German blue ram- hole in the head?

Tank
What is the water volume of the tank? 10 gal
How long has the tank been running? About a year
Does it have a filter? Yes, sponge
Does it have a heater? Yes
What is the water temperature? 82. F
What is the entire stocking of this tank? (Please list all fish and inverts.) one GBR, 6 ember tetras, shrimp and snails.

Maintenance
How often do you change the water? Every other week or so
How much of the water do you change? 15-25%
What do you use to treat your water? Prime
Do you vacuum the substrate or just the water? Just water, fully planted

*Parameters - Very Important
Did you cycle your tank before adding fish? Yes
What do you use to test the water? API master
What are your parameters? We need to know the exact numbers, not just “fine” or “safe”.
Ammonia: 0
Nitrite: 0
Nitrate: 5-10
pH: 7.6

Feeding
How often do you feed your fish? Once a day
How much do you feed your fish? A little bit..
What brand of food do you feed your fish? A variety, mainly hikari micro pellets, bug bites, and vibra bites
Do you feed frozen or freeze-dried foods? Yes, bloodworms, mysis shrimp, or cyclops every week or so

Illness & Symptoms
How long have you had this fish? About a month
How long ago did you first notice these symptoms? Today
In a few words, can you explain the symptoms? Pitting in his head, beside his eye
Have you started any treatment for the illness?no
Was your fish physically ill or injured upon purchase? No
How has its behavior and appearance changed, if at all? His colours are a little less intense. He is acting fine, eating well and excited to interact

Explain your emergency situation in detail. (Please give a clear explanation of what is going on, include details from the beginning of the illness leading up to now)
I got this little ram as a bit of an impulse purchase around a month ago. I was at my lfs and saw the healthiest looking young rams ive ever seen. I had a suitable tank for one so he came home! He’s been doing fantastic, eating great, very social, so colourful, no issues. There was a bit of algae starting in the tank three days ago so I turned the lights off for a few days, today I turned them back on and noticed the pitting! He’s been so healthy, in my most established tank, eating a good diet, I’m not really sure how it happened. Note, I live in Canada so don’t have access to most meds. Just salt and stuff like melafix. I have a cycled quarantine tank that my bettas been hanging out in for a while now, so I can move him there if salt will help but I’m nervous to do salt with a gbr. Help please! First two photos are from today, last one is from about two weeks ago for comparison.

 

Hoping someone might see this. I moved him to a tank all alone and in a quieter area of the house. I also discovered my heater was only bringing the water up to 79 or so rather than 82. I’m going to add a small amount of salt- it’s a 10 gallon tank so I’ll start with just 1tbsp.

 

A201

 

Might be early stage Hexamita/ HITH.
Don't panic, you're doing so much right.
Keep the heat at 82 - 84 degrees. No charcoal in the filtration.
Its thought that a mineral deficiency might be a contributing factor towards a Hexamita outbreak.
A bigger weekly water change should bump up the mineralization of the environment.
No real need to QT. Hexamita is usually fish specific.
All salt does is promote a healthy slime coat.

 

It’s getting worse. I don’t know what else to do

 

Looks like numerous eroded sensory pores. If the Ram is still eating you might try feeding a medicated flake food. Plenty of dewormer fish foods on line.

 

Might be early stage Hexamita/ HITH.
Don't panic, you're doing so much right.
Keep the heat at 82 - 84 degrees. No charcoal in the filtration.
Its thought that a mineral deficiency might be a contributing factor towards a Hexamita outbreak.
A bigger weekly water change should bump up the mineralization of the environment.
No real need to QT. Hexamita is usually fish specific.
All salt does is promote a healthy slime coat.

Yeah, sorry, but for once I have to beg to differ. I just had a case myself last year.

Hexamita is a Protozoan that infects the intestines and blocks the absorbtion of vitamines and minerals, which in turn causes the sensory pores to erode, starting with those on the head.. It is contagious and I can at least confirm that a lack of minerals can contribute to it, but this is not finally cleared. Especially soft water fish like Microgeophagus should not have a problem due to lack of minerals, quite the opposite.

In this case the openings in the head have become infected with secondary infections.

I would treat the whole tank with a med like e.g. Sera Flagellol. The treatment usually takes 3 days followed by an 80% water change and 3 more days of filtration with activated carbon and a week of extra vitamins.

Only problem is: Redmare is located in Canada. If any this stuff would have to be imported.

Until it arrives the fish will be beyond rescue, so I would advise to euthanize the fish and still do the treatment, because very likely the whole tank is already infected.

