Regal Angel Issues - Severe Lymphocystis and Secondary Bacterial Infection

[FlexingFishSticks]

Such a good looking fish. Hope it pulls through.

 

[code4]

I hope your not updating is not a bad sign. I have used Epsom salt to help with swelling in the eyes before.

 

[cshouston]

I hope your not updating is not a bad sign. I have used Epsom salt to help with swelling in the eyes before.

Not updating? I just updated! As for epsom, @Randy Holmes-Farley has stated before that it’s ineffective in saltwater fish. It’s a freshwater fish treatment. Epsom is magnesium sulfate which is already a major constituent part of saltwater.

 

[Thaxxx]

I know it looks worse, but maybe just maybe it looks like that from the healing process.
That's what I'm hoping for.
Is he staying upright and swimming much?

 

[cshouston]

I know it looks worse, but maybe just maybe it looks like that from the healing process.
That's what I'm hoping for.
Is he staying upright and swimming much?

I’m also hoping it’s just the healing process. It is staying upright (perhaps a slight tilt which I was attributing to trying to see out of a good spot of the eye), and is swimming a bit. It’s not cruising, but it does move around the tank a bit, and spends some time high up, some time down low.

 

[code4]

Not updating? I just updated! As for epsom, @Randy Holmes-Farley has stated before that it’s ineffective in saltwater fish. It’s a freshwater fish treatment. Epsom is magnesium sulfate which is already a major constituent part of saltwater.

Did not mean to offend. My kindle does not always update right away when I open it. I know that some folks feel Epsom is ineffective in saltwater fish. But others feel it does. I had good results using it on my regal. Either way I hope the best for yours.

 

[cshouston]

Quick update: the regal is swimming better, and the cloudiness doesn’t look as bad as it did in the last photo. The really ugly scab seems to have fallen off, and I can actually see its pupils again. The lymphocystis is still just as bad though.

Quick question, @Jay Hemdal if I may. If the lymphocystis hasn’t resolved by the time my fallow period ends, is it safe to introduce the regal? Would that risk transmission to other fish? Or is the virus like varicella zoster in humans where most of us contract and recover from the chicken pox, but it lays dormant until our immune response is compromised by age/stress, allowing it to re-emerge as shingles? To clarify, is this something most to all fish have anyway?

Edit: Answered my own question through research. Posting this here in case anyone searches lymphocystis and comes across this thread.

“Affected fish should be isolated and monitored for secondary bacterial or mycotic infections that should be treated with appropriate drugs. Lesions associated with lymphocystis eventually regress. In some individuals, tumorous lesions may require surgical debulking, particularly when they interfere with prehension.

Fish should remain quarantined for at least 1 month after recovery. It is unknown whether previous infection with lymphocystivirus is protective against reinfection; however, recrudescence of viral infection has been reported in stressed fishes. Therefore, stress and skin trauma should be minimized. In addition, decreased stocking density and water temperatures may aid in disease suppression by decreasing stress.”

 

[Jay Hemdal]

Quick update: the regal is swimming better, and the cloudiness doesn’t look as bad as it did in the last photo. The really ugly scab seems to have fallen off, and I can actually see its pupils again. The lymphocystis is still just as bad though.

Quick question, @Jay Hemdal if I may. If the lymphocystis hasn’t resolved by the time my fallow period ends, is it safe to introduce the regal? Would that risk transmission to other fish? Or is the virus like varicella zoster in humans where most of us contract and recover from the chicken pox, but it lays dormant until our immune response is compromised by age/stress, allowing it to re-emerge as shingles? To clarify, is this something most to all fish have anyway?

Edit: Answered my own question through research. Posting this here in case anyone searches lymphocystis and comes across this thread.

“Affected fish should be isolated and monitored for secondary bacterial or mycotic infections that should be treated with appropriate drugs. Lesions associated with lymphocystis eventually regress. In some individuals, tumorous lesions may require surgical debulking, particularly when they interfere with prehension.

Fish should remain quarantined for at least 1 month after recovery. It is unknown whether previous infection with lymphocystivirus is protective against reinfection; however, recrudescence of viral infection has been reported in stressed fishes. Therefore, stress and skin trauma should be minimized. In addition, decreased stocking density and water temperatures may aid in disease suppression by decreasing stress.”

