This thread in ongoing and forgive as I haven't the time to read through it all. That said, I have 45 years experience (for what it's worth, lol) and science background, but know that there are diseases now (over seas shipping) not found when I was a kid in the 60's.
As well the mouth build up of "what ever" hard to say without microscopic examination of tissue - bulge, tumor like thing makes it harder to conclude that said - I've treated the same fish with the similar type of rigid looking mass and I still mho state FC (or concurrent with something else) due to it's nature and a huge variety of manifestations beyond the cotton mouth look so common on articles on it.
The bacteria builds up (and by the time it looks like this is deeply embedded inside the fish) columes and perhaps like in cancer tumors (where the body tries to contain cells acting aberrantly) it may do the same.
Don't know for sure without a lab but I've seen it in my own rainbows and along with other treatments did specific mouth dabs (avoiding gills) with meds (see all links below).
Meaning it could be some sort of parasite (or even virus) concurrent with bacteria (often seen in this fish unfortunately, grown in horrific conditions overseas)
(do wwm search and then find and insert search results keyword or you will GO NUTS from trying to find it though all the information there, lol)
As an example only:
http://webcache.googleusercontent.c...umor+on+rainbow+fish&cd=2&hl=en&ct=clnk&gl=us
<<<Using the above link, designed by our very own Neale, I am inclined to think virus, specifically Lymphocystis, or possibly tumorous growths. Please stop pulling him out of the hospital tank. I think that the constant removal and treatment has more to do with the bloody stool than a possible Columnaris infection. I believe it is more likely viral or tumor. Just keep the water quality in there good and clean. Let the lumps heal over, and leave him be for a while.>>
The problem with no lab biospy is one tries this med based on best conclusion as to what "it" is and then observes if there is an improvement meaning either - wrong diagnosis, or correct diagnosis and wrong med all the while fish is suffering and "it" progresses. (and I agree with last poster experience counts here, and my science background mearly allows me to understand some of the more scientific raw data to draw my own conclusions - that's it)
Sorry hard to organize all in small space so put last first here) see below of wetwebmedia - great professional site and tons of saved information.
http://www.wetwebmedia.com/FWSubWebIndex/rainbowfaqs.htm
(note the photos of advanced stages of FC at bottom link to Vet Merck manual - pretty sad for fish, and shows severe ulceration so on) NO longer all fuzzy and cottony at all.
I tried on various occasions to keep both this rainbow and gouramies and two common diseases kept recurring. (from source)
First fish "TB" ( Mycobacterium marinum) (common esp in gouramies) can take years to actually manifest after seemingly having no symptoms - them bamm dead fish with severe symptoms showing up suddenly overnight (my moonlight) and after years of this with these imported fish just stopped. (they are often grown in very bad conditions - called "ticking" time bomb).
Usually that however involves (at some point) a deformed spine (curved) and sunken belly (often showing up overnight)! But it's been there often since a fry, and a fish's immune system can fight it off for years until it can't.
And if this is the case (I think more then one if that diagnosis) then ALL of your fish are potential carriers, regardless if they manifest later or not (and again can take years sometimes. You should not add, nor move fish to another tank, and all equiptment needs to be sterilized - it is highly contagious. (I brought much literature to my local petstore - famous name, after noting the woman who tended the aquariums (gouramies were full of TB ulcers and near end stage) had ulcers on her hands and arms! And her doctors could not identify what it was!
Please note with re to fish meds at great link below - certain meds act toxic-ally at diff ph's and hardness...(I did much research for years on all of this but tossed much as downsizing and just haven't the time to do all the research again, but here are main links)
Second so called "foot and mouth, hoof and mouth - ok being silly but cotton wool mouth disease" is as others have noted - FLEXIBACTER- COLUMNARIS (see link to great site below) and note their med page as often what is mentioned to treat is useless.
