Discus with I believe with HLLE (yep!)  11/05/08 Hi I have a 75 gal tank with 8 Discus four are the size of the picture I am sending and the remaining being silver dollar in size. Filtration is a Penguin BioWheel 350 filtered with Bio ceramic filter balls and filter cartridges w/activated carbon, second one is a whisper filter 60 gal that I use filter cartridges with. 1 airstone. Gravel1-1 1/2" deep. Artificial silk plants. Feeding is as follows: San Fran Bay Frozen Spirulina Brine shrimp, San Fran Bay frozen beef heart, Beef heart flakes, Hikari bio encapsulated w/vitamins bloodworms, Hikari microwafers, frozen plankton, omega one color flakes, omega one vitamin flakes, Tetra cichlid sticks. I dose the water with VitaChem once a week and add to frozen food. I vary the food giving flakes and frozen everyday and feed 4-5 times a day. Water parameters today are: AMM- 0, Nitrite- 0.3, PH- 7.5, temp- 85 degrees. Water changes are done once a week at 75% change with Kordon NovAqua Plus. I want to make sure this is HLLE I noticed Sunday clear matter floating around like poop but totally transparent note all fish have normal poo.  This was discovered on fish yesterday added salt and this morning it is worse can you let me if I am correct in HLLE and I've read the threads metro is what I should use. The first picture is yesterday, next two are today. <Greetings. This does indeed look very much like Head-and-Lateral-Line-Erosion, or HLLE. This disease is "caused" by one of two things, possibly working in combination, though the precise details are obscure. The Hexamita parasite is at least partially involved, and while normally associated with problems with the digestive tract (commonly observed as white, stringy feces due the excess mucous production) the parasites somehow can spread to the surface of the fish under certain situations. Once that happens they cause the sensory pits on the head and flanks to become infected and ultimately the pits decay, causing the tell-tale wounds we call Hole-in-the-Head (HITH) or HLLE, depending on where the wounds are seen. It is possible Hexamita is latent in many fish, and only under specific situations does it become a problem, and both diet and water quality seem to be extremely probable triggering factors. With cichlids, any nitrate level about 20 mg/l seems to lead to a, elevated risk of HLLE/HITH. Every cichlid I have ever seen with the disease was in an overcrowded tank or one with infrequent water changes, and this is based partly on observations of my own mistakes! Bob Fenner has also written convincingly about the appearance of HLLE/HITH in marine fish as being closely related to lack of vitamins. Herbivorous fish are particularly prone to receiving inadequate diets, and cichlids are overwhelmingly at least partially herbivorous in the wild. Even fish-eating cichlids will be consuming herbivorous fish, and in that way consuming the plant material in the guts of their prey. Tinned peas, Spirulina flake and cooked spinach are usually taken by even the most carnivorous cichlids. So while the immediate treatment is Metronidazole, long term you need to review water quality and diet, and see if there's anything there you can improve. Cheers, Neale.>

Help with sick Severum Severum Starting To get Hole-In-The-Head 9/9/08 Hi, I have a 200 litre aquarium which has 5 angels, 1 Oscar, 1 silver shark, 1 bichir, and a breeding pair of Severums. All fish are totally fine expect for the Severum which has been getting strange white bumps around his eyes and on his head for the last few days. I have attached a picture, I wonder if you could advise what is wrong with my fish and how to treat it?? Many thanks Jason Ingold < It looks like you Severum is showing the first signs of Hole-In-The-Head disease. After the pus filled blisters pop a hole is left in its place. The holes continue to grow eating away the skull. There are some ideas to what the cause of this disease could be but no exact pathogen has been identified. The stress of breeding could have weakened your fish and made them vulnerable. If it was my fish I would place it in a hospital tank with clean warm(82 F) water. Treat the tank with Metronidazole and Nitrofuranace. If the fish is still eating then feed a medicated food with Metronidazole in it. Generally I would try to improve the diet with a quality pellet food. If you fish is still eating I would try a little trick I stumbled on a few years ago. I had an south American cichlid like yours that just started to get the disease but was still eating. He especially love black worms. I took the portion of black worms in a little plastic cup with some water and medicated the worms with the dosage of Metronidazole. The worms died right away and I quickly fed them to my fish. The fish were unaware that the worms were dead and ate them all up. The lesions turned black the next day. I did a major water change, cleaned my filters and got some fresh fish food that was high in vegetable matter. I felt that this would provide the minerals my fish may have been missing. Hope this helps.-Chuck>

