Angelfish With Swollen Mouth

Mehu

Hello,

When trying to research this without posting I noticed a LOT of threads closed saying to search in the search bar for this. So far no luck with my specific issue and I am concerned for my angelfish so please take my request seriously.

I have a marbled angelfish who is little under the size of my hand. Two days ago I noticed his mouth was open and not closing. Upon closer inspection he appeared to have a small white dot on the left side of his mouth and his mouth looked a little crooked. His face looked a bit swollen as well.

I assumed that possibly he had locked lips with the other angelfish and may be got cut on his face and it may be got infected. After searching and searching I finally decided to do a small water change with some stress coat and also start the tank on EM erythromyacin as an antibiotic to fight the inflammation in his face.

He has now been on the Erythromyacin for 2 days as directed and I am about to do the 25% water change and redose as per directions. However, his face does not look better. In fact the white spot seems to be protruding more. I can't seem to identify this, at first I assumed it was either some sort of bacterial infection or mouth fungus and that the erythromyacin would help but so far no luck. I plan to continue treatment until finished but as his mouth is stuck open and he is not eating I am a bit worried that his health will continue to go down hill if I don't figure this out.

I have had him in the same tank for about 13 months. He has one other angelfish in the tank with him. They mostly get along and only very rarely see them lock lips, they usually swim side by side. I also have mollies and BN pleco in the 55 gallon tank. Well established tank with lots of gravel and also an eheim 2217 canister filter, two internal box/sponge type filters, a UV sterlizer, heater, a couple of live plants (anubias, java fern), drift wood. Parameters are normal (0 ammonia, 0 nitrite, 10-20 nitrate, 7.4 ph, 78 degrees)

He won't even eat brine shrimp which he loves, he is still swimming normal but his mouth is open and he has those white spots on the side of it. His lips appear swollenish but it's kind of his face down to his gill plates. I can't immediately see anything stuck in his mouth, and due to the spots on the outside I was fairly certain it was an injury at first.

No new fish introduced to the tank, or other tanks in a very very long time. Consistent water changes every 4 days or so, varied diet of high quality pellets, brine shrimp, occasional blood worms, I usually have a fresh veggie in the tank for the pleco but angels don't eat it.

Any ideas what I can do for him? Anyone identify the white spots as anything?



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FishGirl38

Okay...wow. I had a similar issue with 2 angels in a 45G tank...they were about the same age and size as yours and suffered the same issues. Started out with what looked to me like culminarius or some kind of body rot near their mouths. The flesh around their face began to receed around the wounds until their mouths basically rotted off of their faces...I tried erythromycin with no luck, as well as myracin 1 and 2 with no luck. Both of my angels died.

I chalked it up to my water quality. Angels are considerably delicate and prefer a PH of 6.4-7.4 ish. The liked softer water and my PH was always at 8.0. I assumed that my water was too harsh for them and that's what caused the myserty infection...so, I'm curious what your PH is reading...

Myracin oxy might be a good option to try.
 

Mehu

Okay...wow. I had a similar issue with 2 angels in a 45G tank...they were about the same age and size as yours and suffered the same issues. Started out with what looked to me like culminarius or some kind of body rot near their mouths. The flesh around their face began to receed around the wounds until their mouths basically rotted off of their faces...I tried erythromycin with no luck, as well as myracin 1 and 2 with no luck. Both of my angels died.

I chalked it up to my water quality. Angels are considerably delicate and prefer a PH of 6.4-7.4 ish. The liked softer water and my PH was always at 8.0. I assumed that my water was too harsh for them and that's what caused the myserty infection...so, I'm curious what your PH is reading...

Myracin oxy might be a good option to try.

PH about 7.4. It's a bit hard out of the tap but I have a lot of drift wood so I also have a bit of crushed coral in my canister to keep things stable for the mollies.

Would general cure do anything to the beneficial bacteria? Would it be worth using alongside erythromycin ?
I don't want to lose the angel, he's big and interactive.
Any common reasons they would get their mouth inflamed/open like that? No new fish introduced, regular water changes.

Could his mouth be broken/dislocated from may be hitting glass during the night?

He's not eating and today is the last day of erythromyacin and I am worried what to do next.
 

FishGirl38

If today is the last treatment for erythromyacin I would find a bacterial medication and dose with that as a next step. I believe erythromyacin is primarily a fungal medication? When my angel was dealing with this issue, I eventually thought that culminaris couldve been to blame because of how rapid my fishes decline was.

Maybe try furan or terramycin? I read these are effective bacterial medications.


I would keep researching and looking for medications. As long as you keep trying to reverse the issue then youve done everything you can for him.
 