Great article (photos of different manifestations and real science data referenced at end of article)
(and why internal treatment - even broad spectrum as secondary infections and or true fungus sets in as it does it's horrific damage) (note - as well in gov and fisheries research hot summer months it is rampant - lower temp of tank may help)
Please note this common mistake in med choice (m1 is gram positive not gram negative) (see other link below as to correct medicine and how they work)
<<As an alternate choice, Maracyn (erythromycin) for Flexibacter (NOT my correction) and Maracyn-Two (minocycline) (YES my correction) for Aeromonas can be used in the water. Overseas fishkeepers can use either Waterlife’s Myxazin or Interpet’s AntiFungus and Finrot.>>
http://www.flippersandfins.net/flexibacter.htm
I've done hundreds of betta rescues where this and it's various forms is common (many different manifestations and as well shows up differently often in different fish species) and did much work on treating often end stages (covered with eyes missing) and even did government research to use h202 (very common in commercial fisheries so a great deal of this type of scientific data out there) (so much research as I used it after end stage due to building fire and holistic methods used on myself (iv's from doctor due to internal fungus! run wild into all of my organs and even bloodstream) - (was getting Masters in biochemistry).
But by the time is shows up on the surface the columes of bacteria are deeply embedded in the body of said fish, organs et al... and one reason why hard to treat with baths medical treatments (I learned that the single cell discoloration in the betta - didn't know what it was at first, but quickly learned that was THE beginning and best time to treat)...
Like us manifesting the same diseases in different manners same with species of fish and even individuals... rainbows seem to get it much on the mouth area I have observed. (and all of these are in humans as well, just differently expressed).
So, I've found that if the fish are still eating, medicines in food is important... along with hospital tanks and treatment in a darkened quite environment (to reduce stress).
(salt baths are great for later wound healing and even concurrent with certain meds - gradual up and down) I do a daily partial off the bottom to keep water quality up.
Here is a great site for this bacteria... (link below)
It is a gram negative bacteria so some common suggested treatments are useless.
M1 (Erythromycin) not effective but M2 is...Minocycline (although one MIGHT have a gram positive concurrent with gram negative - but most fish diseases gram positive are more rare but possible one could use together).
The BIG plus with Mardels M2 is their formula that states (esp for fish that do not eat) it is absorbed into their systems internally and gradually builds up in dose (as I do partials each day to keep water quality steller and adjust meds accordingly (good margin for measuring error)
(one can not use charcoal, and I would highly recommend bare hospital tank as meds ARE affected by organics and other factors in any set up tank - not to mention harm to plants and medicating non sick fish which can cause bacteria to develop resistance - common now).
I found Acriflavin (API fungus cure) helpful as this author states for ( which contain Acriflavin, which is active against flex bacteria in mild cases) (but also often TRUE fungus sets in and this is useful for that as well) (on top of lesions, ulcers so on) and often I use it when treatments with M2 are ending... or for spot treatments (mouth, tails fins so on - diluted and MAKE sure cotton swab is dabbed off so no meds ever run into gills - I often tilt fish in net opposite direction - takes some doing and one works fast with wet towels underneath - to avoid gills.)
(anti-fungal medication for effective treatment of fungus and secondary bacterial infections. Pre-portioned packets contain Victoria Green B and Acriflavine )
This said Minocycline is member of this class of Tetracycline antibiotics and many persons assume all antibiotics in this class are the same, which is not true. Minocycline (sometimes spelled Minocycline) is more gram negative than its cousins and has shown effectiveness for Columnaris.
Maracyn 2 is a product that contains Minocycline which treats Gram Negative bacteria.
http://www.americanaquariumproducts.com/Columnaris.html
<<Columnaris (often referred to in the past as "cotton wool disease" or "cotton mouth disease") is a warm water, gram negative strictly aerobic and nonhalophilic (meaning they do not live in saltwater conditions) bacterium often appears like a fungus (or more correctly; Saprolegnia) however it is not a fungus, although many treatments for fungus are effective for mild cases of Columnaris (Flexibacteria), which is why Erythromycin is a strange choice of treatment as it is rarely effective for either Fungus of Columnaris (yet is often suggested, which really makes me scratch my head as to why these sites suggest this treatment). >>
Same site and explanation of how medications work so you can decide which is best...
http://www.americanaquariumproducts.com/Aquarium_Medication.html
As for how I treated - it depending on stage of progression (salt baths or if on tail of betta, dab of diluted h202 or real old fashioned mecurachrome - hard to find) and salt bath all done extremely gently - each transfer so on).
