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Help Needed With Treatment!

The.WishMaster

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12 Jan 2022
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Amsterdam
Hi All,

I have been running a community tank since last 5 months. Apart from some sick guppies that died everything has been going smooth. 4 days ago, one of my honey gouramis suddenly lost color and then next day a wound/scrape appeared on top of it. It was lying in the corner of the tank. I have taken it out and put it in a floating plastic bucket on top of the aquarium and I am changing its water daily. I don't know how to treat it and what is it. One of its eye is now fuzzy as well and its not eating anything. It only moves when it notices something is near.

I have tested tank's water. There is no Ammonia, Nitrite, or Nitrates. Ph is around 7.2 / 7.4 and Kh is around 8. I already changed 50% of the water 1 week ago. I now see that one more fish in the tank is sort of acting weird. Trying to scratch it self but it doesnt have any visible ICH or anything on it.

I would like to treat the whole tank with some all purpose medicines JUST to be sure that fishes that are there are healthy and anything hidden can be treated. How can I do it? Its a 180L tank. Temperature stays around 25 degrees. There are two filters and its heavily planted too with Co2 at 2 bbps.

Here are the fishes that are in it:
15 neon Tertras
2 Pearl Gouramis
3 Honey Gouramis (+1 in quarantine about to die)
4 Corydoras Pandas
2 plecos
6 Zebra Danios
2 Amano Shrimps
2 Golden Rams (1 of them is trying to itch/scratch its body against the sand and is acting a bit weird)

  • Please let me know if its ok to treat all the fishes as a precaution?
  • What medicines/anti-biotic I can use to treat them all
  • How to use that said medicine ?
  • Lastly, how to treat the sick gourami, should I even try?

Attaching the pictures of Sick Honey Gourami and the Tank.

Thank you.
 

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Tim Harrison

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Disease is usually a sign that all in the tank is not well. It's often necessary to figure out what the root cause is and eliminate first otherwise any treatment will just provide a temporary fix. The stocking ratio might be on the high side, it leaves less wriggle room if tank maintenance and husbandry isn't on point.

Large and substantial weekly water changes, spotlessly clean filter etc are all vitally important to fish and aquatic critter health. If all else has failed treat with a combination of eSHa 2000, EXIT, and gdex. This will provide an extremely broad spectrum of action and eliminate parasites, bacterial and fungal infections, and help to heal any open wounds and ulcers. eSHa products are also usually well tolerated and shrimp safe

Always follow the instructions carefully and don't forget to take into account the capacity of the filter when calculating the appropriate dose and also don't forget to remove absorbent filter material like activated carbon. It may absorb the active ingredients of the treatment.
 

Simon Cole

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25 Dec 2018
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Buckingham
Diagnosis
The infection started very rapidly, and this was after the fish lost colour. Seems less likely to have been directly caused by a bump and a graze which are nevertheless common on the dorsal hump.
The infection then became more apparent on the dorsal hump where we can see a white patch, with signs of raised or missing scales and a red patch that looks like topical infection of the dermal tissue.
The eye became infected afterwards and presumably caused the cornea or the sclera to become white too . All three infection zones appear to share aerobic conditions; if the loss of colour was slime coat infection then that supports this.
The fish exhibited signs of fatigue associated with gill damage such as laying down (significant).
If there is not hair-like white fungal growth then it is hard to link this to Saprolegnia (significant).
The location implies that it is a saddle-back infection, and notably this did not start on the caudal peduncle which is common with Saprolegnia.
Eye infections are commonly caused by Streptococcus. I haven't observed eye infections in fish with Columnaris (Flexibacter) and I observe that these infections normally spread to the mouth organ.
Aeromonas and other "anaerobic" gram-negative bacterial infections tend to show up as reddening of the dermis which can be somewhat similar to Flexibacter infections.
Bettas are vulnerable to Columnaris and are in the same subfamily (Luciocephalinae) as the Honey gourami Trichogaster chuna (significant).
There can be primary and secondary infections meaning that you could have two pathogens or more.
Overall it is up to you to guess the likely infection pathogen(s). I am hoping to offer a few subtle hints above.
I use the AAP website to aid diagnosis and select treatments. It is a massive website so get reading! I haven't found anywhere online that has so much detail, reasoning and guidance, and it fits with my own paradigm of thinking on this topic.
A fish vet will know a lot more than me, and I would be careful not to draw "post-hoc-ergo-propter-hoc" assumptions based upon anybody's past experience of what they "thought" they were treating.