 

Yeah, sorry, but for once I have to beg to differ. I just had a case myself last year.

Hexamita is a Protozoan that infects the intestines and blocks the absorbtion of vitamines and minerals, which in turn causes the sensory pores to erode, starting with those on the head.. It is contagious and I can at least confirm that a lack of minerals can contribute to it, but this is not finally cleared. Especially soft water fish like Microgeophagus should not have a problem due to lack of minerals, quite the opposite.

In this case the openings in the head have become infected with secondary infections.

I would treat the whole tank with a med like e.g. Sera Flagellol. The treatment usually takes 3 days followed by an 80% water change and 3 more days of filtration with activated carbon and a week of extra vitamins.

Only problem is: Redmare is located in Canada. If any this stuff would have to be imported.

Until it arrives the fish will be beyond rescue, so I would advise to euthanize the fish and still do the treatment, because very likely the whole tank is already infected.

Oh no... that’s not the news I was hoping for. He is isolated now and the tetras he was with before are showing no signs. He is still eating and acting fine but the wounds definitely look infected. Would it be worth trying a strong salt treatment? Also, what May have caused this, and how do I avoid it in the future?

 

Not every fish that has Hexamita will show the HITH symptoms. Tetras usually will show symptoms akin to any other internal parasite.
I would not know what salt should do about this. The parasite is inside the fish.

Many cichlids come with hexamita. It can take weeks and even months until the signs show. Most often because something is wrong with the tank conditions and husbandry, ending up in stress on the immune system and BAM! That's when it goes acute.

I am not very surprised about it considering your waterchange regimen.

Avoiding it in the future: Almost impossible. It's as common as ich and camallanus. Either the fish come with it or not. The most important sign is white stringy poop. While smaller tetras or barbs will either lose weight or develop a condition that looks a bit like dropsy and just drop dead before you even know what happens, bigger fish like cichlids or gourami will next show the first pores on the face erode. That's the point when one can be sure it's Hexamita and when treatment is advised asap.

I'm so sorry to be the bearer of bad news today. :/

 

Not every fish that has Hexamita will show the HITH symptoms. Tetras usually will show symptoms akin to any other internal parasite.
I would not know what salt should do about this. The parasite is inside the fish.

Many cichlids come with hexamita. It can take weeks and even months until the signs show. Most often because something is wrong with the tank conditions and husbandry, ending up in stress on the immune system and BAM! That's when it goes acute.

I am not very surprised about it considering your waterchange regimen.

Avoiding it in the future: Almost impossible. It's as common as ich and camallanus. Either the fish come with it or not. The most important sign is white stringy poop. While smaller tetras or barbs will either lose weight or develop a condition that looks a bit like dropsy and just drop dead before you even know what happens, bigger fish like cichlids or gourami will next show the first pores on the face erode. That's the point when one can be sure it's Hexamita and when treatment is advised asap.

I'm so sorry to be the bearer of bad news today. :/

I appreciate your knowledge. It appears I can actually get sera flagellol here in Canada! Is that worth doing?

 

YES! If you can get it within this week you might even have a chance to safe the fish. But it will be marked for life.
It's also a good thing to have in your fish pharmacy in general. It's one of those targeted meds that are not nuking a tank completely.

Little tip for the treatment: Do a 50% wc beforehand, keep aeration up and rather leave it in a day longer than the instructions say (those say 3-7 days depending on how severe the case is.). Otherwise keep to the instructions.

There are little side-effects. Worst case can be a bacteria bloom, in which case you only have to do a waterchange and redose to the amount of water you replaced.

 

YES! If you can get it within this week you might even have a chance to safe the fish. But it will be marked for life.
It's also a good thing to have in your fish pharmacy in general. It's one of those targeted meds that are not nuking a tank completely.

Little tip for the treatment: Do a 50% wc beforehand, keep aeration up and rather leave it in a day longer than the instructions say (those say 3-7 days depending on how severe the case is.). Otherwise keep to the instructions.

There are little side-effects. Worst case can be a bacteria bloom, in which case you only have to do a waterchange and redose to the amount of water you replaced.

great! Shipping says 5-16 days... so it could be either way. I also have human antibiotics left over from something or other, clarithromycin and doxycycline. From a bit of research, it looks like it's the same stuff as fish meds... would that be worth trying?? I feel like I have nothing to lose

 

would that be worth trying??

Nope. Antibiotics are targeted against bacteria, Protozoans are not bacteria.