To... internal meds (from national fish pharmecia so depended on what I had in my med chest and research on how medications work (degree in psychology with one year of meds but forgotten so that link above was greatly helpful) along with baths.
This was one of their products I had on hand and used successfully for my dwarf neon rainbows along with baths of M2... and later gently salt bathes - several weeks. My ph at the time was high but not that high but this gave me the clue that it was ok in feed.>>
Oxytetracycline Hydrochloride
Fish Disease Diagnosis: Gram-positive and gram-negative bacteria. Marine ulcer disease, cold water disease, bacterial hemmorrhagic septicemia and mouth fungus.
Fish Disease Treatment: 1/4 teaspoon per 20 gallons every 24 hours with a 25% water change before each treatment. Treat for 10 days. 250 grams (treats 4000 gal.) Or, if mixed into feed, 2 teaspoons per pound of Koi pellets. Feed for 14 - 21 days.
If your pH is 8.0 or above, it is suggested to use this medication in the feed.>>
If aggressive I had to act aggressive with meds but most gentle for fish - hoping the live foods (or frozen) and meds would boost their immune systems. As they healed I would continue meds in food and go to straight salt treatment... sometimes it would take weeks, even months and often (most) the bettas were in such sorry state to begin with they would not make it. Many did however.
BTW even cory cats (learned from my old Dr. Innes book from way back) can be treated with salt bathes but as with all fish, one must start off with a low dose and gradually (more so with them) build it up over days then ditto for on the way back down. (unless wild caught a no no)
I try to avoid meds that harm kidneys so on...
Site for human grade meds and super information by professionals (can talk to Gary as well if you can get him)
Click top bar (disease prevention).... (then bottom link) never easy, lol.
http://www.fishyfarmacy.com/diseases.html
http://www.fishyfarmacy.com/
Bacterial: (or do searches to see what else "it" might be)
(I have these products but found them not as helpful as a bath - resistance perhaps??? save for in foods)
http://www.fishyfarmacy.com/fish_diseases/bacteria.html
http://www.fishyfarmacy.com/articles/columnaris.html
FlexiBacteria are involved, which cause Columnaris disease
Treat with: TMP Sulfa -or- Sulfa 4 TMP -or- Parinox.
(note the article on salt - great for hospital "stays" only if for fresh water fish)
Well have to go - hope this helps anyone with this problem.
Other links with references:
Vet Merck manual on bacterial diseases.
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/170414.htm
The order Cytophogales (Myxobacterales, slime bacteria, fish slime bacteria) includes an important group of opportunistic pathogens of fish that are common inhabitants of soil and water. The gram-negative, rod or filamentous bacteria have a distinctive gliding motion and form palisading masses on infected tissue. Skin or gill lesions have slimy or cotton-like surface exudates, which usually cover surface necrosis, ulcerations, and marginal hemorrhages. Flavobacterium columnaris , the member of this group responsible for columnaris disease (cottonmouth disease, saddleback), is most common in warm water and warmwater species of fish. A presumptive diagnosis can be made from visualization of typical myxobacteria on wet mounts of infected skin or gill tissue. If the disease is diagnosed early in the course of infection, a treatment with potassium permanganate may be efficacious. If the disease becomes chronic, it may have become systemic, in which case treatment with oxytetracycline for 10 days is recommended. Columnaris disease can be confirmed by isolation of the organism on Ordal’s or other cytophage media. Sensitivity tests are difficult to perform because F columnaria will not grow on Müller-Hinton media. Columnaris disease can be prevented by reducing organic loading and avoiding traumatic injuries. Cytophaga psychrophila causes coldwater (peduncle) disease and fin and tail rot. It most commonly infects coldwater fish but can be found in warmwater fish subjected to low temperatures. The lesions are especially common on the dorsal, posterior surface of the fish under the dorsal fin but may be found on any part of the body. Advanced cases show necrosis and ulceration of the peduncle. Both Flavobacterium and Cytophaga infections can be controlled by oxytetracycline.
http://www.fishvet.com/columnaris.htm
Fish 'TB" and great photos references.
http://www.reefkeeping.com/issues/2003-07/sp/feature/index.php
http://www.flippersandfins.net/fishtankgranuloma.htm
http://emedicine.medscape.com/article/223363-overview
........................
http://www.proteomesci.com/content/8/1/26
As well the mouth build up of "what ever" hard to say without microscopic examination of tissue - bulge, tumor like thing makes it harder to conclude that said - I've treated the same fish with the similar type of rigid looking mass and I still mho state FC (or concurrent with something else) due to it's nature and a huge variety of manifestations beyond the cotton mouth look so common on articles on it.
