Integrating Companion Animal knowledge into Aquatic Veterinary Medicine

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INTEGRATING COMPANION ANIMAL KNOWLEDGE INTO AQUATIC VETERINARY MEDICINE

C. I Walster BVMS MVPH CertAqV MRCVS

Diversity v

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Over 300 species across several Phyla farmed Around 2000 species kept as ornamentals Numerous species hunted or used for sport Varying habitats/ecosystems Varying physiological requirements

Veterinary Roles General v v v v v v v v v v v

Fin Clip

Disease Ecology – VHS in the Great Lakes Environmental – Water Quality, AMR, pollutants Gill Epidemiology Snip Fisheries Management Aquaculture/Ornamental Fish Farms Aquaponics Sea food inspection Fish distributors and pet retailers Private practice clients -Koi ponds / house calls Public Aquariums / Zoos Research – zebra fish

Veterinary Roles and Reality v v

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Fish Farms similar to poultry or pig practice Fisheries Management – working for Governments Gill or NGO’s Snip Sea Food Inspection – public health role Fish Distributors and Pet Retailers - Industry Private Practice Clients -Koi Ponds / House Calls Marine Mammals – lots of interest, few jobs possibly the military or university Public Aquariums / Zoos – Inspection, Research, Public Education, Conservation Zebra fish – Laboratory animal medicine

Farming - Why the requirement?

Currently aquatic animals provide the protein requirements to half the human population “Predictions are that by 2050 half the animal protein consumed by people will come from aquaculture.”

Barry O’Neil, President OIE – May 2009.

Beef/Veal 57MMT (16%) Poultry 59MMT (16%)

Farmed Fisheries 63MMT (17%)

Image from www.fcrn.org.uk

"Fish to 2030: Prospects for Fisheries and Aquaculture”. World Bank, FAO and the International Food Policy Research Institute (IFPRI).

Lamb/ Mutton 8MMT (2%)

Pork 90MMT (26%)

Harvest Fisheries 59MMT (19%)

2010 Global Animal Protein Production

Other Animal Protein 25MMT (7%)

Ornamentals - Why the requirement? v Romans kept Conger eels v Chinese kept Goldfish v Japanese kept Koi v In some countries e.g. UK, Germany, USA as much as 10x combined population of cats and dogs v Marines and some freshwater are a useful source of income for indigenous peoples – worth more than as food v Helps protect natural environments – Project Piaba and New England Aquarium

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LACK OF LICENCED TREATMENTS

various programs INAD’S USA, Draft EU Vet Med Reg – Cascade

Disease – limits returns, insurance issue de Balogh FAO (2010) v K. Mis-information v Resistance to current treatments v Water Resources and other users s se a e s Di c i t v Misinformation a Aqu v

THINGS YOU ALREADY KNOW Environment Water Quality Management

Disease Ecology Geographical

History Clinical Exam

Vectors Reservoirs

Diagnostic Tests Diagnosis Treatment

Microscope Surgical Instruments X-ray Ultrasound In-house Biochem

Hosts Temperature Skin Scrape Gill Biopsy Blood Sample Post Mortem Sampling Anaesthetic Machine Water Quality Test kit Faecal sample

Confidence If not go to www.wavma.org

THINGS YOU ALREADY HAVE THINGS YOU MIGHT NEED

THE HISTORY i. ii. iii. iv. v. vi.

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Pond or tank, indoor or outdoor, freshwater or marine?

Volume and stocking density?

Species kept Recent introductions or not?

Symptoms seen and timespan?

Water quality as measured by the owner (temperature, pH, NH3, NO2, NO3 as a minimum plus if possible GH, KH and DO2 and any other readings they might have)?

Feed type Any other relevant environmental factors?

Clinical Exam v v v

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Check water quality. DO NOT rely on owners!

Visualise the fish Excess mucus/slime (colours dull possibly parasites/bacterial) Measure opercular rate (increase/decrease rate and effort) Obvious lumps, bumps or ulcers (aeromonads/ pseudomonads, lymphocystis, papilloma) Fin or tail erosion (possible flexibacter) Are the white areas erythematous (possible septicaemia) Any other lesions apparent (cotton wool indicative of fungal infection).

80% PLUS OF DISEASES CAN BE DIAGNOSED BY: Water Quality Testing

Skin Scrape

Faecal Sample

Gill Snip/Biopsy Pictures courtesy Dr R. Loh/Dr. N. Saint-Erne/WAVMA

Additional Testing Bacteriology

Venepuncture Analyse with in-house Biochem etc.

• Samples for bacterial culturing are taken from lesions, organs (kidney) or blood.

• Use sterile technique to avoid contamination.

• Bacteria are grown in culture media at 20-25° C for 3-5 days.

• Growth is identified to bacterial species, and then tested for antibiotic sensitivities.

