Can Fish get Keloids?

Feet4Fish · Aug 9, 2020

6-8 weeks ago I noticed my Annularis got sliced on his side by one of the tangs. I never showed any signs of secondary infection but was did form hypergranulated tissue. It appears healed at this point but has a significant amount of hypergranular tissue/keloid. I have no concern about the fish but just curious on why this would occur. As a surgeon I know why it occurs in humans but not as well versed in fish!

xxkenny90xx · Aug 10, 2020

Sounds like you might know more about this than us....

Jay Hemdal · Aug 10, 2020

Feet4Fish said:
6-8 weeks ago I noticed my Annularis got sliced on his side by one of the tangs. I never showed any signs of secondary infection but was did form hypergranulated tissue. It appears healed at this point but has a significant amount of hypergranular tissue/keloid. I have no concern about the fish but just curious on why this would occur. As a surgeon I know why it occurs in humans but not as well versed in fish!

That is unusual- fish typically heal completely unless there is an infection. Here is a thought; Mycobacterium are present in most tanks. Could the injury be a site for infection? They just changed the genus on some of these, but the commonly seen species are fortiutum and cheolonae. That could be a granuloma?
jay

Feet4Fish · Aug 10, 2020

Thanks for your thoughts!!! Would be easy enough to isolate him in a hospital tank. Do you happen to know the susceptibility to these strains of Mycobactrium? I will definitely be
Looking into the sensitivity later tonight. You’re idea of a granuloma is definitely a strong differential! In people we often debride such formations. Do you have any idea if it can be resorbed by the fish?

Jay Hemdal · Aug 10, 2020

The really isn’t an effective treatment for myco in fish. Besides, it is commonly cultured from frozen seafoods, so the fish would just be exposed again. As far as debridement, that always makes me nervous that other bacteria might take advantage and invade the tissue. “Watchful waiting” is what I usually do. In freshwater fishes, I sometimes see acute care infections that cause rapid losses in a group of fish. Strict Isolation and possibly euthanasia are the only controls for that....but that isn’t what is going on here.

Jay

Feet4Fish · Aug 10, 2020

So in one sense with our closed systems that get fed frozen food the muck is acting like an opportunistic pathogen?

Jay Hemdal said:
The really isn’t an effective treatment for myco in fish. Besides, it is commonly cultured from frozen seafoods, so the fish would just be exposed again. As far as debridement, that always makes me nervous that other bacteria might take advantage and invade the tissue. “Watchful waiting” is what I usually do. In freshwater fishes, I sometimes see acute care infections that cause rapid losses in a group of fish. Strict Isolation and possibly euthanasia are the only controls for that....but that isn’t what is going on here.

Jay

Jay Hemdal · Aug 10, 2020

Feet4Fish said:
So in one sense with our closed systems that get fed frozen food the muck is acting like an opportunistic pathogen?

So - basically, yes - atypical myco can be cultured from seafoods (it is sometimes called fish handler’s disease) and even swimming pools, as well as soil. Trying to eliminate it from an aquarium isn’t possible. Usually, fish can fend it off. I do see older fish dying with histopath showing acid fast granulomas that if cultured, would probably show myco (but the cultures take so long to grow, I don’t usually try that).
Jay

Feet4Fish · Aug 10, 2020

Jay Hemdal said:
So - basically, yes - atypical myco can be cultured from seafoods (it is sometimes called fish handler’s disease) and even swimming pools, as well as soil. Trying to eliminate it from an aquarium isn’t possible. Usually, fish can fend it off. I do see older fish dying with histopath showing acid fast granulomas that if cultured, would probably show myco (but the cultures take so long to grow, I don’t usually try that).
Jay

Thanks for your insight! Trying to think back on some micro and histology classes from like 16 years ago! Will reacquaint myself with myco and yank some old med school books down from the shelf tonight!

Feet4Fish · Aug 22, 2020

Some updated pictures. Still have him in hospital tank. He is acting and eating normally. Have been treating him daily Fish Recover M by Brightwell. Also I have been adding Beta Glucan to his food. Would love any further suggestions.

Jay Hemdal · Aug 23, 2020

Wow! Those look less like granulomas to me now. Walleyes get a growth like that - Dermal Sarcoma Virus. Walleye also get Lymphocystis and some other viruses that cause growths like this. Annularis angels are well-known for getting Lymphocystis, this doesn't look like that, but perhaps a related virus?

This just shouts for debridement, but I'd resist a little longer, for fear of spreading the virus/bacteria further.

Jay

Feet4Fish · Aug 23, 2020

Jay Hemdal said:
Wow! Those look less like granulomas to me now. Walleyes get a growth like that - Dermal Sarcoma Virus. Walleye also get Lymphocystis and some other viruses that cause growths like this. Annularis angels are well-known for getting Lymphocystis, this doesn't look like that, but perhaps a related virus?

This just shouts for debridement, but I'd resist a little longer, for fear of spreading the virus/bacteria further.

Jay

So best to keep him isolated in his own tank. Also continue food laced with vitamins and beta Glucan. Any benefit to adding vitamin C?

Jay Hemdal · Aug 23, 2020

As long as the isolation tank is a good environment....if it’s marginal, it would just induce more stress. I don’t know about the vit C, but since it isn’t fat soluble, it won’t hurt.
Jay

Feet4Fish · Aug 23, 2020

Jay Hemdal said:
As long as the isolation tank is a good environment....if it’s marginal, it would just induce more stress. I don’t know about the vit C, but since it isn’t fat soluble, it won’t hurt.
Jay

What ultimately is the definitive treatment? If it is a sarcoma of some type is there any realistic treatment? In humans we use chemo, radiation and amputation when feasible.

Feet4Fish · Aug 23, 2020

Jay Hemdal said:
Wow! Those look less like granulomas to me now. Walleyes get a growth like that - Dermal Sarcoma Virus. Walleye also get Lymphocystis and some other viruses that cause growths like this. Annularis angels are well-known for getting Lymphocystis, this doesn't look like that, but perhaps a related virus?

This just shouts for debridement, but I'd resist a little longer, for fear of spreading the virus/bacteria further.

Jay

It doesn’t appear like lymphocytis from my vantage point either. Have a Queen angel who once had that.

little research on WDS taught me it’s benign lesion that seem to flat and regress seasonally.

Jay Hemdal · Aug 23, 2020

Feet4Fish said:
What ultimately is the definitive treatment? If it is a sarcoma of some type is there any realistic treatment? In humans we use chemo, radiation and amputation when feasible.

No treatment that I know of. I was just speculating there - wondering if it could be a virus related to WDS. The fish looks good in all other respects, so I'm hoping it will be self-limiting.

Jay

ichthyogeek · Aug 29, 2020

I'm currently remote attending MACNA, and Dr. Gregory A. Lewbart just presented a case study regarding a tang (orangeshoulder tang) that had a similar injury happen! I can't remember what the prognosis was, but it might be worth reaching out to him about it!

Feet4Fish · Aug 29, 2020

Thanks! Fish is still doing good by no change in lesion!!! Will reach out to him!

Feet4Fish · Dec 9, 2020

Long overdue update....he has healed the lesion! I ended up debriding and cauterizing the granulomatous lesion. Continued feed food laced with beta Glucan and Selcon. He stayed in isolation tank for about 5 months. I reintroduced him last week as all is going well. Thanks @Jay Hemdal !!!