Mehu

Erythromycin is for bacterial but I doubt it's too strong because it's not supposed to hurt my cycle. I may need to buy a bigger hospital tank if I ma going to treat with furan (which I have on hand) but I probably don't want to dose the whole tank he is in. He's currently in a 55 community. My hospital tank is only 5 gallons and too small for such a big angel. My other tank is 20 gallons but full of fry.

If today is the last treatment for erythromyacin I would find a bacterial medication and dose with that as a next step. I believe erythromyacin is primarily a fungal medication? When my angel was dealing with this issue, I eventually thought that culminaris couldve been to blame because of how rapid my fishes decline was.

Maybe try furan or terramycin? I read these are effective bacterial medications.


I would keep researching and looking for medications. As long as you keep trying to reverse the issue then youve done everything you can for him.

Erythromycin is for bacterial but I doubt it's too strong because it's not supposed to hurt my cycle. I may need to buy a bigger hospital tank if I ma going to treat with furan (which I have on hand) but I probably don't want to dose the whole tank he is in. He's currently in a 55 community. My hospital tank is only 5 gallons and too small for such a big angel. My other tank is 20 gallons but full of fry.
The furan-2 pack does not mention anything about mouth rot or anything. Do you think it would help?

The main symptom I notice and am worried about is his mouth looks open, may be crooked, and the tissue around it swollen. He does also have a red spot on one side and white spot on the other side. He won't eat.
 

FishGirl38

What your angel is dealing with sounds exactly like what mine was dealing with. I'm not 100% sure that furan would help because I can't see the fish, even if I could see him, a diagnosis is a shot in the dark. However, the fact that the erythromyacin isn't working and its geared towards bacterial infections gives us a clue.

I read up a bit and have an Idea as to why its not working. There are two kinds of bacteria that affect fish, gram positive and gram negative. Erythromyacin is recommended for treatment of gram-positive infections. I'm even more sure now that whatever you're dealing with is a gram negative bacteria. It may not be culminaris but I'm thinking its something similar.

I read that furan and terramycin are effective treatment for culminaris, so if that's the case, it should help here. If culminaris is gram-negative and w/e your angel has isn't affected by a gram-pos medication, then Id try something for gram-neg bacteria.

Because I really don't think this is fungal. If your tank parameters are healthy than its not fungal. It could be parasitic, however, if that's the case itd be even harder to treat, because it must be something internal that is causing external symptoms. Id try a gram-neg medication before anything else. And I have to quarantine my angel in a 10G. Itll be enough space for treatment. And its thr perfect size for medicating, most medications are dosed by the 10G.

Take a look at the active ingredients in the medications....what the box says isn't always 100% correct either believe it or not.
 

rainbowsprinkles

My guess is the slow form of columnaris. I stupidly bought the prettiest angel instead of the healthiest one and one day later mouth rot shows up. Really hard to treat. I’m treating mine with jungle fungus clear right now in a quarantine bucket. Not sure if it’s working but only day 3.
 

Mehu

Yesterday was the last day of erythromyacin. Today I came down to check on him and yeah the small white spots on the side of his mouth seem a tiny bit bigger. No change in lips. Not eating.

Heading out to pick up a new tank since my 2 big ones are occupied and my small one is too small for this big boy. Had him over a year and he's never left this tank... so it will be interesting trying to catch him.

I have a bit of furan-2 and konaplex on hand. I will see if the store has more furan-2 as I am sure I don't have enough for a full course of treatment.

If he didn't have those white spots I would assume it was a dislocated jaw or fracture or he ate a rock, but the spots on the side of his face lead me to believe it's an infection or something so treating it as such. I REALLY hope he gets better, he's so unique. He needs to eat soon or he'll get worse.

Alright, bought a new tank, filled it with dechlorinated water, put in my spare cheapo heater (I don't trust this heater for long term). Waiting for the two tanks to match in temp, then I will move over one of my cycled in tank filters into that tank as well as a new small sponge filter. Should be enough filtration and aeration for him, the medication will probably kill the BB on the cycled filter but I have extra in tank filters running on all of my tanks for situations like this. Everybody should be ok.

I have left over furan-2 and kanapolex from many months back. I can start him on that. The local store said they should get more in tomorrow. Once the temps are right and the filters are running I will move him and medicate the new tank.

My cat bit a hole in my 50 foot python during the ordeal so... now I am out that... buckets for a while I guess.

Uhg, I hope he makes it.

I moved him.

The original white bump seems to have popped/gone away but he suddenly today has huge ones on his lip. It's very easy to see in the new aquarium. He is now getting a furan-2 kanaplex mix. As of an hour ago.


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angelcraze

Any new things added from the LFS lately? The white spots could also be fungus as a secondary infection. Hard to say looking at the pic. I have also read about certain viruses and fibroids that can cause white nodules around the mouth.