• MALDI-TOF

Pictures courtesy Dr R. Loh/Dr. N. Saint-Erne/WAVMA

DIS - EASE Cause - Variations in water quality v Cause – Stress - Transportation v Common diseases: v

q White Spot/Ich (Ichthyophthirius multifiliis) q Flukes q Aeromonad ulcers (most commonly isolated hydrophila) q Fin Rot (Flexibacter) q Saprolegnia (Possibly a primary pathogen fungus like) q Malawi Bloat (African Cichlids) Spironucleus q Ammonia burn

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Monogeneans (Gill & Skin Flukes) Digeneans Trematodes Nematodes (Camallanus, Capillaria) Cestodes (Tapeworms) Cilliates (Motile- Ich, Trichodina, Chilodonella, non-motile - Epistylis)

6. Crustacea (Argulus, Ergasilus, Lernea) 7. Flagellates (Spironucleus - Hexamita, Ichthyobodo - Costia)

8. Dinoflagellates, Coccidia, Microsporidians, Myxozoans

http://edis.ifas.ufl.edu/fa041 (fa107- 115 for posters)

Ichthyophthirius multifiliis Ich or White Spot • Even the detection of one trophont requires treatment • Extensive lesions guarded prognosis • Theront is life stage most susceptible to treatment.

• Treatment is formalin, Malachite/ formalin, salt or temp>30oC • Trophont Time to Maturity 50°F / 10°C = 35 days 60°F / 15°C = 14 days 70°F / 21°C = 5 days 80°F / 27°C = 3 days • Three treatments required (variable dependent on temp) • Cryptocaryon irritans (s/w)

Skin and Gill Fluke Dactylogyrus (gill flukes) • Mainly found on gills but also skin.

• Cause gill filament hyperplasia resulting in hypoxia.

Signs include rapid respiratory movements, clamped fins, and flashing.

Gyrodactylus (skin flukes) • Mainly found on the skin and fins but also the gills.

• They are hermaphroditic and viviparous.

• The young are parasitic immediately after birth, often never leaving the original host.

Treatment Praziquantel Bath: 5 – 10mg/l for 3-6 hours.

Repeat in 7 – 10 days if Dactylogyrus

http://edis.ifas.ufl.edu/fa111

Hole in the Head Disease (f/w) Head & Lateral Line Erosion (s/w) • Multi-factorial cause: – Intestinal flagellated protozoa (Spironucleus) – Water quality – Diet

Fish Vetting Essentials

Fish Vetting Essentials

Cyprinid Herpes Viruses n n

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CyH1 Carp pox – candle wax CyH2 Goldfish Hematopoietic Necrosis – lethargy, gill necrosis, pale nodules kidney &spleen. Mortality varies CyH3 Koi Herpes Virus (KHV). Carriers!

CEFAS – CyH1

CEFAS – CyH2

CEFAS – CyH3

Aeromonad Ulceration n

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Variety of aeromonads (e.g. salmonicida,

hydrophila, caviae and sobria) Fish skin is only one cell thick and it is an effect of bacterial toxins which prevents the skin from sealing the erosion.

Aeromonads inherently multi-drug resistant

Fish Vetting Essentials

Fish TB (mycobacteriosis) n

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Marinum most cited but issues over identification Zoonotic – no treatment 30% ornamental fish may be carriers due to use of earthen ponds JRSM

Fish Vetting Essentials

Tenosynovitis, bursitis, gout, rheumatoid arthritis, and even destructive polyarthritis.

Steroids, Surgery.

Basic Pharmacy n n

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Enrofloxacin 10mg/kg i/m every 3 days Metronidazole – Hexamita, HITH as a bath 25mg/l up to 3 weeks Levamisole 10mg/l (min 12hours +) for nematodes & Immuno-stimulant Lufenuron (e.g. Program) 0.1 mg/l for Crustacea Praziquantel 5-10 mg/l for fluke & Cestodes Vitamin C 10mg/l supportive therapy Virkon Aquatic 2mg/l continuous flow or 4mg/l twice daily – supportive/preventive Salt 0.5oz per UK gallon (~4.5 litres) – treatment, supportive or “First Aid” in f/w tanks

Basic Surgery Fin repairs v Abscesses v Suture Wounds v FNA - lumps and sex v Lumpectomy v Enucleation v Correcting buoyancy issues v

Surgery tips & Issues Short procedures wrap in damp towel and cover eyes – 5-10 minutes v Surgical site rarely sterile v Always use gloves – minimises skin damage v Fish skin is not elastic - 2nd intention v Always use monofilament v Fish up to 30cm single layer closure v Simple interrupted usually sufficient v Good Haemostasis v

Anaesthesia v Induction – bucket, water from pond etc. 2nd bucket for recovery v Anaesthesia maintenance - simply dribble solution over the gills or use air stone and pump with fish tubed in mouth. v It is possible to adjust anaesthetic solution in real time with some more advanced machines. v Remember dosage, speed of induction and recovery are temperature dependent Photos Dr’s Loh, Saint-Erne, Harms, Lewbert

Anaesthetic agents v

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Many commonly used veterinary anesthetics for small animals can also be used with pet fish.

(Brown 1993; Ross 2001; Lewbart 2005; Saint-Erne 2010; Loh 2012): Benzocaine (ethyl p-aminobenzoate) – Dose at 12.5 mg/L of water for a shipping sedative, 25–500 mg/L for anesthesia (may need to dissolve in ethanol first).