The bacteria builds up (and by the time it looks like this is deeply embedded inside the fish) columes and perhaps like in cancer tumors (where the body tries to contain cells acting aberrantly) it may do the same.
Don't know for sure without a lab but I've seen it in my own rainbows and along with other treatments did specific mouth dabs (avoiding gills) with meds (see all links below).
Meaning it could be some sort of parasite (or even virus) concurrent with bacteria (often seen in this fish unfortunately, grown in horrific conditions overseas)
(do wwm search and then find and insert search results keyword or you will GO NUTS from trying to find it though all the information there, lol)
As an example only:
http://webcache.googleusercontent.c...umor+on+rainbow+fish&cd=2&hl=en&ct=clnk&gl=us
<<<Using the above link, designed by our very own Neale, I am inclined to think virus, specifically Lymphocystis, or possibly tumorous growths. Please stop pulling him out of the hospital tank. I think that the constant removal and treatment has more to do with the bloody stool than a possible Columnaris infection. I believe it is more likely viral or tumor. Just keep the water quality in there good and clean. Let the lumps heal over, and leave him be for a while.>>
The problem with no lab biospy is one tries this med based on best conclusion as to what "it" is and then observes if there is an improvement meaning either - wrong diagnosis, or correct diagnosis and wrong med all the while fish is suffering and "it" progresses. (and I agree with last poster experience counts here, and my science background mearly allows me to understand some of the more scientific raw data to draw my own conclusions - that's it)
Sorry hard to organize all in small space so put last first here) see below of wetwebmedia - great professional site and tons of saved information.
http://www.wetwebmedia.com/FWSubWebIndex/rainbowfaqs.htm
(note the photos of advanced stages of FC at bottom link to Vet Merck manual - pretty sad for fish, and shows severe ulceration so on) NO longer all fuzzy and cottony at all.
I tried on various occasions to keep both this rainbow and gouramies and two common diseases kept recurring. (from source)
First fish "TB" ( Mycobacterium marinum) (common esp in gouramies) can take years to actually manifest after seemingly having no symptoms - them bamm dead fish with severe symptoms showing up suddenly overnight (my moonlight) and after years of this with these imported fish just stopped. (they are often grown in very bad conditions - called "ticking" time bomb).
Usually that however involves (at some point) a deformed spine (curved) and sunken belly (often showing up overnight)! But it's been there often since a fry, and a fish's immune system can fight it off for years until it can't.
And if this is the case (I think more then one if that diagnosis) then ALL of your fish are potential carriers, regardless if they manifest later or not (and again can take years sometimes. You should not add, nor move fish to another tank, and all equiptment needs to be sterilized - it is highly contagious. (I brought much literature to my local petstore - famous name, after noting the woman who tended the aquariums (gouramies were full of TB ulcers and near end stage) had ulcers on her hands and arms! And her doctors could not identify what it was!
Please note with re to fish meds at great link below - certain meds act toxic-ally at diff ph's and hardness...(I did much research for years on all of this but tossed much as downsizing and just haven't the time to do all the research again, but here are main links)
Second so called "foot and mouth, hoof and mouth - ok being silly but cotton wool mouth disease" is as others have noted - FLEXIBACTER- COLUMNARIS (see link to great site below) and note their med page as often what is mentioned to treat is useless.
