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Q: How do I treat HITH/HLLE?
A: Lacking a solid answer as to what causes it in the first place, I would recommend all of the following:
- Keep the tank as clean as possible. The water should be clear and not smell, and the bottom should be regularly cleaned, with frequent water changes (and I do mean frequent--at least every few days or even daily.) If your tank is anything less than the ideal environment, it's time to get religion. Try to provide as clean and stress-free an environment as possible at all times, not just when your fish actually get sick. (Regardless of the role of water quality in HLLE, I would urge everyone to keep their tanks as clean as they can--there are many problems that are definitely caused by poor water quality and can be prevented simply by doing regular water changes.)
- Treat for Hexamita. Given the frequent association of Hexamita with HLLE, this seems like a prudent step to take, and if nothing else, it can help with other infections possibly present. Indeed, many (most?) cases of HLLE seem to respond to Metronidazole. (Metronidazole is used in most hole-in-the-head medications or can be readily found in common anti-protazoan medications like Paragon II.) Also suggested are giving magnesium sulfate (Epsom salts) orally, and raising the tank temperature to 95F (35 C) for seven days. (1) Many commercial products like Hex-a-mit contain Metronidazole, or it is available under the name "Flagyl" to pharmacists and veterinarians.
Thanks to Jeff (mitt@mitre.org) for contributing the following on medications for Hexamita:
"Metronidazole is the preferred medication. It is the same medication found in Hexamit. It is also found as one of the ingredients in Paragon II. Dr. Axelrods Mini Atlas recommends 100mg metronidazole per 10 gallons every other day for 3 treatments (and the dose can be safely doubled). Hexamit recommends 250mg per 10 gallons with the same time schedule. I found that the 100mg was not effective but the 250 was. Some recommend 3 consecutive treaments rather than every other day (have not tried it).
Metronidazole is a commonly available medication at any pharmacy or vet, so contact your vet (if you have one) and get a prescription--it will be a fraction of the price than buying it mail order or from the local aquarium shop. 250 mg Capsules or tablets work fine (Capsules--empty them; tablets--simply dissolve in warm water).
Metronidazole in food. The Axelrod mini atlas recommends 100mg of metronidazole mixed with 1 tablespoon of food. The food could be beefheart (then refrozen in small servings) or a paste of dry food and water (then frozen into small servings).
Treatment should include both food (if they are eating) and in the water. I feed them the food for 7 days.
Paragon II is also effective and expensive. Follow the directions on the package--it recommends the "every other day for 3 treatments" method. I found that it disturbed the biological balance in the tank (even though it claims it won't) resulting in elevated ammonia levels and sluggishnish in the fish. It does work quite effectively against HLLE, but be careful with this medication--reduce feeding and check ammonia levels daily.
There are also dips to treat HLLE--never tried it but they are supposed to be very effective if you can get our fish out of the tank and into another container for a while. (I'd like to hear more in this area, too.)"
- Add vitamin supplements to the food. Since calcium and potassium should already be well supplied by most dry foods, adding vitamin C and D is probably a higher priority. (And don't go overboard with it! Overdosing fish with vitamins isn't good for them either.)
Odds and ends: Giving the fish a tank that receives direct sunlight or has full spectrum/actinic lights for synthesis of vitamin D MAY help, though I haven't seen much on this. Carbon should be removed from filters if medication is being used so it does not adsorb the medication. Given the lack of support for the proposed carbon-HLLE link, I don't see any sound reason to stop using carbon as a routine practice.
Sources:
- "Fish Disease--Diagnosis and Treatment", Edward Noga, published by Mosby-Year Book, Inc., 1996.
- "Discus Health", Untergasser, TFH Publications, 1991.
- "Nutrition and Feeding of Fish", Tom Lovell, published by Van Nostrand Reinhold, 1989
- Leo Morin (Seachem), personal communications. (10/96)
- Nathanael Henderson, unpublished data.
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Copyright Nathan Henderson (jude@pconline.com), 1996-97. This document may be freely distributed, printed, put in web pages, etc. as long as it's not altered. (So use it all you want however you see fit--just don't mutilate or edit it, please.)
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