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FAQs on Freshwater Head & Lateral Line Disease, HLLE, HITH (Hole In The Head)... Non-cures

Related Articles: Head and Lateral Line Disease (HLLE), Freshwater DiseasesFW Disease Troubleshooting, Ich/White Spot Disease, Freshwater Medications

Related FAQs:  Freshwater HLLE 1, FW HLLE 2, & FAQs on FW HLLE: Causes/Etiology, Cures, FW Case Histories, SW Case Histories, & Marine HLLE: HLLE 1, HLLE 2HLLE 3, Nutritional Disease, Aquarium MaintenanceFreshwater MedicationsFreshwater Infectious Disease, Freshwater Fish ParasitesIch/White Spot DiseaseAfrican Cichlid Disease 1, Cichlid Disease

Identifying and fixing the root cause/s is paramount. IF protozoal co-activity is a concern an antiprotozoal (e.g. Flagyl/Metronidazole) may be efficacious (mainly added to foods).
Herbal remedies are a farce ("..."Fix")

HLLE Treatment    9/30/12
Bob and/or Neale,
Do you have idea if Praziquantel is effective for HLLE on cichlids?
Rick Novy
<Mmm, well, see WWM re the condition/syndrome AND the anthelminthic, but no... HLLE is mostly considered "caused" by poor water quality, nutritional deficiency/ies and perhaps by a Protozoan (Hexamita, Octomita) that is not affected by Prazi... Some folks tout Metronidazole/Flagyl... B>
Re: HLLE Treatment    9/30/12

Thanks Bob,
<Welcome Rick>
Yeah, I've read through the WWM entries and did not see any mention of Prazi,
<...? Nah, try the search tool... on every page>
of which I have a quantity on hand. I thought I'd check before going out to make a purchase of Metronidazole.
This Bolivian Ram has a large affected area on the left side from the base of the pectoral fin to the front of the dorsal fin.  He's the only ill fish from all my tanks at the moment, but not responding at all  to treatment with antibiotic (erythromycin). I just yesterday noticed what looked like some pitting along the lateral line, and that led me to consider HLLE.
Not sure how that would develop as the tank is clean, I rotate food every meal, and nobody else in the tank is ill. The only thing I can think of is the stress from being the odd man out in a reverse trio.  He has been quarantined for over a week now, and fortunately is eating.
I've attached a photo.
<... see WWM re FW HLLE... B>

Hole In the Head Disease on Oscars I have a red tiger and albino Oscar that are around 8 months old, about 7-8 inches, residing in a 75 gallon tank with a couple Plecos as well.  In the past couple weeks they've each developed a case of hole in the head disease. I'm pretty good about water changes and maintenance, but I will admit right before the HITH set in I had waited about a week longer than usual to change the water.  Right after that late water change is when I noticed the first spot appear.  A few days later when it still had not gone away and one appeared on the other Oscar, I started medicating with MelaFix.  I followed the MelaFix directions and medicated for 7 days followed by a 25% water change yesterday.  While medicating I chose not to remove the carbon from my filter (Fluval 304), because the directions said it was recommended, but not absolutely necessary.  The spots seem to be looking slightly better and I've chosen to remove the carbon and try the MelaFix for another seven days.  My pH is around 7.5 and my nitrates are still reading quite high at around 80-90 ppm.  Sorry for the long-winded description, but is there anything else you can recommend?  I've found searching for information on HITH very frustrating because there seems to be debate about the causes as well as treatment. Oh yeah, in terms of diet, I've been feeding them a couple dry foods (Hikari pellets and sticks), frozen blood worms, brine shrimp, and feeder fish from a local pet store.  I know the feeder fish are a potential cause, so I've ceased feeding them those since the HITH set in.  Once again sorry for the long description, but any advice would be greatly appreciated. < Your high nitrates may be  the cause of the problem. Clean the filter, vacuum the gravel while doing a 30% water change and treat with Metronidazole. The treatment requires lots of water change so that will get the nitrates down. They should be under 25 ppm.-Chuck>

Re: Oscar with HLLE Chuck, This is another letter in regards to the  Oscar I am taking care of at work. Thanks for your help so far. Just a few more  questions.  1. I found some liquid multi vitamin, but it is berry flavored for  taste.  Can I still add this to his food, or should I get pill form and dissolve  in warm water?< Neither, Go to Drsfostersmith.com and get a bottle of Vita-Chem.> 2. Should I try to add Metronidazole, Cichlid Vital, ph Lower at  the same time or different days?<The Metronidazole and cichlid vital could be added now and modify the pH with the water you replace doing the water changes.> 3. How long and often should I treat the Oscar with the above  medication?  i.e.. once a week for a month, every other week for 2 months,  etc... <Follow the directions on the packages. The disease may be gone but the healing will take time.> 4. I also have some multi-vitamin enriched Krill, Is it all right  to feed him that?< That would help.-Chuck> Thank for your help, John

