The Puffer Forum

Good idea Kass. I don't know of any fish-specific vets, but I'm sure I can get some advice from one of the vet offices around here.

PP: My hubby is going to help me out, and I think he could help me take pictures as well. If the surgery is a success hopefully it will help other puffer owners. I can't guarantee the picture quality; my digital camera is outdated and has a mind of its own. We'll try our best to document this.

The biggest problem arising now, which is terrible timing because this is the first time this has happened, is the major mass has spread into his stomach region, and I'm assuming in amongst his organs because I see a bulge when he eats. The main mass is more like a 'hill' than a 'mountain' if that helps explain the shift of the parasites. This looks like it will be more challenging.

I don't know why they decided to shift after months of staying in a similar region... It's like they know what I'm planning.

This is going to sound gross, but maybe you could make a tiny incision and suck the worms out with a thin piece of airline tubing or one of those bulbs you use to squirt water into your ear?

Try here:
http://www.aquavets.com/
I have never tried or used this site, but I think it was posted here by someone.

It's stickied at the top of the forum!

Phaedrus wrote:It's stickied at the top of the forum!

Oops

Don't batter yourself, we all do it - I did recently on the acronym thread.

I get beat on enough, i do not intend to contribute to that...

Well, I need to do something for poor Bismarck.

He is starting to change behavior- getting irritable, feeding less, and not swimming as much. He still greets me at the glass, but swimming seems uncomfortable for him. The nematode has shifted to his stomach region as well as expanding where it was already present in his tail. I am afraid that I need to make the decision to either put him out of his pain, or try and save him and risk hurting him more. Now that the QT tank is empty, I can keep him in a recovery tank, but I am very nervous about surgery after the points brought up in this thread.

I think I may go ahead with it this weekend, but I need any advice you all can muster. I need to figure out the best way to sterilize and possibly close up the wound, preventing his skin from ripping should he puff up. Any ideas are welcome, the countdown to the decision begins... I am aiming for Saturday if I decide to do surgery. Otherwise I am going to wait a month or so until euthanizing unless he makes a turn for the better.

I will take video/pictures if I do the surgery.

this is such a tough call, I wish I could offer some helpful advice but all I can offer is my wishes. Good luck if you go for the surgery option, I shall be thinking of you and Bismark

First, I highly recommend trying to operate. If he dies in surgery, then he was kindly euthanized anyway, and if he hangs on for a while and suffers afterwords, it's got to be a better death than worms eating your insides, even if it's not as painless as being quietly put down, there's hope. I have not operated on a puffer, but I have operated on a few frogs(my cat brought several in eviscerated and one large bullfrog I caught had a pile of BBs under its skin from the kids that were torturing it), which have some significant skin similarities, and the skin is TOUGH. Like trying to cut rubber with a dull knife, even with an actual surgery scalpel. The slime makes the blade slide instead of bite, and there is significant danger of damaging below the site by crushing or by cutting too deeply when enough force to get through the skin is applied. I'm going to suggest pinching the skin with tweezers or your fingers, and cutting the opening with a snip of some razor-sharp scissors. When stitching the wound, I found the because of the force necessary to pierce the skin that all penetrations had to be made by starting on the inside of the skin and pushing out, and that an anvil piece of some sort on the other side to push the suture needle into prevented some of the trauma of the skin stretching so much.

Thanks for the very detailed post, Nick. You definitely brought up a good point about doing the surgery, and if I am able to get my hands on all of the tools I will need then I am going to do it this weekend.

I hope his skin is as tough, because that would make me feel a lot safer about the sutures (if I can stitch the incision) staying put. I was planning on using some forceps for removing the worms, and I'll use those for the initial incision as well.

What do you recommend for sterilizing the wound? He'll be getting anti-biotic baths during recovery, but I would like to use something to sterilize the incision.

I'd apply ethanol with a Q-tip, myself. Also, I was thinking about this, and since this may take a while, how are you planning on keeping him breathing? A tube with a 3/32" exterior diameter siphoning a trickle of water into his mouth and out his gills might be effective in that regard. Where did you get forceps that include scissors? I'd be afraid of accidentally cutting the fish or worms when removing them. I am about 60% sure I have some real sutures with needle attached somewhere around here, if thats one of the tools you lack I could drop one in the mail.

I guess I was hoping I could make it as quick as a dental job, but I know that's unrealistic. I'll try using a tube and hope it keeps him from suffocating. As for the forceps, I don't have any that include scissors? I meant that I will use forceps to pinch the incision area so I can cut into the skin without puncturing too deep, and then also use them to remove the worms, though they may be too wide. My friend's mother is a doctor so I am hoping I can get my hands on some of the equipment. If not I may need some advice on where to grab substitutes. I have some very sharp, precise scissors with only about 1/4" long blades that I think I will use with the forceps to make the initial incision.

I am going to check with my vet first to see if he might be feeling generous and let me grab some sutures, but if he doesn't I may take you up on your offer. I'm also going to try and get a hold of a fish vet and see what advice I can get. Thanks again for giving me all of these good suggestions.

Ok, now I understand about the forceps. There is nothing wrong with giving away suture, so I hope your vet does it. I was also thinking that as soon as he's recovered from the surgery, a systemic IP treatment like flubenol is probably going to be necessary, as even tiny bits of remaining worm will grow back, it would have to be done as soon as possible, so very little decaying matter will be left...

I have plenty of it left, so that will be easy to do. I am going to isolate him today or tomorrow in the 20 gallon QT.

Tonight I am going to call my friend and see if her mother will be willing to lend me a couple of basic tools, and then tomorrow I will call the vet to see if I can get my hands on suture material.

This is exciting- My husband just walked in when I explained my dilemma with medical tools and he said he'd ask the clinic at the nursing home he works at if he can borrow some things. They let us borrow a few things (stethoscope & scrubs) to use as props for a play, but I didn't realize they had medical tools... yippee! I'll post tomorrow if we get our hands on some tools or not!