Oscars With Hole-In-The-Head  12/30/2005
Greetings Bob,
< Chuck this time.>
We have 2 Red Tiger Oscars that both developed the HLLE. We keep a good tank ( check to make sure that all the levels are good) for them. However, is there something you can recommend that we do to help out our fish? We would like to have them around for a while.
Thanks, Robert and JoAnna
< This is usually caused by stress. Check the water chemistry. If that is OK then try a more nutritious food or change the diet to a better grade of food. Maybe add some live food too. Metronidazole will work to treat it but the causes of the stress must be addressed and corrected for a long term solution.-Chuck>

Oscars With Hole-In-The-Head  1/1/06
Thanks Chuck for your reply. We have them in a 72 gallon tank with 1 canister filter and one Bio wheel filter. We change the water weekly (25% change). We also have an old Pleco in the tank as well. He just hangs out on the back of the tank .We are currently feeding them Tetra Cichlid sticks and the pellets and occasionally krill. We quit feeding them live food when one of the people in the Tropical Fish hobbyist said that live fish is not good.
What would you consider a good quality food? Should we be adding broccoli to the tank also? We would like to keep Felix and Oscar (yes they do act like the odd couple too!) around for a long time. Your help is greatly appreciated!!!!Thanks, Robert & JoAnna
< Clean the filter and vacuum the gravel on alternate weeks. I know canister filters are a pain to service but the should be cleaned at least once every two weeks. On the weeks that you do not clean the filters you should vacuum the gravel. There is quite a bit of waste that accumulates there that needs to be removed. This should keep you water quality at its best. Forget the broccoli. I would try some Spectrum pellets and Spirulina flakes. These have lots of vitamins and minerals and should help with a deficiencies in their diet.-Chuck

Oscar with Hole-In-The-Head  12/16/05
Hi Chuck, I have still been trying to cure my Oscar, but to no avail.  I put him in a bare 30 gallon and treated just as you described for quite some time but he did not seem to be recovering at all...getting worse in fact.  He didn't like the medication at all, but I did it 3 days on one day off for two weeks.  After that I just kept the water pristine and kept the lights out for the whole day.  I did turn the lights on, wait 30 minutes, and try to feed him.  He seemed hungry.....he gets all excited and swims back and forth waiting for the food, but when the he gets the food in his mouth he just opens it back up and the food comes out.  I have tried med. pellets, small pellets (Hikari Gold), flakes, brine shrimp, frozen brine.....pretty much everything, same result.  He just spits the food back out over and over. The one visible change in him after the treatment was the dimples in his head, which cover a decent area from behind his left eye all the way back near his fin, turned black.  Well, I should say rather that they are now outlined in black, but very prominently.  At first I thought it was a good thing, like it was healing, but the dimples seemed to be worsening still and he still can't eat.  It's been several months now.
I am to the point where I am considering euthanasia, but would like to get your feedback first.  I have really done so much and tried very hard to cure him.  I don't like to think about him being so uncomfortable, and if he is just going to keep getting worse the I will have to do it sometime anyway.
He isn't eating....what do you think?  Do you know anything about the blackening around the dimples/holes? Thanks, Tim
< The black is a good sign that things may be healing up, at least around the edges. Try to get him to eat live black worms. He should. Give him a couple of feedings over a couple of days. One the third day place some worms in a small plastic cup with some water. Add a tablet of Metronidazole. It should kill the worms instantly. The worms now have the medication in them. Now quickly feed them to your Oscar. Getting the medication inside the fish should really help. Continue to do this until the spots turn black.-Chuck>

