# Need a diagnosis for my front



## charboog (Sep 22, 2004)

My front who is probably close to 4 years old and about 9 inches long has a white "spot" coming out of his body just above one of his eyes. To look at it with a magnifying glass it looks like a tiny piece of his brain. I have scoured the pest and disease books and it doesn't look anything like any kind of worm or parasite, etc. that I can find. He isn't extremely itchy, but I do see him gently dragging on the gravel occasionally. I have treated the tank with QuickCure, Jungle Parasite Clear and Furan-2 (with the Furan I did see it darken and shrink a little, but after the 4 doses that are recommended it came back within a few days) I am just about to start another round of the Furan-2, but I thought I'd check to see anyone else has seen this before.

He is in his own tank. I test the water regularly and keep it very clean. I do feed him frozen krill, which makes me wonder if they could carry any pests.

If anyone has any ideas, I'd greatly appreciate the input. I haven't posted to the disease forum yet. I thought I'd see if it's something known to Frontosa's first.

Thanks.


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## boredatwork (Sep 14, 2007)

First thing I thought of was hole in the head (HTH). I have never seen it in person, but see if this fits the symptoms.

http://www.aquariumfish.net/information ... e_head.htm


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## charboog (Sep 22, 2004)

Unfortunately I've had fish with "hole in the head" before. This looks very different. But that does give me the idea to try a few metronidazole treatments just in case. Thanks a lot for your comments. I really appreciate it!


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## cichlidgirl1 (Sep 17, 2007)

I could really use a picture of the area. ITs so hard to help when we dont know what it looks like etc.... A pic would be REAL helpful. I wonder if it might be a tumor of sometype ? I know fish can get tumors or growths like any other animal.

CG


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## charboog (Sep 22, 2004)

I'll try to get a picture that you can actually see and then I'll attempt to attach it as soon as I can.
Thanks


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## cichlidgirl1 (Sep 17, 2007)

I got a free photobucket account and then upload the pic from my camera to the computer (windows photo gallery) then i upload that pic to the photobucket. I then click on direct link, copy it then click on the image icon here in the post and paste the image in . Works better for me than trying to do a attatchment.


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## charboog (Sep 22, 2004)

Thanks for the help. The picture is pretty good. I tried multiple times to re-size it, but I guess I need some more lessons.
You can kind of see the white thing just under his scale and then it hangs out. It was a little longer until the end fell off this afternoon. I hope this will help make an identification.


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## cichlidgirl1 (Sep 17, 2007)

I saved this pic to my photo gallery and then i examined it under the magnify setting . It appears to not be coming out from UNDER a scale but more like its something that is coming out of a hole through the scale (there is a round edge that goes around it on the scale that is a different color than the scale.

I believe its either a parasite or hole in the head. I have seen similar things on discus (hole in the head) . Im not sure if that is what it is or if it is a parasite.

There are two types of hole in the head, one that is bacterial and one that is protezoan parasite in nature. the bacterial one is often seen on oscars and other large messy CA/SA cichlids, it is a result of dirty tank conditions and will often heal on its own with clean water conditions (regular heavy duty tank cleaning and for me weekly doses of melafix (I recently cured two rescue oscars that had multi pits in their heads from that type. Open new pits often are seen with a yellowy white "worm" sticking out of the hole, the "worm" is actually a trail of puss that is being discharged. The protazoan kind is harder to cure but can be cured with meds. If i had to guess by the pic, i would say your fish had hole in the head. I think there are some meds you can net the fish and dip a q tip in the medication and treat the exact spot of infection and not the whole fish and also treatments where you dose just the infected fish in a concentrated dip. I cant remember those meds names (sorry been a long time since i had discus and im sure that there are better meds now anyway).

I would see what others here say and recommend for a treatment. Then go from there. If no one has any better ideas i would ask what the best treatment for parasites is and if it did not clear it up then i would treat for hole in the head. Ask around and find out the best current treatment for hole in the head is since it has been many years since i have treated a fish for that protazoan and im sure they use a different treatment now.

