Angelfish Problem - What Is This Protrusion/postule?

[emmsy]

I am gonna start a thread tonight to discuss this exact point (If Colin or Wilder doesn't do it first), about timescale and asking for help with treatment. I think a good debate is in order.

Goota go

Emma

 

[Tolak]

I am gonna start a thread tonight to discuss this exact point (If Colin or Wilder doesn't do it first), about timescale and asking for help with treatment. I think a good debate is in order.

Goota go

Emma

Nice idea, I'll add my two cents in a bit. Excellent idea with the vet, a vet with experience in aquatics is hard to find, consider yourself lucky to have one so close.

As far as timescale, I sent a little e-mail to Steve at AngelsPlus;

I was wondering if you could do me a little
favor &
take a look at the pics of this angel;
[URL="http/www.fishforums.net/content/forum/240789/Ang"]http/www.fishforums.net/content/forum/240789/Ang[/URL]
elfish-Problem-What-Is-This-Protrusion-postule-/

I've seen larger cichlids with HITH, as well as
the
scarring from HITH after it has been cured. In
none
of the cases I have run across has there been
white protrusions, nor has it healed on its own
without some consistent large water changes, and a
change in diet.

In the cases of angels with internal protozoans
I've
treated I have yet to see it progress th HITH.
What
throws me with this one is the healthy maintenance
&
water conditions that have been maintained. These
two
are the main causes of HITH, and with the fish
just
starting to show signs of internal protozoa
problems I
am bewildered as to how the external HITH could
progress, if that is what it is.

Just something I thought might be of interest,
you
can post on that board if you like, or just
respond to
me. This is basically for my personal knowledge,
as I
have never seen an angel come down with HITH when
the
tank & diet are maintained.

Thanks!

John


His response;

Hi John,

Yes, that is hole in the head. Classic look. It
always starts with protruding puss. If you r's
didn't, it was not HITH or you simply missed it.
That stage can be very short - sometimes only a
day or two. The hole is what is left when the puss
heals. It's also quite common in angelfish. The
cause is unknown, but I believe something as
simple as long-term overfeeding can do it. If the
tank is overcrowded, it doesn't even take
overfeeding. Simply correcting the over-population
or reducing the amount of feed will work
everytime, if that caused the problem.

Hope that helps.

Steve Rybicki
Angels Plus [URL="http/www.angelsplus.com/"]http/www.angelsplus.com/[/URL]
P.O. Box 886
Olean NY 14760
716-372-5273
Fax 866-809-8537 (toll-free


One more vote for HITH. What still bewilders me is the lack of dietary & water condition causes, which Steve has mentioned. I'm very interested to see what this vet says as a hands on diagnosis is much more definitive.

I also called National Fish Pharmacy's help line this afternoon, and plan on e-mailing them a link to this topic in a bit. I'm interested to see what they come up with as well.

***Edit to Add***

National Fish Pharmacy got back to me;

Hi John,

HITH (hole in the head) is a protozoa that causes Hexamita. In early stages, this protozoa will send up what I call cones (because sometimes they look hollow, or have a hole down the middle of them), before they turn into the actual "hole in the head" or advanced stage of pathogen that they become.

This disease and well as the common strains of Ich are starting to mutate on us. This is due mainly to global pollution and improper use of medications.

I would try this drug, and only this drug to see if it works: Quinine Sulfate. Quinine Hydrochloride will not be effective. Metronidazole will not work either.

Best Regards,

Dr. Brian G. Aukes; PhD
c/o National Fish Pharmaceuticals
http/www.nationalfishpharm.com

 

[Colin_T]

Tolak

The fish is old and could well be suffering from other problems, worms, gill flukes, etc. It doesn't take much to stress an old fish and if it is suffering from other problems then the combination is what brought it on.

Interesting to know that other people now believe common fish diseases are mutating and developing resistant strains. Also that metronidazole no longer works. I suppose it depends on what strain is affecting the fish as to whether or not it will work on them. Otherwise it's a vet job for some Quinine. That should stop the fish catching malaria too

 

[emmsy]

Quinine Sulfate causes pH elevation in intracellular organelles of parasites, so I can see where he is coming from whith this cause of treatment. I was suprised to hear him say that Metronidazole will not work. I wonder the reasons.

Emma

 

[Bloo]

I am bowled over by the response. Tolak, thank you for going out of your way to help identifying this. I really appreciate it and I've certainly gained knowledge.
Unfortunately I don't have much time to read and respond indepth as I'm about to go into a meeting (just drinking a cup of tea in a 5 minute gap!)

I will respond later tonight in more detail.

 

[Tolak]

Quinine Sulfate causes pH elevation in intracellular organelles of parasites, so I can see where he is coming from whith this cause of treatment. I was suprised to hear him say that Metronidazole will not work. I wonder the reasons.

