Regal Angel Issues - Severe Lymphocystis and Secondary Bacterial Infection

[cshouston]

I have a regal angelfish in QT with another 14 days of copper to go. It had a rough trip thanks to FedEx losing the package for a day and being delivered late. It was near death when it arrived. It has had these two white spots on its tail fin for two weeks. They haven’t changed, disappeared, or moved in that time. Also, I noticed exposed rays on its anal fin. It has been in QT with a bristletooth tang, but everyone is well fed and I haven’t noticed any aggression between them. I’m still considering moving the angelfish to a smaller tank by itself for the remainder of treatment.

Water parameters are steady at:
1.025 sg
8.0 pH
0ppm ammonia
~5ppm nitrate
2.0ppm chelated copper (Copper Power)

My guess is possibly lymphocystis, but I’m not positive. I’m prepared to administer kanaplex/furan-2 in the smaller tank. Hope you don’t mind my tagging you @Jay Hemdal and #reefsquad

 

[Jay Hemdal]

Is the fish feeding well? If so - very cool! The spots on the caudal *could* be Lymphocystis, but that generally grows on fin edges. These look to be broken fin rays. I wouldn't treat for that. The bare anal fin spines are another matter. That looks like it could be infected. If you think it is growing/spreading, then you should medicate. If it seems stable, I would leave it be, and just watch it carefully. Moving the angel to a smaller tank is risky - these are tough enough to get through quarantine without also having to battle issues of it being in a small tank. If you do decide to move/treat, yes, the Kanaplex/Furan is a good choice.

Jay

 

[cshouston]

Is the fish feeding well? If so - very cool! The spots on the caudal *could* be Lymphocystis, but that generally grows on fin edges. These look to be broken fin rays. I wouldn't treat for that. The bare anal fin spines are another matter. That looks like it could be infected. If you think it is growing/spreading, then you should medicate. If it seems stable, I would leave it be, and just watch it carefully. Moving the angel to a smaller tank is risky - these are tough enough to get through quarantine without also having to battle issues of it being in a small tank. If you do decide to move/treat, yes, the Kanaplex/Furan is a good choice.

Jay

Thank you, Jay. The fish is eating well on mysis, spirulina enhanced brine, and nipping at red seaweed sheets. The bare spines are a new development which is why I was concerned about aggression despite not having seen any. I can’t think of anything that would have taken that much tissue in one day.

I think I will put it in solitary for the remainder of its quarantine period, and treat with kana/furan to be safe. I prepared a 10 gallon tank just in case, already cycled, with plenty of aeration. Smaller volume means smaller dose, anyway, and I won’t be unnecessarily treating the other fish.

We have too much invested in this fish to risk it, emotionally as well as financially. Everybody loves it! Once the DT is ready, it’s going in first for a week or two to settle in before I start introducing the other QTed fish.

 

[Jay Hemdal]

Thank you, Jay. The fish is eating well on mysis, spirulina enhanced brine, and nipping at red seaweed sheets. The bare spines are a new development which is why I was concerned about aggression despite not having seen any. I can’t think of anything that would have taken that much tissue in one day.

I think I will put it in solitary for the remainder of its quarantine period, and treat with kana/furan to be safe. We have too much invested in this fish to risk it, emotionally as well as financially. Everybody loves it! Once the DT is ready, it’s going in first for a week or two to settle in before I start introducing the other QTed fish.

That is a sweet looking fish - good luck with it!

Jay

 

[cshouston]

That is a sweet looking fish - good luck with it!

Jay

Thank you. I’ll hope to reply with good news in a few weeks.

 

[cshouston]

@Jay Hemdal if you wouldn’t mind taking a look at this most recent photo from this afternoon:

I finished the course of Furan-2 and Kanaplex, but over the last couple of days, the fish has developed cloudy eyes that appear to be bulging somewhat. Also, there are white, fleshy looking bits on the top of the dorsal fin and where the damage was done to the anal fin and rays were exposed (one ray is still fully exposed with no tissue left). I’m beginning to wonder whether the tang actually did attack the regal while in the larger QT tank. When I moved it to the 10gal to medicate with antibiotics, I did notice slight damage below one eye.

I suspended copper treatment, did a large water change today, and put some cuprasorb in the power filter. Is there anything else I can do at this point, or should I just hope the fish heals on its own?

I have on hand: general cure, metroplex, kanaplex, furan-2, doxycycline, and api fungus cure (acriflavine + Victoria green)

thank you for all your help

 

[Jay Hemdal]

Hmmm, the eyes are the biggest worry to me. The three spots you circled on the fins all look like Lymphocystis to me, so no need to treat for that. White cloudy eyes can be a sign of Neobenedenia flukes, but not so much the popeye that you're seeing at the same time. Did the fish flop around in the net when you transferred it? Mechanical damage can cause cloudiness and popeye. Is it still eating? If so, I would expect it to stop in a day or so - due to the eye issues. Shouldn't there be a couple more days on the Kanaplex treatment?