Best thing at this point until we figure out what this is is to keep his hospital tank water pristine. Even better than using antibiotics which only provide an artificial bandage for for fish to heal more easily. The healing really relies on a clean tank with pristine conditions and good nutrition.

If you've already started treating with antibiotics, I suppose it's best to complete treatment, but I they are more hardcore than you think on your water params. I really wouldn't jump to using multiple antibiotics in your tank. Purely my two cents.

Can you try to look into his mouth with a flashlight? Anything stuck?
 

Mehu

Have you researched parasites? Any new things added from the LFS lately? The white spots could also be fungus as a secondary infection. Hard to say looking at the pic.

Best thing at this point until we figure out what this is is to keep his hospital tank water pristine. Even better than using antibiotics which only provide an artificial bandage for for fish to heal more easily. The healing really relies on a clean tank with pristine conditions and good nutrition.

If you've already started treating with antibiotics, I suppose it's best to complete treatment, but I they are more hardcore than you think on your water params. I really wouldn't jump to using multiple antibiotics in your tank. Purely my two cents.


He was in a tank with over filtration, UV sterilizer, religious water changes every 4 days (15-30%). No new fish(I stated all of this in my initial post) for many many months in any of my tanks. I have been researching for days, less likely to be parasites or fungus but if you know of a specific one I am all ears.

His mouth has been open and he hasnt eaten now in 5 days. At this point, yes, I am going to try and treat with medication and hope it helps. He is in a new hospital tank because of the fact that they will kill my BB, starting with fresh water, a cycled (box) filter, and a new sponge filter.

I am using the furan-2 and kanaplex because it is stated on multiple sites to be the best way to wipe out things like colmanaris. If the fish hasn't eaten at all in 5 days I want to wipe whatever it is out because I don't have months to slowly treat him and hope something works. I probably have 1-2 more treatment chances before he starts to starve which is why I am posting on here looking for ideas/help.
 

angelcraze

Sorry I wasn't a help. I really didn't mean to criticize Just caution against antibiotic use. I agree you are keeping your tank in good condition. Maybe his jaw is locked? What would prevent him from closing his mouth? Hmmmmm.

Nothing in the mouth? I can see down my angel's mouths. He never closes it?

Have you seen some of the viruses? Lymphocystis can occur overnight and regress overnight.

Well if it's bacterial columnaris, Furan2 and kanaplex together is the preferred treatment. I hope it works for him.

Also just FYI, a healthy fish can go a lot longer without food. But I understand your immediate concern.
 

Mehu

Sorry I wasn't a help. I really didn't mean to criticize Just caution against antibiotic use. I agree you are keeping your tank in good condition. Maybe his jaw is locked? What would prevent him from closing his mouth? Hmmmmm.

Nothing in the mouth? I can see down my angel's mouths. He never closes it?


I was wondering if he got a locked jaw, fractured, or may be ate a rock on accident. I have looked down his mouth and it is kind of dark so hard to tell. I was debating taking him out and actually like shining a flashlight down to be sure there was no rock in his mouth but the white spot/infection seems to be getting worse and looks painful. I would hate to stress him out and physically touch him if he does have an infection. Hoping if it is an infection it is treated and the swelling of his upper lip goes down and he closes his mouth.

I was hoping someone on here would be able to identify the white patches, today they look a lot worse. Hoping if those go down his mouth will close but it could be wishful thinking.

If his jaw is locked, is there a safe/least painful way to help him?
 

angelcraze

I'm so sorry I can't ID the white spots for certainty. If the antibiotic combo doesn't help, I would think maybe it is viral if there is no fuzziness.

Maybe the white spots are a cause for the mouth issue, or maybe the mouth issue decreased his immune and pathogens or virus could take hold. Idk, I'll step out cause i'm just grasping at straws and guessing.

Not sure how to help that, but I can search if you want. I agree with not handling him to look in his mouth. Try a small flashlight when he faces you.
 

Mehu

I stopped by the LFS and the owner said that it was most likely caused by the angels fighting. He says usually it happens in bigger cichlids and that the white bump is either bacterial or viral and the furan-2 isn't a bad call. He said my angel is so big and his forehead is so big that he shouldnt starve any time soon and he can probably go quite some time.

Hopefully that is true and he has some time to heal. Hopefully his jaw recovers enough where he is able to eat..
 

angelcraze

All I found when I quickly searched earlier was possibly massaging around the jaw. I have never handled a fish like that, so i'm just passing the info. I read it's difficult to manually manipulate the jaw shut, since their jaws are on a forward hinge or something. I also read sometimes it corrects itself on its own. Sorry i'm not more help and I really hope it corrects itself soon for you.