Oscar Still Has Hole In The Head 11/3/05
Hi all, I have read through the forums and have done what is recommended (mostly Chuck's recommendations). 
<<Chuck knows his cichlid stuff!>>
I have a large (12-14 inch) red Oscar in a 75 gallon tank by himself. I had him with a Tiger Oscar until they outgrew the
tank and he became aggressive with the Tiger. I plan on getting him in a 125+ but I have to move to a new place first. He developed pitting on the left side of his head, fairly high up. At first I thought he just lost a scale from bumping into the top of the tank (he gets very excited when I feed him), but it has progressed.
I use RO water and treat it lightly with Cichlid Essentials. I feed him Hikari pellets. I do have frozen brine cubes which I am going to start supplementing in to his diet. I normally feed him a small amount in the morning and at night. I bought a bottle of the Hole-In-The-Head Guard with Metronidazole and have followed the directions on the bottle. They say to use it every other day for three treatments with 25% water changes between treatments. I have followed the directions exactly. It has been a week since the last treatment and I see no improvement. 
How long should I wait before I treat him again?
Is there anything else I can do? 
My nitrates are low, ammonia and nitrites 0. My water temp is 80ish. This is a large beautiful fish and I really don't want to lose him.  Thanks for any help you can provide. Tim
< Go to Cichlid-Forum.com and check out the 22 page article on the causes and treatment of hole in the head disease. Metronidazole reacts to everything, light, heat, organics etc... In a best case scenario you treat the fish in a bare tank. Treat with Metronidazole and Nitrofuranace every 8 hours with a 33% water change in between treatments for three days. Lots of work and lots of money too. After reading this article you will best be able to determine the cause and be able to treat appropriately.-Chuck> 

Parrot Cichlids With Hole-In-The-Head - 2/28/2006 HELP. About two months ago My 2 parrots who are around 2.5 years old - we had them from babies, started to develop fungus type 'sores' on their head (no where else, and none of my other Cichlids have this problem) then it disappeared only to return again and now I need help. I treated them for Velvet, Fungus, Hole in the head etc., to no avail. Although my water qualities etc., were fine, water temp was tried at between 24-28 (this was double checked by Maidenhead Aquatics) I changed to the fish shops own water in the hope it would make a difference - it didn't. I have not added any new fish, gravel, plants etc., Food is still the same dried in morning and frozen in evening (Krill, bloodworms, Mysis, Green food, Artemia etc). I do a water change every week, (sucking up all pop from gravel in process) I have tried to do it daily, every other day, weekly and even longer - no difference. The last month 'his' sore has got bigger and does not seem to be responding to anything. He is eating well and his stools are normal. For the last month, 'he' has started to hang round the top of the tank as if trying to get more oxygen, rapid gill movement (compared to the other parrot) and generally looking off colour doesn't really want to move, and when he dose it looks like he hasn't got full balance, although he eats well, and moves fast and straight into the caves when startled. The other parrot I am sure knows something isn't right as she is hanging below him instead of her usual haunt the caves. I have a 5' tank and an external Fluval 404 pump. I am an experienced Cichlid keeper but was given these fish from my son, they are magnificent and very clever and cunning. I have no trouble between my fish what's so ever, if anything the parrots rule the tank, or at least did. I have photos of his head if it will help anyone to help me. My local fish shop said that as they are a hybrid fish, they are not as healthy and tolerant to changes as the normal cichlid and that they don't know much about them as they don't and never will stock these fish. < Do a 50% water change, vacuum the gravel and clean the filter. The drug of choice is Metronidazole, but you need to get it inside the fish. Take some live Calif black worms or Tubifex and wash them very well. Place them in a disposable plastic cup or bowl. Drain off most of the water. Add Metronidazole to the worms. It should kill the worms. Immediately feed them to your affected fish. You know it is working when the pits turn black. This disease is thought to be caused by stress. Things like dirty water or a lack of minerals/ vitamins have also been thought of as a cause. If the fish are not eating then treat the water . It may help but will not be as effective as getting the medication inside the fish.-Chuck>

Hole-In-The-Head Cichlid Photos  - 3/1/2006 Thanks for this advise, did you see the second email I sent to you from home last night with photos on this fishes head - showing this complaint?  It may help, also do you think it is Hole in the Head or Fungus etc????  Many thanks  Sheena Jolliffe < We got the photos and the reply is still the same. They are posted on the site.-Chuck>

