Mystery Lesion on Clown

[Newstead]

Hoping someone here might have a clue, as neither my LFS or 2 other forums have been able to identify this.
Female clown, 3.5 years old
She and her mate are the only fish in a biocube 29
In August I noticed a red bump where her left nostril would be. A small flattened clear bubble developed over it but it all healed in 2 weeks with no intervention.
8 weeks ago the lump was back and a clear bubble appeared over it within a week or two. I soaked their food in Selcon, expecting it to heal up sgain.
Instead it has gotten progressively larger and she has quit spawning.
I put them both in a hospital tank as they have never been apart since I purchased them as juveniles in June 2012.
Did 1 five day round of Maracyn 2 as I found one mention of bacterial infections causing a bubble over "fermenting" tissue in an article on gas bubble disease.
The bubble was gone the first day in the hospital tank (could have been ruptured in the transfer). The lump remained. Changed all water, ran poly-filter, then did a round of Furan2 for five days. By day 2 of that I could see a tiny bubble reforming.
When she refused food for two days I began changing all the water, acclimated them back to the biocube water, and moved them back.
The male has never shown any symptoms. Within an hour of being back in their tank she began eating well again, but I am afraid this thing is going to continue getting worse.

Any ideas??? We would hate to lose her.

 

[Newstead]

The pic above is from a few weeks ago before treating her with anything. This pic is from today, after the Maracyn2 and Furan2.

 

[melypr1985]

Boy oh boy... that's a new one on me. I think you were on the right track with the furan 2. You may want to add kanaplex and metro to that and hit it with the "full monti" I think the furan 2 didn't work for you because it didn't have enough time. Antibiotics are slow to act, but best done in QT like you were doing. I get why you stopped though, it's nerve wracking when they stop eating for sure.

Now aside from that, you could try epsom salt in the DT to reduce the swelling. Continue with the Selcon as well.

@Humblefish will want to weigh in on this one.

 

[Newstead]

Thanks for the response - it is weird, isn't it? I have even written a couple of marine specialists at vet schools but have not received answers.
I did add epsom salts their last day in the hospital tank, but since I removed them later that day it probably didn't have a chance to help. When I saw her stomach beginning to look thin and she refused all foods (soaked mysis, Reef Frenzy, NLS pellets) after 2 days I just couldn't stand it. She has always been such a piglet.

So epsom salts are ok in the DT? There are just a collection of mushrooms, various euphyllia and a sun coral.

 

[human]

I'm just guessing here, but it's possible it may have a parasitic copepod embedded deep in the tissue and that bubble is caused by a secondary infection.

 

[Newstead]

I have wondered about a parasite ... if you zoom in you can see the lesion looks ragged. Why can't she have gotten something easy to diagnose ??? (Though I know we have been lucky - these were our first saltwater fish and they have survived three and a half years of our learning curve. We had a pseudochromis with them who died after 2 1/2 years).

 

[SandJ]

I have the same issue with a maroon clown. Still have not figured out what it is. I have a thread about it here on r2r. I have been meaning to update it (below is a picture from Jan 7, 2016). The largest bubble is about 3/4".

My clown had it when I bought the tank setup. Previous owner had no idea what it was (isopod was my guess also). It goes away and comes back. Good news it that it does not seem to affect the clown.

 

[melypr1985]

That looks severe. There has to be an underlying issue- a parasite or injury- something along those lines.

 

[Newstead]

Sand, sorry to "like" this but finally to see something similar is a relief in a way. How is your clown doing? Have you tried any meds? Anything help?

 

[cope413]

Looks like it could be lymphocystis.

If it is, it's viral, which would explain why there was no noticeable change with your treatment.

The good news is that if it's lympho, it's likely not fatal and it should resolve itself in a couple months with normal good husbandry.

If the fish is still eating and acting normally (aside from not spawning), I wouldn't worry too much unless it starts to spread, the fish stops eating, or shows other signs of stress.

 

[SandJ]

Sand, sorry to "like" this but finally to see something similar is a relief in a way. How is your clown doing? Have you tried any meds? Anything help?

It acts completely normal. Eats well. Chases the other fish from its area of the tank. The bubbles go away (deflate, leaving loose "skin" behind). Then they reappear. I believe it has been this way for about 6 months (I have had the tank since November).

