¶ Introduction to Fish Wound Healing
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You're listening to Veterinary Vertex , a podcast of the AVMA Journals . In this episode , we chat about how topical natroxone potentiates cutaneous wound healing in black belt cichlids , with our guests Anthony Cerreta and Karisa Tang .
Welcome to Veterinary Vertex . I'm Editor-in-Chief Lisa Fortier , and I'm joined by Associate Editor Sarah Wright . Today we have Anthony and Karisa joining us . Thank you guys so much for joining us here on Veterinary Vertex Podcast .
Thanks for having us !
All right , let's swim on over . So , Anthony , your AJVR article discusses how topical naltrexone potentiates cutaneous wound healing in black belt cichlids . Please share with our listeners the background on this article .
Cutaneous wounds are pretty commonly seen in fish , both in public and home aquaria settings , and that equates environment is pretty conducive to developing secondary infections . So we felt it was pretty important to investigate strategies that will help improve wound healing and kind of mitigate these secondary effects .
And the topical naltrexone in Ilex ointment was chosen because it's successfully been used in the treatment of lateral line depigmentation in TLA , which is a multifactorial , chronic integumentary condition that results in these depigmented to ulcerated skin lesions . So our objective was to evaluate this topical naltrexone in this kind of acute wound healing model .
Yeah , super cool article . Very clinically applicable too , so I really enjoyed reading it . And then what are some of the important take-home messages ?
¶ Naltrexone's Effect on Cichlid Wounds
Um , two big ones is a topical naltrexone in ilex ointment , when it's applied every three to four days , resulted in significant improvement both in the time to visualizing the resolution of the wound healing and then also significantly decreased wound area .
And then we didn't see any adverse effects during routine health monitoring following these repeated treatments , because we were repeating the treatments every three to four days .
Karisa , let's turn it over to you now . What sparked your interest in fish wound healing ? Were you a student before a student , a resident ? Was there a particular case ?
We were all students all the time and forever for sure . But , as Anthony mentioned , fish get wounds all the time for various reasons social complexities , really every animal but the difference is they're aquatic , so things are a little bit harder .
And actually it started with Dr Greg Lubart at North Carolina State University , who was collaborating with Dr Megan Strobel at the time at National Aquarium , now at Shedd yay , who had mentioned hey , I wonder if naltrexone works , like there were some papers and rodents and humans and maybe it would work in a fish , I don't know .
So Dr Megan Strobel actually used it in head and lateral line erosion in a population of fish at National Aquarium this one time and they all got better pretty much and it was really really profound .
And so she and I are friends because our entire community is very small and we were talking about it and I started using it in a host of different species and realized that you know , we think it works , but of course that's not strict science .
So we really wanted to design something that could be more perspective to be able to share with the rest of the community . This works or this doesn't work . So that was the inspiration .
That's awesome , Anthony . Sarah asked you just a minute ago what are some of the major findings , but every time we do a study , we find something that's surprising , which leads to more research . What did you find in this article when you were doing this work that you found surprising ?
Zinc funding was just how quickly the wounds actually healed . So the wounds were treated
¶ Origins of Fish Naltrexone Research
with naltrexone every three to four days , healed around day 19 . So these were cichlids that were kept in kind of traditional warm , tropical fresh water , freshwater , temperate environments and in fish . There is a positive correlation between overall water temperature and how quickly the wounds will close .
But we were pretty surprised just to see how rapid the wounds visually resolved .
Yeah , also thank you , Karisa , for doing the Greg Lubart shout out . He actually was my first research mentor , took a chance on me as a student when I was like I want a project . So, thank you to Greg
Yeah he is a lot of people's first mentor . Truly shout out to Greg for all he has done for the entire community .
Agreed . So this is in cichlids specifically , but do you guys have any plans to look at naltrexone and other species ?
Yeah , so in anything zoo-related you're looking for a sample size , and so we had a lot of black belt cichlids and that's why ultimately , the study was in them . But , as Anthony said , like what we did was kind of prospectively , make these very regular , very shallow wounds and see how they healed .