HELP!!!!! I am scared my 6" Jurupari will not make it over night!!  5/31/07
Jurupari With Hole-In-The-Head Disease
Okay this is the deal, for about 2 years we have had a 55 gallon freshwater tank and within the first year we had acquired - 2- 1.5" black tetras, 1 - 1.5" Tiger barb, 1 - 2" Figure Eight puffer, and 1 - 3" algae eater. Every thing was fine for several months, and then about 6 months ago the Puffer died, we weren't sure why, probably because I was too busy with an new baby to tend to the tank like I should have.
< Actually as puffers get older they move to salt water from fresh water. this is not true for all FW puffers but it is true for most sold at stores.>
We observed the fish and took care of the tank, making sure there was nothing going to harm the other fish. Since the other fish seemed fine we decided two weeks ago we would like to get another puffer (they are so much fun.) Well I went to my LFS in search for a puffer and I came upon a Beautiful 6" Geophagus Jurupari at the price of $50 - I didn't buy it, but placed an order for the puffer instead. A week later I came back to pick up the puffer and the "smart" fish guy was there so I asked about the Geophagus - he said it was a great hardy fish and that it would be fine with a puffer and the fish I had at home.
< Most puffers are actually brackish fish unless you got a specific species that is found in true FW. The Satanoperca jurupari actually comes from soft, warm, acidic waters of South America.>
I said I will take it, and they loaded him up with the puffer and I brought them home to there new tank. Since this was my first time to purchase a fish that cost more than $10 - I had never even heard of putting new fish in a QT before entering them into my display tank. I have always just acclimated them then added a little of my water at a time over about an 45 min. time period - and this is what I did with the Jurupari and the Puffer. After being in our tank for 2 days I noticed tiny white specs on the puffer and immediately went to the computer to learn it was ich. I decided to go with the heat, salt and daily water changes instead of the chemical route. Since I didn't have an extra tank and heater etc. I used a large clear acrylic salad bowl and placed it into the large tank to share the 87 degree temp and air with an air stone and a little gravel. Concerned about the ich and curious to know more about the Jurupari, I again turned to the web. I began to realize my water conditions were totally wrong for the Jurupari. Now I was really concerned my water conditions were going to stress this beautiful fish. I immediately began to attempt to lower the hardness, pH, & alkalinity of my tank water with water changes, aquarium salt, and a pH buffer - I just could not get it down!! After loads of research - I realized the that the Texas Holey Rock and landscaping gravel I had in my tank were causing the high alkalinity and water hardness! I immediately removed the rocks and the next day I removed the gravel replacing it with black Tahitian Moon Sand for the Eartheater - but now my bacteria is gone and I have began to notice little tiny holes on the head of my Jurupari! I immediately searched WWM and found this was HITH! I did as suggested and ordered Metronidazole (Hole-In-The-Head Guard) from DrsFosterSmith.com, along with Marc Weiss Instant Amazon, and Vita-Chem. I did a water change, then administered the HITH meds, now he wont eat and he has began to get blood streaks in his tail, he hangs out at the top and is kind of out of balance. Believe It Or Not! I am already in love with this fish!!! I am willing to do whatever it takes to save these fish!!! Other than not researching the South American Cichlid before I bought it - Please tell me what I did wrong, and what I can do to fix it!! Helpless in Houston, Beth
< The genus Satanoperca overall is a very touchy group of fish. They require very clean soft acidic water to thrive. Anything less that this and they break down with a long list of maladies that you have now encountered. All of the changes have created stress in your fish and he has begun to shut down. For the short term I would isolate him in a 10 gallon tank with and airstone and a heater. The water would be 50% treated tap and 50% R/O. Set the heater at 82 F. Treat the tank with a combination of Metronidazole and Nitrofuranace. The Metro with treat the bloat and the Nitro will treat the bacterial infections in the fins. Treat on day 1, 3 and 5. On days 2 and 4 just do a 50% water change while vacuuming out any waste. When the fish acts hungry then you can start to try and bet him to eat some medicated fish food with Metro in it. In the long term the big tank really needs softened water. I would recommend using an R/O unit to remove the dissolved minerals and adding a buffer to acidify the water to a mildly acidic pH. these fish are bottom feeders so make sure some food gets to the bottom. They do not like any waste in the water. The nitrates should be under 10 ppm. This is very clean water and will require lots of water changes. the other fish will like the new water with the exception of the puffer.-Chuck>

