Tail Surgery?

After much consideration, and many searches of this forum, I am intending to perform a surgery on one of our axies. Diglett is a tan coloured adult and he has developed a worrying warty lump on top part of his caudal fin, about halfway down his tail. I first noticed the lump over 6 months ago and it was so tiny it was hardly visible. Over time it has grown and is now causing the top of his tail to curl over. It is entirely on one side of the fin, and does not extend to the fleshy part of the tail – with a bright light behind him, it appears like there may be a blood vessel running from the fleshy bit to the lump…
Recently the lump has developed a pinkish colour. I fear that if I ignore it much longer it will continue to grow, eventually impairing his swimming from the fin curling and maybe even grow into the flesh of the tail.
I have not taken the surgery decision lightly and have decided to ask the experts amongst you for any final words of advice.
I intend to cut a “V” section from the fin with small sharp stainless steel scissors, removing the lump and treating the wound with Mercurochrome.

Photo of lump

I wouldn't advise you to carry this out your self, unless there is absolutely no chance of getting your axolotl to a vet. If this is indeed the case there are a couple of vets who have been kind enough to advise here ( Rayson and Herpvet). Would you wait for one of them to advise and help? . As a non vet my other concern is that you mention that there are many blood vessels running to the lump, how do you aim to control/ stop the bleeding?

I don't want you guys to think this is a rash, mindless decision, and I am eagerly hoping for some advice from vets here who know about axies. I searched a LOT of past threads on the forum about lumps, surgery and amputations before I made this decision.
I have not been able to find a vet here who even knows what an axolotl is!!
I am confident in my ability to perform this operation if necessary but need some specific advice, for example: How much bleeding will occur?

Hi there Platterpus,

I considered for a period of time whether or not I should reply to this message, but having seen it I felt morally obligated to do so. A few points that instantly sprung to mind:

I do applaud your obvious concern about your axolotl, but I cannot condone your proposed idea on how to proceed. For me, the idea of intentionally performing an act of surgery on any animal without appropriate anaesthesia / pain relief is unacceptable.

I understand and accept your concerns about there not being vets in the area who know about axolotls, but on the other hand any and all vets will have access to the necessary sterile equipment, instrumentation, drugs, a good knowledge of proper aseptic technique and the skills required for surgery. I’d like to put forward that it is perhaps easier for a vet to learn a little bit about axolotls than it would be for a layman to hastily learn “how to be a vet”. There are a plethora of methods of anaesthetising an amphibian, with items and products that ALL vets will have at their disposal. Even if not especially “exotics minded”, I do think that any vet would have a better chance of successful, ethical surgery than a layman.

I think that the need for appropriate anaesthesia and analgesia is of paramount importance. Similarly, the need for experienced monitoring during the procedure (and afterwards) cannot be overlooked. I know that you think you are doing your pet a favour by considering operating on it by yourself, but I feel that it’s welfare would be compromised by such an act.

You have stated that: “I am confident in my ability to perform this operation if necessary”. I honestly don’t see how you can make that statement, especially as you then go on to say that you don’t know how much bleeding will occur, and you don’t seem to know how you would deal with significant blood loss. In such small patients, blood loss is a major concern.

You have also stated: “I am eagerly hoping for some advice from vets here who know about axies”. I am not attempting to be elitist here, but as a vet (who knows a bit about caudata), I personally feel that it would be negligent for a Veterinary Surgeon to talk a lay person through how to do an operation such as this, when there are vets in the nearby area. My advice would be that if you want this procedure performed, you should take your axolotl to a vet. They can then contact a more exotic-animal minded vet elsewhere for advice if necessary. There is a whole referral structure in place for exactly this sort of scenario. If a vet does not know about a specific specialist type of surgery, species, or unusual disease, they should know how to find and contact another vet who does.

I do not know about the laws of Australia, but in the UK The Veterinary Surgeons Act (1966) would prohibit the performing of any surgical procedure by a person other than a vet, who holds an MRCVS (with the exception of certain very specific exemptions laid out by the agricultural act). As I said, I do not know if similar applies in Australia, but I suspect it will do.

To put this scenario into what is perhaps a slightly crude yet more familiar context, imagine someone saying to you, "My dog has a lump in it's skin, but there isn't a small animal vet here. There are only large animal vets in the area. As I am worried about the lump, I'm going to chop it out of my dog using a pair of non-sterile scissors, while my dog is fully conscious, and without any pain relief. I hope it doesn't bleed too much". I know that that is not exactly what is being proposed here, but I feel that the issue is the same and I hope that you would agree that that sounds fairly irresponsible.

