Page 45 - WSAVA2018
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Serum Chemistries (Serology):
ALT(SGPT) 20-50 IU/L
AST (SGOT) 100-300 IU/L
Total Bilirubin 0.1-0.3 mg/dl
Alkaline Phosphatase 10-20 IU/L GGT 1-3 IU/L
Uric Acid 1-2.5 mg/dl
Blood Urea Nitrogen 5-15 mg/dl Creatinine 0.2-0.5 mg/dl BUN/Creatinine Ratio 10-20 Creatinine Phosphokinase 14.5 IU/ml Glucose 30-120 mg/dl
Cholesterol 200-400 mg/dl Triglyceride 50-500 mg/dl
Amylase 25-50 IU/L
Lipase 25-50 IU/L
Total Protein 4-10 g/dl
Albumin 2-6 g/dl
Globulin 2-4 g/dl
A/G Ratio 0.7-1.2
Osmolality 220-420 mOsm/kg Calcium 8.5-13.5 mg/dl
Phosphorus 10-15 mg/dl Caciuml/Phosphorus Ratio 0.6-1.3 Magnesium 3-5 mEq/L
Sodium 100-140 mEq/L
Chloride 90-120 mEq/L
Potassium 4-30 mEq/L
Na/K Ratio 3-30
Radiographs of fish can be taken successfully with standard veterinary radiology equipment. The radiographs can be taken without anesthesia by briefly restraining the fish in a sealed plastic bag with a small volume of water. The fish in the plastic bag can be placed directly onto
the film plate or digital sensor, and the bag taped down if necessary to hold the fish in the correct position. Fish can also be anesthetized and then taken out of the water and positioned for radiographs. Gas bladder (swim bladder) abnormalities, spinal deformities, abdominal masses, and occasionally ingested foreign objects can be evaluated using radiology. Abdominal viscera are not easily distinguishable in a radiograph without a contrast medium. A flexible rubber catheter can be inserted orally to place barium or iodinated contrast medium into the stomach
or intestines to perform contrast studies on the intestinal tract. The dosage for barium is 5 to 10 mL/kg body weight and the iodinated medium is dosed at 1 to 2 mL/kg. Be careful not to leak barium into the oral cavity and onto the gills, which could impair oxygen diffusion through the gills.
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Ultrasound imaging can be performed on fish confined in a small container of water, as the water serves to couple the transducer to the fish’s body, eliminating the need for ultrasound gel. Transducers of 5 to 10 MHz work well for visualization of internal organs at depths up to 13 to 20 cm into the body, with lower frequency transducers producing images at greater depths of tissue penetration. If not waterproof, the transducer can be placed inside a plastic cover (e.g., plastic bag, examination glove, or condom) for protection. The transducer can be held several centimeters away
from the fish if it is in the water, and the transducer repositioned until the desired image is obtained. Motion imaging can be used for guided tissue biopsy collection, abdominocentesis (coeliocentesis), or pneumocystocentesis.
Endoscopic examination of the oral cavity, gill arches, and the pharynx can be performed by passing the endoscope into the mouth or gill operculum of an anesthetized fish. Flexible endoscopes can be passed through the esophagus into the stomach or intestines. Koi and goldfish have no stomach, but the proximal intestine is elastic and can distend to hold ingesta. Laparoscopy (coelioscopy) can be performed in larger fish to visualize internal organs or take biopsy samples.
A small surgical incision can be made through an anesthetized fish’s body wall to insert an endoscope. Coelomic cavity visualization is used to evaluate the
liver (hepatopancreas), the gonads to determine gender or reproductive organ development, the presence of adhesions or inflammation, the gas bladder position and status (inflamed, deflated, or fluid infused), or to collect an abdominal swab for bacterial culture. If the coelomic cavity has been insufflated with air during the procedure, the air must be removed to prevent buoyancy problems immediately after the procedure. The small incision can be closed with a simple interrupted absorbable suture, or sealed with methacrylate tissue adhesive.

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