Re: HELP!!!!! I am scared my 6" Jurupari will not make it over night!!
Finding Nitrofurazone - 6/1/07
> Also, where can I find Nitrofuranace? I didn't see it on DrsFosterSmith.com.
< They sell it as simply Furanace or Furan-2.>
Can I use API's Triple Sulfa?
< You can try it but I don't think it will be as effective as the medications I have recommended.>
Am I treating hemorrhagic septicemia, is that what the blood streaks are, or is it some sort of bloat?
< These medications are good for bacterial and fungal infections. Your are treating both external and internal bacterial infections.>
I am going to get an extra tank right away - I guess because I will be doing a 50% water change every day I wont need a filter on the QT tank.
<When you medicate a quarantine tank , the medications are affecting the biological filtration. You remove the fish waste in the tank with the water changes.-Chuck> Thank you so much with helping me on the specifics - I am extremely grateful!!!!!
> Beth

Re: HELP!!!!! I am scared my 6" Jurupari will not make it over night!!
R/O Water - 6/1/07
> Since I don't have access to RO water right away can I use bottled distilled for the water changes? It is 0 everything?
< Distilled removes more minerals than an R/O unit so either would be fine.-Chuck.>

Re: HELP!!!!! I am scared my 6" Jurupari will not make it over night!!
> Jurupari Needs Treatment - 6/1/07
> WWM Team - THANK YOU for your quick response!!!
< We know how important information is when your fish are sick.>
OK, I bought a 10 gallon tank, wiped it out with distilled water, and filled it with distilled water.
< Pure distilled water is not needed. Next time mix 75% distilled with 25% tap water.>
I heated the water to 84 so there wouldn't be a drastic temp change for the Jurupari - I am slowly lowering it to 82. Right now the tank only has the heater and an airstone in it. I also put 1 tsp of Instant Amazon and 20 drops of Vita-Chem, since I did a Metro treatment in the big tank yesterday, I won't treat him with it again today. My main concern is the other medicine you mentioned - I was unable to locate it online or at the LFS's I have near my house. I did find API's Triple Sulfate Anti-Bacterial Fish Med that is for Hemorrhagic Septicemia - should I use this to treat the water?
< I looked in the Drsfostersmith.com catalog and found both medications I mentioned available. The tri-Sulpha is not as effective as the medications I had mentioned. If cannot find them then go ahead and try the triple Sulpha.>
The If so, should I do it today and alternate the treatments every day, or should I wait until tomorrow and do both medications at the same time?
< Treat with both medications at the same time.>
If not, please tell me were I can get the Nitrofuranace and I will have it next day aired to my house. By the way the Jurupari's fins aren't
clenched anymore now that he is in the Distilled Water - but it looks like he is also suffering from fin rot - is this also because of the water conditions, or is this something new?
< The fin rot is a bacterial infection from high nitrates in the water. This disease will respond to the antibiotics.>
Also, is there an RO unit you would suggest for my tank?
<If you have a 55 gallon tank and you probably need to change up to 30% of the water every week. This means you need to generate about 20 gallons per week for water changes. So you need to get one that generates at least 20-30 gallons per week. They are usually sold in Gallons per day. So get a unit that generates at least 5 gallons per day and you can always lower the pressure and reduce the amount needed.>
Now. about the big tank, my tiger barb wont eat and he is gasping for air - it looks like he has dark green patches on his sides and the top of his head - and maybe one single spot of ich on his back fin (if this is possible.) Also, yesterday the puffer looked like most of his ich spots were gone and this morning he was covered with twice as many.
<The ich medication has probably affected the biological filtration. Check the water for ammonia and nitrite levels. Both should be zero. Reduce levels with water changes.>
UGH! I feel like this is all my fault! Not researching before the purchase of new fish. Now I feel like I am in way over my head.
Helplessly trying to reproduce the Amazon in Houston! Beth
<This is all part of the learning process. We are here to help.-Chuck>

