By DAN MORSE
Staff Reporter of THE WALL STREET JOURNAL

RALEIGH, N.C. -- Three veterinarians stood over a $4.95 goldfish named Hot Lips, prepping her for surgery. The senior vet, Craig Harms, slipped a syringe into the nine-inch-long fish's swollen belly. He drew out clear fluid -- a bad sign.

Dr. Harms retreated to the hallway, pulled out his cellphone and called the owners in New York's Catskill Mountains. It was Wednesday morning, Aug. 14.

"Hot Lips is doing OK," he said, before delivering the bad news about the liquid. "It puts the possibility of liver disease or kidney disease back in the picture. ... We'll keep you posted as we move along."

Dr. Harms and his colleagues are among about 20 vets in the nation who perform surgery on pet fish. Not one of them makes it his sole practice. But the need for such services is growing. Americans are building more backyard fishponds, stocking up on pets that they swear have their own personalities.

Large "pond-kept fish" rank as the fastest-growing fish-pets in the nation, while the broader category of fish ownership grows faster than dogs, cats, lizards or any other pet type, according to the American Pet Products Manufacturers Association in Greenwich, Conn., and pet fish tend to grow bigger when they have more room to swim. Koi, the goldfish's fancy and often-expensive cousin, are particularly popular. They can live well past 30. So when these much-loved pets grow lumps or quit swimming, some owners give surgery a shot.

More are reaching out to Dr. Harms and his colleagues at North Carolina State University's College of Veterinary Medicine. One reason: Surgeons there have developed an advanced way to keep their patients alive on the operating table -- a portable device that pumps fluids, including anesthesia, into their mouths and out their gills.

The North Carolina surgeons will take cases that other vets consider hopeless. In March, they fused two crushed vertebrae along the spine of a 21-inch, $900 koi named Ladyfish. The three-hour procedure followed X-rays and a CAT scan. Ladyfish's owner, a North Carolina Roto-Rooter manager named David Smothers, recently brought in a smaller koi named Wendy for similar work. "To see this little girl swimming again, it's just incredible," Mr. Smothers says.

That expertise caught the attention of Deb and Greg Ireland, who live in Liberty, N.Y., about 90 miles northwest of New York City. The couple, both in their mid-50s, bought Hot Lips three years ago when she was a three-inch baby. They picked her out of a pet-store tank because of the fish's striking snow-white body, reddish-orange back and small spot of color above her mouth.

The Irelands acclimatized Hot Lips to their pond, in a backyard oasis of gentle waterfalls, a barbecue grill and lounge chairs. Hot Lips grew into a svelte beauty, making friends with the couple's 25 other fish, among them Pinto, a large koi, and Alice, a naturally round oranda, a type of goldfish.

Last fall, the Irelands noticed some lumps on Hot Lips. "Maybe she's got some oranda genes in her," Mr. Ireland told his wife, hoping to ease her concerns. By spring, Hot Lips's stomach had swollen like a baseball. Mrs. Ireland gave her regular injections of antibiotics. That cleared up the sores but didn't reduce the swelling.

Mrs. Ireland began looking for a surgeon. By early August, she was telling surgeons at North Carolina State about a pink, bumpy growth protruding from Hot Lips's vent.

"How soon can you get her here?" veterinarian Greg Lewbart asked.

Three days later, the Irelands took Hot Lips to an aquatics shop in Warwick, N.Y., where she was specially packaged for overnight shipping. "Hang in there, Champ," Mr. Ireland said.

That night, Mrs. Ireland couldn't sleep and spent her time tracking Hot Lips's travel itinerary on the UPS Web site. By 10 a.m. the next day, Hot Lips had arrived safely in North Carolina. The operation was to take place the following morning.

The Irelands had reason to feel good about their surgeon. A native of Iowa, Dr. Harms earned his bachelor's degree in biology at Harvard, where he became taken with the idea of working with aquatic animals. He then went to vet school at Iowa State University. He has since had advanced training in microsurgery.

During the past eight years, Dr. Harms, now 41, has operated on about 125 fish for pet owners and while teaching seminars for other vets. All but one fish survived. The pet owners generally pay between $350 and $1,000. Dr. Harms's research-journal articles have chronicled, among other cases, the removal of a hematoma the size of a pencil eraser from a three-inch gourami.

Operating on Hot Lips, Dr. Harms wedged the Irelands' goldfish into a V-shaped bed of foam rubber. The sedated fish was still, save for the motion of her gills as water and chemicals flowed through. A water pump provided the only constant sound in the room.

Dr. Harms, wearing aqua surgical scrubs and a light-blue mask, cut and retracted enough of Hot Lips's sides to reveal the first of two growths. With his fingertips, he gingerly probed beneath the yellow, slimy mass. "Looks like we got a big ol', fluid-filled, nasty ovary," Dr. Harms told his team.

The growth had been pushing into Hot Lips's central organ cavity, wending its way around her tiny colon. At Dr. Harms's request, one of the other vets inserted a catheter into Hot Lips's vent, hoping that it would support the colon as he cut near it.

No good. By the time Dr. Harms's instruments reached the colon, it had torn. He would have to repair it with surgical thread the thickness of a human hair.

At 11:04, Hot Lips stopped gilling.

Pam Govett, a vet assisting in the surgery, switched the anesthesiology flow device to pure, dechlorinated water. This supplied Hot Lips with oxygen in the same way a ventilator keeps human patients alive in a hospital. Next, the fish's heart became the big concern. Jenny Kishimori, a former U.S. Army intelligence officer now in veterinary school, put a tiny audio probe just below Hot Lips's throat. They couldn't hear a pulse, just water sloshing through the gills.

The team adjusted the probe. Finally, the sound of a steady, though slow, beat filled the room. "Thump-thump ... Thump-thump..." A low-normal 28 beats per minute.

Dr. Harms eventually removed two growths, which together accounted for about 40% of Hot Lips's weight, which had been 13 oz. But it was then clear exactly how sick she'd been: with damaged kidneys, scant body fat and pale gills suggesting anemia.

Dr. Harms turned back to the frayed colon. He pinched its underside with forceps, rotating it enough to sew together a lateral tear. An assistant retracted the catheter slightly as saline solution ran back into Hot Lips's colon to test the fix. It held.

In New York, Hot Lips's owners waited by the phone. Nervous, Mrs. Ireland finally called the vet school, but could reach only an intake room. "Hot Lips hasn't made it back yet," she was told.

Forty minutes later, her phone rang. "It's not looking real good," Dr. Harms told her. He explained all his team had done. "The biggest concern for me right now is: She's been on pure water for over two hours and she hasn't started gilling," he said.

"Keep trying," Mrs. Ireland said.

Back in the operating room, Hot Lips's pulse had faded to 14 beats per minute. Dr. Harms injected her with adrenaline, which spiked her heartbeat to 32, but he didn't really expect that to last.

"Come on, Hot Lips," the soldier-turned-vet-student Ms. Kishimori pleaded, "Wake up!"

Dr. Govett smoothed out Hot Lips's tail. "Such a beautiful fish," she said.

Nearly five hours after the procedure began, Hot Lips's pulse faded to nothing. Dr. Govett extended her thumb and forefinger into Hot Lips's chest, applying several minutes of CPR to try to start her heart.

"I think not," Dr. Harms said finally, walking out of the room to call New York.

Write to Dan Morse at [email protected]

Updated September 9, 2002