Treatment
Pharmacological antibiotics have dire environmental consequences if not used correctly, that I mention in paragraph 5, here.
"Treatments" are usually chemicals that are antimicrobial and are generally some sort of biocide. If you use them in your aquarium as opposed to a treatment tank then that is up to you but they will interact with the entire aquarium ecosystem (sometimes including microbial life in filter media and substrates, sensitive livestock, and the water column including protozoa, flagellates, ciliates, rotifers). I generally only treat in treatment tanks. If you want to apply similar treatments in your aquarium as prevention then I'm not that useful because I don't typically do this unless I actually need to decontaminate. It's good that other members are helping you with this.
UV is often bounded-around as a treatment, but it will only suppress the waterborne spread of certain diseases between individuals, and will not cure a localised infection. My thoughts on UV are in paragraph 2 of the link above.
If you are thinking of using doxycycline on the assumption that it is Columnaris then feel free to ask how I have successfully treated Bettas with this infection before (who had it as bad as it gets: lost scales, degraded fins, and extensive areas of dermal tissue ulceration; they were listless and seemed hopeless, but I saved them and aided them to full recovery).
Generally speaking, I favour the bath and dip methods of treatment to initially knock back surface infections. Then I will use either a chemical treatment or a pharmaceutical antibiotic in a sterile, highly-aerated, quarantine tank, also feeding a decent flake food (swapping the food if I think this caused the infection), including infected fish and not necessarily every fish in the community. I will sterilise nets, tanks and equipment between water changes, and generally I try to keep the treatment tank as sterile as possible, being very careful to only feed fish one flake at a time, and immediately siphoning out any contaminant. I favour isostatically-balanced aquarium salt and a highly nutritious diet for post-treatment recovery. I also use organic anti-microbial agents like Indian almond leaves in the aquarium to reduce pathogen abundance and diseases reoccurrence, even considering oregano as a feed.
Please use the @ symbol if you want to get me because I sometimes miss posts.

Question: Do your Neon tetras or other fish have white lips? You have a mix of Neon terta (Paracheirodon innesi) and Cardinal tetra (Paracheirodon axelrodi).
 
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xZaiox

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Maidstone, UK
Hi,
Do you have more pictures of the gourami? The pictures don't give a clear close up shot of the wound, and I'm concerned that looks somewhat like Columnaris (aka saddleback disease) - do any other fish in your tank have a similar wound? Or frayed fins? White patches? It's especially concerning that you said this appeared overnight (which Columnaris frequently does).

I would strongly advise keeping the fish isolated from others because Columnaris is very contagious and can easily take out a tank. I don't know if you happen to have strong antibiotics on hand, but Seachem's 'Kanaplex' can treat it, and it works even better if used in combination with API's 'Furan 2' (these are brands, the drug names are Kanamycin / Nitrofurazone). I've personally experienced a slow version of Columnaris (cotton mouth) before that responded fully to just Kanaplex alone, but I caught it quite early. Be aware these medications do target gram-negative bacteria (as well as gram-positive), and that means they will effect filter bacteria, so it's important to keep an eye on ammonia/nitrite if using them.

In the mean time, if you have it available, Methylene blue can buy time with Columnaris, you can dip a swab in a bottle of Methylene blue and gently rub it on the fishes effected areas (no dilution). This will stain the areas blue (it's only temporarily) and will provide an antiseptic effect. Really though, this is only to buy time.

The difficult thing with fish diseases, is there are so many different types, and it can be difficult to diagnose a fish, let alone treat them. I always think it's best to think of the greater good - i.e what is best for the tank as a whole. Exposing a whole tank to medications to treat one fish is not good in my opinion, unless a large amount of tank inhabitants are displaying the same symptoms. I will reiterate though, I strongly recommend isolating this gourami.