One other possiabiltiy is that this is located on the nuchal hump, that hump is a fatty deposit, it could be fat protruding from a wound , but i dont personally think that is it because of the diameter of the hole, i think its hole in the head with puss coming out or a parasite that has burrowed into the fish head.

You should be able to check whether it is a worm or puss by netting the fish and take a gauze pad and wipe the area, if the "worm" breaks down onto the gauze as a yellowy smear then its puss , if it stays there on the fish or part breaks off leaving a solid piece behind then its likely a parasite. Any thing solid or wiggly or that retracts is obviously a parasite.

Hope this helps and can get you started on the best way to treat this.


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## charboog (Sep 22, 2004)

Wow, I really appreciate the effort you made to check this out! If it is hole in the head, I'm confused because I keep his tank spotless, except for feeding him the krill, which I'm sure leaves debris no matter how good an eater he is.

He has no pits on him that resemble the usual hole in the head, so I was leaning towards parasite, but I didn't realize there were the two types. I'm going to try netting him (I really hate to stress him out though) and see what happens. I was looking at him yesterday thinking, I just want to take tweezers and pull that thing out, but I'm not going to do that!

I'll post my findings after I check him out. Thanks again for taking the time to check out the picture and give me suggestions


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## cichlidgirl1 (Sep 17, 2007)

That would be the best thing, to net him to see if its puss or not. If its a parasite you should not be able to see yellow liquid on the gauze or tissue when you touch it to the spot. It very well could be a parasite of some type. It just looks so much like what hole in the head used to look like on some discus . I will get you a pic of the hole in the head im referring to and try to post it for you. Im suprised nobody else has responded to your pic with suggestions. I would feel more comfortable if someone else responded and agreed since i have been very lucky and have not had to deal with too many problems like this over the years in my own tanks...


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## charboog (Sep 22, 2004)

That would be great if you could find the picture. I'm going to clean the tank today and try to test the "thing" although as I look at it now, there's almost nothing there to check. If it's a parasite, it's hiding and if it's puss, it broke off again. I'll do my best.

I haven't seen any responses to posts from the moderators of the forum, maybe one of them will read this and give their input. I'm just grateful that you have responded. I was completely stumped, and at least I now have a path to follow.

Thanks again :thumb:


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## cichlidgirl1 (Sep 17, 2007)

im still looking for the pic with the "worm" sticking out, but here is a link to a pic and question on a front with HITH until i can find the one im looking for. If you look closely at this pic it shows a similar sized round hole very near the spot yours has one (near eye on nuchal hump).

http://images.google.com/imgres?img...&hl=en&safe=off&rlz=1T4TSHB_enUS299US299&sa=N


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## charboog (Sep 22, 2004)

Thanks for the picture and article. I hope you can find the "worm" picture. I'd really like to see it.

I have metronidazole and I don't think it could hurt to treat him with it. So I might give it a try first.


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## cichlidgirl1 (Sep 17, 2007)

im going to post a link here at another site i go to and let some frontosa experts i know take a crack at it before we have you treat him ok ? I will get back to you this evening or tomorrow with what they have to say on the problem.

CG


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## charboog (Sep 22, 2004)

That sounds great! I'll hold off on his treatment till I hear from you.


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## Fin (Dec 8, 2003)

To me it doesn't look like hole in the head from all the reading that I have done over time on the internet .Symptoms are the fish will develop small gray colored pinhole abbrasions around the eyes and head .

It almost looks like a worm of some sort ??? Hard to tell from the pictures ..

