| Using Topicals Effectively
When using topical antiseptics, we need to consider a couple things in order to select the right one for the job and for the fish:
1. How deep and wide is the wound?? This is particularly important because we need to do everything we can possibly do to avoid scarring, especially on show-quality fish. The deeper and wider the wound, the more chance the fish surface tissue is going to exhibit significant scarring.
2. Is the fish healing already? Unlike mammals that heal from the inside out, fish heal from the outside-in. As a fish wound starts to heal, you will see a small opaque membrane form over the wound. This is a very thin membrane designed more to protect the wound than to offer cell reconstruction. But once we see this membrane form, we absolutely cannot disturb it with topical applications, etc.
3. How aggressive do we need to be in treating the wound? If you are using a properly selected injectable antibiotic, then chances are that you do not need to be aggressive in treating the wound topically. Of course, it is always important to ensure that the fish's immune system is running at peak performance by removing ALL stressors including parasites, poor water, etc. Without doing this, the fish will never have a chance to heal itself. Oh.. keep in mind that even with all of the antibiotics (in all forms), the trick to healing a wounded koi is to let it heal itself. Proper use of antibiotics and antiseptics thus becomes critical in getting the fish to fix itself.
Now let's look at topical antiseptics. Below is a list of common topicals that we use in the koi hobby and some good and bad points about each:
1. Potassium permanganate paste. PP paste is a mainstay as a topical antiseptic and probably exhibits the best overall results especially against BOTH bacterial and parasites. BUT.. it has serious downsides that need to be considered before using it on your fish. PP is an indiscriminate killer and this includes the ability to destroy the marginal tissue around the wound site. While you will get an excellent antiseptic and anti-parasite effect, you also increase the chance of destroying viable tissue and by doing so increase the potential for scarring.
2. Betadyne and iodine. First we need to understand that betadyne and iodine are not the same thing. Sure, they are both effective topical antiseptics but they work in significantly different ways. Iodine is the more powerful of the two and works virtually on-contact. This makes it effective as a topical since we need immediate effect before the fish is placed back in the water. But unlike PP, iodine is more targeted to the bacteria and less caustic to the surrounding tissue. Where people make mistakes with iodine is using it when the wound healing membrane is intact, thus destroying the seal. Iodine should be used as a swab with a q-tip and worked up and under the scales surrounding the wound. It is not effective against parasites. An important point to remember if you are dealing with an ulcer induced by a parasite attack.
Betadyne is not effective on fish. And the reason is that betadyne is slower to react to the bacteria and so it needs to be on the affected tissue for a longer period of time. Hard to do when the fish has to be back in the water quickly. This is why it is used as a surgical scrub. While you might see some level of contact effectiveness, the better choice by far is iodine.
3. Topical antibiotic creams and ointments. There are alot of these available OTC and some are more effective than others. When selecting one, the primary consideration is what bacteria is the topical effective against? We know that the primary pathogenic bacteria in open koi wounds is aeromonas/pseudomonas. A close second, especially in mouth rot cases is flexobacter columnaris. And unless you have the ability to culture the bacteria for ID, the best we can do is make a really good and educated guess that the pathogen is aeromomas/pseudomonas. And this is actually a good way to think as we will be right 90% + times. However, if you are at the local drug store looking for a "human" topical, ask the Pharmacist which of the topicals is quinoline-based. And tell him it is for aeromonas/pseudmonas..not only will be impressed, but will get you a suitable OTC human topical.
Of course the other consideration is how long will a topical stay on the fish. There are all kinds of "fish bandages" out there and some are even effective for awhile IF used and applied properly. But the rate of success with topical creams and ointments is fairly low. However, there are a couple of these topicals that are targeted specifically for koi wounds. The one I like is Debride. I had the opportunity to be part of the field testing for Debride before it came to market and I know it works when used properly and dilligently. Debride exhibits enough contact effectiveness to help reduce pathogen numbers at the wound site and will stick on the fish for sometime (but not long enough to be really effective). Without clinical evidence, my experience is that using Debride helped reduce scarring.
But no matter what you have in your koi medicine cabinet, the very first step you need to make is carefully and accurately assessing the wound site and determining the proximate cause of the problem (i.e, parasites, physical wound, etc) as this will help you determine the best course of action. Also, the location of the wound on the fish may be a key factor in determining what med to use as well since deep tissue wounds, such as along the dorsal and caudal areas need to be treated differently than thin tissue wounds along the head and mouth region. PP paste used on a head wound or mouth wound can cause collateral tissue damage and enhance any scarring.
One of the tricks I really like to use on show-quality fish where scarring is going to be a factor, is to use iodine swab on the first pass.... blot dry and then apply Debride to the wound. This provides immediate contact antiseptic action with the iodine and the longer lasting, penetration ability of Debride.
Hope this helps...
REC
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Quote: 
10-31-2006
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