I think I'm going to do a complete overview on types of meds and what they help against in the near future so I can just link to that article.

It's really necessary and helpful to know what things can even be treated with what type of med. I would not even think of using e.g. a worm med against bacteria. Completely useless.

Edit: And I know you want to do something, but a small mistake in dosing these meds can nuke your tank, kill all the beneficial bacteria and give all your fish kidney failure. You want that? I don't think so.

 

Nope. Antibiotics are targeted against bacteria, Protozoans are not bacteria.

I think I'm going to do a complete overview on types of meds and what they help against in the near future so I can just link to that article.

It's really necessary and helpful to know what things can even be treated with what type of med. I would not even think of using e.g. a worm med against bacteria. Completely useless.

Edit: And I know you want to do something, but a small mistake in dosing these meds can nuke your tank, kill all the beneficial bacteria and give all your fish kidney failure. You want that? I don't think so.

I know the antibiotic won't help the protozoans, but it does appear to have a secondary infection, that's what I was thinking with that!

 

good point, I would still wait until the other med has been used, as the erosion will keep going on until the protozoans are gone.

So first the parasite, then the other infection. You got alder cones or IALs? If so, use them to suppress the secondary infection until the meds arrived.

 

good point, I would still wait until the other med has been used, as the erosion will keep going on until the protozoans are gone.

So first the parasite, then the other infection. You got alder cones or IALs? If so, use them to suppress the secondary infection until the meds arrived.

Yep, I put IALs in a few days ago, got a nice tint to the water. Poor guy looks so rough... but is still acting fine! He's still eating well and is excited to see me and wants to follow my finger. But is missing half his head man some days I hate fish keeping

 

Yep, I put IALs in a few days ago, got a nice tint to the water. Poor guy looks so rough... but is still acting fine! He's still eating well and is excited to see me and wants to follow my finger. But is missing half his head man some days I hate fish keeping

I know such situations. Been there more than a few times. Never easy.

 

I know such situations. Been there more than a few times. Never easy.

Oh hey, would Metroplex work? It says for flagellates, and I can get it on ebay with 4 day shipping (for only a buttload of money)

 

Oh hey, would Metroplex work?

Technically, yes. By chance I lately looked up the side effects of the active ingredient and I would rather not use it for fish. I got that stuff once against a stomach bacterium that causes ulcers. And the side effects were already unpleasant for an organism my size.
I'm really surprised over and over again how much hard stuff Seachem sells...

 

Technically, yes. By chance I lately looked up the side effects of the active ingredient and I would rather not use it for fish. I got that stuff once against a stomach bacterium that causes ulcers. And the side effects were already unpleasant for an organism my size.
I'm really surprised over and over again how much hard stuff Seachem sells...

So I would be better off waiting longer for the sera stuff?

 

I personally would wait, but mostly because I know what I'm getting with that stuff, the Seachem stuff would likely work, but I can't predict the side effects.

Your choice in the end, I don't want to make you wait in vain and lose the fish, but I also don't want to let you risk more than just that one fish by using the other med.

I can only explain the pros and cons

 

I personally would wait, but mostly because I know what I'm getting with that stuff, the Seachem stuff would likely work, but I can't predict the side effects.

Your choice in the end, I don't want to make you wait in vain and lose the fish, but I also don't want to let you risk more than just that one fish by using the other med.

I can only explain the pros and cons

Thank you so much for your level headed assistance! I can drive to the metroplex seller and get it today, and I think that's my best bet. I think if I wait any longer it will be too late, and maybe it's silly, but I really love this little dude. His name is Jinx.

 

I've definitely seen success here with metronidazole (what I'm assuming is in metroplex) for HITH. If I'm not wrong even AvalancheDave recommended General cure for loaches with it, unless I'm mixing things up. However I don't disagree with MacZ because their other meds like kanaplex are severely underdosed. I'd say go for the metroplex since it seems your only shot for a current treatment. Good luck.

 

8 hours of driving and $70 later, Jinx got his first dose of metronidazole last night. I also got him some of the Thera A food, in case the extra nutrients help him get better or prevent it. He ate well this morning, and is currently trying to impress a guppy he can see in the tank beside him, so he seems to be feeling alright! I’ve got a good feeling... we might be able to get through this!!

 

He took a turn for the worse overnight. He’s barely moving. I think I wish I had clove oil ☹️

 

He took a turn for the worse overnight. He’s barely moving. I think I wish I had clove oil ☹

Frägg!

There are alternatives. PM me.