Oscar with Hole in the Head Disease 8/4/05 My husband and I have a 11 1/2 inch Oscar in a 55 gallon tank by his self. About 2 months ago, he developed hole in the head. We started treating him with Melafix. We treated him with that medicine for about 2 weeks. No improvement. We went to the local pet store and they recommended Pimafix for fungal infections as well as start including aquarium salt with every water change and to remove activated carbon filters. They told us to use a teaspoon of Pimafix  for every 10 gallons. We treated for about 4 weeks, problem got worse. Our fish is now not eating and hasn't eaten for about 3 weeks at the time of the Pimafix. We went to another petstore and they recommended Maroxy-2 for fungal infections. The problem has still gotten worse. He does not eat and has slow labored breathing and lies at the bottom of the tank on his side. We are VERY worried about our dear fish. Can you please help us. We are desperate! George and Lisa < Check the water quality. Ammonia and nitrites should be zero. Nitrates should be under 25 ppm with the lower the better. Clean the filters and do a 30% water change while vacuuming the gravel. Now that the tank is clean you should treat with Metronidazole as per the directions on the package.-Chuck>

Re: Sick Oscar 8/5/05 Where do I find the Metronidazole? < Drsfostersmith.com.> We are both novices when it comes to fish. How do I check the levels of ammonia and nitrate? < Buy a FW test kit to check levels.> I cleaned the filters and the gravel and did a water change last night and he does not seem to be doing any better. Lisa < Improving your fish's living conditions will improve his immune response. Organic matter  in the water and filter will absorb some of the medication making it less effective. So removing this waste will make the medication more effective. While you are waiting for the metro, you can add a teaspoon or rock salt per ten gallons of water and treat with a double dose of Nitrofurazone or a single dose of Clout. These medications may cure your fish and the metro may not be needed. I think metro is still the best choice.-Chuck>

Oscar sick?. foaming water, Oscar with Hole-In-The-Head I have a 5 year old albino Oscar and he is really sick I'm thinking that has hole in the head. Recently he developed a sore on his head and around his eye looking painful. I've been treating him with Aquarium Pharmaceuticals Mela Fix for a month at least every time I would put a minimum amount the sore would bleed and he would go crazy swimming from one end to an other hitting the glass so I stopped that medication and started giving him some antibacterial medication the name escapes me right now. I'm doing a frequent water change since I feed him blood worms the water turns into a reddish color after every feeding. I do remove the carbon filter when treating him I leave it out at least 8hours while I'm at work once I get home I put I back in until the next treatment. A few days ago I did a gravel cleaning and now my water is foaming on the top with white/brown bubbles I changed all the filter replacing with new ones. I lost I have no idea what to do please help me if I don't act now I think he is going to die since he is not himself just staying in one spot all the time close to the heater. Should I change my complete filter system?.. I have an internal Hagen bio life filter it's a 20gal tank he is about 10" should I get a bigger tank? So many questions. Thank you so very much, hope to hear from you soon. Angèle < First of all stop feeding you Oscar. The biological filtration has probably been affected by the medications and you are having big spikes in the ammonia levels. The ammonia is deadly to fish and stresses them to the point that they come down with other diseases. Do a 50% water change, vacuum the gravel and clean the filters. Treat with Metronidazole and Nitrofurazone every other day for three treatments. On the days you do not treat, do a 50% water change. On the seventh day use good activated carbon and remove the medication from the water for 24 hrs. The use Bio-Spira to get the biological filtration back on tract. Feed you Oscar once each day a quality food with lots of vegetable matter in it. Make sure it is all gone in a couple of minutes. Remove any uneaten food with a siphon. It will take some time for all the holes to heal over. Keep the nitrates under 25 ppm with water changes and feed a varied nutritional diet.-Chuck>

My Oscar hurt bad, poisoned
4/29/08 Hello, <Hi there> I just found your website and I'm hoping that you could help me. My Oscar had HITH and I went to PetSmart and got some medication. <What exactly?> His head seems to be getting better, but he is going crazy! He's been swimming rapidly and hit himself on the gravel, side of the tank and the log on the bottom of the tank. He scrapped a chunk of skin off his head, his gill and some on his side. Last night he banged himself pretty hard that he chipped his bottom lip. He's still eating some freeze-dried bloodworm, but he spits out the pellets. I'm very worried about him and I don't know what to do. He keeps hurting himself and I don't think he's going to heal if he keeps it up. Please help, I feel so helpless with him. Thank you. Resy <Something toxic going on... likely related to the Neuromast destruction treatment. I'd quickly change about half the water (treated to remove sanitizer...) and run some activated carbon in your filter/circulation path. Bob Fenner>

Re: My Oscar hurt bad 4/29/08 I treated him with anti-parasite tablets twice, <... Please... specifically... this term means nothing. What active ingredients?> 48 hours in between treatments. I changed 25% of the water after the second treatment and put back the carbon filter. I also put the stress zyme and stress coat as directed in the box. Should I change 50% of the water again? <I would, yes. B>

Re: My Oscar hurt bad 4/29/08 This is what's on the box: Active ingredients: Praziquantel; N-[[(N-Chlorophenyl) amino] carbon 1]-2,6-difluorobenzamide; Metronidazole; Acriflavine. Wont' changing the water again stress him more? It was only two days ago. <Better to be stressed than die from toxic reaction... Likely the Flagyl/Metronidazole is at root here. B>

Re: My Oscar hurt bad  4/30/08 Thank you. I will change his water again. How often should I change his water afterwards? Should I put a new carbon filter again, also? <See WWM re water changes and yes to the chemical filtrant. B>

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