# Severum has sores, fin rot and white pimples



## Marin

Hi all,

I really need advice on how to cure my severum. He has been sick for many months by now, appetite has been variable. But lately he is almost anorexic, not eating his pellets, although he is still interested in dried krill (but spits it out after eating). I did notice transparent poop too. THere are also white cottony growths on his skin which eventually burst out to an open sore and then leave a hole behind. I guess he already had HITH, which was treated with meds, but the holes and the head erosion remained. He is continuing to have more of those pits now. He has white cottony growths on his tail and dorsal fin too.. The sores are actually mostly present on his left side (around the eye) and one right on the forehead. His left fin has fin rot. I already used MAracyn by itself anout a month ago for the fin rot, it improved but did not go away. THen I treated with Metranidazole thinkin git may be HITH, it made a slight improvement too.

About 10 days ago I noticed he was not using his left gill to breathe, I panicked, started a treatment with ParaGuard. I did a search and bought PraziPro and continued with it for 2 more doses. Although he started using his both gills, he got progressively worse , not eating at all. His fin rot started to have septicemia and the pimples eroded suddenly. So I stopped the treatment 2 days ago , did a large water change, increased the salt conc to 2 tbsp per 5 gallons. The fin rot looks better, but pimples are there and nothing is under control. He is sometimes hiding, sometimes not. I really cannot tell if this is parazytic, fungal, bacterial or all. THere are no new additions to the tank for at least a year. About a year ago, I added a small shark, which died in a month. Lots of problems arised after that.

Here are the aquarium conditions:
1 golden severum (7 years old)
1 algea eater (4 years old)
60 gallon tank with aeration and Penguin Bio-wheel filtering
Large Water changes twice a week,
Ammonia 0, nitrite 0, nitrate 20ppm, pH around 7.0.
Have kept 1 tbsp of aquarium salt per 5 gallons for a long time. Currently has twice that amount.

Any feedback is greatly appreciated. I was thinking of using MAracyn two, but I am really not sure. I also have Seachem metranidazole, maracyn I, PAraziteGuard, PraziPro, Fungus Clear and can get most anything suggested online or from the stores.

Much thanks,
Marin


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## Marin

Hi again,

I am trying to get new pics but so far no success. Here are older pictures of the severum:
http://www.cichlid-forum.com/phpBB/view ... highlight=

The white spots are now more numerous and he is not eating at all, not even the dried shrimp. But he is still actively swimming. I saw him flashing a few times today. I have made 2 large water changes in 3 days and today the wounds and the fin look a lot better. I also kept the salt level of 2 Tbsp per 5 gallons.

But overall, he still has frayed left fin, reddening at the base from time to time. There are craters in the head and around the eye , three of which are filled with white growths. Those are also slightly inflamed. Today he is more active than yesterday, but he is still not eating and I am worried to be late.

Which medication do you think is best, Metranidazole or Maracyn-II? Should I mix two Maracyns? I cannot decide if I need to address the infected wounds and fin first or try to go with HITH treatment with metronidazole (is 200mg of met per 5 gallons ok)? I will really appreciate any help..

Thank you.
Marin


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## Robin

Hi Marin

sorry your fish isn't doing well.

It sounds like HITH but can't say for sure. There's so much information and debate on what HITH is exactly, how it is caused and what the best treatment is. 
In answer to your question I would go with the metronidazole but follow the dosing directions in this article: 
http://www.cichlid-forum.com/articles/spironucleus.php

I think often times when metronidazole doesn't work it's because the med wasn't given long enough or strong enough and met is fussy in that it is light and temperature sensitive.

It sounds like you're keeping up on the water quality but let me make one suggestion: siphon the gravel and under decorations thoroughly and then remove some of the gravel, then start the metronidazole treatment. If there is any kind of waste build up in the gravel then make sure you don't remove any of it until it's been siphoned.

I would keep the salt levels as you have them: 2 tablespoons per five gallons. The salt may help prevent bacteria from adhering to the fish's skin. You might also add a jet to increase water movement--this will also help prevent bacteria from adhering.

I don't know if carbon in the filter contributes to HITH or not but it's not going to hurt to remove it if you have any in your filter cartridges. You can just cut the media and shake the carbon out.

Let me know how it goes and if I don't get right back to you here please don't hesitate to PM me.