Emma

By all means e-mail them; [email protected] You would know the technicalities as far as how meds operate, and could perhaps explain it in layman's terms to those of us with very little formal education in pharmaceuticals.

 

[Bloo]

Hi All. Just a quick update.
I took the fish along to the vet on Saturday. But this time, the postules have broken off and only a couple of tiny white spots remained on the head, above they eye. But I can actually see indentations where the previous postules were.
Anyway, the vet doesn't have quinine sulfate (says it's outdated to use for HITH?!). And the fish was prescribed with Flagyl (Metronidozole) to soak live food in and then feed once a day for 5 days.
In conjunction, Tririssen injectable every 2 days. I've never injected a fish before (a host of other animals yes, but fish never) but it all seems to be going well.

The 2 Angel fish are seperated in their own 10 gallon bare filtered/heated tank. Obviously this is only short term and they'll return to the 120 gallon tank once it's cleared up.
So we shall see how it goes I guess.
I will update as we progress.

 

[Miss Wiggle]

thanks for the update Bloo, glad you got to a vet and hopefully should be on the up from here

 

[Bloo]

OK, so I think it's going OK as far as i can tell. No more postules but how do I know if it's actually healing or not just going onto next stage of pitting? I can certainly see some dents in the head where the postules were. But how fast would this enlarge if in fact the flagyl has not been working?
I've had to move the angels back to the large tank though because the infected angel stopped eating the medicated food and wasn't looking happy in the pospital tank at all. It's looking much perkier back in the main tank again and back into normal swimming action. And I'll just move it to the holding tank to see if it will take medicated live food once a day. Not sure what else to do?

 

[Colin_T]

Any pits/scars on the fish should stay as they are and not get bigger if you have treated the fish properly. Once it's cleared up that is it and any scars left over remain permanently.

The water quality in the treatment tank is probably bad and stressing the fish, hence the reason it no longer wants to eat when it is in there. Make sure there isn't any ammonia or nitrite in the hospital tank and if there is remove it before putting the fish back in. If there is a reading in the hospital then it's probably easier just to drain the tank completely and refill it with water from the main tank.
You can also feed the medicated food to the angel in the main tank. This will mean you aren't stressing the fish by catching it out every day.

 

[Tolak]

Any time I've medicated a fish I've used a separate hospital tank. I've also done 50% water changes daily, which is really what is needed for HITH. A vitamin enriched diet is essential as well. Since this is something usually seen in larger messier cichlids, soaking a quality cichlid pellet in a little liquid vitamin is usually done.

After looking into this even further, internal protizoans can affect the uptake of nutrients, over time having the same effect as a poor diet. Poor diet & poor water quality are implicated in HITH, poor uptake of nutrients would give the same effect as a poor diet.

In my experiences medicating with metro, 5-7 days is often a little too short a time period, I med 10-14 days, and have yet to see a recurrence with the longer med period. I've had a few recurrences medicating for a shorter period. Yes the fish will seem unhappy by itself, this takes a bit of getting used to by the fish as well as the aquarist. By doing this you are avoiding medicating well fish, can target feed the ill fish much easier, and have an easier time with water changes or any other water parameters that need adjusting.

That injectable is a sulfa based med, odd in that my Dr. prescribed a sulfa based antibiotic for me earlier in the week. Nasty flu-type symptoms, off work for a few days, which is unheard of for me. The meds are working great for me, if they work half as well for your fish it should be well on it's way to recovery.

 

[Bloo]

Thank you Colin & Tolak. I "think" we're on the upfront and it's improving / healing. No more postules and no further evidence of increase in hole sizes. Fish appears well and healthy & alert. It's had it's last injection of Tribrissen and last night I fed the whole tank some pellets soaked in the Flagyl. Not ideal (at all) I know (and understand the consequences of medicating fish where not needed), but the Angelfish just wasn't looking well at all in the hospital tank. Even leaning to one side and flipping over - and partially resting on the bottom - and not eating. Whereas back in the main tank it's zipping all over the place & eating as normal again.

I'm still not sure how it got the HITH in the first place. I certainly don't consider my tank overstocked (tank stock in my profile info), it's extremely well maintained with strict water changes & dechlor. Double filtered and a very varied diet. So just don't know on this one.
But at least I've learnt something about HITH. I'll post back here in a week or so just to (hopefully!) give the final thumbs up.

 

[Colin_T]

The bug that causes HITH is in most tanks. It would have come from the LFS originally and chances are any fish you buy will have been in contact with it somewhere along the line. Many fish can live with it indefinitely but when they get old and weak then they become more susceptible to its effects.

 

[Bloo]

Just to say: I think we're cured

 

[Miss Wiggle]

excellent, really pleased Bloo