Re: HELP!!!!! I am scared my 6" Jurupari will not make it over night!! - 6/1/07
> Treating A Jurupari
> Well after I put the Jurupari in the 10 gallon QT tank he immediately perked up his fins and biting at the glass as if he was hungry...so I tried mixing some vita-chem and Metro in with some flakes and letting them dry, but he seemed to just make a mess with them through his gills. So I thawed some bloodworms and added vita-chem and Metro to them in a little bowl, let them soak and got him to eat two servings yesterday. This morning when I woke up he as floating at the top again with his fins clenched - I tested the ammonia and it was .5 ppm (How is that possible?)
< All fish waste and uneaten food turn into ammonia. You have no biological filtration. If he is eating then feed once a day. Feed only enough food so that all of it is gone in two minutes. Remove all uneaten food while doing the water change.>
Immediately, I did a 50% water change, tested again and it seemed like it was between 0 and .25. So administered the Metro and Triple sulfa. After being in the meds for an hour or se he began shedding some serious slime and his tail was kind of floating up - I waited a while and there was no change so I did another 50% water change diluting some of the meds. His fins are clenched and he seems unbalanced -
and he keeps floating up - and he wont eat again. Do you think he can make it or does it seem unlikely? I am heart broken and completely consumed by the issues at hand. Thanks for your help! Beth
<When a fish is stressed it develops a heavy slime so the parasites cannot get to its skin. Now the medications are diluted and you fed him three times yesterday. Your fish has gone through a lot. Currently he is not being treated and just sitting in z 10 gallon tank. If he is strong he may come back.-Chuck>

Re: HELP!!!!! I am scared my 6" Jurupari will not make it over night!!  6/3/07
Jurupari Worn Out
This morning my Jurupari was upside down in the QT tank - I looked closer and he was still breathing - I stirred the water up and he swam up top, but quickly floated back down to the bottom. He is still at the bottom, although he is upright now - What should I do? Do you think he is suffering?
< You fish has gone through a lot. I would recommend that you keep up with the daily 50% water changes until he dies or gets better. He is probably too weak for any medications. Let him rest and build up his strength and see if he has anything left to fight back.-Chuck>

Neglected Cichlids With Hole-In-The-Head  7/21/07
I have been bad. Over the summer I neglected my 150 gallon cichlid community. I was busy expanding my perennial garden. I only recall doing three 50% water changes in the past four months. The glass was covered with crusty hard algae which took forever to scrape off. Now my Geophagus has HITH syndrome. I have been doing partial water changes every three days. Is 25% too much of a water change? Should I do less more frequently? I had been testing my water once a week and all parameters were normal except the nitrates were about 40 ppm all summer. My test kit says this is high end in the safe zone.
I do have hard water and my pH is approx. 8.
<Most Geophagines require warm soft acidic water that is very clean and low in nitrogenous wastes. Keep the nitrates under 20 ppm with water changes.>
My major question relates to a large 8" gold Severum. He is about 1.5 years old. He looks great except for one thing. For the past 6-7 months I have noticed that he has a "divot" behind one of his eyes. Like a very small thumb print indentation (about the size of a pea).. I never really thought much about it. It wouldn't be the first time I have seen a cichlid with a deformity. For the longest time I watched it and there has not been any changes in it till now. Now the impression actually looks like a hole. It is much deeper.
It is not white or fuzzy or pussy like the Geophagus' holes. I could try and send you a picture of it if that would help. He is still eating and swims normal with not other signs of distress other than that divot/hole.
< A photo would be helpful.>
Also, I feed my fish a variety of foods, including flakes, pellets, frozen blood worms and brine shrimp. Also shrimp pellets and algae wafers. Will the improved water quality reverse the HITHS alone, or will I need to treat with Metronidazole?
< If you see no improvement then I would add the Metronidazole.>
Should I add vitamins?
< Won't hurt.>
One last question, would it even help to use a hospital tank or should I keep everyone in the community?
<Medications may affect the biological filtration. It is always best to treat sick fish in a hospital tank unless all the fish in the tank are effected.-Chuck>
The rest of the residents include two rainbow cichlids, two Laetacara curviceps, four large unknown tetras, three clown loaches, five sajicas, Cory catfish three tiger barbs, one Danio, and a large chocolate cichlid.
Thanks for your help, Linda