Great article (photos of different manifestations and real science data referenced at end of article)
(and why internal treatment - even broad spectrum as secondary infections and or true fungus sets in as it does it's horrific damage) (note - as well in gov and fisheries research hot summer months it is rampant - lower temp of tank may help)
Please note this common mistake in med choice (m1 is gram positive not gram negative) (see other link below as to correct medicine and how they work)
<<As an alternate choice, Maracyn (erythromycin) for Flexibacter (NOT my correction) and Maracyn-Two (minocycline) (YES my correction) for Aeromonas can be used in the water. Overseas fishkeepers can use either Waterlife’s Myxazin or Interpet’s AntiFungus and Finrot.>>
http://www.flippersandfins.net/flexibacter.htm
I've done hundreds of betta rescues where this and it's various forms is common (many different manifestations and as well shows up differently often in different fish species) and did much work on treating often end stages (covered with eyes missing) and even did government research to use h202 (very common in commercial fisheries so a great deal of this type of scientific data out there) (so much research as I used it after end stage due to building fire and holistic methods used on myself (iv's from doctor due to internal fungus! run wild into all of my organs and even bloodstream) - (was getting Masters in biochemistry).
But by the time is shows up on the surface the columes of bacteria are deeply embedded in the body of said fish, organs et al... and one reason why hard to treat with baths medical treatments (I learned that the single cell discoloration in the betta - didn't know what it was at first, but quickly learned that was THE beginning and best time to treat)...
Like us manifesting the same diseases in different manners same with species of fish and even individuals... rainbows seem to get it much on the mouth area I have observed. (and all of these are in humans as well, just differently expressed).
So, I've found that if the fish are still eating, medicines in food is important... along with hospital tanks and treatment in a darkened quite environment (to reduce stress).
(salt baths are great for later wound healing and even concurrent with certain meds - gradual up and down) I do a daily partial off the bottom to keep water quality up.
Here is a great site for this bacteria... (link below)
It is a gram negative bacteria so some common suggested treatments are useless.
M1 (Erythromycin) not effective but M2 is...Minocycline (although one MIGHT have a gram positive concurrent with gram negative - but most fish diseases gram positive are more rare but possible one could use together).
The BIG plus with Mardels M2 is their formula that states (esp for fish that do not eat) it is absorbed into their systems internally and gradually builds up in dose (as I do partials each day to keep water quality steller and adjust meds accordingly (good margin for measuring error)
(one can not use charcoal, and I would highly recommend bare hospital tank as meds ARE affected by organics and other factors in any set up tank - not to mention harm to plants and medicating non sick fish which can cause bacteria to develop resistance - common now).
I found Acriflavin (API fungus cure) helpful as this author states for ( which contain Acriflavin, which is active against flex bacteria in mild cases) (but also often TRUE fungus sets in and this is useful for that as well) (on top of lesions, ulcers so on) and often I use it when treatments with M2 are ending... or for spot treatments (mouth, tails fins so on - diluted and MAKE sure cotton swab is dabbed off so no meds ever run into gills - I often tilt fish in net opposite direction - takes some doing and one works fast with wet towels underneath - to avoid gills.)
(anti-fungal medication for effective treatment of fungus and secondary bacterial infections. Pre-portioned packets contain Victoria Green B and Acriflavine )
This said Minocycline is member of this class of Tetracycline antibiotics and many persons assume all antibiotics in this class are the same, which is not true. Minocycline (sometimes spelled Minocycline) is more gram negative than its cousins and has shown effectiveness for Columnaris.
Maracyn 2 is a product that contains Minocycline which treats Gram Negative bacteria.
http://www.americanaquariumproducts.com/Columnaris.html
<<Columnaris (often referred to in the past as "cotton wool disease" or "cotton mouth disease") is a warm water, gram negative strictly aerobic and nonhalophilic (meaning they do not live in saltwater conditions) bacterium often appears like a fungus (or more correctly; Saprolegnia) however it is not a fungus, although many treatments for fungus are effective for mild cases of Columnaris (Flexibacteria), which is why Erythromycin is a strange choice of treatment as it is rarely effective for either Fungus of Columnaris (yet is often suggested, which really makes me scratch my head as to why these sites suggest this treatment). >>
Same site and explanation of how medications work so you can decide which is best...
http://www.americanaquariumproducts.com/Aquarium_Medication.html
As for how I treated - it depending on stage of progression (salt baths or if on tail of betta, dab of diluted h202 or real old fashioned mecurachrome - hard to find) and salt bath all done extremely gently - each transfer so on).