Edit: @Simon Cole beat me to it 😂
 

Simon Cole

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Seachem's 'Kanaplex' can treat it, and it works even better if used in combination with API's 'Furan 2'
Good call. For Columnaris, the AAP website recommends Kanaplex combined with Nitrofurazone, and this has always been widely supported elsewhere as very effective. You are bang on dead right! :thumbup: The only thing I would note is that the AAP website states: "(note Furan 2 is NOT pharmaceutical grade)." I am a doxycycline user when it comes to this sort of infection, so I'm pretty useless, but I remember struggling to get Nitrofurazone in the UK, so Furan 2 sounds logical. Lots of sources agree with this treatment choice, but there are lots of people who claim almost anything can treat it and they are very wrong (EHSA 2000 in particular really gets my goat because it never works for me, and they advertise it as an effective treatment for Flexibacter even though it has nothing in the ingredients that is proven to be very active in lab trials or is a "known" commercial treatment). I did wonder whether this could have jumped from the other fish in TheWishMaster's aquarium. I had some Black neon tetra Hyphessobrycon herbertaxelrodi who kept this as a chronic condition for several months or years and would pass it on to Bettas in a community aquarium, so I moved the Bettas out. I could remove the infection from the Black Neons in a treatment tank, also using PP baths, but it always came back when they were reintroduced into the aquarium and they would get back the tell tail white lips. They seem to be disease vectors for Columnaris, which is something I have also read elsewhere. You also get a lot of white lips in commercial Neon tetras these days. Certainly a proper UV bulb would be a good long-term solution if this is this case. Great advice about using dips and isolation, I agree entirely. Hopefully it is not this disease, but overall you hit the nail on the head and I would recommend following your advice because it is broad enough to treat most pathogens potentially causing these problems.
 
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xZaiox

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I am a doxycycline user when it comes to this sort of infection
Truthfully, I would like to have other antibiotics on hand. I really don't like using Kanaplex due to how harsh it is on kidneys, and nitrofurazone seems wildly carcinogenic...
there are lots of people who claim almost anything can treat it and they are very wrong (EHSA 2000 in particular really gets my goat because it never works for me, and they advertise it as an effective treatment for Flexibacter even though it has nothing in the ingredients that is proven to be very active in lab trials or is a "known" commercial treatment).
You and me both, I never understood why esha meds seem to be touted as a cure-all, I've never had much luck with them for anything more than a mild infection. I was certainly confused about the '2000' too... it seems like all of the ingredients only target gram-positive bacteria. I'm especially dubious of it claiming to treat neon tetra disease, when it's generally regarded as incurable...
Certainly a proper UV bulb would be a good long-term solution if this is this case.
Agreed on this, I run one myself :thumbup:
 

The.WishMaster

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12 Jan 2022
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Thank you for the help guys. I am think about getting a 30-40L Treatment tank. If this Gourami can survive till then its great otherwise I will observe any weird behavior from other fishes and those who seem suspicious, I would put them in the hospital tank and treat them with broad spectrum anti-biotics. Any recommendations for all-in broad medicines that I can use as a general treatment?
@Simon Cole you asked about the Tetras, neither tetras or other fishes have any mouth related diseases that I can visibly see. Everyone else seems to be doing normal. As for Tetras, I bought 15 from the store but multiple people have told me that some of them are cardinal tetras and most are neon.
All fishes live pretty happily with each other. The only tank bully we have is the pleco. It attacks any fish that comes near it during feeding time.
 

Simon Cole

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Any recommendations for all-in broad medicines that I can use as a general treatment?
I prefer to make a distinction between disease treatment, pathogen suppression, and decontamination in terms of what you to achieve.
Sometimes the treatment that you think will supress the spread of a disease actually does a lot more harm to the fish, phenoxyethanol springs to mind here because it tends to kill the fish first. Other times invertebrates get badly affected.
Many forms of pathogenic bacteria are already in balanced numbers inside aquarium ecosystems. It is actually quite hard to find "all-in" treatments that do not unbalance the microbial population and lead to infection outbreaks further down the line. The difference here is whether something is highly-infectious as opposed to opportunistic, or whether fish still carry the disease continue to act as vectors for infection.
That is why the treatment tank model is so widely supported. Once you treat diseased fish, the chances of transmission upon reintroduction reduce considerably.
Fish that are disease vectors also play an important role in transmission. This leans towards suppression techniques like proper UV, or treating them at the same time as any acutely infected fish.
The problem comes when people assume that certain internalised diseases are completely mitigated by "all-in" treatments. Yes this can work, but it is more likely to be suitable for treating pathogens in water and those on the surface tissues of the fish. If they worked then they would need to get into cysts etc. and have a proven antimicrobial action on the pathogen proven through lab trials, and not damage fish too badly in the process.
That is precisely why many of the worst bacterial infections are actually quite hard to treat without using something that has both a specific action and is also highly effective. The worst pathogens often require specific medications.
I think that you would need to check whether Kanaplex and Furan 2 are suitable as an "all-in" treatment @xZaiox. The AAP website links in my message above might help somewhat.
But if you were going down that route, then I wonder firstly what effect this would have on the aquarium ecosystem, and secondly whether if you were using a separate treatment tank, that a broader aquarium decontamination treatment would be more effective. There isn't really any logic in doing a diagnosis and then targeting everything apart from the disease that you diagnosed. It would unstable the microbial balance and could make problems worse.
Lots of microbes already consume pathogens in the aquarium, so you probably don't want them destroyed unless you can be sure that the disease is eliminated at the same time.
The only tendency I have to do this is when I am already leaning towards decontamination and am happy to reintroduce the microbes using an egg-cup of clean garden topsoil afterwards.
It all depends upon how highly you value the role of microbes in the way that your tank cycles, and you should note that plants offer bioremediation and nutrient balancing too.
However, I do think that botanicals have tremendous potential to supress pathogens without damaging the microbial balance. So I would be looking at things like Indian almond leaves and dietary changes. I think that they have already identified several hundred active compounds in Indian almond leaves.
In terms of the three distinctions it should not mean that you cannot find a treatment that does all three at once. I do not know what that is because I do not know for certain what pathogen(s) caused the infection. If you assign a probability to each pathogen then you can select appropriate treatments. I actually think that the treatment mentioned by @xZaiox above seems like a very good candidate, so I would start by looking more closely into how you would apply it.
 
