sick koi

[m4rt1n]

i have in my quarantine tank a very sick momontaro sanke, its about 14 long. when returning from our club show it would appear to have got damaged in its bag.
at first it looked like bruising to both pectoral fin muscles but has developed into rather a nasty situation firstly swellings appeared at both sites.
to the quarantine tank i have been adding sabbactisun on a daily basis then i was advised to use salt as they work hand in hand. at first i added salt at 1/2 oz per gallon and the fish recieved an injection of what i believe to be fortum, then the fish was good for a day or two then it swole up quite bad like dropsy at the problem areas. then a week later it was given a second injection, and salt was added a day later at a further 1/4 per gallon now the fish has swollen up from top to tail and now looks like dropsy. and its not a pretty sight. the fish will eat. although i prefer not to feed
is there a chance that the antibiotic is reacting to the salt as it seems that the fish worsened when more salt was added.

any suggestions anyone

[aquitori]

Quote: Originally Posted by m4rt1n i have in my quarantine tank a very sick momontaro sanke, its about 14 long. when returning from our club show it would appear to have got damaged in its bag. at first it looked like bruising to both pectoral fin muscles but has developed into rather a nasty situation firstly swellings appeared at both sites. to the quarantine tank i have been adding sabbactisun on a daily basis then i was advised to use salt as they work hand in hand. at first i added salt at 1/2 oz per gallon and the fish recieved an injection of what i believe to be fortum, then the fish was good for a day or two then it swole up quite bad like dropsy at the problem areas. then a week later it was given a second injection, and salt was added a day later at a further 1/4 per gallon now the fish has swollen up from top to tail and now looks like dropsy. and its not a pretty sight. the fish will eat. although i prefer not to feed is there a chance that the antibiotic is reacting to the salt as it seems that the fish worsened when more salt was added. any suggestions anyone

You got pics? Also, what does your club KHA have to say about this?

[REC]

M4rtin,

Let me ask a couple of questions:

1. How long was the fish in transport???

2. Was it exposed to other fish at the show?

3. Have you checked the condition of the gills?

4. What is fortun??

5. Can you give us a more accurate time line of events?

Here is my initial thought and then from your answers, maybe we can pin this down.. I am thinking that this is "environmental" dropsy, caused by the stress of transport and/or being at the show. If the time line is short, chances are that this is not bacterial unless the fish was harboring a bacterial infection before the show and the stress pushed it over the line.

I have not used sabbactisun but know what it is. If you think it works, continue it use as it appears to be quite harmless as a natural herb type product. I don't know what fortun is.

Anytime I see dropsy symptoms, I recommend that a salt bath be done at .6% for 30 minutes (two tablespoons of salt per gallon of water in a separate container) if the fish is strong and eating. If the fish is weaker, start the bath at .3% and work up to .6% as the fish will take it. The salt bath will kick start the osmotic process if indeed this is the problem and the swelling should recede within 24 hours. If not, try it again. Of course, pristine water quality is required and heat the fish up to 78 deg F if you can.

We know that bad water and high stress can cause "environmental" dropsy and what has happened is that the fish has lost its osmotic balance and starts to retain fluid. It is always difficult to tell what is actually causing the dropsy symptoms (bacteria, viral, parasitic, or environmental) so we need to start excluding those that we can and the salt bath treatment starts that process.

One of the key indicators of bacterial and sometimes viral dropsy is the condition of the gills. If the gills are uniformly pale and in otherwise good condition (not tattered), we can point to an anemic condition and this leads us to organ damage, either the kidneys or liver, or both. And once we are here, the chances of saving the fish are pretty remote as the damage to these organs is done and they do not regenerate or heal.

So, I think this might be a good place to start.

REC

[johnsmith]

Interesting post and good response REC. I think REC sees this as a pre-existing condition brought on by stress. I would not rule out another dynamic- one I think is much more likely?
I'll use a real life example- I did a water change and noticed that my koi began sulking immediately. Without going into details, I suspected copper. I did another water change but this time with resins that pull out metals and I also bound the free copper with an off the shelf binder. In ten minutes the koi were fine and eating and active- disaster averted.
Lets ’say I had not acted when I did. And lets say I just added salt and maybe treated for parasites in a shot gun approach ( masking layer #1) . The fish would not have responded so I might add some PP to the water? And then changed more water ( masking layer #2). Now I see some red bodies and so I begin injecting, dipping, bathing, and maybe add some sterilizing agent to the water. I start netting the fish , anesthetizing them and examining gills and body. ( masking layer #3). I then see ulcers forming and maybe some trace ammonia. I switch antibiotics and get no results even after removing fish from my pond and placing them in isolation. One by one they die. And the gills are damaged ( from aeromonas and from copper that I don’t know about). I write on the local fishvet board that I got KHV from a carrier fish I bought last year as it is the best surviving in this mess.
My point for the ramble is it is best to look for a simple answer first. Except for the ‘nose’ bruise or irritated anal fin bone, koi don’t usually bruise themselves in a bag ( net accident maybe). If so, a simple ointment with a steroid agent is all that is needed. I’m kinda suspecting your quarantine system? Can you describe the size ( gallons), number of fish held, the water source, the temperature, the filtering technique and the age of the setup?
Finally it is always good to call the show chairman and ask if any one else is having problems with any of their fish. This helps provide perspective.
JR