I apologise if my post comes across as being inflammatory – it is honestly not intended to be. You obviously care a great deal about your pet and are trying to do your best by it. I just wished to point out some of my thoughts on the issue and see what you thought.

Best regards,

Liam Reid BVMS MRCVS

Hi platterpus I can't think of the link off the top of my head but try googling Australian Herp Vets there is a list of all vets in Australia that deal with axolotls, from memory I think there is one or two in adelaide.

My instinct says don't do it but in reality, I run a pack of pig hunting dogs and on occaision have had to stitch wounds whilst in the bush with no medical training. All the dogs have survived and do not have horrific scars. So I would be a hypocrite to say No.

So call me a hypocrite No don't do it, Use a vet. I agree whole heartedly with Liam

Hi Platterpus,

Rayson (Darkmaverick) a veterinarian on this board has kindly put together a list of Herp Vets in Australia who may be of some assistance to you. These are the vets in South Australia:

Dr Mark Hill, Somerton Park Veterinary Clinic,
76 Byre Avenue, Warradale, 5046 08 8295 6924

Drs Duncan McFetridge & Judy Whigham, Chandlers Hill Veterinary Hospital,
190 Chandlers Hill Road, Happy Valley 5159 08 8322 2090

Extract from: http://www.caudata.org/axolotl-sanctuary/vets.shtml

Thank you for the fast and considered responses. I definitely have concerns about causing him pain but my paramount concern is his survival. I have been agonizing about this for a month now and have tried to find a vet who knows enough about amphibians to help. Unfortunately I am over 2-3 hours away from those vets recommended. I will certainly telephone them both this week to see if they know any vets nearby who are competent for the task.
Sorry if I sounded 'cocky' when I suggested that I was "confident..." - I meant it to suggest that I was willing and not afraid to do it if I have to. I would not have posted to this forum if I intended to hack him up with a rusty pair of scissors!!!
There are several posts here in which home-surgery is recommended and explained in detail. That alone was the factor which compelled me to ask for help - sorry if I've misunderstood!
I am not 100% committed to the idea of doing it myself, but if I can't find practical, local help then I am extremely uncomfortable to ignore this problem...
BTW, does this mean that you agree that the lump MUST be removed???

I think that if you try to snip it's fin with out it being restrained or anesthetized you run some risk of an unfortunate cut in the wrong place. They're quite slimy and unlikely to hold still while the fin barber goes to town. I'm sure one of the vets will chime in eventually. It sounds like you have been patient so far, and are not planning on doing anything brash.

Hi Platterpus,

All the previous advice have very thoroughly summarised all the critical points. I recommend you fridge your axie for the time being while arranging for a vet appointment.

Your vet (even a non exotics vet) will be able to perform some minimally invasive procedures to determine the pathology. These include a fine needle aspirate, whereby a small amount of tissue/cells are obtained to view under microscopy for staining and cytology, imaging such as ultrasound, to even obtaining a small biopsy. This can determine if the lump is cancerous, an infection or a local tissue reaction and whether surgery is necessary.

Anaesthesia, analgesia, prophylactic antibiotics and anti-inflammatories will be indicated during surgery. In addition, a thorough risk assessment of the relevant anatomy will be essential to avoid surgical excision into blood vessels, nervous tissue and vital organs.

Regards

Thanks again for the advice - I do really appreciate it. I will phone the vets listed tomorrow...
I do understand all the important points that you guys make - most of them I have considered very carefully over and over before even posting this thread.
I would seriously prefer to find an experienced vet to take care of this decisively. If I am unable to find one then what do you suggest I do? Ignore it? I just can't do that...
BTW, I'm also a little confused about why there is so much specific information about home surgery (amputations, in particular) from senior contributors on this forum site (types of blade, temperature, sterilising etc) if it is such a horrendously unthinkable thing to do???
Thanks again for your time and comments.

Platterpus said:

BTW, I'm also a little confused about why there is so much specific information about home surgery (amputations, in particular) from senior contributors on this forum site (types of blade, temperature, sterilising etc) if it is such a horrendously unthinkable thing to do???

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I suspect the reason for this is that you asked for advice from professionals and you'll struggle to find a professional who is willing to endorse home surgery. We're lucky to have a number of vets on the forum these days but this hasn't always been the case when other have asked for advice.

I too suggest finding a vet before opting for home surgery.