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xZaiox

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Any recommendations for all-in broad medicines that I can use as a general treatment?
Definitely not - "general treatment" is not a good idea for the exact reasons that @Simon Cole just outlined, regarding microbial balance. Your tank is an ecosystem, and the beneficial bacteria protect the fish from all sorts of terrible infections. That's why if any treatment is going to be pursed, you should really have an idea of what it is you're targeting, and find the most gentle way to target it that preferably won't have any drastic effects on the biological balance. Now I'm not saying antibiotics are never called for, after all I did advise using them in my original reply to you, all I'm saying is they can have serious consequences and their use should be tightly moderated. Think about humans - with us, excessive antibiotic usage can lead to a C.diff (Clostridioides difficile) infection, and this infection can be quite nasty and difficult to treat itself with medications. In-fact, an effective treatment for it is to actually take a stool sample from a healthy donor and give it to the sick patient. Microbial balance is really important.

Now that the lecture is out of the way, there are some medications that I think are very useful to keep on hand, namely antiparasitic medications. Praziquantel is a very safe medication that is fantastic for treating gill flukes (although there are some resistant strains...), Fenbendazole is useful for treating certain internal parasites such as capillaria when fed, and Levamisole can also treat this. Metronidazole is great for treating hexamita when fed in the food, but this does also target anaerobic bacteria, and will have an impact on the fishes gut microbiome.

Parasitic infections can quite commonly result in further infections with bacteria and/or fungi (although true fungus infections in aquariums are rarer and often due to poor water quality). For this reason, I think it's far better to pay close attention to your fish, and understand common signs of parasites. Treating for parasites won't generally upset the biological balance because the medications usually don't possess antibacterial properties, so it's far safer to use these in the main tank (although it can be costly depending on the size of the tank).

Methylene blue is useful to have on hand too. This has antibacterial, antifungal properties, and can even be antiparasitic in high amounts. I personally only really use it for dips, swabs, and baths in mild infections, it won't really be able to fix any serious illness, but it's a useful first-line treatment that can treat mild cases of fin rot, external fungal infections, ulcers etc. It can also reverse nitrite toxicity and cyanide poisoning by kicking them off of the blood and allowing oxygen to bind again.

Seachem's 'Paraguard' is useful for dips and baths too, and I tend to find the most use out of it when dealing with an unknown external parasite. It has quite a broad range of treatment, but I wouldn't bother using it for anything other than mild cases. Cupramine or other copper treatments can be very effective for all sorts of external parasites, but the dosage for this has to be monitored very closely, and it's also horrible on the fishes body, so I would generally advise not using copper unless absolutely necessary.

Plain old aquarium salt can be useful for mild external infections, but make sure to check whether or not your fish can tolerate it first, i.e scaleless fish like cory cats tend to be much less tolerant of salt. Don't ever use this in a tank with plants because it will likely kill them or damage them. It's useful for things like fin rot.
I think that you would need to check whether Kanaplex and Furan 2 are suitable as an "all-in" treatment @xZaiox.
By "all-in" treatment, do you mean dose the main tank? I would absolutely not ever dose these medications in the main tank unless the majority of fish were showing symptoms of a severe disease, these two in combination will likely heavily mess up with the ecosystem. I would personally isolate the sick fish to a hospital tank and treat them there, then do a very large water change (like 80% or so) in the main tank, in order to hopefully reduce any freefloating bacteria. Bonus points if you have a UV steriliser that can also be turned on.
The worst pathogens often require specific medications.
Absolutely, even in humans the most common antibiotics only have a narrow range of infections that they treat.

