At what point do you decide a medication is not working?

All right so I'm treating V's fin rot. Here's the breakdown:

1) He came home to me with mild fin rot. Treated with clean water, aq salt, Kordon's Fish Protector. For about 12 days, he seemed to be healing.
2) Day 12: Saw what looked like a VERY slight return, still held out hope (this was where I really screwed up, I should have intervened right here).
3) Day 14: Sometime between 9p and 11p, fin rot EXPLODED. It happened so fast I thought that maybe it was him tail biting, but it's obviously not. Major amount of obvious degradation on the tail fin, probably about 15 rays affected all-told, damage ranging from a few millimeters of fraying to up to 1cm of membrane missing on 6 of these rays. Localized to the tail, one very severe area and one less-severe area. All areas affected appear to be areas previously affected by the fin rot. One slit in the pectoral fin. Begin treatment with Paraguard. Rush order placed on Methylene Blue and Kanaplex for daily baths.
4) Day 16: May be noticing very slight decay on analfin, slit in pectoral fin appears to be 50% healed, several new rays fraying on the severe area of the tail (this group of rays had a hole in the membrane across them during the initial progression on day 14, not the hole has spread outward to the tips creating the fraying as far as I can tell).

I'm thinking that at least the Methylene Blue will be here tomorrow and I will begin baths with that. Kanaplex could take a little longer, hopefully by Saturday.

I know that fin rot, especially in bettas, is a very long ordeal. So, that said, at what point do you decide a course of action isn't working? How soon should progression stop/is it a bad sign that there's new rot after I've started the medication? I haven't done WCs yet because I wanted to give the medication some time to build up in the water, but will start doing them tomorrow. V's behavior is unaffected, he eats and swims and interacts. The first night, during the rapid degradation, he seemed very listless but since then he's been more normal. But to look at his beautiful fins rotting away, I can barely stand it, it's a like a vice around my chest.

I guess what I'm asking is, is it okay that I'm still seeing some degradation? By okay I mean, it doesn't mean this medication is not enough, does it? Obviously it's not progressing nearly as rapidly as it did that first night and there is a tiny bit of healing occurring on the pectoral fin but there is still some definite progression. I'm about to add the 3rd dose of Paraguard and I'm thinking I'll continue using it and see if the methylene blue/kanamycin dips are of more assistance. But should the addition of medication stop progression right away? I would imagine not.

I'm also watching the water parameters, so far they are unaffected by the removal of the carbon filters but he's a single betta in a 10 gallon tank so I may just not be seeing it yet. I'm determined to heal this fish. He clearly had a very rough beginning. I just want to know at what point I should upgrade his in-tank medication?

I'm fairly certain it's bacterial, there seems to be a pinkish discoloration. Though I did notice today that there was some kind of cloudy/clearish/white, slimy growth on the suction cup that holds his thermometer in place. Fungus or algae? I removed it and cleaned it off.

Also, I'm not sure how long to treat with medication assuming it does eventually work. Until there is new growth on all damaged areas? Or until everything is completely healed? If anyone knows how often I can/should do WCs with Paraguard? One of the medications becomes ineffective after 24 hours, which is why you re-dose every 24 hours, but I don't want to pull out the other meds if they are supposed to build up in the water. I guess I should call the number on the bottle.

EDIT: I'm attaching a photo of the degradation. This is what it looked like within that 2 hours explosion. Since then there's been an increase
in fraying in the really bad area. Above the severe area, where you see the 2 small chips, that area has now become frayed as well.