I one time experienced myself a planaria outbreak and heres what happened

Look through this thread 
http://www.cyphos.com/forums/showthr...light=planaria


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## cichlidgirl1 (Sep 17, 2007)

Hi, getting some responses over there, will get some more tomorrow im sure. Got some home work for you. Do you know what planeria worms are ? They are super tiny white wiggly worms that live in the substrate. When first hatched they look like tiny super short threads floating in the water, over time they grow longer and reproduce at alarming rates but live hidden most of the time. I had them once , they seemed to me to hide when lighting is low and only come out when feeding time etc.. if it gets worse they can often be seen on the glass, looking at first like dirty white algea, then as they grow you can start to see individual white worms stretching and moving across the glass and free swimming up towards the lights. They also will be floating in the water column, looking like very short hairs or threads, they are so short you wont assume they are worms at this point. I never had any attatch themselves to my fish but evidently some have had this happen. It is often caused by over feeding, too thick of sand or gravel, not vacuming the gravel/sand good enough and over all dirty substrate conditions. Especially over feeding and not cleaning substrate good enough. Here is a link, this also looks similar to your fish, so you need to inspect to see whether you might have had a unnoticed planeria worm outbreak. Stir up the gravel or sand a bit and shut off the filter to look in a canister type and also maybe move the cartridges on a hob to distrub any that might be in there, they will fall out the outflow. Get back to me on this tomorrow please. Here is that link :

http://www.cyphos.com/forums/showthread.php?t=6810&highlight=planaria

We should be able to figure this out pretty quick, just have to nail it down this weekend and start treatment.

BTW: What is your Nitrate readings and substrate vacuming program , how often do you vacume the bottom of the tank and what is your water change schedule ?

Thanks, 
CG


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## charboog (Sep 22, 2004)

Wow, those are some pics... I did a cleaning today to lower the water level for treatment (46 gal tank with only the one fish in it,) so I will keep him in there for treatment. I haven't seen anything like you describe, or like those pictures. I vacuum the gravel every 2 weeks with my water changes. I sometimes do it at one week intervals, but lately, it's been every 2 weeks. I change all filter media (canister) every 4 weeks. I'm careful about keeping the water clean, which is why I worry about feeding the frozen krill to him, very messy. I didn't get to check if the thing is pus or not, it had broken off so that there is nothing sticking out currently. I'm going to see what it looks like in the morning and try then. I don't know what the nitrates were before my water change, but all chemistry is good now. Guess I shouldn't have jumped the gun with the water change!

Thanks


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## charboog (Sep 22, 2004)

I went back and looked at the pictures again and read all the posts. The one thing that doesn't seem to fit my fish is that there is actually a hole that this is coming out of. It didn't seem to be that same situation for the fish with planaria.


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## cichlidgirl1 (Sep 17, 2007)

OK, could you please take another pic or two of the affected area for me, so i can see what it looks like with no pus or worm sticking out. Also, when you look at the fish do you see a second area where it looks like there is a old scar or pit (or maybe a new one starting, it looks the same size, just a bit lighter in color etc... Its even with the top of the eye and just to the left of the existing wound we have been looking at. Do you see that ? I put your pic in my photo bucket to try to zoom and add more contrast. I can just make out a mark, can you see it in person when you look at the fish ?


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## charboog (Sep 22, 2004)

Here is a new pic. There is a little mark to the left. He has a few funny things on him that have always been there but I can't be sure if this is one of them. I uploaded the picture at 1024 x 768 to see if this will help you to see it better.

There is a very tiny piece still sticking out of the hole, but nothing like yesterday.


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## cichlidaholic (Dec 7, 2005)

I don't believe this is HITH, or planaria.

Considering the meds you've used, I don't think it is anything parasitic, either. I would go ahead with the second round of the Furan, just because I don't believe the manufacturers ever advise using the meds long enough.

Since this has turned up in the fatty tissue, I believe it might be the equivalent of a ruptured sebaceous cyst, and what you're witnessing is actually the substance that makes up the cyst, oozing out of the only hole it can ooze out of. (I think that's why it keeps getting knocked off.)

Now, if this is what it is, the only thing I would be worried about is possible infection if the cyst also ruptured "inward".

Is he eating okay? Any clamped fins or stressed appearance?