You know, I was just thinking what if the white bumps are scar tissue, or skin healing from lip locking? Normally I see the scar tissue on the lower lip, but it looks opaque white and like a bump. The mouth stuck open has me stumped
 

Mehu

All I found when I quickly searched earlier was possibly massaging around the jaw. I have never handled a fish like that, so i'm just passing the info. I read it's difficult to manually manipulate the jaw shut, since their jaws are on a forward hinge or something. I also read sometimes it corrects itself on its own. Sorry i'm not more help and I really hope it corrects itself soon for you.

You know, I was just thinking what if the white bumps are scar tissue, or skin healing from lip locking? Normally I see the scar tissue on the lower lip, but it looks opaque white and like a bump. The mouth stuck open has me stumped


I don't think it's scar tissue since the new bump just appeared. I think an infected blister. The fish store also thinks either viral or bacterial.

I saw the thing about massaging the jaw but due to the fact it looks painful and infected I might wait a while to see if things get better.

The store said he could go like a month or more with as big as he is. Not sure about that but I think he can finish his antibiotics since he started them and if his face looks less infected or blistery or whatever and isn't healing on its own I could try that.

I tried looking down his mouth when he faced me, nothing visible close to the mouth. If he swallowed a rock it would be far down. The fish store seems to think his jaw is like that from fighting though.
 

Mehu

So anywhere he had a white spot blistered up. Red/pink on the outside and a big blister/boil that was white in the center. After about 24 hours they pop and he is left with a wound/hole.

Does this still sound like something like colmanarus that should be treated with antibiotics or should I be treating it like hole in the head?

All boils/wounds are around his head especially his mouth.. He doesn't look so great today.

I am trying to keep the water clear and today is the beginning of day 3 on the antibiotics (kanaplex and furan-2). Should I continue treatment? Does this still seem bacterial or viral or could it be parasitic?

Anyone have experience with fish getting giant blisters around their heads/mouth that eventually rupture and leave a large wound? Should I be doing anything different? I don't like my fish suffering.
 

Mehu

I thought that I would wrap this up for anyone who might find it in the future. Here is a quick recap of what happened.

I had an angelfish older than a year old, kept in a well maintained tank. Woke up last week to find his mouth open/swollen like he was yawning. After some observation noticed a small white raised dot on his face. More white patches started appearing and growing around the mouth/face/head. They would have red/pink a little around them but the center would look like a large raised boil. After about a day or two of those appearing they would pop and leave a nice sized wound behind. One on the side of his mouth turned into a nasty looking wound/hole. He didn't eat.

I started treating the entire tank with erythromyacin. No effect. Got him his own tank, kept water clean and treated with furan-2 and kanaplex. He looked worse and worse but the last day or so no new white spots appeared and one of the big boils on his face did not pop but started to go down. He started swimming a bit wobbily and this morning he was upside down. I went to check on him and he wedged himself in an upright position on a plant I gave him when I first put him in (so he could have something to hide beind). Within a few hours he died.

Total time from noticing mouth stuck open until death -7 1/2 days.

If he had lived and not shown signs of improvement I was considering treating for hole in the head. Most likely this might be columnaris which is what I was currently treating for. Fish store figured it was either viral or bacterial.

He was a big, smart, interactive fish and he will be greatly missed. Good luck to anyone searching.
 

rainbowsprinkles

Sorry about your fish. Nothing can be done with a virus. and many strains of columnaris have evolved multidrug resistance to antibiotics. The boils don’t really fit with columnaris..more like Furunculosis? Also hard to treat and resistant.

I went through 3 rounds of antibiotic treatments with my angelfish plus salt and meth blue baths hydrogen peroxide swabs and now given up on meds and just treating him with high tannin water from magnolia and white oak. But not much hope at this point.
 

Mehu

Sorry about your fish. Nothing can be done with a virus. and many strains of columnaris have evolved multidrug resistance to antibiotics. The boils don’t really fit with columnaris..more like Furunculosis? Also hard to treat and resistant.

I went through 3 rounds of antibiotic treatments with my angelfish plus salt and meth blue baths hydrogen peroxide swabs and now given up on meds and just treating him with high tannin water from magnolia and white oak. But not much hope at this point.
When I was desperately searching yesterday I found one forum post somewhere with a flowerhorn with almost identical symptoms (swollen/open mouth, boils/white bumps around mouth and head) Someone told him it was a certain strain of colmanaris, I can't remember if it died within a few days or the forum post just ended. I was reading a LOT of posts on the internet this week trying to figure out something.
 

rainbowsprinkles

In case anyone else on this thread is also a nerd like me who likes to read scientific papers on columnaris - I found this one informative.. doesn’t talk about treatment but definitely helped me understand the disease a bit better.. also talks about how it can stick around in the aquarium forever...
 

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