Hope some of this helps @The.WishMaster 😊:thumbup:
 

The.WishMaster

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@xZaiox I mean't if there is a way to sort of do preventive treatment in a separate tank? I saw Aquarium co-op's video on how they quarantine every new fish with 3 medicines all together as a preventive thing before adding into the community tank. I thought doing t the same can at least make other fishes healthier in case they are carrying something from before I bought them. My gourami is still alive. Just very non-responsive and is not eating. I am not sure if to euthanize it or try to actively treat it.
 

xZaiox

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I also pre-medicate fish when they're in quarantine before joining the main tank. With the amount of wild caught fish circulating fish stores, I think avoiding parasites is near impossible, and ever since medicating the new arrivals in quarantine, my tank has been far healthier and happier.

I personally do 3-4 doses of praziquantel, 2 doses of levamisole and I also feed them metronidazole medicated foods for 2-3 weeks. Since doing this I've had no outbreaks of flukes or worms, and I've not seen many cases of internal parasites (although one of my dwarf rams currently has them... I don't think he ate much of the medicated food in quarantine). These medications are all quite easy on the fish and so I've never encountered any that don't tolerate it.

I don't medicate for bacteria or fungi unless I directly see an infection, and I don't treat for ich unless I see it either. Fish are very stressed when being transported, and the nets can either injure them or mess up their slime coats, and all of this will make it much easier for ich to take hold. So basically, by the time the quarantine is up, any fish with ich should be showing the spots (they can sometimes get past quarantine, but I've not had that happen). I prefer to not treat for ich because I don't think the medications that treat it are very nice, and I don't like unnecessarily exposing fish to them.

I've only had ich once, and tried treating it with eSHA exit + 2000, and this didn't even get rid of it fully. I turned the temperature up to 30.5C for 2 weeks and it went away and never came back. So I'm definitely in favour of heat treatment for ich.

The things that concern me most with new fish are always parasitic; ich, flukes, hexamita, capillaria, camallanus worms etc. I think an aquarium with a healthy biological balance and regular maintenance will rarely result in bacterial infections. Columnaris is somewhat of an exception; it's aerobic so it actually prefers the condition of a clean well-oxygenated tank. I think it's just best to pay close attention to the fish and immediately quarantine them if columnaris is suspected. A UV steriliser will help prevent it from spreading.
 

jaypeecee

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Hi @The.WishMaster

Here in the UK, there is a company that is run by a veterinarian who specializes in fish treatments. Her name is Dr Fiona Macdonald. It may be useful to contact her to see if she can help but there is likely to be a charge for her services. I've just realized that I forgot to provide the link o_O in my initial post. Anyway, here it is:


JPC
 
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sparkyweasel

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. I'm especially dubious of it claiming to treat neon tetra disease, when it's generally regarded as incurable...
A lot of advertising is very carefully worded. Claiming a product can be used to treat a disease is not the same as claiming it can cure it. :)
 

xZaiox

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A lot of advertising is very carefully worded. Claiming a product can be used to treat a disease is not the same as claiming it can cure it. :)
They also have a product called 'HEXAMITA' which says it can be used to treat hole in the head, which is often believed to be a result of an internal hexamita infection (although it does appear other factors may be involved). Anyway, they specifically list in the instructions that it's often treated with medicated food, but some fish stop eating, so you can use this medication instead. What does it contain? Copper sulphate, Ethacridine lactate, Acriflavine, Methylene blue - How the hell is this going to treat hexamita?? 3 antiseptics and copper? I've honestly lost all respect for this company. Seems like a predatory attempt to exploit people wanting to save their fish.
And a lot of farm-bred fish are in poor health too.
100% agreed.
 

Simon Cole

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I observe that these infections normally spread to the mouth organ.
Thanks for a moment of light relief in this serious thread. :)
Now I have to teach my fish to play.
If it did then my melodeon would need to be quarantined. It took me a few seconds to realise this wasn't a euphemism for something that most Victorian moralists might regard as sinful :angelic:
 
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