.

 

[dkpate]

JSoong, you are awesome.

Jntm, I hope it works out for you, let us know please!

 

[jntm]

Thanks, Jsoong - very helpful again! Starting from the clues you gave me in your first message, I've been able to find a couple of useful-looking links:

Sedate with Finquel or Clove Oil

Gives what seem to be very clear sedation instructions for Finquel and clove oil. I'm in the UK, and some other websites suggest that Finquel may not be available here to the general public.

A helpful video (though for solid-looking koi rater than my very modest goldfish!), is at:

Where can I buy cheap MS 222 / TRICAINE-S / Finquel Anaesthetic in the UK? - Practical Fishkeeping Forum

What I'm still not too clear on is how to stop any bleeding. You suggest:

'a bit of pressure with a bit of gauze on the wound is all you need. But with big vessels, some kind of cautery (chemical or electrical) or suturing might be needed'

I don't really have the tools for cautery or suturing, so it would probably have to be the pressure/gauze option. I can't really visualise what that would involve. How do you use the gauze on the end of a tail fin? Pressure on the cut vessels for how long? What is the clotting time for fish blood (I assume it does clot?) Clearly you can't keep the fish out of water for any significant length of time.

I haven't yet decided whether to try it myself - it seems a rather scary option. But in case I do, I'm trying to get as clear a picture as I can.

Pointers to any good web links much appreciated!

Thanks again for your very valuable help.

 

[jntm]

I've just found a website in which someone describes removing a growth (on the side of ther fish's mouth) by tieing it off. Any thoughts on that option? It might avoid the bleeding problem?

 

[jsoong]

Tying it off is basically suturing .... In surgery, we usu. put a clamp (hemostat) on bleeding vessels & tie around that. If one is really worried, one would do the tying first & cut above the suture. If the growth has a narrow stalk, I would try that. For something that small, a 4-0 or so nylon or silk is what I would choose ... basically a fine mono filament fishing line that is fine enough to be pliable to tie. <You might want to practice on something else first ... it is tricky to tie properly with nylon ... you need minimum of 6 square knots for it to hold, and you need to keep tension while tying or the knot will be loose ... silk is more forgiving.>

Normally pressure for 5 min or so would be fine (in people anyways .. never tried in fish!). It might be a bit longer due to colder temp. <Clotting time varies with temp ... the actual mechanism in fish or people is the same.> Looking at the web sites, people working with Finquel simple have the fish out of water for the entire time (5-10min at a time). When I sedate my fish (with salt) I never take them out of water. You can do the same as well. Have a helper support the fish in a wet towel so the body is in the water (make sure the gills & mouth is clear). Flipping the fish over belly up may make this easier. You only need to have the tail out of water to work on. The fish won't struggle much if it is mostly in water.

In Koivet's video, they do long surgery by "ventilating" the fish. They have a water pump pushing water (and anesthetics) through the fish's mouth & across the gills while the fish is anesthetized. <This is for abdominal surgery ... don't need that for what you are doing!>

 

[jsoong]

This is one of many surgical suturing & tying guides:
YouTube - SSA Surgical Knot Tying Tutorial

BTW - I usu. make my students work on shoelaces first & work them down to finer sutures.

 

[jntm]

Superb information - thank you! Of course the mind-bending bit of the video is the speed of the suture tieing in the demo in the last second or two!

In the amateur tieing off description I found on the web, the author first tried dental floss, but two attempts failed because it came undone (your point about 6 knots) and ended up using string. All a bit harrowing and it took three separate clove oil sedations, but the fish seems to have survived OK.

The growth doesn't have a narrow neck - it is growing on one side near the tip of the tail fin, so the suturing would be producing the same effect as cutting off the tip of the fin.

Imagine moving down the fin away from the fish to where the pointed bottom lobe of the fin narrows to about 1 cm. The next 1 cm of the fin is where the growth is, with another 1 cm of the very narrow extreme end of the tail fin sticking out beyond the growth. There is some kind of stiffening (cartilage?) along the bottom edge of the fin, which therefore runs through the growth.

So tieing it off would involve crumpling about 1 cm of fin (which one would otherwise cut) and would include the cartilage.

The blood vessels run more or less down each edge of this lobe of the fin, and can't be more than about 0.5 mm wide externally and so, I guess, can't have a bore more than perhaps 0.3 mm - maybe even less. So tieing them off individually would be very fiddly, and probably beyond my dexterity.

Could one cauterise them using heat - e.g. a very quick touch on each vessel with something like a fine soldering iron? Not exactly up to your professional surgical standards, I realise, but it is the sort of thing available in a domestic setting! Obvious precautions about using electrical gadgets in a wet setting, of course.

Otherwise your (much simpler!) suggestion seems to be:
a) Keep the fish's head and gills under the anaesthetic-containing water (making sure that mouth and gills are not obstructed).
b) With the tail out of water, cut off the fin tip that holds the growth, using something like a craft knife with a new and sterilised blade.
c) Put modest finger pressure on the blood vessels in the cut tip for, say, 5 mins.
d) Release pressure, and if all seems well, move fish to recovery tank.

That ought to be within my skill range (famous last words!)

 

[Joyler]

I wish you the best of luck, and a surgeons hands!! Keep us updated!!

 

[jsoong]

Practice & you will be able to tie like that! I did my share of ER work in my younger days ... I can still lay down 6 surgical knots in 10-15 secs. ...

With a 1 cm stalk, you would be crumbling the fin quite a bit. With the cartilage in the stalk (that would be a fin ray), it prob won't hold too well. Tying the vessels individually will require either hemostats to grab the vessels, or actual suturing with a needle. <You use a needle to pass the suture around the vessel & tie that off.> Without the ability to "borrow" equipment from a hospital, it is a bit tough to duplicate at home.

I think the simple approach, using just pressure to control bleeding is prob the safest. Just grab the ends with a piece of gauze & squeeze. <PS the cotton fibers in gauze triggers clotting reaction better than just plain finger or other smooth surfaces ... the rough surface starts the cascade better, or so my old surgical prof told me.>

It will be easier to cut with scissors, esp with the fin rays. You would want good quality surgical scissors ... which is often used in model building, so is available from hobby shops. <A university level dissection kit would also have the scissors. Most university book store will carry them.> Ideally, Iris scissors would be best. This is one source from a Canadian hobby shop:
Fine Surgical Scissors Iris and Dissecting
& is surprisingly affordable ($3 each).

 

[jsoong]

Another source of fine sharp scissors - cuticle scissors from the cosmetic/manicure counter ... The cuticle scissors are just a sharp as iris scissors.

 

[jntm]

Many thanks, Jsoong, for all the wonderful information! I think I've got a fairly complete picture now - it seems feasible (famous last words!) - so I'll start gathering up what I need!

 

[OhNeil1969]

Please keep us posted on your progress. I sympathize with you about your fish. I find the idea of performing surgery on a fish very intriguing.