[Tamianth]

REC,
I found this on the Fortum:

FORTUM is supplied as a white to faintly yellow powder containing 118mg sodium carbonate per gram of ceftazidime.
On the addition of Water for injection, FORTUM dissolves with effervescence to produce a clear solution for injection or infusion.
Pharmaceutical form

Powder for Injection/Infusion.
Clinical particulars

Therapeutic Indications

Treatment of single or multiple infections caused by susceptible organisms.
May be used alone as first choice medicine before the results of sensitivity tests are available.
May be used in combination with an aminoglycoside or most other β- lactam antibiotics.
May be used with an antibiotic against anaerobes when the presence of Bacteroides fragilis is suspected.
Indications include:
Severe infections e.g
-septicaemia, bacteraemia, peritonitis, meningitis.
-infections in immunosuppressed patients.
-infections in patients in intensive care, e.g. infected burns.

Respiratory tract infections including lung infections in cystic fibrosis.
Ear, nose and throat infections.
Urinary tract infections.
Skin and soft tissue infections.
Gastrointestinal, biliary and abdominal infections.
Bone and joint infections.
Infections associated with haemo- and peritoneal dialysis and with continuous ambulatory peritoneal dialysis (CAPD).
Posology and Method of Administration

Posology

Dosage depends upon the severity, sensitivity, site and type of infection and upon the age and renal function of the patient.
Adults:-

1-6g/day in 2 or 3 divided doses by iv or im injection.
Urinary tract and less severe infections.
- 500mg or 1g every 12 hours.
Most infections.
- 1g every 8 hours or 2g every 12 hours.
Very severe infections particularly in immunocompromised patients including those with neutropenia.
- 2g every 8 or 12 hours, or 3g every 12 hours.
Fibrocystic adults with pseudomonal lung infections.
100-150mg/kg/day in 3 divided doses.
In adults with normal renal function 9g/day has been used without ill effect.
Infants and children (> 2 months):-

30 - 100mg/kg/day in 2 or 3 divided doses.
Doses up to 150mg/kg/day (maximum 6g/day) in three divided doses may be given to infected immunocompromised or fibrocystic children or children with meningitis.
Neonates (0 - 2 months):-

25-60mg/kg/day in 2 divided doses.
In neonates the serum half life of ceftazidime can be 3-4 times that in adults.
Use in the Elderly:-

In view of the reduced clearance of ceftazidime in acutely ill elderly patients, the daily dosage should not normally exceed 3g, especially in those over 80 years of age.
Renal Impairment:-

Ceftazidime is excreted unchanged by the kidneys. Therefore in patients with impaired renal function the dosage should be reduced.
An initial loading dose of 1g should be given. Maintenance doses should be based on GFR:-
Recommended maintenance doses of ceftazidime in renal insufficiency.
************************************************** **
Source:
http://www.medsafe.govt.nz/Profs/dat.../Fortuminj.htm

[REC]

HI Kathy... Thanks for the information.. I know Fortum as ceftazadime or one of the cephalosporins... this is a broad spectrum antiobiotic, with very good gram negative coverage. It is primarily a human antibiotic. I am not sure its effect has been studied on fish, but it is growing in popularity in the vet world. I checked with my horse vet neighbor and is aware of it but does not use it.

Ceftazadime is known to be nephrotoxic and so it use is not recommended for dropsy cases where kidney problems are suspected. It is best administered IP or IM although I have nothing on dose rates.

Ceftazadime is in the same family as amikacin.. these are aminoglycosides and both have the potential for increased toxicity. Apparently ceftazadime has a lower potential for toxity than amikacin.

It is highly recommended that sensitivity testing be done prior to its use to determine effectiveness.

Interesting choice of meds.. maybe something we should look into.

REC

[Tamianth]

Welcome REC...

I was curiouse as to what the Fortum was also! I made notes and stickied to my book with the info!

[m4rt1n]

hi all and thanks for your replies

i am by no means an accomplised koi keeper and dont go into the medical side of things but i have kept koi now for about 10 years with few fatalities strangley enough most died due to dropsy
the salt solution is currently 3/4 oz per uk gallon
the fish is now swollen from tip to tail
it has been suggested that i change the medication to baytril

[REC]

The extent of the dropsy symptoms as you describe is not good... Please check the condition of the gills for us and let us know what you see. Healthy gills are crisp and meat red.

One more thing about ceftazidime.. this is a third (or fourth) generation cephlasporin and while effective against gram negative bacteria, each successie generation of a med has a reduced effectiveness spectrum. The process is that as bacteria develop resistence to a particular med, a new generation of that med is developed but with a narrower spectrum. By the time they get to the third or fourth generation, the spectrum is such that it almost becomes a "designer" med suitable for a particular bacteria. While this is not bad, what it tells us that with a narrow spectrum, the chances of hitting the pathogen in question gets tougher. And this is why sensitivity testing is so critical.

But as we know with dropsy symptoms, unless it is environmental and can be reversed with a salt bath, the damage to the organs is done and not reversible.

REC