OK so here's an idea of what I wanted to do
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Hole in The Head - Hexamita
Description - Hexamita is a flagellated protozoan found in the gastrointestinal tracts of a variety of cold and warm water fish, it particularly seems to affect cichlids. If untreated it can lead to death of the fish.
Etiology - The exact causes of HITH are still being debated, however it is thought that the main triggers are poor water quality, poor nutrition, overcrowding and stress.
Appearance - The name of the disease say's it all, the main symptom is sore's/lesions around the head, these often start behind/above the eyes. As the disease progress's these will spread and new ones will appear, this can be accompanied by a loss of colour, general lethargy of the fish and a loss of appetite
Differential Diagnosis - At the time that my Oscar had this disease both myself and my partner were ill with chest infections and we're also in the process of renovating our bathroom, as such we hadn't been able to keep up with the maintenance that this tank required. I knew this so I had been watching for signs of disease and illness, knowing that Oscars (amongst other cichlids) are prone to HITH I had a vague idea of the symptoms from previous research about the species. I initially noticed slight white marks behind his eyes one day and decided to monitor the situation for a day or two more before deciding on treatment as the fish had a habit of fighting with the decor and ending up with scratches and scrapes, I wanted to give it a day or so to see if they got worse or started to heal by themselves. By the third day they were no better so I got my fish health book (Interpets Manual of Fish Health) and checked up the symptoms of various diseases, the section on HITH had a picture of a discus exhibiting similar lesions in exactly the same place. I had previously spoken to my local vet regarding fish diseases and they had advised me that should I ever need prescription medications I should bring a picture of the fish showing the symptoms to the surgery and they would discuss treatment with me. So I took a picture and took my fish health book to the vets and spent some time discussing the symptoms and conditions to ensure my diagnosis was correct and we decided on a course of treatment.
Treatment Modalities - The medication recommended by my fish health book and by the vet was metronidazole, I had read that it was best to give this in medicated food, when I discussed this with the vet he said it would be very expensive and time consuming to get a medicated food made up for me (I did not realise at this time that if I got the medicine in a powder form and make up the food myself) however he could get me it in liquid form the next day and I could give Oscar baths in it for 2 hrs per day. From my reading on the internet and discussions with experienced cichlid keepers and breeders I found out that clean water was absolutely paramount and good nutrition in the form of vitamin enriched food (a standard human grade multi vitamin from the chemist dissolved in water, then soak the cichlid pellets in the water) would also help.
Journal of experience -
I'll start from Day 3 as this was when my diagnosis was confirmed and I startde to take appropriate action, day's 1&2 are covered in the diagnosis section.
Day 3 - Confirmed diagnosis with the vet and ordered the medication, carried out a 50% water change on the tank, no change in symptoms, tested the water and stats were ammonia - 0, nitrite - 0, nitrate 5ppm (after water change). I knew I had to keep up water changes but I was also unwell and very busy trying to sort out the bathroom, at this point we had no useable bath/shower so had to commute to the in-laws every night to get a wash so I didn't think I'd eb able to fit in daily water changes. So I decided to set off a cut off point for nitrates, 20ppm and do a large water change when they got above that, small daily water changes would be carreid out as I removed water from the tank to give oscar his medicated baths and replaced that with clean water, probably not even a 10% change but a little bit is better than nothing!
Day 4 - Got meds from the vet and picked up some multi vitamin. Decided to feed Oscar before his bath because even though the medication is good for him it doesn't mean it would be nice and he might sulk and not eat afterwards. I planned to do his bath's in a big garden tidy tub, 6 gallons of water would cover him and give an inch or so extra depth and he had room to swim around a bit, also it's easy to put a small heater and filter into the tub to keep teh water at a stable temp and aerated while he's being treated. Now I've not had to catch Oscar since he was a little baby, now he's a 10" brute so I wasn't looking forward to it! Drained 6 gallons of water from the tank directly into the tub, moved a small filter (that runs in his tank so is mature) and heater into the tub and added the medication, 7mg/100litre. Then set about trying to catch Oscar, sorry to say i must have stressed him out a bit with my inexpert netting of such a big fish, however I learnt my lessons for the next time. Eventually got him into the tub, dried myself off, covered the tub with a towel to keep it dark so he stayed calm and left him for 2 hrs. While he was in the bath I did a 30% water change on the tank and a very thorough gravel vac. When the two hours was up I went to put him back in the tank, removed the towel and realised he was lying on the bottom of the tub not lookign happy, the filter had slipped so was giving no surface agitation so I assume the combination of meds and low oxygen for 2 hrs was not good for him. Switched on the airstone in the main tank and put him back in. He fell head first into the plants and stayed there for 30 seconds or so. I'll admit my heart was in my mouth I didn't think he would recover for a minute but he soon swam off and within 5 minutes seemed to be back to his usual self. I noticed the lesions which had previously been white looked slightly red after the bath, this soon faded to white so I assumed this is a sign of the medication working.
Day 5 - Basically the same as day 4 but slightly better planned, I caught oscar much easier and kept checking the filter in his bath to make sure it was givign him oxygen, while he wasn't happy when he went back in the tank he was definately better than Day 4. However the lesions seemed to be getting worse and a new one had opened up on his cheek
Day 6 - As before, I gave him another bath and big water change, however this bath used up the last of his medications, I'd contacted the vet but they couldn't get me anymore for 3 days (it was over a weekend). This worried me slightly however after his bath when I inspected his lesions one of them was showing definate signs of improvement, the other one by his eye was getting worse as was the new one on his cheek. After some discussion with my fishy friends I think that this is a sign the medication had started working but had not been fully sucsessful. I decided until i could get the medication I would keep up the vitamin food and water changes and hope that a few days of rest not being netted and bathed would help him to heal.
Day 7 - Noticed definate signs of improvement but only in one lesion, carried out a 50% water change and thorough gravel vac, oscar looked quite lively and active which encouraged me
Days 8 & 9 were the weekend when we were really trying to get the bathroom sorted, I was only able to do 1 water change however oscar continued to show some signs of improvement, it was only gradual but he certainly wasn't getting any worse
Day 10 I couldn't do any water changes however I noticed the new lesion that had opened up looked significantly better than previously and the one behind his eye was nearly gone. I knew I was getting more medication the next day but was unsure if I should re-start his bath's or not. He seemed to be on the mend so I didn't want to stress him out by netting him but on the other hand didn't want his condition to worsen without more meds. So I just decided I'd wait until the next day and make a judgement call depending on how he looked then.
Day 11 was very hectic, I got caught up in work and had to stay late so couldn't get to the vets before they closed so couldn't get the meds, didn't get home and to sit down to have my dinner until 11.30pm (up for work at 5.30am
) so couldn't do a water change either. However Oscars improvement continued so I wasn't too worried.
Day 12 - Picked up the meds from the vets but decided not to continue treatment as the lesion on his cheek was no more than a scratch, one by his eye had gone and the other was still there but looking improved. Decided to give him a couple of days and monitor his improvement and to start the bath's if nescessary at the first sign of deterioration. Did another 50% water change.
Days 13 & 14 - Did 30% water changes both days, his improvement continued, one lesion was still lingering a little but was still very much improved, decided not to use the next course of meds.
Day 15 onwards - by this time our bathroom was useable again and we were both feeling better, I continued 30% water changes most days and within another couple of days the lesions were completely gone.
