Hole In the Head Disease!!! [Archive]

Furyous

10th March 2008, 12:41 AM

the most recent theories include a lack of minerals and vitamins from poor nutrition, specifically a lack of calcium, phosphorus and Vitamins C and D; and stress from poor water quality, especially high levels of nitrates (> 40 ppm), caused by overcrowding, insufficient filtration and/or poor tank maintenance.

Treatment of HITH is aimed at improving poor nutrition and/or poor water conditions!

One must always keep a close eye on the quality of the water by testing the water parameters. The pH should remain stable and the ammonia and nitrite should read zero and the nitrates should be less than 20 ppm, with 10 pmm or less being ideal. The tank must have adequate filtration, and regular tank maintenance with partial water changes, in order to keep these levels in check. If your tank is too small or overstocked, it will be nearly impossible to keep nitrates below 20 ppm. This can be remedied by upgrading your tank size, by reducing the amount of fish in the current tank, avoiding overfeeding and/or by increasing the frequency of partial water changes.

Feed your oscar a varied diet of pelleted food that contains supplemental vitamins (e.g. HBH Oscar Show). You can also choose a pelleted food that will provide a good staple, such as Hikari's Staple, Gold, Biogold, New Life Spectrum or Omega One and supplement it with vitamins. You can add the vitamins yourself. Put pellets in a single layer in a small glass jar and pour in enough liquid multi-vitamin (human multi-vitamins are fine to use) to cover the top of the pellets and let them soak for about a minute or until they are soft, but not mushy or falling apart, and then feed. Vitamin supplemented pellets can be fed 2-3 times per week as a preventive measure but can be fed daily when treating HITH.

Additionally, supplement your oscar's diet with crickets, mealworms, blackworms, earthworms and shrimp but avoid spiders and other poisonous/stinging insects and anything that could have come into contact with pesticides. Oscars are insectivores and should not be fed feeder fish because they provide little nutritional value and an oscar will have difficulty digesting the scales of some feeder fish. Also, many aquatic animal tissues contain thiaminase, which when fed raw to fish can lead to a thiamine (Vitamin B12) deficiency. As well, feeder fish are often kept in extremely poor conditions, so they may introduce disease into your tank.

It is advisable to culture HITH lesions and treat with an antibiotic that the bacterium is susceptible to because this has been shown to aid in healing. Unfortunately, most aquarists do not have the ability to culture and identify bacteria. So, as a final treatment option, aquarists continue to use medications containing metronidazole as a bath (e.g. Hex-a-Mit), in order to treat a secondary infection from Hexamita that might be preventing healing. Metronidazole also treats Spironucleus as well as various other bacteria, so it may be of benefit on that basis. If unable to find Hex-a-Mit or Seachem's powdered metronidazole, then metronidazole tablets from your vet or physician can be used. Metronidazole is used at a concentration of 5 ppm and this can be achieved by using a 250 mg tablet for every 50 liters (or every 13 gallons) of aquarium water. The tablet(s) are crushed and dissolved first in lukewarm water, then added evenly over the water's surface. After three days, change one third of the water and add fresh carbon to your filter to remove the drug. This drug may be harmful to sensitive plants but should not harm the bio filter. For aquarists in other parts of the world, who are unable to find Hex-a-Mit, they may use Waterlife's Octozin.

Treatment is simple and effective. Maintaining excellent water quality with frequent partial water changes to keep nitrates under control and feeding a varied diet, supplemented with vitamins, are simple measures, which both treat and prevent Hole-in-the-Head!

NovaCaine

10th March 2008, 02:17 PM

Everything you ever wanted to know about HITH / HLLE...
but were afraid to ask!
Written, edited, and published by Adam Dagna

HITH or Hole In The Head

Hole in the head, or HITH, is also known as head and lateral line erosion, or HLLE. They are just different ways of describing the same disease. It affects the sensory organs in the face as well as those along the lateral lines, causing pitting in both regions, hence its name. Much of this disease remains a mystery because many of the studies done have been inconclusive or contradictory in their findings. However there are generally four theories that stand out and have been substantiated numerous times by different studies: environment, diet, "the carbon theory", and Heximita infections.

Environmental causes can be divided up into two major sub categories, those being water conditions, and stress. Poor water conditions have been linked to many cases of HITH and can be a major factor in its onset. It is important to say that this is pretty much a blanket category encompassing all aquarium disease, as problems are rarely seen where water quality is not an issue. It is possible to have diseased fish and have perfect water but this it is uncommon at best. That being said, proper water filtration and movement is a must. As a rule of thumb your ammonia should read 0, nitrites 0, and nitrates should be less then 40 ppm, and less then 10 ppm is ideal. Nitrates have been linked in some studies to the development of HITH where a fish is kept for long periods of time in water with levels exceeding 40 ppm. Stress can come in many different forms, but competition between tank mates is one to watch in the aquarium. This usually manifests itself in two ways, either unfair competition for food, or pestering. If you have fish of different aggression levels in the same tank (not necessarily fish of different species, as each fish has a different personality), one or both is likely. Either the more aggressive fish will pick at or straight out beat up the less aggressive fish or it will simply eat more then its share of food leaving the other with less then adequate portions. This is highly stressful and over time will wear at the fish’s immune system and can contribute directly to the next factor.