Jack Dempsey With Possible Hole-In-The-Head 9/6/07
Hello Crew, I wrote in on July 17, 2007 regarding my Jack Dempsey Phin who was having problems with Fish Lice. Thanks to your advice I have gotten the fish lice cleared up but we still have a significant health concern. At the time we were treating for fish lice, I mentioned that there was a spot near his head where the scales had fallen off. The spot has continued to get bigger and is now about the size of a nickel that is completely void of scales. In the last few days I noticed that the scales around the area are becoming extremely inflamed. I mentioned it to my local fish store clerk and he suggested a five-day cycle of Maracyn-Two. I have completed the cycle and the situation remains the same. To compound the problem our algae-eater has become very aggressive lately and chases Phin around the tank trying to latch onto his sore area. Do I need to separate the fish in order to give Phin time to heal? Is there anything that I can do to help him heal? Any suggestions would be helpful! Best regards, Emily
<Separate the algae eater from the Jack Dempsey. The best option would be to place the Jack in a clean hospital tank. Treat with a combination of Nitrofuranace and Metronidazole. The Metro will treat the Hole-In-The-Head and the Nitro is effective against bacteria and fungus.-Chuck>

White protrusion on Angelfish... HLLE?, FW    9/2/07
Hello,
<Hi there>
My large male angelfish has several areas around his eye, nose and head that look like white shreds. From one of these areas, there is a white protrusion, like the tip of a worm, but from what I've seen described it's too big to be an Anchorworm.
<Ah... not likely... instead... this sounds like "neuromast destruction"... aka as Head and Lateral Line Erosion... the white "worm" is mucus from the fish... maybe accompanied by a good deal of the Protist Octomita... formerly Hexamita ... necatrix mostly>
I also have discus,
<Mmm... much to relate here... by and large I am NOT a fan of mixing Pterophyllum and Symphysodon...>
and in the past two of them have gotten this same symptom.
<Yes... way too often such parasitic (and infectious) diseases "ping pong" twixt these genera>
The first one I treated with a parasite medication (I think it was the jungle one that fizzes)
<Actually, there are a few...>
and also an antibiotic because the area where the protrusion was coming out from looked infected. He survived. When the second discus got this, however, I did the same treatment but she did not survive. Now the angel seems to have the same thing, only with his there are several shredded areas (the discus only had one) and the shreds seem to be coming out from around his eye as well. When I look closely, he also has a number of very small areas where the scales seem a little popped out. The protrusion itself is pretty big...about an
eighth of an inch long and wide. These 3 fish have not gotten this one after the other....there was probably about a 2-3 month span from the first discus to the second one, and it's now been over 6 months since the second one died. I can't find anything in the various fish disease descriptions that matches this. I did notice when I was looking thru your FAQ's on discus that someone else had written about the same thing with his discus, and you advised to treat by dabbing Merthiolate/iodine on it.
<Sometimes works>
Is this even available in the U.S.?
<Mmm, if not... easily mixed, made-up...>
I thought it was banned because of containing mercury.
<Maybe...>
Is there any other treatment for this?
<Yes... likely the symptoms can be cleared by a one-time use of Metronidazole/Flagyl.
Please read here: http://www.wetwebmedia.com/metranidazole.htm
and the linked files above...
... but the root cause... By improving water quality and separating the Angel/s and Discus...>
Have you had anyone else describe this type of disease?
<Oh yes>
Thanks so much for your help. I really don't want to lose this angel, but I'm afraid I may have discovered it too late, since he has so many areas affected.
P.S. he lives in a well established 60 gallon tank I've had for over 2 years with various other community fish, including other angels (his children actually), discus, Congos, Rasboras, rummies, threadfins, Plecos, catfish, and a black ghost knife fish. Everyone else seems healthy and happy, and the water tests out fine.
Jaz
<Well... quite a mix... Please take the time to read up re each species here... in terms of water chemistry and temperature ranges... Along with space issues, you really need two tanks here. Bob Fenner>