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## cichlidgirl1 (Sep 17, 2007)

I agree. I think the "worm" is actually pus, from what kind of infection i cant be sure, but i would recommend you do a second treatment as well, since you said you noticed improvement with the first dose. It might have came back because the treatment was not long enough in duration to eradicate the infection. I would use that med and do larger than normal water changes until this clears up. Just keep an close eye on the fish during this second treatment to make sure that it continues to eat good and not act off or odd in anyway. Maybe increase the oxygen content with a bubbler while treating with the meds. (I always like to add extra oxygen when treating with meds even if it does not say to). Read the directions on the packaging carefully and remove any carbon from the filter if called for. Keep us informed, this has been a very unusual case and I know im very interested to know what treatment eventually will cure it. Good luck and dont hesitate if you need more advice. Oh, also keep an eye on the cycle of your tank, when using strong meds (especially antibiotics) it can affect the cycle of the tank and damage the biological agents that process the ammonia and nitrite found in your water (a good liquid test kit can be helpful such as a master test kit like API makes or similar).


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## charboog (Sep 22, 2004)

Thank you both for all your help. I will start the Furan and keep a close eye on him. He is eating normally and he doesn't clamp his fins. The only thing I notice is an occasional rub on the gravel, but not like he's uncontrollably itchy. I'll definitely keep you posted on what happens.

I also wanted to ask about recommended feeding. He loves his frozen krill, but I find it extremely messy and we will be going on a vacation, and the housesitter (who has taken care of our fish before) won't be cleaning the tank (it will be three weeks between cleanings) so I don't want to have her feed the krill. He likes the Hikara pellets, but they don't sink, and he won't go to the top of the tank to feed. I can't find a sinking food here, so I thought I'd ask what other Fronts eat. He seems so picky. Also, he is currently in a 46 gallon all by himself. I feel like he could be lonely, but I might just be projecting human emotions on him. Any thoughts? I had put a pleco in with him just before he developed his hole, but I removed him to my 90 gallon in case it was stress that caused the problem, again....am I projecting? :-?

I'll start treatment today and report back as soon as I finish the 5 day course.

Thanks again for all the work you've done! =D>


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## cichlidaholic (Dec 7, 2005)

I would not add any other fish to the tank with the front. Frontosas actually like to be with other frontosas, anything smaller might become a snack, and you certainly don't have the space for more fronts.

How about picking up some freeze dried krill, and dividing out feedings for your housesitter? I find that the freeze dried stuff usually gets pushed down into the tank by my surface agitation, and works well for fish that won't feed from the top. Or, you could slice small pieces of the frozen krill and instruct the fish sitter not to feed daily, maybe every other day?

Sebaceous cysts fill with white gunky matter called "sebum". It's actually kind of like a soft cheese, where once it starts seeping out of a hole, it will take on the shape of the hole, making it look "worm like".

When do you leave for vacation? You want to make sure this doesn't abcess...He may need some stronger antibiotics such as sulfa or a combination of erythromycin and minocycline.


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## charboog (Sep 22, 2004)

I will leave my guy alone, although he never showed an interest in eating tankmates when he was in my 90 gallon. I just thought that a small pleco might help clean up the uneaten food.

I'll give the dried krill a try, and pre chop some of the frozen like you suggested.

We leave on 12/1, so I should have plenty of time to get him back to normal. I do have the triple sulpha antibiotic also. I can use that after I finish this round of treatment it he isn't completely healed.


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## cichlidgirl1 (Sep 17, 2007)

I have a bit of advice for your vacation fish sitter. First off, dont let someone feed your fish from the bag themselves, its easy for someone who does not know what they are doing to overfeed and end up polluting the tank and killing your fish.

First decide if your gonna feed him every day or every other day, prepare the amount of food to feed and put each serving in a zip loc storage bag. If you have never measured it out before, better to be on the lighter side than too much. That way they cannot over feed. I would recommend they feed him every other day or even every 3 days (wont hurt him at all and will make it less likely that there will be fouling of the water in your tank).