Diet is the most commonly accepted and supported cause of HITH. It is believed that the disease is more akin to scurvy, or rickets; both vitamin deficiency diseases in humans (scurvy is caused by not having enough vitamin C in your diet over extended periods; early sailors would get it because fresh fruit and vegetables could not be stored for long voyages). Just as the human body degenerates if proper diet is neglected for too long so do aquarium fish. If an unbalanced, or an out right improper diet is fed over a long period of time the fish can suffer greatly. Don't mistake a fat fish with a healthy fish, just as you wouldn't mistake a fat person for a healthy person. Simply eating food is not good enough; it has to be the right food. A link has been found between the development of HITH and a lack of calcium, phosphorous, and vitamins C & D. Many of the common fish foods sold in the hobby today are enriched with vitamins to make them more balanced, though supplemental vitamins can be added to them as well. Know the diet of your fish and be consistent, and varied. As a side note for carnivorous and semi-carnivorous fish such as Oscars, red devils, and Jaguars, feeder fish should never be chosen as a primary food source because they have virtually no nutritional value. In addition feeders contain the enzyme thaimase which breaks down thiamine. Thiamine is an important vitamin and if you use feeders as a large portion of your fish’s diet it WILL develop a thiamine deficiency. Fish fed exclusively or largely diets of feeder fish are extremely likely to develop HITH. They are also in high risk of contracting other diseases, such as ich, numerous other parasites, or fungal infections. It is important to resist the urge to watch your fish chase their food; it is for their own good.

The carbon theory is probably one of the most hotly debated concerning the cause of HITH. The idea is that the carbon used to remove harmful toxins from the water actually causes the disease. At first this may seem absurd and contrary to what you have read or been told, however when you take into account the number of cases of HITH directly related to carbon (i.e. HITH appears when carbon is introduced and disappears when carbon is removed) it is hard to argue with it. Many studies failed to produce results when testing for the carbon theory, as many fish with carbon in the tank did not come down with the disease, and this has lead to it being somewhat discredited as a real cause. In my experience the cause does not come so much from the carbon itself but from carbon dust. When carbon is shipped to the stores it is jolted and jostled across the country hundreds or thousands of miles in the back of a hauling truck. As the carbon particles rub against each other carbon dust is formed. Anyone who has ever used carbon knows this as the black sludge that comes off when it is washed. Improper or unthorough washing of carbon can lead to that dust being introduced to the water. This in turn causes the disease, so when the carbon and more importantly the carbon dust is removed the HITH goes into remission. Another theory is that prolonged use of carbon causes many vital trace elements to be absorbed, and this deficiency in the water leads the fish into the illness.

Hexamita was once believed to be the main cause of HITH, but has since been debunked as a major factor. This information has seemingly not gotten to the general public however as expensive drug treatments seem to be the first thing suggested by local fish stores to cure the disease. Heximita is an intestinal parasite that can affect many tropical fish, interrupting the ability to absorb nutrients through the intestinal wall. It has been found in many cases of HITH however they are usually in the pits and craters formed on the outside of the body, and are largely a non parasitic species commonly inhabiting aquarium water, while the intestines are clear of the true parasite. Many times cases of HITH have improved dramatically with the treatment of a hexamita drug, though there are equally as many that did not recover at all, showing no signs of improvement. It is believed that hexamita when found in relation to HITH is actually a matter of a secondary infection brought on by the suppressed immune function and not the cause of the HITH. In cases where hexamita is are present in the intestine treatment of the HITH can not begin until the infection is cured.

How to treat HITH

Contrary to popular belief, and common fish store advice, HITH is actually very easy and extremely inexpensive to cure. It can be cured, or rather sent into remission in several easy steps. Just as a note I've found it is best if you follow the steps in the order they are listed, some steps are not vital to recovery but steps 1 and 2 are essential. It is interesting to note that this treatment does not requite expensive drugs, but relies on good diet and tank maintenance. Following these steps a fish can be cured with little or no money spent.

1) Feed a balanced and vitamin enriched diet. Get your fishes diet back on track and supplement whatever pellet food you choose with vitamins twice a week. If you can’t find any vitamin supplements at your fish store, just powder a common high quality multi-vitamin, then dissolve a small portion in some tank water and allow the pellets to absorb it. In addition feed a larger variety of foods, being sure that they are all relatively close to the fish’s natural diet. Some examples are earthworms, crickets, mealworms, beef heart, crayfish, shrimp, blood worms, or krill. The list could go on ad infinitum, and freeze dried versions of any of the above mentioned foods are good choices too. See the recipe below for a good balanced home made food.

2) Start doing water changes of at least 20% but not more then 50% every three days, usually 25-30% is sufficient. This is the only effective way to lower excess nitrates from the water, make sure that you vacuum the gravel at the same time, as detritus and feces can collect here without your knowing.

3) Add 1 tbs of aquarium salt to every 5-10 gallons of water. It is important not to use table salt as it is treated, kosher salt, marine/aquarium salt, or any untreated forms of salt are ok. Make sure to add new salt for water removed in water changes and be aware that once salt is in the tank it will stay there until removed by water changes so do not add more then what you removed.

4) Raise the temperature in the tank to 80-82° F. This will increase the fish’s metabolic rate and decrease healing time. Be sure not to raise the temperature above 84-86° F as this can cause undue stress to the fish and is not productive for healing, also do not raise the temperature with out first following steps 1, 2 and 3, as you will simply cause the HITH to advance at a more rapid rate

5) Remove all carbon from your filters. This is a precautionary measure unless you know for a fact that the carbon is the main cause. In future purchase only high quality carbon, and make sure that it is thoroughly washed before addition back in the tank. This is especially important if you are planning to treat per step 6, as carbon will remove medication from the water.

6) If all else fails or for very advanced cases it will be a good idea to treat the tank for Hexamita, follow the directions for dosing on the box, or bottle, and continue treatment for at least a week. Then go back to treating per steps 1-5.