Induction time in 1-3 minutes, recovery in fresh water in 3-15 minutes. Fat soluble, so prolonged exposure will produce longer recovery times.

Carbon Dioxide (CO2) – A dose of 100–400 mg/L will cause unconsciousness, high exposure will cause death. Canister of CO2 is used with air line and air stone to bubble gas through the water.

Use with caution, under constant observation, and in a well-ventilated area.

Avoid breathing CO2 released from water. Induction is in 1-2 minutes and recovery in 5-10 minutes in fresh water.

Diazepam (Valium) – A sedative and muscle relaxant, used as a pre-anesthetic agent.

Can be injected intramuscularly at 0.1-0.5 mg/kg, or given orally at 1-4 mg/kg.

Ethanol (ethyl alcohol) – 1% added to the water will produce sedation, 3% or more will result in euthanasia.

20 ml of 100 Proof (50%) Grain Alcohol in 1 Liter of water will produce a 1% solution.

Ether (dimethyl ether) – Dose at 10-15 ml/L water.

Induction occurs in 2-3 minutes, recovery in clean water in 2-3 minutes. HIGHLY EXPLOSIVE! Do not use near flames or sparks!

Eugenol/Isoeugenol (clove oil) – Eugenol: 1 drop = 0.029 ml = 28.6 mg For sedation during transport, use 3-5 mg/L (1-2 drops per 10 Liters) in shipping water.

For anesthesia, use 30-60 mg/L (1-2 drops / Liter of water).

Mix vigorously with water. Induction occurs in 2-3 minutes. Excellent for short duration physical examinations.

Not recommended for use in invasive surgeries due to low analgesic effect.

A dose of 4 drops per liter (114 mg/L) induces euthanasia in 10-60 minutes.

Anaesthetic agents v

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Isofluorane (1-chloro-2,2,2-trifluoroethyl difluoromethyl ether) – Dose at 0.5-1 ml/L water for anesthesia. Euthanasia dose is 4 ml/L. Spray the required dose through a 25 gauge needle under the water while mixing.

Induction in 2-8 minutes, recovery in clean water in 3-30 minutes.

Ketamine Hydrochloride – Dose at 1 gram/L water, or 66-100 mg/kg injected intramuscularly.

Provides sedation and immobilization for handling or transportation. Dose can be given orally by injecting into a food fish fed to larger fish needing sedation. Hyperactivity and ataxia can occur during recovery.

Lidocaine – 1-2 mg/kg IV or 0.1-2 mg/kg IM total dose, injected into/around tissue. Provides local analgesia only.

Pentobarbital – 20-40 mg/kg IM or IP. 60-100 mg/kg IP for euthanasia.

Prolonged anesthesia time (6-24 hours) with cardiac and respiratory depression.

Propofol (2,6-diisopropylphenol) – Anesthesia induction dose is 1.5-2.5 mg/kg intravenously. Use parentally only.

Induction time is 5 minutes, recovery in 60-75 minutes.

Quinaldine Sulphate (2-methylquinoline sulphate) – Dose at 5-10 mg/L for sedation during transport, 25-200 mg/L for anesthesia.

Induction in 2-6 minutes, recovery in fresh water in 5-20 minutes.

Acidifies low alkaline water, use sodium bicarbonate buffer in water as necessary.

Tricaine Methane Sulfonate, MS-222 (3-Aminobenzoic acid ethyl ester) – Dose at 10-40 mg/L for sedation (handling/ shipping).

Dose at 50-400 mg/L for anesthesia induction, 50-100 mg/L for maintenance.

Induction in 1-5 minutes, recovery in 3-15 minutes in clean water.

Acidifies water – buffer with equal volume of sodium bicarbonate, or use in hard water.

Has 21 day withdrawal time when used with food fish in the U.S. 2-phenoxyethanol (98 carbon chain alcohol) – Dose 1- 4 mg/l with lower dosages for sedation and higher for anaesthesia

Stages of Anaesthesia (adapted from Brown, 1993; Ross, 2001)

Stage Plane 0 0 I 1 I 2 II 1 II 2 III 1 IV

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Description Signs Normal Swimming actively, equilibrium normal Light sedation Reduced motion, ventilation decreased Deeper sedation Only responds to gross stimulation Light anesthesia Partial loss of equilibrium Deep anesthesia Total loss of equilibrium Surgical anesthesia Total loss of reactivity, low respiratory and heart rates Medullary collapse Cessation of respiratory movements, followed by cardiac arrest, then death

Various surgeries

Fish fight abscess Buoyancy Issues

Eye enucleation

Lumpectomy

Fin Repair Wound/Abscess Treatment FNA

Photos Dr’s Loh, Saint-Erne, Johnson

Emerging Issues RAS – developing economical, generic and workable systems v Cleaner Wrasse – safety and status v AMR –treatment failure v Fish meal/fish oil supply v Draft EU Medicines Reg – loss of cascade v Opisthorchiasis – liver fluke v

Advances Non-lethal testing – surveillance and monitoring v “Pond side” diagnostics v Area Management Agreements v Alternative nutrition v Genetics – selecting for disease resistance v

Happy Fish Vetting!

Questions?