That is fairly accurate. I'm guessing it was written by Humbelfish? I have never heard the word "prehension" used on a fish web site before (grin). Lymphocystis is almost always seen in new acquisitions. Some people say it is the stress from transport that brings it on, others say fish are exposed to the virus when they move through wholesaler's systems (that's how Neobenedenia becomes so prevalent). Here is an excerpt from my upcoming fish disease book:

Lymphocystis (cauliflower disease)

This is a common viral disease of marine, brackish, and certain freshwater fishes (usually those with marine relatives: glassfish and rainbowfish). It is a chronic (long-lasting) but self-limiting (usually going away on its own) syndrome caused by an iridovirus. The virus causes hypertrophy (enlargement) of the epithelial cells of a fish’s skin and fins.

Initial symptoms consist of off-white to gray nodules on the fish that spread and grow larger over a timeframe of 10 to 90 days. Commonly, when a Lymphocystis nodule forms on a pectoral fin, a new nodule will soon begin to form on the part of the fish that is brushed by the fin, indicating that direct contact can be a mode of spreading the infection.

When Lymphocystis first starts, the small growths can be misdiagnosed as a protozoan infection, such as Cryptocaryon, or even a bacterial infection. The fact that the lesions are long-lasting and do not cause the fish to become acutely ill rules out these more virulent diseases.

Since Lymphocystis is most often seen in newly imported fishes, capture and transport stresses are often mentioned as the stressors that allow this disease to take hold. While this may be true, it may also be that the cause is actually exposure to other infected fish in the aquarium systems of the exporter, importer, or retail suppliers. In any event, it is extremely rare for a fish held in captivity for more than four to six months to suddenly develop this disease.

Treatment with copper sulfate has also been implicated in the development of Lymphocystis in marine fish. The connection is actually not very clear, in that copper sulfate is most often used on newly imported fishes, and those are the ones that develop the disease most often.

Lymphocystis infections can sometimes become more serious, covering large areas of a fish’s body and even interfering with proper feeding if the cell growth involves areas around the mouth. In rare instances, the virus can also cause enlargement of the cells of internal organs, especially in marine fishes (Wolf 1988). This has the potential of causing serious, yet difficult-to-identify diseases in marine fishes.

A variety of cures have been suggested for this disease over the years. Some public aquarists have reported that a reduction in the animal’s environmental stress level will help reduce the severity of an infection. Others have reported that treatment with a mixture of malachite green and formalin (Quick Cure, Formalite, etc.) helps limit the spread of the lesions. Since both of these compounds can damage an aquarium’s bio-filter, and since both are toxic to fish, care must be taken if this method is attempted. By far, the most commonly recommended treatment involves surgically removing the hypertrophied skin cells, followed with a topical antibiotic to hopefully prevent secondary bacterial infection.
The issue with all these suggested treatments is that because Lymphocystis is usually self-limiting, remission of the disease will almost always occur in spite of any treatment undertaken. Additionally, cutting the tissue to remove the lesions releases viral particles into the aquarium, potentially spreading the disease to other fish. Finally, any time a fish is handled, there is a risk to its health due to injury or infection.

The general advice is to never intercede with a Lymphocystis infection—just let it run its course. The only exception might be if the fish develops a severe form of the disease and its mouth develops lesions that might inhibit it from feeding. Even in those extreme cases, surgery around the mouth will also cause the fish to stop feeding, so it may be better to just wait it out (Hemdal 2014).

Interestingly, aquarists do not seem to report Lymphocystis infections in their fish as often as they did in the 1970’s and 1980’s. Anecdotally, the disease does not seem as common in public aquariums overall as it used to be. The reason(s) for this change are unclear. It may be that more aquarists are familiar with the syndrome, know that it is usually self-limiting, and therefore do not report it. It may also be that marine fish traveling through the commercial supply chain are being handled better, with less stress, making the outbreaks less common.

The table below (adapted from Hemdal 2014) lists the marine aquarium fish groups known to be vulnerable to the Lymphocystis virus (+ = can occur, ++ = commonly infects, +++ = extremely common).

Common Name Taxonomic Group Prevalence

Angelfish (marine)	Pomacanthidae	++
Blennies	Blenniidae	+
Boxfish	Ostraciidae	++
Butterflyfish	Chaetodontidae	++
Damselfish, clownfish	Pomacentridae	+
Dottybacks	Pseudochromidae	+
Gobies	Gobiidae	+
Groupers	Serranidae	+
Hamlets	Hypoplectrus spp.	+++
Moorish idol	Zanclidae	++
Porcupine fish	Diodontidae	+
Rabbitfish	Siganidae	+
Royal gramma	Serranidae	+++
Scorpionfish, lionfish	Scorpaeniformes	+
Tangs, surgeonfish	Acanthuridae	+
Triggerfish	Balistidae	++
Wrasses	Labridae	++

No doubt Lymphocystis will infect marine fish other than those species on this list, but it’s a good starting point of known carriers of this disease. Some marine aquarium fish are so commonly affected with Lymphocystis that diagnosis can be made just knowing that they are the species involved. If an aquarist says they see a growth on a royal gramma, copperband butterflyfish, or hamlet that they just acquired, it is very likely to be Lymphocystis. The only freshwater fish that are prone to this disease are those that are from a family that has marine origins, such as the glassfish, Chanda and possibly Athernidae – the rainbowfishes.

