Successful Treatment of Severe Ulcerative Dermatitis and Bacterial Septicemia in a Lake Sturgeon (Acipenser fulvescens)
Treatment options for teleost species with dermal lesions have historically been a challenge with limiting factors such as therapeutic efficacy, contact time, frequency of handling, and product availability.1 Honey is an ancient remedy used for a wide range of wound types including ulcers and burns. It is suggested that its phenolic constituents, supersaturated sugars, osmotic effects and hydrogen peroxide-producing enzymes stimulate antioxidant, antimicrobial, and debriding activity. The effectiveness of honey in clearing infection and accelerating wound healing has been studied in human and veterinary medicine, although not typically in fish species.2-4
We report the successful use of a multimodal treatment protocol in an estimated 32-year-old, cultured lake sturgeon (Acipenser fulvescens) with a severe ulcerative dermatitis and a systemic bacterial infection of unknown etiology. Dermatitis, with diffuse multifocal severe ulceration, necrosis and keratinocyte degeneration was identified in the pectoral fins, the tail, the caudal fin and the rostral head, with epidermatitis of the ventral body wall. Dermal ulceration often invaded into the underlying muscle and bony tissues of nearly three-quarters of the tail. Aeromonas hydrophila was cultured from serial blood and tissue samples. The fish was treated under anesthesia (tricaine methanesulfonate) once weekly. Treatments included systemic antibiotic therapy with chloramphenicol (50 mg/kg) and ceftiofur crystalline free acid (Excede®, 6 mg/kg). All dermal lesions were debrided weekly and treated topically with either honey, L-Lysine HCL gel, or Silver Sulfadiazine Cream 1% (SSD). Each topical treatment was restricted to specific regions of dermatitis and one area of the tail was left untreated. All areas were assessed for second-intention healing prior to each weekly treatment. Two weeks after the initial presentation, new tissue necrosis, invasion of muscle and wound retraction were noted in the untreated original lesions. As this was not observed in the honey-, lysine-, and SSD-treated lesions, topical treatments were initiated in that area. Honey utilized was harvested from a Melissa officinalis bee apiary located in a diverse floral garden of the aquarium. All topical therapies were allowed a minimum of 10 minutes contact time with the dermal lesions prior to submersion of the fish. The honey remained adhered to the lesions after submergence between 5–20 minutes. Systemic antibiotic therapy was discontinued after 34 days based on lesion appearance and a negative blood culture. All lesions resolved within 72 days of the initial presentation. Adverse reaction or delayed healing was not observed with any therapy. The rate of wound healing, re-epithelialization, neovascularization, product adhesiveness, and underwater retention appeared to be the most effective when lesions were topically treated with honey, followed by SSD, and lastly lysine gel.
The authors have employed the same local honey for wound care with additional aquatic species including mammals, invertebrates and elasmobranchs. The antibacterial properties of honey are reportedly relative to its floral origins.5 Investigations of the honey's antimicrobial activity would be helpful in further understanding its potential indications in aquatic animal cases.
The authors wish to thank the Animal Health and the Fishes Departments and Christine Nye, horticultural programs manager at the John G. Shedd Aquarium.
* Presenting author
1. Fleming GJ, Corwin A, McCoy AJ, Stamper MA. Treatment factors influencing the use of recombinant platelet-derived growth factor (Regranex®) for head and lateral line erosion syndrome in ocean surgeonfish (Acanthurus bahianus). J Zoo Wildl Med. 2008;39(2):155–160.
2. Bischofberger AS, Dart CM, Perkins NR, Kelly A, Jeffcott L, Dart AJ. 2013. The effect of short- and long-term treatment with manuka honey on second intention healing of contaminated and noncontaminated wounds on the distal aspect of the forelimbs in horses. Vet Surg. 2013;42(2):154–160.
3. Malik KI, Malik MA, Aslam A. 2010. Honey compared with silver sulphadiazine in the treatment of superficial partial-thickness burns. Int Wound J. 2010;7(5):413–417.
4. Staunton CJ, Halliday LC, Garcia KD. The use of honey as a topical dressing to treat a large, devitalized wound in a stumptail macaque (Macaca arctoides). J Am Assoc Lab Anim Sci. 2005;44(4):43–45.
5. Carnwath R, Graham EM, Reynolds K, Pollock PJ. 2014. The antimicrobial activity of honey against common equine wound bacterial isolates. Vet J. 2014;199(1):110–114.