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Kohaku with severe lymphocystis


August 18, 2008
I received a call from a friend who informed me about his 48 cm, very tame doitsu kohaku with a strange growth inside the mouth, just behind the upper lip.  Upon close inspection it was clear that the lymphocystis virus was responsible for the wart-like growth, almost the size of a marble.  The whole upper lip was also covered with smaller growths.  What was disturbing was the fact that the fish was unable to eat properly and because of the constant nibbling on algae on the side of the pond, the growth has become tender with clear signs of infection.  The skin also exhibited tell-tale red streaks, indicating that the infection may become systemic.  A scrape revealed no parasites

The owner of the fish was advised that lymphocystis is a virus and could not be cured with the normal antibacterial medication normally used for treating koi.  Lymphocystis could only be cured through the immune system, and normally disappears during the second summer after infection.  In this case, however, there was a real danger that the fish would not survive because of its inability to eat as well as the danger of infection and frequent injections.


The alternative that we were faced with was to surgically remove the growth and administer injections to combat bacterial infection as well as apply acriflavine neutral.  This latter course was influenced by an article written by Dr. Johnson in his book Koi Health and Disease.  Although not subjected to sufficient tests, Dr. Johnson noted that in a few tests conducted by him, evidence had been found that acriflavine may have some antiviral properties that could be worth exploring.  Dr. Johnson further mentioned that his tests were based on a three to five hour bath in an acriflavine solution, repeated after five days.

I was not really able to spend three to five hours on two occasions to place the fish in an acriflavine bath, and the owner of the fish did not have the confidence to do it by himself. Faced with the above situation and the suggestions by Dr Johnson, a plan of action was drawn up.

August 22, 2008
At 15:00 the fish was placed in anesthetics.  When the koi was sufficiently sedated, it was slipped into a thick plastic bag with a hole cut in one corner, just big enough to allow the mouth to protrude, without inhibiting gill movement. 

This was done to allow a second person to restrain the fish without damaging the cuticle.  (You don’t want a fish thrashing about while holding a scalpel in his mouth, do you?)  The lip and viral growth was dried with a paper towel. 

The viral growth was then firmly grasped with forceps and removed with a scalpel.  It only took a few seconds.

No attempt was made to scrape off the smaller growths on the upper lip.

The bleeding was checked with a common Lennon’s product.           

A small amount of acriflavine powder was mixed with surgical alcohol into a paste and applied to the wound as well as to the viral growths on the upper lip. 

While we waited for the acriflavine to penetrate into the viral growths, an intramuscular injection of 1.2 ml Penilente LA was administered.  We then sealed the growths and wound with Friars Balsam and placed the fish into a container with aerated water.

Most of the acriflavine dissolved into the water and because we did not know its effect on a sedated fish, we moved the fish to a second container with clean water.  We could see that the affected area was deep yellow-orange in colour, suggesting that the acriflavine had penetrated sufficiently for our purpose.

The whole procedure took less that two minutes, but believe me it was two minutes of action!

Five hours later the owner phoned to inform me that the fish was feeding from his hand!


August 28, 2008
A follow up consultation took place and this time the fish was very lightly sedated, and on inspection it appeared that the remaining growths were much smaller and the wound almost healed.  The red streaks and markings on the skin were gone.  We applied the acraflavine paste again and released the fish back in to the pond.

September 5, 2008
Fish lightly sedated. Wound has healed completely. Lymphocystis growths once again reduced in size. What is very interesting is the fact that these small remaining growths are now smooth-textured and not wart-like anymore. We applied the acraflavine paste again and released the fish back in to the pond

September 21, 2008
Lymphocystis growths smooth but one can still feel the unevenness when you run your finger over it. I did not apply acriflavine, this time. The fish was now able to eat and lead a normal life. (As normal as can be in the confines of a pond).

This process was really not intended as an attempt to prove above all that acraflavine can interfere with the virus. It was necessary to go through the procedure and it seemed like a good idea to also try to get rid of the growths. It is only one case and it actually proves nothing, because it is already spring and the disappearance of the Lymphocystis growths may be coinciding with the increase in temperature or some other reason.


August 2009-08-25

This time it was another friend and fellow hobbyist who informed me that his prized Tancho Kujaku has developed rough wart like lesions on exactly the same place as the fish mentioned above. This time the growth, also inside the mouth, just behind the upper lip was not as big as the previous case, but also disfiguring and an angry red colour. This time however the fish was only sedated and a topical application of Acriflavine paste was applied. This was repeated every 3 days for 4 consecutive treatments. The fish was sedated only for the first treatment and subsequent applications were done by just lifting the head clear of the water and then applying the paste.

Again the angry red colouration has disappeared and the lesions have become smooth and noticeable smaller. I will report back as soon as I visit the “patient” again.

August 2010-08-18

Today I went to inspect the Kujaku that was treated almost a year ago, and the growth has disappeared completely. It is very good news, because the fish has already gone through the worst part of winter and there is no sign of a returning lesion. It is only one year that has passed and the next twelve months will really be an indication of the effectiveness of the Acriflavine application. I will follow this case up in another year.

Last Updated on Wednesday, 18 August 2010 10:07