Robin


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## Marin

Hi Robin,

Thank you very much for your reply. I have read the article very carefully. I bought Seachem metranidazole powder and will start the treatment today. Since this is a reoccurance, what I should do is to add 400mg for every 10 gallons every 8 hours right? Wow. Since the fish is at school, I am not sure if I can medicate him every 8 hours, but I'll do my best. He is actually not my own fish, but I am taking care of him with a friend of mine in the lab.

I have two questions though:

-Should I raise the temp to 30 deg as suggested ? It is currently at 25 deg (76 F). I know that it is routinely recommended not to raise the temp during treatments, but metronidazole seems to precipitate out of the water column at lower temperatures.

-The store ran out of the regular aquarium salt, so I bought American Cichlid Salt instead. Are they the same thing? The directions say it should be added like 1/2 teaspoon per 30 gallons. If it is not the same thing, I will try to find aquariums alt tomorrow, but should I also use this one? I don't know how to compare the dosages of the two kind.

THe fin looks a lot better, he is breathing normally through the gills. But he is completely anorexic and not moving much today, so I am worried. Now I am going to do another large water change, siphon the gravel really well and take some out. I already removed most orniments out to make the cleanings easier. The nitrates seem to be around 10ppm now.

Thanks,
Marin


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## Robin

> Since the fish is at school, I am not sure if I can medicate him every 8 hours, but I'll do my best.


Just come as close to that schedule as possible. And ideally over the first few days you should check on the fish. You never know how any individual fish is going to react to a new medication



> I bought American Cichlid Salt instead. Are they the same thing?


Probably not. You want Sodium Chloride. At the grocery store you can get pickling or kosher salt--no additives and it's cheaper than Aquarium salt.



> Should I raise the temp to 30 deg as suggested ? It is currently at 25 deg (76 F). I know that it is routinely recommended not to raise the temp during treatments, but metronidazole seems to precipitate out of the water column at lower temperatures.


Actually it's just a few ailments that raising the temp is not a good idea, Columnaris, a bacterial disease is one that comes to mind. Since we don't know for sure what's going on with your fish I would raise the temp slowly and only while you can observe the fish. If you notice white fuzzy growth suddenly spreading, and/or the open pimple areas getting larger then you shouldn't raise the temp further.

Robin


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## Marin

Oh, OK I will get pure Kosher salt then. So I assume it is the same dose as aquarium salt. I will not raise the temp today, but tomorrow I'll try it while I am at school. I also removed charcoal from the filters.

One more question, do you think the presence of wood in aquarium can do any harm? Like harboring more/different bacteria? He has a piece of trunk in his aquarium as an orniment (bought from a store) which is actually coming into pieces. I removed it a few days ago to make the cleanings easier. If the wood is actually harmful to freshwater fish, than I will not put it back.

Thanks,
Marin


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## Robin

I don't think wood is harmful necessarily but when you're dealing with an unknown element/ongoing illness with a fish my inclination is to get rid of anything that 'it', whatever 'it' is can be clinging to--sounds like you have a similar sense. And especially where the wood is coming apart--I wouldn't put it back in.

Robin

One of my tanks has a goldfish that I've had for a good ten years now. For the longest time the fish seemed to be suffering from something--(I won't go into the details here, not the same symptoms as your fish)--and none of the meds I tried made any difference. Then I decided to remove more than half the substrate and ever since the fish has been better. ? Don't know.


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## BillD

Generally speaking, with parisitic ailments the temperature is raised, while lowered for bacterial infections/treatments. My experience with Maracyn is that it is a waste of time. It treats only gram positive bacteria and most fish diseases are gram negative. Also, the dosages on the packets of medication are often far too low to be effective. This move was apparently to placate the FDA, since the meds are sold over the counter. If you are treating for parasites the whole tank needs to be done, but for bacteria, a 10 gal tank makes it much easier and cheaper.


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## Marin

Hi again,

I have been treating the whole aquarium with metronidazole (400mg per 10 G of water) for 3 days by now. Since the tank is located at the school, I cannot do 3 times per day unfortunately. But I am doing twice per day, changing about %25 of water before adding the new dose. I am keeping the temp at 29 deg (80 F). IT took a day to adjust the new temp, so I thought may be metro precipitated out the first day and was not effective? I am also keeping the 2 tbsp aquarium salt per 10G. I have removed about half of the gravel and almost all orniments from the aquarium.