But in reality we're looking at chronic wounds , like when we have things that don't heal well on their own . How do we fix that ? And it's really hard to be able to design a study that's perfect to be able to account for that .
So, right now we're kind of taking cases where we have chronic wounds already in the collection and taking lots of photos and treating them with naltrexone in different ways so that we can kind of write it up as a more retrospective thing , because we're so interested in chronicity .
¶ Surprising Healing Speed Results
Very cool . We hope to see that manuscript in our journals in the future . And then , Anthony , do you see a role for AI in this area of research ?
Really good question . One aspect of this study we were measuring how we were measuring the wound area . So, we were taking photographs , kind of from set distances , of each of the wounds and then using an image processing software and actually we were kind of manually tracing out the wounds that it would then use to kind of calculate that wound area .
But I think AI would be really interesting , both calculating that wound area and then overall the scoring system that we were using and kind of grading how these wounds were healing .
Super cool . I love everyone's responses to that question . And then , for those of you just joining us , we're discussing how topical naltrexone potentiates cutaneous wound healing in black belt cichlids with our guests Anthony and Karisa .
Anthony , how did your training help you get through the study design , complete the project and then get across the finish line and get this article submitted and published ?
Yeah , I think , speaking with Greg Lubart , I was incredibly lucky to have him as a mentor throughout veterinary school and then kind of through internship , just really gaining that experience with study design and writing .
And then both Karisa and I completed the Illinois Zoological and Aquatic Animal Medicine residency and that provides both guidance and kind of mentorship on prospective study design and executing these studies and completed a master's as part of that program .
So ultimately kind of that culmination helped with both kind of learning how to conduct these projects and execute and write the papers afterwards .
Good job , my mentor , Karisa . Now this next set of questions is going to be really important for our listeners . So , Anthony , what is one piece of information the veterinarian should know about Topical naltrexone for wound healing in fish ?
I think topical naltrexone it's cheap , easy to apply and even with a short contact time if you're applying it every three to four days will help heal acute wounds in fish quicker .
Very well said . And then Karisa , on the other side of the relationship . What's one thing a querist should know about using naltrexone to help with wound healing ?
It may seem ridiculous to think about topical treatments in fish . Like they're in the water you put them in . It falls off almost immediately a lot of the time , except with Ilex . But it's not actually ridiculous . And what's great is that this paper , you know , says that and that , like Anthony said , very short contact times can lead to beneficial conclusions .
So even though it is extra handling time , it can be very , very worth it
yeah , I'm an equine orthopedic surgeon , so I learned a lot reading this
¶ Study Design and AI Applications
manuscript , and even more just now . So thank you , uh , as we wind down , we like to ask a little more of a personal question , so I'll start with you , Anthony . What is the oldest or the most interesting item on your desk or in your desk drawer ?
yeah , I think this is a good one because I think it's also probably the strangest . Um , but we just recently moved , uh removed a trichobesaur from an echidna , so I currently have a piece of that because we sent it out to a forensics lab to try to figure out what the hair is actually .
So that is probably the interesting , or most likely strangest thing on my desk right now .
Yep , that's strange . What was the hair ?
It's looking like it's actually echidna hair which stumped every lab because no one had that hair .
Huh , fascinating Karisa . How about you ?
Oh , we're just sitting at my desk Shoot . Okay , I thought I was going to . I have porcupine quills on my desk . We don't currently have porcupines , but we did at
¶ Clinical Applications for Veterinarians
some point . So , yeah , I think that's going to take that cake .
Were they from the porcupine or were they from a patient ? That the porcupine won the battle ?
You know , that's a very fantastic question . It's from the porcupine itself , naturally .
Yeah , well , that's the first time we've had either of those answers to that question , so we can lecture diplomats of ACZM . Well , thank you so much , Anthony and Karisa , for being here today . We really appreciate your time and for sharing your manuscript , too , with our readers .
Thank you so much for having us .
Yeah , and for having us .
And to our listeners . You can read Anthony and Karisa's article on AJVR . I'm Sarah Wright with Lisa Fortier . Be on the lookout for next week's episode and don't forget to leave us a rating and review on Apple Podcasts or whatever platform you listen to .