To... internal meds (from national fish pharmecia so depended on what I had in my med chest and research on how medications work (degree in psychology with one year of meds but forgotten so that link above was greatly helpful) along with baths.
This was one of their products I had on hand and used successfully for my dwarf neon rainbows along with baths of M2... and later gently salt bathes - several weeks. My ph at the time was high but not that high but this gave me the clue that it was ok in feed.>>
Oxytetracycline Hydrochloride
Fish Disease Diagnosis: Gram-positive and gram-negative bacteria. Marine ulcer disease, cold water disease, bacterial hemmorrhagic septicemia and mouth fungus.
Fish Disease Treatment: 1/4 teaspoon per 20 gallons every 24 hours with a 25% water change before each treatment. Treat for 10 days. 250 grams (treats 4000 gal.) Or, if mixed into feed, 2 teaspoons per pound of Koi pellets. Feed for 14 - 21 days.
If your pH is 8.0 or above, it is suggested to use this medication in the feed.>>
If aggressive I had to act aggressive with meds but most gentle for fish - hoping the live foods (or frozen) and meds would boost their immune systems. As they healed I would continue meds in food and go to straight salt treatment... sometimes it would take weeks, even months and often (most) the bettas were in such sorry state to begin with they would not make it. Many did however.
BTW even cory cats (learned from my old Dr. Innes book from way back) can be treated with salt bathes but as with all fish, one must start off with a low dose and gradually (more so with them) build it up over days then ditto for on the way back down. (unless wild caught a no no)
I try to avoid meds that harm kidneys so on...
Site for human grade meds and super information by professionals (can talk to Gary as well if you can get him)
Click top bar (disease prevention).... (then bottom link) never easy, lol.
http://www.fishyfarmacy.com/diseases.html
http://www.fishyfarmacy.com/
Bacterial: (or do searches to see what else "it" might be)
(I have these products but found them not as helpful as a bath - resistance perhaps??? save for in foods)
http://www.fishyfarmacy.com/fish_diseases/bacteria.html
http://www.fishyfarmacy.com/articles/columnaris.html
FlexiBacteria are involved, which cause Columnaris disease
(note the article on salt - great for hospital "stays" only if for fresh water fish)
Well have to go - hope this helps anyone with this problem.
Other links with references:
Vet Merck manual on bacterial diseases.
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/170414.htm
The order Cytophogales (Myxobacterales, slime bacteria, fish slime bacteria) includes an important group of opportunistic pathogens of fish that are common inhabitants of soil and water. The gram-negative, rod or filamentous bacteria have a distinctive gliding motion and form palisading masses on infected tissue. Skin or gill lesions have slimy or cotton-like surface exudates, which usually cover surface necrosis, ulcerations, and marginal hemorrhages. Flavobacterium columnaris , the member of this group responsible for columnaris disease (cottonmouth disease, saddleback), is most common in warm water and warmwater species of fish. A presumptive diagnosis can be made from visualization of typical myxobacteria on wet mounts of infected skin or gill tissue. If the disease is diagnosed early in the course of infection, a treatment with potassium permanganate may be efficacious. If the disease becomes chronic, it may have become systemic, in which case treatment with oxytetracycline for 10 days is recommended. Columnaris disease can be confirmed by isolation of the organism on Ordal’s or other cytophage media. Sensitivity tests are difficult to perform because F columnaria will not grow on Müller-Hinton media. Columnaris disease can be prevented by reducing organic loading and avoiding traumatic injuries. Cytophaga psychrophila causes coldwater (peduncle) disease and fin and tail rot. It most commonly infects coldwater fish but can be found in warmwater fish subjected to low temperatures. The lesions are especially common on the dorsal, posterior surface of the fish under the dorsal fin but may be found on any part of the body. Advanced cases show necrosis and ulceration of the peduncle. Both Flavobacterium and Cytophaga infections can be controlled by oxytetracycline.
http://www.fishvet.com/columnaris.htm
Fish 'TB" and great photos references.
http://www.reefkeeping.com/issues/2003-07/sp/feature/index.php
http://www.flippersandfins.net/fishtankgranuloma.htm
http://emedicine.medscape.com/article/223363-overview
........................
http://www.proteomesci.com/content/8/1/26
