Talking a Case History

Whether you work in a laboratory or veterinary hospital, nothing is more valuable than a full and accurate case history. With the myriad of potential problems relating to the case at hand, the more information you have, the better your chances of effectively pinpointing the problem or problems.

Your job as a diagnostician is to ask the appropriate questions so that you can put together an almost visual imagery of the situation at hand.

It is important for you know the source of the fish. If possible, obtain prior history to any problems arising.Careful and informed decisions about the source of the fish, from pet shops to commercial suppliers, can alleviate many hassles. When obtaining background information from many suppliers, it may be difficult to get straightforward facts. It is good to establish a relationship with suppliers who you can trust for reliable information, and to ask questions so as to not make your client defensive.

It is often helpful to ask if any treatments have been applied to abate the problem or problems. There are countless over-the-counter drugs available for fish hobbyists (many of which would be prescription drugs if used for other species). Drug treatments, by themselves, may cause adverse health problems.

Is there reason to believe that there is buildup of ammonia or nitrite? This type of water quality problem is particularly common in home aquaria which have a short tank acclimation time prior to adding fish (i.e., "new tank syndrome").

If water quality is suspect, have basic water quality parameters been checked? Readings of pH, salinity, dissolved oxygen, hardness, chlorine, etc. can be done from simple test kits. Sometimes it is worthwhile for a water sample to be sent to a professional laboratory.



When fish arrive for health assessment, what condition are in? Were there any additives in the water during transport? If fish are dead, how long? If the water was extremely cold, a fresh dead fish may have little autolytic change. A fish which was dead for several hours at warm temperatures may not provide the most useful information.



Don't be afraid to ask questios and talk to your collegues to learn more about unfamiliar cases.This all-important information arms you, the diagnostician, with added insight and awareness, prior to proceeding with an actual necropsy. Apriori knowledge of case history may significantly help you to find what you are looking for!

Obviously, there are countless questions which may be relevant to your case. The best way to proceed in obtaining a case history is to ask succinct, appropriate questions. These questions should not be open-ended; for example: How is your water quality? ... This question is so vague to the general pond owner or hobbiest that is may not yield helpful information. Rather, you might ask: How do you do your water changes and how often? Good communication skills are everything.

It is also helpful for your questions to not be leading; for example: have you noticed that the fish are slower to respond to feed recently? The client may tend to respond favorably only to be agreeable with a projected or "telegraphed" thought coming from an expert in the field. Developing good skills in taking accurate case histories yields a distinct advantage in the clinical examination of fish health problems. Some sample questions are in the next screen. Also, you may wish to refer to some of the references (regarding necropsy, case history and water quality) listed in the section "About FishGuts."


Questions To Keep In Mind

Are the fish hyperactive/calm?
Have there been changes in diet or appetite?
Are there any new materials added to the system? Recent construction on the system or use of pressure-treated lumber; new pvc piping?
Are there any solvent odors?
Any source or non-point source run-off?
Have there been new animals introduced into the system?
New plants introduced in the system?
Any medications or treatments?
What drugs/dosages/duration?
What are the response(s) to treatments?
What condition is the animal(s) submitted? Alive/moribund/dead Was there excessive stress or trauma in the transport?

How is the problem manifested?
How long have you noted this problem?
Are there mortalities? acute vs chronic?
What type of system are the fish housed in?
Static, recirculating, flow-thru?
What are the materials of the system?
What is the water source?
What type of filtration is there?
How do you make water changes?
Water quality: How often are water changes done? Measurements of chlorine, pH, D.O., hardness, salinity, temperature?
Have there been changes in water quality parameters?
Are there any behavioral changes?
Where are the fish in the water column?






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