Although, for the sake of equanimity I will say that over the past 17 years I've seen aggressive caudates regularly rip each others tails in half or take sizeable chunks out of them with little or no blood loss, no obvious signs of lasting distress and no post attack infection (no treatment from myself). I'm not suggesting they don't feel pain or that what you're proposing is risk free. I am however suggesting that if one of your axie's tank mates mistook that growth for a worm and bit it off I would have very little concern for it's heath or recovery.

Platterpus said:

I would seriously prefer to find an experienced vet to take care of this decisively. If I am unable to find one then what do you suggest I do? Ignore it? I just can't do that...

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Hi there Platterpus,

First of all, let me commend you on your obvious dedication to your pet. You clearly are not just "wanting a go at surgery" or trying to avoid vets bills, you have thought about this quite a lot and come to the conclusion that home surgery is your last resort.
If you were isolated from all vets, and the mass was causing severe problems, then home surgery might be an acceptable course of action, providing a qualified veterinarian was consulted (they may be prepared to give instruction if it was an emergency situation and there were no vets within travelling distance)

As you have vets locally, I would speak to them about removing the lump (if necessary). If they are unfamiliar with amphibian anaesthesia and drug dosages, then there are a number of resources which will allow them to read up on this. Mader's "Reptile Medicine and Surgery" has an excellent chapter on amphibians, Carpenter's "Exotic Animal Formulary" has drug indications and dosages, and there is a whole article dedicated to "Anaesthetic considerations for amphibians" in the journal of Exotic Pet Medicine, vol 18, no 1 (January) pp 40-49.
Please note that a background knowledge of veterinary medicine and surgery is required in order to properly use such resources.


If indeed surgery is indicated, and your local vets do not wish to perform the operation themselves, they are obliged to refer it to someone who is. I am sure there will be an exotics vet somewhere in the country! Not that this "needs" to be done by anyone holding a qualification in exotics, any vet should be able to prepare themselves for such a task. Consulting an "expert" may well even provide your local vet with the information s/he needs to perform the operation themselves.

This may mean you will have to travel, or pay a little more. As I said at the start, you're main concern is obviously the animals welfare. If you're dedicated enough to consider performing surgery yourself then I'm convinced you're dedicated enough to go the extra mile/pay the extra money.

This case definitely needs professional rather than amateur attention. As previously mentioned, it may prove prudent to find out what the lump is prior to removing it, and to remove it in a pain and infection free environment, with minimal stress, trauma and blood loss. Whilst normal tail bites may be seen to be well tolerated, it is a habit of tumours to draw blood vessels to themselves to allow growth. As such, this lump may have a substantial blood supply which will need to be ligated or cauterised - something that vets are trained to do, but which may not be performed adequately or quickly enough by a layman. If blood loss is marked, vets will have access to replacement sterile fluids which the layman will not

One last note on lumps in general. It is better to go in to a vets early and making them aware of a small lump than leave it til the thing becomes large and well established. Also, it is very useful to keep a record of the lumps size, either by taking photographs or just by measuring it.

Please keep us aware of the progress,

Kindest regards,

Samuel J. Kerr

Once again, thank you to everybody who has taken the time to advise on this. It's clear from the sensible and comprehensive posts that you guys really care!
Today I phoned the vet (Dr Mark Hill) and I spoke to a rather unhelpful and unsympathetic reception girl who refused to put me in contact with the Doctor.
Undeterred, I attempted to leave a message about Diglett and my contact details for the Vet to call me whenever convenient. It was pretty obvious that she had no intention of helping me so I gave up (temporarily).
I phoned the second Vet on the list - who, by contrast - was amazingly helpful and concerned. Unfortunately, they no longer have an 'exotic' Vet practicing, and so referred me back to Dr Hill! (now the only Axie vet in Adelaide!)
AAAARRRRGGGHHHH!
Now I don't give up that easily, so I phoned the first Vet again, hoping that someone else might answer the phone!!!
Thankfully, a different girl answered and was much more helpful! She spoke to the Doctor and explained the situation - we now have an appointment (next week!?! - this guy must be busy!) - and if required, the surgery will be done immediately after our consultation...

Argh, that would have been beyond frustrating for you. Good on you for following it through!

I would keep the axie in the fridge as Rayson (Darkmaverick) has advised until the day of the appointment.

A guide to fridgeing can be found here: http://www.caudata.org/axolotl-sanctuary/Fridging.shtml

Please keep us posted!