The severum is definitely doing better. The skin looks a lot better, holes are healing too. However I noticed a new cottony growth after raising the temp. But it is just one and I have not noticed it spreading to the entire body yet. He is interested in food, and swallows it easily, but he still spits it out. I can still observe some white stringy poop. He is communicating with us again and swimming happily, not hiding on the bottom any more. Today I tried giving brine shrimp and he looked very excited, since they were so tiny he did not need to spit them out and hopefully he got some nutrition. I will try to make the beef heart recipe as suggested in HITH article too. My questions now are:

-Right now it is the third day I started metronidazole treatment, adding 400mg per 10G twice per day. Since I cannot do it three times per day, should I continue for 5 days or more?

-I wanted to continue adding Kosher salt (NaCl) instead of aquarium salt, but I noticed that it has some anti-caking agent (yellow prussiate of soda), would it harm the fish at 2 tbsp per 10G dosage?

- I am worried that he is not getting any nutrition. Is it a good idea to give frozen brine shrimp and krill occasionally as food? He is not eating his pellets. Should I feed him the beef heart mix as suggested in HITH article?

-Is there a vitamin mix that can be used in water (if it makes sense)? Since he is not eating right now, I cannot give anything by mouth.

Much thanks,
Marin


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## Robin

I'm so glad to hear the fish is doing better. I definitely get the impression that this is a favorite fish.

I wouldn't worry too much about him not eating. Fish can go for many weeks without food. And it's not a good idea to abruptly change the fish's diet, especially if they are ill. I would continue to offer him the food(s) he's been eating all along. Just try a little and if he spits it out wait and try again later.

I think extending the metronidazole to a full five days would be fine and also a good idea for the reason you stated. I know when I've fed my fish met-soaked food I fed them it for ten days.

The Kosher salt--the additive probably won't do him any harm--it's one of those things were we don't know of any problems with it--it's such a minuscule amount, but when treating a sick fish you want to err on the side of caution so you should switch to salt that doesn't have an additive. Look for Pickling salt--I know I've used both kosher and pickling and at least up here in the state of maine they had no additives.

I don't know what sort of vitamins you could add to the water. Perhaps someone who has used them will chime in here.

Have a nice Thanksgiving, Marin.

Robin


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## Marin

Thank you for your reply. Homer (the severum) has been present in the lab since I started my PhD. My advisor is also very fond of him, he is our lab mascot. We sure don't want to loose him.

Do you think I can continue metro treatment for 10 days (dozing twice per day)? This is a norm for other pets and people, but I don't know much about fish. This disease looks like it is very stubborn. He is definitely doing much better, except for eating. IS it typical that it takes such a long time for them to start eating?

Also, his fins are breaking apart, actually they were already diseased before, now he seems to be loosing the dead parts of the fins. It is not horrible but looks bad. Typically , a dark spot appears first in the middle or at the tip of the fins and then it rots away. There is no septicemie right now, the broken parts looks clean. Does spironucleus also cause fin rot? I hope metronidazole is also taking care of that, or may be I should use something else later?

We are celebrating Thanksgiving with Homer in the lab today, but I don't think it is a good idea to feed him turkey, hah!

Happy Thanksgiving!
Marin


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## Robin

Sorry I didn't get right back to you, I was away, no internet.

I wouldn't hesitate to go ten days on the treatment. Especially if Homer seems to be improving but has not fully recovered. 
You may need to treat with something after the met. There may be more than one thing going on here, perhaps a bacteria that met is not effective on. But as long as he seems to be healing I'd wait on treating with something else.

Water changes whenever you can fit them in

Lucky fish to have company for the Thanksgiving Holiday

Robin


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## Marin

Hi Robin, the 10 day treatment is over, but unfortunately I could not do it twice per day during the weekend. There is no more improvement and he is still not eating. Below I am attempting to post some pictures of him.

The below pictures shows his holes with cottony growths inside, located right above the left eye and on the forehead. Also, there are some craters on the gill plates. THere are various small holes on the head and around the mouth too, from previous infections. This left fin also has fin rot, but it is not visible here.










































THe below two pictures show the right side of the fist, the lateral erosion around the eye from previous infections. There is also a streak on the nose, which is getting deeper. The tail and dorsal fin has this large dark spots which are rotting away, and also the white cottony growths. These white growths did not imrove with metronidazole treatment.


