I would also set 40 dollars cash in a envelope for emergencies like your filter or heater stops working so they can buy you a new cheap one at walmart if they need to.

I have fed freeze dried krill before, not too messy and my fish snap it up good after i fed it once or twice, i soaked mine in warm water first then for my juvies tore it into peices they can fit into mouth, but your fish is big enough to eat them whole or at least in only two pieces. I have not done this myself, but i bet you can soak your freeze dried krill till they rehydrate and plump up (4 minutes or so) then put each serving in a zip loc baggie with some water or better yet a cube tray to be FROZEN. That way your sitter can just drop a "small krill cube into the tank and as it melts it will release the krill. I would try it at home first make sure he eats it like that and if he does you can just have the sitter drop in a cube every other day or so. One small ice cube will not mess with the temp of your tank either. I would also think if he is eating one to two krill every other day he will be healthy enough till you return, no need for the floating pellets.

I also cut up shrimp for human consumtion, i buy the cooked shrimp and slice it up in smaller pieces , i bet you could do the ice cube thing for that too, the shrimp sink to the bottom of the tank. I got a small bag with about 30 shrimp for 4.95 in the frozen food section of my local grocery store /supermarket.

You could just feed him shrimp and freeze dried krill for a couple days to see how much he needs then make some cubes up and have them ready to go in the freezer. I really like the ice cube tray idea. I think i might even try it here at my house in the next day or two to see how it works.

Not sure what to do about the sinking pellet though, i know sometimes you can soak your floating pellets and they will get heavier and sink a bit especially when you press the air out of it. I have not done that but i have heard other people saying that you should do that if all you have is floating pellets. I would think that the shrimp or krill might be enough though and you might not need to do that.


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## charboog (Sep 22, 2004)

Thanks for the great ideas. I'm going to freeze some dried krill tonight to see how it works!


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## cichlidgirl1 (Sep 17, 2007)

remember to hydrate it first for a few mintutes in water so it will sink better.


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## charboog (Sep 22, 2004)

I soaked it for about 10 minutes before I froze it and I'm going to feed it to him today!


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## cichlidgirl1 (Sep 17, 2007)

Let me know how it works, i would guess it would slowly melt then release the krill , probably smell good to the fish too. wonder if they will play with the cube as its melting. Cant wait to find out if it works, that will be so convienant when we go away for a few days LOL


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## cichlidaholic (Dec 7, 2005)

I don't see any need to freeze the freeze dried krill. In fact, the process of freezing it _may_ be removing more nutrients from the food than is already removed by freeze drying it to start with. :-?


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## cichlidgirl1 (Sep 17, 2007)

my fronts also like to eat hikari brand freeze dried vitamen enhanced tubiflex worms . I hand feed it to them like a snack and they really seem to like it. I only use the hikari vitamen enhanced and never live or frozen ones since they can be bad for your fish. This brand is good and clean and has good reviews, i know i like it. You can also press the square of worms onto the glass and the fish will come over and eat it off the front of the glass. ITs fun to watch , mine have little feeding frenzy for them. That brand is also loaded with a whopping 67 percent protien and i noticed my fish bulk up on it pretty good and have good colors.


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## charboog (Sep 22, 2004)

I'm on the last day of treatment with Furan and he looks better, but there is still the little hole area showing. Should I go ahead and try the Triple Sulpha treatment next, after giving him a few days off (adding the carbon to clear this med)? Or should I do another round of Furan first???