I have not tried any meds. No other fish housed with it are affected. I considered moving it to a hospital tank, but it has zero other symptoms and seems content, so I have not tried to move it and treat it.

No known injuries. There was a small, slightly darker area on the white stripe where the new bubbles came up.

Here are a few more pictures:

Jan 7- profile to show how big the bubbles are

December 1, 2015

Eta: hope I am not butting in on your thread, I don't have much to offer except pictures of my clown and what appears to be the same issue.

 

[Newstead]

Absolutely not butting in - I truly appreciate your input. Mine was really stressed by the meds, as evidenced by not eating. Now that she and her mate are back in their tank she is eating well again, but does hang out more in her corner at times, then swims around the tank again. I hope we can at least document their progress - it has been so frustrating not being able to find anything similar.
I have read up on lymphocystitis, cope413, and examples always show a white, solid looking lump - perhaps we have a new variant? Or injury with infection? Or parasite with infection?

As you can tell, it is driving me nuts.

 

[Humblefish]

If it is a lingering infection (big IF), then 10 days of continuous antibiotic treatment may be required to completely knock it out. Also, IF it is an infection you can be sure it is a gram positive one as a gram negative would have killed by now.

My recommendation would be to treat with kanamycin (Kanaplex) every 48 hrs for 10 days. See what happens.

 

[Newstead]

Humblefish, would you move both together again to a treatment tank? I hate to medicate the male unnecessarily but am afraid the stress of separating them would be worse.

And if she quits eating again, how long can I let that go? I will be ordering Kanaplex tomorrow.

Thanks for the help, everyone!

 

[Humblefish]

Humblefish, would you move both together again to a treatment tank? I hate to medicate the male unnecessarily but am afraid the stress of separating them would be worse.

And if she quits eating again, how long can I let that go? I will be ordering Kanaplex tomorrow.

Kanamycin is relatively mild (for an antibiotic) so I don't see much harm in also treating the male. You might also consider ordering some Furan-2 and Seachem Metroplex, as combining those with Kanaplex provides the most potent antibiotic mix I have ever used. As a backup plan just in case kanamycin by itself doesn't get the job done.

Fish can typically go without eating for up to 2 weeks before reaching the point of no return i.e. becoming too weak.

 

[Newstead]

Update: I decided against moving her to a hospital tank again as other than the bubble she was doing so well in her regular tank. After research, I ordered Dr. G's Antibacterial Caviar, which has Kanamycin and metronidazole. I have been feeding it to her 2x day for 12 days (I did miss a second feeding 2 days while grandbaby was here). The first week there was no change in the lesion and bubble. By day 8 the bubble was gone and has remained gone (the longest it has been gone). The lesion appears smoother and a tiny bit smaller. The directions say to feed for up to 14 days, so I will continue for 2 more days then take a break.
Interestingly, the male won't tpuch this food, but the female can't eat it fast enough - she stations herself by the baster and eats each caviar as it comes out.

 

[Humblefish]

Good to know that Dr. G's Antibacterial Caviar contains kanamycin and metronidazole. I will try to remember that for the future.

 

[Newstead]

Humble, you are responsible for setting me on the search for that combo! Knock on wood, looks like that combo is helping more than the Maracyn 2 or Furan 2 did in the hospital tank.

 

[Humblefish]

Humble, you are responsible for setting me on the search for that combo! Knock on wood, looks like that combo is helping more than the Maracyn 2 or Furan 2 did in the hospital tank.

I have to give Andrew Sandler (hedgedrew) credit for turning me on to the Furan-2/Kanaplex/Metroplex combination for dealing with serious bacterial infections. From that I extrapolated using kanamycin and metronidazole to treat BSJ disease and other infections.

You can see hedgedrew's incredible tank here: http://reefkeeping.com/joomla/index.php/current-issue/article/147-tank-of-the-month

 

[Newstead]

Another update on Ilsa, our female clown. 3 days after stopping the Dr. G's antibacterial food (instructions say up to 2 weeks), the lump was larger and the bubble back. 2 weeks later I have started her back on it since the lump has grown almost to her top lip and there are now 3 bubbles. SandJ has been helpful sharing info on her tomato clown which passed away from a similar lump with bubbles on her side.

Here is a pic of her yesterday - still eating but hanging out more and more in her top corner. I may try another hospital tank to try the combi of Furan2, Kanaplex and metro if she continues to worsen. this HTML class. Value is