Baby Blue had lost considerable weight by the time Dr. Helen E. Sweeney examined the anorexic koi in her West Seneca office. The fish had not eaten in weeks, yet it unleashed a flurry of tail flaps as the veterinarian approached its tank.
Sweeney, unfazed, trained her eyes on the pale blue fish. As she reached into the tank with one hand, its tail began to redden, a sign of stress.
"Fish are never happy to see me," said Sweeney, wiping pond water from her face. "The owners are, usually. It's the owners who are interesting. They have the same bond with fish that some people have with a dog or cat."
Sweeney is one of about 10 veterinarians in the state who practice aquatic medicine, a veterinary branch so new that the American Veterinary Medical Association has yet to designate it a specialization.
"It's something a lot of people don't think about," said Sweeney. "We are a small niche group on the ground level of veterinary medicine. There's not a lot of formal education available, so when you practice you can add to the knowledge base. Much of the knowledge was extrapolated from the food fish practice."
In 2017, about 139 million freshwater fish were owned by Americans, making fish the most popular pet category in the United States. By comparison, there were 70 million dogs and 74 million cats owned as pets in the U.S., according to the AVMA.
Gregory A. Lewbart, 59, is a professor of aquatic animal medicine at North Carolina State University, one of the pioneer academic programs of its kind in the country. Lewbart believes there are up to 400 exotic animal veterinarians in the country who are proficient in primary fish care.
"Aquatic animal medicine is a viable and growing area of the profession," Lewbart said. "It's not going away. Even taking out the pet component, a lot of the world's protein comes from the water.
"It boils down to the human-animal bond, and in this country pets are at a premium. That bond can form with any species. People can get attached to a fish and many owners certainly will pay the cost to care for it."
And it's not just private pet owners who utilize the new specialty. The Aquarium of Niagara Falls relies on Dr. Ed Latson, a veterinarian with aquatic expertise who works at Central Park Animal Hospital on Main Street, said Daniel C. Arcara, the aquarium's collection manager.
"The medical care of fish can be somewhat challenging, yet it's critical for our day-to-day care," said Arcara, who pointed to a recent incident involving a sick axolotl. The Mexican salamander developed fungus on its gills, Arcara said. "Dr. Latson recommended frequent water changes and lowering the water temperature, and the fungus dissipated."
Watching fish swim
Koi is a variety of the common carp and bred mostly in Japan for display in ornamental ponds. The image of a koi leaping in a waterfall has historically served as a symbol of ambition and aspiration.
Frank O'Neill of Kenmore called the scene sheer bliss.
O'Neill and his son, Jeremy, cared for Baby Blue from birth, one of many exotic fish they raised over almost two decades. Their backyard fish pond was created with a back hoe. Last summer, O'Neill hand-shoveled it a foot deeper so the pond could safely accommodate the growing brood.
"They're perfect pets," said O'Neill. "I sit back by the pond usually when I got home from work. I listen to the waterfall, watch the fish swim. I sit and just enjoy."
Baby Blue comes from a good line of koi, said O'Neill. Its father and mother were at least two feet long. At age 10, Baby Blue is 16 inches long but weighed a mere 3.5 pounds when brought to Sweeney for treatment. Baby Blue's resemblance to his father is more than physical, O'Neill noted. "You can tell when they're stressed," he said. "Their tails begin to turn red. None of my other fish react like that."
Sweeney built a bank of knowledge on koi. Born 54 years ago in England, Sweeney was raised in Italy and moved to Georgia. Petite with aquamarine eyes, Sweeney attended the University of Georgia College of Veterinary Medicine. She wrote "Fundamentals of Ornamental Fish Health," a clinical guide for practitioners of aquatic medicine. Sweeney once treated an egg-laden koi, a concern with indoor fish who don't get the natural cues to spawn, she said.
X-rays of Baby Blue taken while the fish was sedated determined three small objects were blocking its digestive tract. Fish thrive on vegetables and whatever else they may find in their habitat, O'Neill later explained, including the stones that line the bottom of the pond. Sweeney said the objects may be stones, and she administered two drops of mineral oil to hasten their expulsion. An injection of antibiotics under the dorsal fin would curb any inflammation.
Sweeney then transferred the groggy fish into fresh pond water (brought to the office by O'Neill along with Baby Blue in a 72-quart cooler), and began to bring it back to consciousness, slowly moving it by the tail back and forth in the water.
"C'mon, buddy," O'Neill repeated, coaxing his koi awake.
$1,000 vet visits
"Twenty years ago, pet fish were a challenge to treat, but it was something interesting," said Dr. Michael J. Weiss of All Creatures Veterinary Care Center in Philadelphia and Sewell, N.J. "It boils down to multiple appointments of longer duration. I could care for six dogs or cats in the time it takes to see one fish. Some fish owners choose not to spend that money. They have already put a lot of money into their tanks. Koi ownership can be a full-time job. An entire visit could run $1,000."
Koi are popular pond pets, often large and colorful. Their cost usually does not top $100 each, but they can be sold for $20,000 to $30,000 with some fetching as much as $100,000, depending on their lineage, said Weiss.
One of the factors driving the increasing number of aquatic veterinarians is the rising popularity of koi, said Lewbart.
"They were always on the radar, but they were never really business," he said. "It's like veterinarians began to realize that fish need that next level of care."
Aquatic animal medicine in the last 15 years is becoming more mainstream, following the same path as avian medicine, Lewbart said.
"From 1993 to 2003, the fish were coming to me by FedEx. If a lady in Iowa had a sick fish, she would mail it to me. If she called me today, I could find someone in driving distance who would treat her fish," Lewbart said. "There are more vets now with experience who are providing primary care for fish."
Dr. Brian Palmeiro is a board certified veterinary dermatologist who established a koi hospital in Allentown, Pa. It was Palmeiro's passion for fish medicine that led him to convert a former pond maintenance supply store into a fish hospital, said Lewbart.
The Lehigh Valley Veterinary Dermatology & Fish Hospital serves koi and other ornamental fish recovering from surgery that require overnight care as well as day care.
Generally, koi can live to age 40, with exceptions.
Hanako, a scarlet-red "flower girl," as its name translates to English, reportedly lived in Japan to the venerable age of 226 years. It died on July 7, 1977.
Lewbart remained skeptical that a koi lived for more than two centuries.
"I know a 40-year old that’s alive, and 40 is on the outer edge of longevity for the species," said Lewbart. "It's very difficult to keep a fish safe for over 40 years much less 200 – with power outages, chemical exposure, floods, hurricanes."
Back in West Seneca, O'Neill packs up Baby Blue, who finally woke up from the sedation. He's been advised to keep an eye on the koi, so he will move his fish to its usual winter home inside the O'Neill house. If the koi does not start eating within two weeks, he must decide whether the fish should have surgery to remove the objects.
O'Neill and his son take their stewardship seriously. When a heron was attacking his fish and eating newly hatched offspring, the O'Neills fortified the pond with stainless steel cables and a fishnet cover. And when Sweeney detected a tumor on another koi that likely was cancerous, O'Neill elected euthanasia. An autopsy later confirmed the tumor to be malignant.
"She's taken care of my fish since I got them," O'Neill said of Sweeney. "Whatever she decides to do, I'll go with it. It's like going to your doctor. They know best."