Experiences with Metro+ and HITH

reptileguy2727

reptileguy2727

Not enough tanks, space, or time
Jan 15, 2006
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Northern Virginia
I am curious about people's experiences with Metro+ (or other metronidazole medications) and treating HITH. I am particularly interested in when it worked (what the HITH looked like, the treatment used, scarring, time needed for it to be cured, etc.). I am also interested in when it didn't work (what the HITH looked like, what did end up working, what else didn't work, etc.).

I have two experiences with Metro+ in treating HITH. One was with my discus. I had a couple develop HITH. I did not change anything except using Metro+. The HITH was the narrow, deep type and discharge was present (so much that in one you couldn't see the hole). The HITH quickly went away with the use of the Metro+. They have no scarring.

My other experience was with a large jaguar cichlid that did not really have HITH but HLLE. The holes were shallow and wide. There was no reaction to the Metro+. There were no stray electrical currents in the tank.

I am differentiating between HITH and HLLE as HITH being the narrow deep pits, in some cases discharge is present. If Hexamita spp. or other protozoa are ever responsible, it seems to be with this type. HLLE may not include the lateral line, but are characteristic of shallow, wide pits that do not include discharge.
 
there is quite a bit of debate on the cause of HITH/HLLE
some attribute the issue with diet otheres with flagellated Protozao.

the way I see it is flagellated protazoa are almost always present and the treatment is with Metronidazole. which is pretty effective at helping erradicate the protozoa.
I did have a female angel that did suffer from HITH but not HLLE there were small pimple like protrusions which would 'pop' and there would be some discharge.
no other agels in the tank had any issues.
she did heal from it but the problem reappeared and eventually she secumbed to a secondary infection.
 
I think the most important thing needed is a distinction between HITH, HLLE, and marine HLLE. I think the evidence shows that they are different diseases with different causes.
 
but that is where the debate lies.

some studies point to flagellated protozoa while others point to diet.
I do agree tho that there should be a dsitinction. however, different studies point to the same cause for both HLLE and HITH as well as LLE in both marine and freshwater fish.

I will leave that up to the scholars who are studying this issue.

in essence there is much conflicting information regarding this problem which seems to have been lumped together.

I'm willing to bet you are as frustrated as I am regarding this issue.
 
From the evidence I have seen it looks like marine HLLE is a dietary issue, possibly involving trace elements and micronutrients in addition to vitamin deficiency. I cannot recall any information or cases that would go against this, if there are please someone let me know.

As far as freshwater goes, that is where much more information is needed. But the current evidence and cases that I am aware of point toward two types. I have differentiated them as HITH and HLLE to keep things organised for myself. HLLE seems to be a more environmental and dietary issue whereas HITH seems to be a protozoa (Hexamita spp. and/or Spironucleus vortens) possibly allowed for by dietary and/or environmental issues (water quality, parameters, etc.).
 
My studies concur with yours re HLLE in Marine fish.

but seem to be inconclusive re freshwater fish.
I suspect you are correct that HITH and HLLE in freshwater are entirely different.but seem to get lumped into the same treatment category.
some reports I have read indicate that HITH may also be attributed to dietary needs while others point to protozoa.
in any case the protozoa are associated with HITH in almost every case..the question is which came first..
I wonder how much the circulation of blood is involved with how the problem spreads.

or the significance of the physiology of the fish with the issue. ie spread in the head as opposed to the lateral line.(lateral lines are associated with the nervous system)
 
The book I have explains that the parasite itself may block off capillaries, leading to tissue erosion. This would be most pronounced in small capillaries and in areas with lots of them (around nervous tissue).

One issue may be that once the protozoa start populating more than their usual levels (they are found in most fish, not just those showing symptoms) that they start to either use up the nutrients themselves (what would otherwise be just enough vitamin is now too little because it is not all going to the fish) or that the parasites' physical presence impedes absorption in the intestines.

I think that cases where 'HITH' did not react to the anti-protozoan medications or otherwise point to a dietary or water quality issue, these were actually cases of HLLE. It is now a chore to go back and re-examine them to make sure they were what they were called (HITH versus HLLE).
 
My experience with HTH came last winter. My Tiger Oscar had developed it and I knew I had to act quickly. I didn't use ANY meds but instead placed her in a hospital tank and did large water changes every other day for a week. I also fed her a variety of foods which included pellets, worms, beefheart and brine shrimp. At the end of the week, the holes had closed and she was back to her beautiful self.
 
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