 

I think that your succeeding in slowing, and in some areas reversing, the infection is definitely a sign of progress. I would expect that the dips that you intend doing will increase the rate of that progress.
I have never used ParaGuard, but as it's antifungal and antibacterial, I think it a good candidate for use, as infection with one often leads to infection with the other. Plus, not having used it, I did google it and see that it contains malachite green, which I have found effective in the past. (btw, do not google Paragard--this will lead to to results for a device that will most certainly not help him).
The speed with which the symptoms blossoms makes me wonder if there was an underlying condition that suddenly manifest itself fully, but you now appear to be starting to control.
In any event, I would definitely not alter his treatment until giving the dips a chane to work--I might contact the Seachem desk before altering dosage or frequency of drips, and as with any drip, remove your fish at the first sign of distress. Also ask their opinion using ParaGuard and methylene blue together in a dip--I am always leery or mixing chemicals.
Best of luck---rick

 

Hi, not sure what all you have in the water?
Salt, cooler temp and very clean water is one way to address it.
However, I read that you then added the paraguard-right? And that kanaplex is on the way? But that the methylene blue will be here tomorrow-right?
I just want to caution you when trying multiple medications, sometimes the cure is worse then the condition imo,
I would follow directions exactly on the paraguard. Mild fin rot normally responds to clean water and a little salt.
I am thinking that since you describe this as an explosion, you need more powerful treatment-when will the kanaplex be here?
If it were me, I would either do the methylene blue or the kanaplex. Personally, I prefer kanaplex.
Good luck!

 

I also prefer Kanaplex; good luck!

 

The only thing in the tank water right now is Paraguard. The Paraguard in-tank treatment and the methylene blue/kanaplex dip was recommended by Mamajin when I initially spotted the mild fin rot but since it was clearly from the cup, decided to see how much good clean water and improved diet would do. Now that it's returned in full force, I've decided to implement her course of action. She has spent a lot of time researching the interaction between medications, what can be mixed and what cannot. The methylene blue/kanaplex will not be in the tank, those are for 20 minute dips daily.

I'm fairly certain I see it on his analfin now, it's still slight but every time I've been unsure whether it was fin rot, it's turned out to be so as far as I'm concerned, it's started on his analfin. With all the progression still going on, I'm wondering if what I see on his pectoral fin is even infected at all, maybe just healing on his own.
ricmcc - I don't know that there's an underlying condition but I do believe he has some kind of weakened immune system. It's just a feeling I get. In addition to the mild fin rot he came home with, he had some other fin damage as well that didn't have rot. This was healed damage, presumably from early in life, that caused some defects in his finnage. These defective areas are also being targeted, which makes me think he's been through something before.

As to the meds - methylene blue will likely be here tomorrow. Kanaplex is coming from F&S. I rushed it yesterday. It said 2-4 days. I'm hoping for 2 That's what I really feel will make the difference as well. And in the future it will be on hand at all times, being so hard to get in stores. I'm really kicking myself for not at least ordering it when I first saw the early signs.

I bought him feeling in my heart that he wasn't the healthiest, but I just could not walk away from him, in large part because of this reason. The first night, when the symptoms rapidly appeared, he did not seem well. He was sitting on the bottom of the tank and hiding when he wasn't. By morning, he was up and about. Now he seems more his normal self in terms of behavior. But I seem to have read that's not unusual

I'm definitely going to hang in there with this medication regime, at least until I can measure the effect of the baths. I just want him to heal :\

Thanks everyone for your support.

 

It looks to me like what you are doing and are going to do should get him to heel nicely I know it's stressful though after all the hard work you do to make these guys happy something goes wrong like this. Hopefully V will pull through and I'm sure he will because you take amazing care of your fish.. Hang in there!

 

Thanks Micaela13, it's really hard to see him like this. Even though he seems to be behaving fine, it's pretty heart-wrenching knowing he's had it rough long before I ever brought him home. I have really high hopes for the Kanaplex I just need him to hang in there until it arrives.

 

You are seriously doing everything you can, don't get discouraged...

Since V is clearly not seemingly affected behaviorally, I would say that he is in for the long haul, just like you.

Sorry your little guy is causing such trouble for you! And himself apparently!

Sickness/disease is NO fun...
I can't even stand seeing cloud-eye start... And that clears up quickly with 5-7 days of treatment.

 

You are seriously doing everything you can, don't get discouraged...

