Angelfish with hole in the head - what to treat with?

S

Seedy J

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Jun 7, 2010
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About two weeks ago, my koi angelfish had a small hole in his dorsal fin and what looked like a pimple at the base, so I had him on medicated food for a while. The pimple went away and now it's turned into a hole, so I'm thinking I should treat for hole in the head disease. He's in a 55g lightly planted community tank, all other fish seem fine and water is good. He acts normal and eats plenty. I have a 5 gallon hospital tank and a good arsenal of fish meds - what should I use to treat him? I have...

Metronidazole tablets, PraziPro, Parasite Clear/Parasite Guard, EM Erythromycin, Maracyn Two, and Maracyn Plus.

From what I've read, metronidazole and high temperature should work? Dumb question - I have a spare heater for the 55 gallon... will that be overkill for the 5 gallon hospital tank, or will it automatically shut off when it reaches the temperature I set? Thanks in advance.
 
What are your water parameters. Usually something like that only starts when there is a reason.... like bad water quality? It doesn't sound like a parasite of any kind, so I would treat with maracyn. I would also try some Pimafix and Melafix mixed together with the medication. Melafix and Pimafix are herbal remedies for bacterial and fungal infections. It gives whatever you are using a boost in the right direction. I Always use that combo to treat infections of any kind and I have never had bad results. It can be mixed with any medication as well. It is tree tree and bay tree extracts.
 
Agree we need your water parameters. Hexamita (Hole-in-Head) is a parasitic disease usually accompanied by long, stringy white feces, and often enlarged pus-filled pores on the face and head or lateral line. Since the angel had only a growth by the dorsal fin it could be something else, but it's a process of elimination. If the medicated food that cleared it up was anything other than Metronidazole (the only drug effective for Hex), then we can probably eliminate that.

If the fish has no other symptoms it was possibly bacterial and the damaged fin may regenerate itself with time and just clean water. Adding more medication may not be necessary, and could in fact harm your biofilter. For now I would just keep an eye on it, but let us know if anything changes.
 
Here are the best pics I could take -



Water parameters are pH - 7, Ammonia - 0, Nitrite - 0, Nitrate - low, maybe around 5 ppm. The food wasn't medicated with metronidazole. I'm not sure I'd say it cleared it up, since there's now a hole where the pimple was.

Now the hole closer to his eye is filling in, but it's kind of white and cottony (hard to see in the pic). Any ideas?
 
Your water sounds good, and thanks for posting the pics. It doesn't look like Hex to me because pitting would usually be noticeable in pores around the head. The hole in the fin is due to dead tissue, as is the fungus gathering on the other spot. Antibacterial food may have taken care of the infection, but fungus will attack decaying tissue.

Out of the medications you listed I would probably use Maracyn Plus, but ideally an anti-fungal med should help clear it up.
 
Try either Pima or Mela fix. One of them is for fungal infections, I don't remember which one is which (bacterial and fungal). You can also mix the two together as directed to fight both at the same time. It is an herbal remedy, but it works really well and it will not bother any other fish nor will it cause your cycle to stall.
 
What kind of diet have you been feeding? Vitamin C deficiency is one speculated contributor to HLLE. I would try New Life Spectrums Thera-A (a garlic rich pellet food that's nutritionally complete) for starters. If you've been feeding old flake food, try getting some new food...they do go stale and lose their nutritional value after a while. Lots of info about HLLE, although I'd go with published articles vs. forums for the most part, this is one of those diseases we don't understand fully, like dropsy: http://www.fishchannel.com/fish-health/freshwater-conditions/hexamita.aspx

A 5 gallon tank is really not big enough to be a hospital tank. It seems like that would really be detrimental, actually - if you are seeing only one cloudy white or cottony eye, that could be simply from mechanical injury. A 16" long tank is really much too small for an angelfish this size, it looks about quarter size from the pics. If you ever get a chance to get a 20 long from the Petco $1 per gallon sale, this is an ideal hospital tank size for larger fish.

I would vote for using the Metronidazole, that is the classic HLLE remedy. I don't know about increasing the temps, I don't think that's necessary really...but garlic food and Metro ought to take care of it.
 
OK, I'll get some pimafix and melafix tomorrow and try it out. Thanks for the replies!
 
what about direct application of Methelyne blue?
 
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