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## cichlidgirl1 (Sep 17, 2007)

I would give it a week off (clear out meds and give big nice water changes , maybe add in some aquarium salts ) watch for improvement on its own. If it does not get worse and especially if it looks better i would continue water changes and clean conditions with the salt added. If none happens and it gets worse then i would not treat with furon again, i would use Metronidizole , follow the directions on the box carefully. Marie (sweet poison) used to keep discus and saw lots of cases of hITH, she said i was right about it looking like it. She was watching thread and commented to me that your fish looks much better. She had commented to me that if it relapses or does not improve that Metronidizole is what they used to treat those fish with . Hope this helps. I agree it looks alot better in the second set of pics so see if it starts to close on its own. Keep in mind if it was HITH that does not go away quickly, its a slow process for it to heal from the inside out (thats why i said to give it a week). My rescue o's have been mending from HITH for 6 mo and still have spots where they have shallow depressions and discolored areas where the pits used to be (still going away) so dont expect over night results if it was HITH (appears to me it might be that)


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## charboog (Sep 22, 2004)

I've got 17 day until I leave for vacation, so I'm not sure about waiting to see if it clears up on it's own. Maybe I should give it the week of water changes and if there is anything at all left, just start some Metro treatments?? I'll be gone for 26 days, but I have an experienced fish keeper coming in after 2 weeks to do vacuuming and water changes. I'm also going to ask her to be on call if my housesitter has any problems. I also have a 90 gal with mbuna and peacocks, a 46 gal with tropicals, and a 29 gal with some "misfit" mbuna (mean females), and a 10 gal with an absolutely insane red zebra female, so I will feel better knowing someone with experience is available.

What do you think about the treatment plan???


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## cichlidaholic (Dec 7, 2005)

> My rescue o's have been mending from HITH for 6 mo and still have spots where they have shallow depressions and discolored areas where the pits used to be (still going away) so dont expect over night results if it was HITH (appears to me it might be that)


That sounds like HITH.

This doesn't.

If you've seen improvements this quickly with the meds (and you won't with HITH - it can take months to clear up if you can clear it up at all :wink: ), then I would agree that you should continue some course of action rather than elect a wait and see approach, especially since you are going away.

I would be very tempted to switch to the sulfa for 5-7 days. Yes, you can replace fresh carbon for a few hours to remove the furan, along with a nice water change before starting it. I think that would be covering your bases better than continuing with the furan.

How is the fronts behaviour? Is he eating okay? Does he seem stressed at all by the treatment so far?


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## charboog (Sep 22, 2004)

He is eating as usual, no stress that I can see.

Maybe I'll try to get a new pic posted after I do the water change tomorrow to get an opinion on how everything looks.


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## cichlidgirl1 (Sep 17, 2007)

Good idea. Dont want to over medicate him if he is just healing up now. Clean water conditions ( two nice water changes each week ) and good substrate vacumes will do wonders if the active infection is gone now. You should be able to see a improvement in 7 days, might be small depending on what caused the lesion in the first place but you should still be able to tell its not getting worse and is starting to heal up.


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## charboog (Sep 22, 2004)

Here is the latest pic. (I should have cleaned the glass first) The actual site is dark like his surrounding color with just a faint white outline. I guess the flash on the camera turns it white, which is probably good because you can see it better. Any thoughts on the next step are appreciated. I am planning on starting a course of Triple Sulpha. I really want to clear this up before I leave.


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## cichlidgirl1 (Sep 17, 2007)

Well , first off, is the area closed now or does it still have the white stuff coming out. If its closed i would think its better and is healing up. If thats the case no new meds are required (have to be careful with meds, dont want to kill off the bb in the tank before you leave on vacation). I would just do lots of good water changes and keep the tank extra clean till its completly gone. I would only medicate if its still oozing the white worm looking stuff. Im sure some might disagree but thats my opinion anyway.


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## charboog (Sep 22, 2004)

I can see a very tiny white spot in the middle when I look through a magnifying glass. It appears to be almost closed, but not 100%. I may check tomorrow and see before I decide.

Thanks again for all your help.


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## cichlidgirl1 (Sep 17, 2007)

how many days till your leaving ?


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## charboog (Sep 22, 2004)

We leave on 12/1


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## charboog (Sep 22, 2004)

I have posted on the Illness and Health discussion forum. Something new has come up and I'm in a panic since I leave soon. If you've been following this post, please look at the new post. I need Help!


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