The holes in the head seems to improve some, but not any more. THe white growths inside the holes reappeared (they were gone the first few days of the metro treatment) and they are not going away. He is still not eating. He is interested in the surrounding though. He is also making these jerking movements, as if trying to get rid of something. Ususally, he just stays close to the surface watching outside.

I will really appreciate any suggestions on what to do next. I was making twice a day partial water changes (%25) before adding metro and so the water is pristine. It is possible that this alone might have helped him improve dramatically at first, and may be not the metro.

I have serious doubts about metro dissolving in water, even though I raised the temp to 30 deg. I bought fish zole metro tablets, was crushing them and trying to dissolve in water before adding, but it never completely dissolves ! If it is just sinking at the bottom, than I am afraid it will not be effective. Any experiences about this?

Much thanks,
Marin


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## Marin

Hi, I was wondering if Praziquantel would be a good choice. THe white thing inside the holes seems like they are growing? I am not sure, but they are definitely not going away. If that is a good one, I have PraziPro and can start the treatment right away.
Should I get rid of metronidazole first though? For how long should I run the charcoal filter for that purpose? Or should I continue using them together?
Thanks,
Marin


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## Robin

Marin you mentioned in your pm to me that there was something that looked like a worm protruding from above his eye. Is it actually a worm? Is it fuzzy looking or smooth? How long would you say it is? Or is it just a long piece of bacteria/fungus?

On the metronidazole, I've always used the Seachem met, don't know if that dissolves any better than what you used.

So far besides the met, what meds have you used?

Robin


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## Marin

Hi Robin, I am staring at that staff that is protruding out of the hole and I cannot say that it is a worm. I realize the other 2 holes also has it, although much shorter. I dropped the temp from 30deg to 28deg when I see the white fuzzy growths 2 days ago. They are not white any more, the biggest one is barely 0.5cm. The color is similar to the fish, and they are not smooth. I almost want to say that they are pieces of tissue from the fish. Or may be long pieces of bacteria or fungus.

BEfore met, I used 2 doses of ParaziteGuard followed by 1 dose of praziquantel per directions. I gave it up too quickly may be. He was not improving at all with those. He did impove with met at first, but not any more. But I could not exactly follow the protocol in the HITH article  I cannot add it 3 times per day. I did add it twice per day at 400mg per 10G for 7 days and since then only once a day (due to my own schedule restrictions).

Before those, I used Maracyn only for 3 doses. It helped with the fin and tail rot, but not the holes.

I have not added anything today and will do a water change now, but then what to do? He is actively swimming now and also eats bits of frozen krill, but he spits them out in 10 sec. That is his favorite treat which we give occasionally. He would not even touch his regular pellets. THen I see him searching the floor, but I am not seeing him actually eating anything. He must be though, since he is still active.

Would you suggest stopping met altogether or may be continuing with it in liue of another med? I was giving it only for once a day since the last 3 days though.

Much thanks,
Marin


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## Robin

Well see the met might be what we need but if he didn't get a strong enough dose then obviously it's not going to do the job
...on the other hand it may be that we need something else.

Unfortunately where so many fish ailments share common symptoms often what we do here is treat for the most likely cause, (in this case HITH), but then if we're sure we've dosed correctly and there's little or no improvement then we try something else.

I'm not sure we've given the metronidazole enough of a chance. So one option is to take a day or two off during which you do numerous partial water changes and gravel siphonings and treat with met again, but: you might consider getting the met from a different maker or at the very least a 'fresh' package of what you're using. Fish meds have a shelf life.
(Before I forget: in your pm you mentioned 'tiny things' in the water--more info--??)

You might even go with something like Jungle's Hole in the head guard--met is one of the ingredients.

Another option is to switch to a broad spectrum antibiotic. Perhaps we're 'just' looking at a bacterial disease here. You could try Kanamycin or the combination of Maracyn & Maracyn-two. There are other choices so if you don't see these shop around at the LFS.

Whatever you end up using it's really important to give the full recommended dosage for the full recommended time. (Unless the fish seems to have a bad reaction to the med)

Don't worry too much about whether or not he's eating enough. Food at this point is a test: give him a little just to see if he eats it AND doesn't spit it back out.

I'm sorry that I don't have a firm answer for you. Thankfully Homer is still strong so hopefully we'll find a cure for him.