Jay

 

[cshouston]

That is fairly accurate. I'm guessing it was written by Humbelfish? I have never heard the word "prehension" used on a fish web site before (grin).

Haha! Actually it came from http://www.vetbook.org/wiki/fish/index.php/Lymphocystis

I’ve decided not to introduce the fish until at least a month after the visible lesions are gone so as not to risk infecting other fish who may not have immunity. Even if it’s self-limiting, I don’t want to risk the potential for complications you mentioned, like mouth involvement.

 

[robby2782]

I can tell you from experience that epsom salt helped a really bad case of Popeye with my personatus angelfish, and it healed up on its own. This was also suggested by the marine biologist that bred them. I would definitely add as it alleviates the swelling.

 

[Thaxxx]

Glad he seems better.
When my angel seemed to be healing I put in a few brine shrimp to see his reaction.
He definitely smelled it and was trying to find it. Even though he couldn't feed still, it was a good sign. I was thinking of hand feeding but waited it out.
Hope he's on the way to recovery.

 

[cshouston]

Another update on my Regal! The eyes seem to be recovering. It isn’t bumping into things anymore, although its depth perception sucks when feeding. It misses the food more often than not, and by a fair margin. I’m sure this will get better with time.

The only remaining concern is the lymphocystis. It has gotten pretty bad, as evidenced by the photo. Still, I know it’s not terminal, and takes a good amount of time to resolve. I’m just keeping the water quality up with changes, and even threw some chaeto in a breeder box right under the light to try and absorb excess nitrate. I don’t know how long this will take, but I’m determined to bring this fish back to full health!

 

[Jay Hemdal]

Wow - that is the worst case of Lympho I've seen in many years. Do you have a higher-res photo? I'd love to include it in my disease book!

At least the fish's mouth is affected!

Jay

 

[cshouston]

Wow - that is the worst case of Lympho I've seen in many years. Do you have a higher-res photo? I'd love to include it in my disease book!

At least the fish's mouth is affected!

Jay

I can try to get a better one for you. I’ll PM it to you when I do.

 

[cshouston]

Optimistic update for my birthday! The regal’s eyes are almost completely better and its depth perception has improved noticeably. It also stopped being afraid of its hide and has been going inside, so that should help with stress. Its appetite is also back with a vengeance *and* it has started eating NLS marine pellets which will help with getting it a more balanced diet with vitamins, instead of just mysis, mysis, mysis. I’m just going to keep plugging away with the water changes and varied, balanced diet and hope the virus gives up sooner rather than later.

 

[code4]

Happy Birthday. And yes. The eyes look better and so worth the extra care. Great job

 

[Ben Pedersen]

It's amazing that your fish still has eyes. This spring, one of my chromis that I have had for 8 years developed a cloudy swollen eye. It got bigger and bigger then popped. The eye eventually disappeared leaving just the eye socket. The fish is completely healed now.. It is completely fine. I was thinking about supper gluing a fake googly eye over the socket.. but she probably wouldn't like it. Prosthetic eyes for only $2.00.

I hope your fish makes it. It's hard seeing an animal in your care suffer.

 

[cshouston]

It's amazing that your fish still has eyes. This spring, one of my chromis that I have had for 8 years developed a cloudy swollen eye. It got bigger and bigger then popped. The eye eventually disappeared leaving just the eye socket. The fish is completely healed now.. It is completely fine.

I was thinking about supper gluing a fake googly eye over the socket.. but she probably wouldn't like it.

Haha! Sorry to hear that it lost its eye, but I’m glad it survived. Something tells me it wouldn’t appreciate having googly eyes, either.

I treated with an aggressive course of antibiotics once the cloudiness started, so I’m thinking I caught it just in time. There was definitely a point where I thought it would potentially lose its eyes, but I’m glad that never happened.

 

[Ben Pedersen]

Just wondering, what can be done with a fish with no eyes? Would it have to be euthanized? Not sure how you would get it to eat. Very sad..

I found a photo of her when she was having the eye problem. You can see her all the way to the right.. I know it is a girl because it spawns regularly.

 

[Jay Hemdal]

I can't remember, do you know where this fish was collected from? This one is really a fighter!

Jay