Since V is clearly not seemingly affected behaviorally, I would say that he is in for the long haul, just like you.

Sorry your little guy is causing such trouble for you! And himself apparently!

Sickness/disease is NO fun...
I can't even stand seeing cloud-eye start... And that clears up quickly with 5-7 days of treatment.

Yeah ha I find myself wishing it was Ich or something not so long-term. Fin rot can be a monster and every fish I've ever seen with it doesn't really seem to know he has it, at least not until it really progresses. But I sure hope he's in it for the long haul, because it's my understanding that that's exactly what fin rot is. I just wish I hadn't wasted so much time going back and forth wondering if it was actually rot. Ha he's funny though. I went to go check his levels and I pull the sample using glass droppers. It's also how I fed him the daphnia, which is the only think he'll eat besides his pellets (even turned up his nose at bloodworms, which is totally mind-blowing). I thaw the daphnia in some Garlic Guard and drop it in one drop at a time. He catches the drop as soon as it hits the water before the little daphnia bits can disperse (so messy!) and he's learned to associate the dropper with food, which is why I only usually test the levels at meals. But since I had to pull out the carbon cartridge and his tank only just finished its TSS cycle, I'm testing once before bed as well. So he's right there up against the dropper expecting me to feed him haha. I considered giving him an extra pellet but the cycle in probably hanging by a thread so I don't want to know it overboard. But it's really cute, he begs like a little puppy.

 

Yeah ha I find myself wishing it was Ich or something not so long-term. Fin rot can be a monster and every fish I've ever seen with it doesn't really seem to know he has it, at least not until it really progresses. But I sure hope he's in it for the long haul, because it's my understanding that that's exactly what fin rot is. I just wish I hadn't wasted so much time going back and forth wondering if it was actually rot. Ha he's funny though. I went to go check his levels and I pull the sample using glass droppers. It's also how I fed him the daphnia, which is the only think he'll eat besides his pellets (even turned up his nose at bloodworms, which is totally mind-blowing). I thaw the daphnia in some Garlic Guard and drop it in one drop at a time. He catches the drop as soon as it hits the water before the little daphnia bits can disperse (so messy!) and he's learned to associate the dropper with food, which is why I only usually test the levels at meals. But since I had to pull out the carbon cartridge and his tank only just finished its TSS cycle, I'm testing once before bed as well. So he's right there up against the dropper expecting me to feed him haha. I considered giving him an extra pellet but the cycle in probably hanging by a thread so I don't want to know it overboard. But it's really cute, he begs like a little puppy.

At least you watch closely enough to know EXACTLY the progression. And you've caught it. Some people just get a fish, let it sit, and it catches disease after disease and then they panic after their fish is too far gone to save...

I'm the same as you, I panic at every little thing that happens quite possibly any different than the day before. My tanks are in my living room, the 75gal is REALLY hard to miss hehe.

 

HAHA that's my exact layout. 10 gallon betta tank and the 29 gallon that's soon going to be a 75 gallon (if I ever get a functioning stand)....all in the living room where I can keep and eye on them AND where I can instruct other household members to do the same. It's unlikely I'll ever miss the onset of anything

 

UPDATE: Well, the good news is there's some more regrowth. The pectoral fin split is almost healed up and, referencing the photo on the original post, the area below the bulk of the caudal fin damage, the 3 little exposed rays in a group all by themselves, appear to be healing up as well. However it could just be that the rays are getting shorter, I'm not completely sure, but I do think it might be regrowth :\ The analfin does not appear to have progressed overnight but the really bad area is still really bad and it did worsen yesterday afternoon so all that damage is still there, no signs of healing as of yet. One or 2 of the rays look slightly less pinkish/discolored though.

Activity level and appetite all seem pretty much normal still. He's in the glass air plant terrarium in the center of his tank sort of flaring at his moss ball, per the norm haha. Not opening his gills though, just the fins.

Can they get fin rot in those gill fins? Are those things even fin tissue or are they more like gill tissue?