Hole In Head Syndrome

[Palemon]

Hi,

I have a female L. Araguaiae with HITH which I've been treating with metronidazole without success.
To put some extensive context:
I got ill a few months back for a few months and couldn't keep up with the maintenance. This caused my male Ara to catch dropsy (right when I finally got better and restarted the maintenance routine, I might add).
I treated it with "success" but the medication/disease left him brain damaged. He lingered for a few weeks before finally losing his battle. During that time, his female grew increasingly restless and finally started to show the first signs of HITH. By that time, the tank had been well kept for a few weeks.
Anyway, I started the treatment : 500mg/100l of metronidazole every 12h with a 50% WC before each dose. I did it 7 times, so 3 days. It did pretty much nothing. I restarted the same treatment 2 days ago but now it has become difficult to get her to eat much of anything.

Has anyone any idea? Another medication or a tweak to the treatment perhaps?

Thank you

 

[Archerfish]

Wow Palemon, sorry to hear of your illness and ordeal. My experience with this is limited but will add what I know. Stress is a major cause of HITH. I am reluctant to use antibiotics for a variety of reasons.
Here is what I would do:
1. Make sure your water quality is impeccable.
2. Check the diet. Is the food fresh or if flake/pellet more than 6-months old?
3. Eliminate any stress. Look for a loud TV or radio sending vibrations to the tank. Cigarette smoke or scented air. Is another fish bullying the araguaiae?
4. Stray electrical voltage can cause stress. Look for a defective heater or internal pump leaking voltage. I use titanium probes in all of my tanks (and ponds) to mitigate this issue.

 

[Ichthys]

HITH can be very difficult to treat even with the treatments that do work, such as Metro.

Are you sure it’s HITH? What are the symptoms?

 

[Palemon]

Thank you for the kind words and the help.

1. The water quality has never been better as I've intensified the already generous WC routine. It sits around 2x50% per week on average.
2. Dietwise, during my illness I must admit to have mostly fed them flakes, I checked, they were around 5 to 7 month old.
She has been eating defrozen bloodworm again for a few weeks and had always been eager to eat the tank's snails. She never accepted artemias.
3. As for the environement, the tank is in a relatively quiet room, they thrived and reproduced here for 2 years. Their only tankmates in 180l are Corydoras Napoensis, if anything, they were the bullies during brooding.
4. I just checked the voltage, it sits around 200mV.

For the symptoms, they are quite unmistakable I believe, she has a slow erosion of the skin and underlying tissue right in the middle of her forehead but also smallers ones on the side of the head.
It looks quite similar to this, although less advanced: https://aquariumscience.org/wp-content/uploads/2022/04/HITH-15.jpg
She has also become a lot shyer and less active.

Thanks again

 

[Archerfish]

You are very welcome, I'm always glad to help. Water changes may not reveal the loss of beneficial bacteria from the antibiotics. Can you test your water parameters?

 

[Alice B]

feeding food soaked in garlic oil or garlic guard (a seachem product I think) with metronidazole mixed in may help get the meds where they need to go

 

[Palemon]

I don't have any test for ammonia or nitrites as all my tanks are "old", but Metronidazole shouldn't be active against aerobic bacterias and the other fish are looking quite well.
My pH is slightly below 7 as usual, with a gH of 6.
While I'm at it, I also never saw signs of water column bacterial proliferation (clear surface and entirely colorless water).
I also added cattapa leaves for a few weeks before running out and seeing no improvement I didn't purchase more.

Thank you Alice, I've been feeding her garlic infused flakes as long as she accepted them, but now she only accepts bloodworm. I will try again and add the metro directly to the food.

 

[Byron]

I will not guess on disease/symptoms issues, but if it is fairly certain that the issue is hole in the head (hexanita) you should look into your nitrate level. High nitrates is now considered by cichlid authorities to be responsible for, among other things, most hexamita. Do you know the nitrate in the aquarium water?