Jay

 

[cshouston]

Hmmm, the eyes are the biggest worry to me. The three spots you circled on the fins all look like Lymphocystis to me, so no need to treat for that. White cloudy eyes can be a sign of Neobenedenia flukes, but not so much the popeye that you're seeing at the same time. Did the fish flop around in the net when you transferred it? Mechanical damage can cause cloudiness and popeye. Is it still eating? If so, I would expect it to stop in a day or so - due to the eye issues. Shouldn't there be a couple more days on the Kanaplex treatment?

Jay

It didn’t flop in the net, but I did notice damage below the eye when I was moving it. The only thing that fits the symptoms in my mind would have been aggression in the larger QT, so it’s likely due to physical trauma from that.

It does appear to have stopped eating as of today. You’re right about the Kanaplex. It says every 2 days up to 3 doses. I was stopping Kanaplex when I finished the Furan-2 regimen. I’ll dose the tank again with Kanaplex.

edit: actually, it’s still eating somewhat. I saw it go for a bit of shrimp that floated by, although it does seem to have a diminished overall appetite.

 

[Jay Hemdal]

Good that it still tried to eat. Not sure what else to suggest except to try another antibiotic once this course is done.
jay

 

[cshouston]

Good that it still tried to eat. Not sure what else to suggest except to try another antibiotic once this course is done.
jay

Thank you. I’ll keep monitoring the situation. In 48 hours, if I don’t note any improvement, I can always switch to doxycycline, unless you would suggest erythromycin instead.

 

[Jay Hemdal]

I was kind of thinking of erythromycin, but it’s all just a guess really....
Jay

 

[cshouston]

Today, on the advice of Dr. Reef who initially quarantined this fish for me, I added a sachet of general cure, as well as a sachet of erythromycin as Jay advised. The eyes looked worse this morning, so I decided to take action now just in case it is bacterial. The Angel isn’t using either hide in the tank, and is just hanging under the filter intake right now.

 

[cshouston]

 

[cshouston]

Pretty rapid progression today. The regal angel is acting like it’s blind, bumping into things, and judging from the eyes, I’m not surprised. It’s currently getting erythromycin. I know it won’t improve overnight, but I feel like it’s just getting worse. It looks like there may be a bleed in its right eye, as well.

This is so frustrating to watch. I feel terrible for the poor fish.

 

[cshouston]

Hey, @Jay Hemdal can I pick your brain for a second? I read from one source that antibiotics are more effective in lower salinity. I haven’t been able to find any supporting facts, though. Is there any truth to that? If so, I may drop the salinity to 1.020 with tomorrow’s water change and see if it helps at all.

 

[Jay Hemdal]

I’m not sure if I agree with that. The reason antibiotics work well in marine systems is that saltwater fish must drink tank water to balance osmotically, swallowing drugs in the water at the same time. FW don’t drink, so antibiotics don’t get inside them as readily. Marine fish in low SG drink less....but that is just a theory, I can’t say for certain. Tetracyclines are inactivated by calcium, so they would be more effective at low salinity.
Jay

 

[cshouston]

Saturday Morning Update: the regal is still alive, which is a good thing. Its eyes are still totally clouded over, though. Last night, I performed a large water change, and added a double dose of erythromycin. This morning, the fish wasn’t swimming up against the filter, but was actually lazily cruising around the bottom. I added some mysis and, while it definitely doesn’t seem to be able to see the food, it gobbled some up when it happened to float by its mouth. The regal is also reacting to changes in light, darting a bit when I turn the light on or off, so it’s probably not completely blind. I’m more hopeful today that it can recover than I was over the last couple of days.

 

[Thaxxx]

I had and still have a Japanese Swallowtail Angel with those same symptoms.
After I realized he could no longer feed because if his site. I qt'ed him and used Furan-2 then General Cure. Slowly he got better and eventually got where he was seeing the food. Three to four weeks without food before he caught his first piece. I said "YESSS" He needed to learn to eat again. Depth perseption was bad for awhile. He's all better now. Well over a year and a half. No ill effects.
Good luck with him.

 

[cshouston]

I had and still have a Japanese Swallowtail Angel with those same symptoms.
After I realized he could no longer feed because if his site. I qt'ed him and used Furan-2 then General Cure. Slowly he got better and eventually got where he was seeing the food. Three to four weeks without food before he caught his first piece. I said "YESSS" He needed to learn to eat again. Depth perseption was bad for awhile. He's all better now. Well over a year and a half. No ill effects.
Good luck with him.

Thanks. I’m using General Cure and Erythromycin right now, but once the course is done, I might try Furan-2 again. I hope the eyes start to clear up soon.

 

[cshouston]

Following up on the regal angel. Its eyes are still clouded, looking almost scabby on one side, and the lymphocystis on the dorsal and anal fins looks worse. It’s still alive at least, so I imagine the antibiotics helped to some degree.

I am continuing treatment with erythromycin up to 10 days, but general cure has reached the end of its directed time. Once erythromycin is completed, I’ll put carbon in to remove any leftover medication, do a 50% water change, and continue to monitor its progress.

@Jay Hemdal is there anything else you might suggest at this point? I greatly appreciate all of your help.