Robin


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## Marin

Robin, your answer is very helpful. I am already aware that I am not understanding what is going on with the fish and so cannot explain it very well. But I have good news! Today he ate a bit of dried without spitting (well he just spit the legs out, typical of him). So I do think met actually worked, and many water changes.. The growth in the holes is almost completely gone . So it is definitely not a worm. I am really not sure why.

I cleaned the aquarium yesterday, added nothing but water conditioner to give him a break, I also dropped the temp to 26 deg. I put the carbon filter back in for a while. Now I really would like to continue with metro, and I will try to get Seachem one. Fish Zole was just much cheaper, but it is in tablet form and more difficult to dissolve. Then I will try to continue with twice a day dosage for 10 days, but I want to make sure I can do this without interruption and will ask for some help.

-So using met for one more round will not harm him, right?

The things in water was just the detritus that needs to be siphoned, it wasn't anything specific. The algae eater grew large and is producing so much poop that it is simply amazing. I am siphoning the gravel most every day. THe algae eater by the way, does not have any holes or any sign of disease so far, as far as I can see.

So if you think pure met is better then the combination medications, I will prefer that one (Seachem) for next treatment. Two more questions:

-Do you think adding melafix will also help?
-Should I keep the salt content at 2TBSP per 5G level ? The last 2 days I ran out of it and so the water is quite fresh actually. But he is so much better today!

Much thanks again,
Marin


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## Robin

Hi Marin,

Melafix won't hurt and it may help. It's suppose to speed healing. I'd follow the directions for one treatment--a week or ten days--whatever it is. You can and should continue with frequent water changes while dosing with Melafix--it's not a med that needs to 'build up' in the water. So just do the water change just before the daily Melafix. 
Continue to siphon the gravel as often as you can. 
The salt: yes I would keep it in there. 1T per five gallons is probably all you need. The sodium chloride is suppose to help prevent bacteria from adhering to the fish's skin. Increased water movement will also help in this way. Dissolve the salt first and add it gradually over several hours time. 
I think given the length and strength of this fish's ailment that going another round of met is a good idea. See if you can do the recommended dosage, (from the article) for three days and just as with any medication it's best if you or someone is around to observe the fish during the treatment just in case he has a reaction to the medication.

I am _so glad_ to hear he's doing better.   

Robin

is it one of those large algae eaters? The kind that grow to be a foot long? If so you might consider finding him a new home and getting a Bristlenose Pleco instead. They clean but only grow to be five inches long. Some algae eaters have been known to attach to sleeping/docile fish at night. Not aggression, just when they come across anything in their path they 'clean' it. Obviously not good for any fish but especially a fish like Homer who's not feeling well


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## Marin

Hi Robin,

So I still have not medicated Homer with Metro yet, since I could not find a person who is still at the department at midnight  I don't want to start it before making sure we can do it 3 times per day. Since it is final exam time, I may have some luck now  But it cannot be me since I have a kid and can't leave the house at midnight.

However, I did purchase Kanamycin along with Metro powder from JEHMCO and was planning to use that and see what happens. I have been adding MElafix for the full week every day and he actually looked OK, also started eating her pellets, but not quite gained her appetite. He is eating 1/10th of what he would normally eat. He is pooping quite normally (not white stringy poop). The holes look better, but unfortunately today I noticed white fuzzy growth in one of them. So I do think I need to medicate more...

Do you think trying Kanamycin is a good idea, or I should wait to find an opportunity to dose 3 times per day with Metro? Would Kanamycin adverse badly in case it does not work?

The Kanamycin directions say that it should be added once a day for a max of 5 days. But there are two dosages on it:
-As a treatment for susceptible internal and external infections, use 26.7 to 66.6 mg/L (100.0 to 252.35mg/gal).
-For systemic infections, the concentration should be 133.3 mg/L (double the max amount above)

Now should I treat this as systemic infection and use the highest recommended dose? The treatment is recommended for 3-5 days, I was planning for 5 days regardless.

Given the exact mg of dosages, I assume the accuracy is important, so I am going to measure the dosage with a digital scale we have in the lab.

I have no idea what kind of an algae eater we have ! I tried to identify it, and actually it does look like one of the birstlenose, but I am not sure! I rarely ever see him and he is already about 15cm now. I hope he is not one of the large plecos. I will try to find it out.

Thanks,
Marin


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