 

[Alice B]

also carbon has been implicated if HITH shows up repeatedly in an aquarium that uses fresh carbon in it's canister filter regularly. I discontinued carbon in the 100 gallon filter and I stopped seeing new cases. I never actually treated the tank either.

 

[Palemon]

Nitrates level are actually an issue for me given how low they are, I'm forced to add some KNO3. I don't know the exact level, but they are low enough that if I skip dosing it shows on my plants.
Byron, while you're here, I've read that non-organic nitrates are fairly innocuous, do you happen to know if this is true?

I only have fired clay, lava rocks and the usuals for mechanical filtration in my filters.

To be perfectly frank, I'm about unsure as you can get about the exact cause of her HITH. She has no secondary symptoms of Hexamita, but she still degrades despite my best efforts.
My hopes for her to recover on her own with proper feeding and cleaning have been anything but successful, hence the metronidazole.

 

[Byron]

I'm responding solely on the nitrate issue/questions.

First on non-organic nitrate...I had to look this up, but it seems more a human issue. Some other members might know in relation to aquatic plants. Regardless of that, I would never add this to an aquarium with fish. But then I also would never add nitrates in any form.

Which brings me to the second issue, nitrates as nutrient for plants. If you have a high-tech planted tank, then it is common to add nitrates. However, this is a detriment to fish. The species, the level and the exposure time factor in, but one thing is clear, all fish are affected negatively by nitrate. Nitrate should always be as close to zero as you can get it and keep it. No fish we keep in aquaria is exposed to nitrate in their habitats.

Aquatic plants take up ammonia/ammonium, not nitrate, as their nitrogen. There are a very few that do actively take up nitrate, but the vast majority do not. Only when ammonia/ammonium is insufficient in balance with the light and all other nutrients will these plants turn to nitrate. The reason is that the plant has to convert the nitrate back to ammonium in orer to use it, and this wastes a considerable amount of energy. So it is a "last resort" of sorts. And given the negative impact on fish, I would never do this.

You should always know nitrate levels, so a nitrate test is something to look into. Nitrates rising is a bad sign, always, so you want to catch it early and then work to eliminate them as much as possible.

 

[Palemon]

Quick Update: Today I tried without success to feed her flakes, both with metro/garlic and without, but she did eat the bloodworm I gave afterward. I'll continue the current treatment, and try again with the flakes tomorrow.

I'm responding solely on the nitrate issue/questions.

First on non-organic nitrate...I had to look this up, but it seems more a human issue. Some other members might know in relation to aquatic plants. Regardless of that, I would never add this to an aquarium with fish. But then I also would never add nitrates in any form.

KNO3 is an inorganic nitrate, hence my question, but I honestly don't know if it remains this way once in a tank.

Which brings me to the second issue, nitrates as nutrient for plants. If you have a high-tech planted tank, then it is common to add nitrates. However, this is a detriment to fish. The species, the level and the exposure time factor in, but one thing is clear, all fish are affected negatively by nitrate. Nitrate should always be as close to zero as you can get it and keep it. No fish we keep in aquaria is exposed to nitrate in their habitats.

I've read and heard some stories of dosing pump having a malfunction and injecting hundreds of ppm worth in the tank and the owner taking weeks to realize because it caused no issue. But I have no idea if these are real stories or if made up to prove a point. I know the EI school of thought is quite generous with the NO3 concentrations.

I am in no capacity to make any strong claim and have read many conflicting studies and opinions on the matter so, because I value my fish more than I do my plants, I always went with a lean approach to fertilization anyway. However I'd tend to be more nuanced on the matter. Wild fishes never see the hundreds of molecules they are exposed to in our tanks, vitamin enriched food, artemias (salt water), artificial lights, or almost everything they see while in our tanks.
But I'm not the best case study, given that in my case dosing leads to lower nitrates level than in a tank with less plant mass, as they consume more than what you can reasonnably remove via WC. To verify this I just have to stop dosing without preparation and after two days my plants start leaking sugars and water quality degrades quickly.