Re: White protrusion on Angelfish  9/2/07
Thanks so much for your prompt reply. Unfortunately, he died overnight. I was afraid he would, given the advanced state of his condition. When I removed him from the tank, he had several holes where the protrusion and shreds had been coming out of. The shreds and protrusion were gone. Before reading your email this morning, I saw that and was thinking it might be HLLE. I've researched this on the web and there seems to be varied opinion on whether this disease is contagious, some saying it's opportunistic towards stressed fish; others saying it's more genetic.
<Agreed on/with all... In addition, does appear that protozoan involvement might be either a cause or net effect proposition... IF the conditions are present (stress from various sources, dietary...) AND coupled with genetic/developmental allowance... can be or at least appear to be "catching">
I'm concerned now for my other fish in the tank. We are doing a major water change today and I intend to watch the others closely for signs, but in your experience is this a contagious disease?
<Can be, yes...>
Should I be concerned that my angel released organisms in the tank that will now attack my other fish?
<These "other organisms" were likely present before... at issue is the entire equation of initial health, suitability of the environment... AS WELL as presence and pathogenicity of disease causing organisms>
So far everyone else seems very healthy. Thanks again for responding so quickly. Like most
hobbyists in this field, I love each of my fish just like I would a cat or a dog, and I hate losing them or seeing them suffer, so it's great to know that your staff is so prompt in responding even on a holiday weekend! :)
Jaz
<Thank you my friend... I am not advocating the pre-emptive use of Flagyl here... I would try spiffing up the environment, and bolstering the livestocks' immune systems through vitamin/HUFA supplementation of foods. BobF>

Help... Flowerhorn hlth.   11/06/07
Good day! Thank you for continually helping hobbyist. I tried other fish websites but they do not seem to know anything. I feel like my FH is dying and they still want me to monitor and observe. Here are the things that I have noticed.
1. Continual flashing and scratching.
2. Body, pelvic fins, and dorsal fins twitching.
3. Stays at the bottom or near surface with clamped fins. (Sometimes, using only 1 pectoral fin)
4. Lethargic.
5. Body slime is visible on the body.
6. Gills are like hidden inside its gill plates and gill appears to be pale. (He does not appear to have rapid breathing. Slow and shallow breathing actually.)
7. Losing equilibrium.
I also noticed that he began to have small holes in his head. A secondary disease because he is not eating anymore, I guess. Is it bacterial or parasite? My guess is gill fluke so I went to a pet shop in New Zealand but they do not have fluke tabs. I was told by "apparently a fish doctor" that he's not sure what it is because fishes are hard to diagnose and that he told me that my best bet would be Furan 2. I want to know what you guys would suggest before I medicate my fish. By the way, he recently had Finrot so I gave him erythromycin, then he had this disease subsequently. Thanks again and again. Please save my fish from his imminent demise.
Take care!!!
Nina
<Nina, your fish sounds as if it has the symptoms of Hexamita and/or Hole-in-the-Head (these may be one and the same disease). It is very common among cichlids, and seems to be related to water quality and diet issues. The classic set of causes are a tank with high levels of nitrate caused by overstocking and infrequent water changes, plus a monotonous diet, in particular lacking in greens (vitamins!). Some aquarists have also implicated things as varied as electrical fields and the dust from activated carbon. Regardless, it's difficult to treat without recourse to a (normally) prescription drug called Metronidazole. (See here: http://www.wetwebmedia.com/metranidazole.htm .) Nothing much else works. Ideally, it's fed directly to the fish. During treatment, make sure you remove the carbon from the filter (if you're using it) and make sure you optimise water quality. Once the fish is better, pay close attention to water quality and diet. Think: big tank, lots of water changes, no live feeder fish, and a balanced, varied diet with plenty of greens. Cheers, Neale>