Aquatic plants take up ammonia/ammonium, not nitrate, as their nitrogen. There are a very few that do actively take up nitrate, but the vast majority do not. Only when ammonia/ammonium is insufficient in balance with the light and all other nutrients will these plants turn to nitrate. The reason is that the plant has to convert the nitrate back to ammonium in orer to use it, and this wastes a considerable amount of energy. So it is a "last resort" of sorts. And given the negative impact on fish, I would never do this.

I would love to stop adding (K)NO3, but dosing ammonia/ammonium seems by orders of magnitude more dangerous given that plants will consume a lethal dose many times over thorough the day and bacterias will degrade it in no time. I may be mistaken but the only way I see would be a continuous injection system. Plus I'm not sure it would be any better for the animals.

You should always know nitrate levels, so a nitrate test is something to look into. Nitrates rising is a bad sign, always, so you want to catch it early and then work to eliminate them as much as possible.

I do have a nitrates test, its ammonia and nitrite that I don't have, it does lack precision however. It only allows me to know that I am below 10ppm which is... something I guess.
I honestly almost never use it, and instead use my plants as a bioindicator.

Thank you for sharing your insight.

 

[Byron]

I would love to stop adding (K)NO3, but dosing ammonia/ammonium seems by orders of magnitude more dangerous given that plants will consume a lethal dose many times over thorough the day and bacterias will degrade it in no time. I may be mistaken but the only way I see would be a continuous injection system. Plus I'm not sure it would be any better for the animals.

No one is going to suggest dosing ammonia/ammonium. The fact is that if fish are present and being fed, there will be all the ammonia/ammonium needed for the plants in a low-tech or natural planted tank. [It is only when you get into high-tech that things get dangerous for fish, that's another issue.].

I do have a nitrates test, its ammonia and nitrite that I don't have, it does lack precision however. It only allows me to know that I am below 10ppm which is... something I guess.
I honestly almost never use it, and instead use my plants as a bioindicator.

I do not see how plants can indicate the nitrate level. Unless you measure for nitrate, you have no idea what the level might be.

 

[GaryE]

A simple, side of the road comment here. I used to have pitting problems when I kept Geophagus and Satanoperca. It's the reason why I keep neither, as what it revealed showed me my limitations. I could heal up neuromast pitting with water changes - 30-50% every 5-6 days. I didn't eliminate it, as when my job got crazy and I stretched to 10 days between changes, it began to come back.

I was on a treadmill, and every time I stepped off it, it harmed my fish. I stayed at 50% twice a week for a long time, but that was becoming a chore, especially since they needed large tanks. so I gave away the fish to people with larger tanks (My largest was a 6 footer) and much more high tech filtration. They also had more time.

They got to move into a 2 foot deep, 8 foot by 8 foot monster tank!

Now that I'm retired, I could keep those fish if I invested in large tanks. I have time, but not reaqlly the inclination.

I could make the scarring heal with nothing but water changes. But the pathogen was waiting for me to slip up.

 

[Palemon]

I do not see how plants can indicate the nitrate level. Unless you measure for nitrate, you have no idea what the level might be.

Plants can be excellent indicators for nitrates. Even before they display deficiency symptoms you can gauge your nitrates level by seeing how the leaves color under the light. This is only true if you are low enough however, above a certain point all you can see is that there is ample nitrates for the plants, but there could be way too much and you'd have no idea.
Lowering nitrates levels leads plants to react more strongly to the light, they will become redder/more coppery and do so from further away from the light compared to when nitrates are higher.
This is easier to spot on plants like bacopas, many rotalas, and others with similar tendencies.
Once you've learned to interpret it, it is quite accurate, vastly more so than a common drop test.
EDIT: A small thing on the subject: https://www.2hraquarist.com/blogs/fertilize-planted-tank/nitrate-limitation


Thank you Gary. I've had my Araguaiae for 2 years before my issues, and Dorsigera for 8 years before that, all went well when I was well, I see what you mean. I refrain myself from hosting large fish because of the requirement you mentionned. Large WC in massive tanks are a difficult thing to keep up with.