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FAQs on Freshwater Head & Lateral Line Disease, HLLE, HITH (Hole In The Head)... 1

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

Related FAQs:  FW HLLE 2, & FAQs on FW HLLE: Causes/Etiology, Cures, Non-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

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>

Oscar Fish Hole in the Head???   4/4/08 Good Evening I have attached a photograph of my Oscar Fish and wondered if you could help. I'm not sure if my Oscar has hole in the head disease. I have studied several photo's of Oscars with this disease however the holes in my Oscar look much bigger and deeper. I haven't seen anything like this before. Are you able to advise?? Any thoughts greatly received. Regards Julie <Julie, yes, that's Hole-in-the-Head disease. Options for treatment in the UK are limited unless you contact a vet. Metronidazole is the usual recommendation by American aquarists, but it isn't freely sold here in the UK. One new product on the market is eSHa Hexamita Discus Disease. Their other products are excellent, so that'd be one product I'd recommend. Follow the instructions carefully, in particular remembering to remove carbon. In any case, the underlying cause of HITH is water quality and/or diet, so review those factors. Do see here: http://www.wetwebmedia.com/FWSubWebIndex/fwhllefaqs.htm Cheers, Neale.>

Oscar, hlth.   2/8/08 Hello. I am beginning to feel concerned about my 6 inch tiger Oscar, Dave. He has been very healthy ever since my husband and I purchased him, that is until about a week ago. It is starting to look like he is missing sections of scales on his head, right above his eyes. Today when I went to feed him I inspected him again, and the top of his head has turned a dull grey, it is usually a nice dark green, brown like the rest of him. It is also starting to look like he may have hole in the head disease. He swims sideways some times, and his head looks terrible. My husband says that he just has a mottled coloration on his head, but it was not like that before. He eats fine, and the levels in his tank are good, he swims around just as actively as always. What should I do? I do not know what to do about it or if it even something to worry about. We cannot afford all kinds of medications for a fish right now, so please tell me what you think, and if it is hole in the head. Thank you so much! Once again, Lena. <Greetings. I can't begin to answer this without some key bits of information. Please tell me the following: [a] How big is the tank? [b] How much water do you change per week? (Be honest!) [c] What food does he get? Does he ever eat live fish? [d] What are the pH, hardness, nitrite, and nitrate? You see, Hole-in-the-Head is very much related to water quality. Cichlids that get Hole-in-the-Head very often live in tanks with a high level of nitrate. It's a lot easier to prevent HITH than it is to cure, though some drugs work (slowly). See here: http://www.wetwebmedia.com/FWSubWebIndex/fwhllefaqs.htm Apart from suitable medications that kill the protozoan that causes the disease, there's no other cure, and it doesn't get better by itself. Cheers, Neale.>

Re: Oscar, hlth.  2/9/08 Hello again, and thank you for your quick response. I looked up some pictures online of Oscars with hole it the head and they look exactly like my fish does. So he does have it. <Oh dear.> He is in a 50 gallon tank, eats peas, shrimp and krill, and I do a 20% water change every week. There is carbon ion the filter, so should I remove the carbon and buy some treatment for him? <Yes; always remove carbon before treating fish. Personally, I consider carbon a waste of money, but some people like to waste money, and who am I to stop them!> My local PetSmart has a product called "Jungle Labs Hole'n Head guard". Do you know anything about this product, or could you please suggest one? <Have absolutely no experience of this product. Do read here for suggestions on treatment: http://www.wetwebmedia.com/FWSubWebIndex/fwhllefaqs.htm Since these antibiotics aren't (legally) available in the UK, I haven't used them so can't offer any great insights into their use.> I gave limited sources for aquarium life supplies so I don't know what I will be able to do, or if I will be able to do anything. Thank you again, Lena. <Cheers, Neale.>

Re: Dave, my Oscar. HLLE remission recounting   -02/20/08 Sorry to bother you again, but I thought that I should update you on my Oscars progress. We started treating him for his Hole In The Head about two weeks ago and he looks a million times better. <Great!> I started a more frequent water change and gravel cleaning schedule and it really seems to help. The large holes on his head have shrunk considerably and many of the smaller ones have disappeared all together. I was wondering, for how long should I be treating him? Until all of the holes are gone? <Unless the medication explicitly says otherwise, yes.> Also, since he has begun healing, we have noticed peculiar horizontal lines going across the length of his body. He has two on one side and one on the other. They look almost like scratches, but there is nothing in his tank that he could have scratched himself on. It looks as though someone took a knife and ran it across his body, creating rifts in his scales. Is this normal? <No; possibly these are signs the lateral line is damaged. On cichlids, there are two lateral lines on each flank: one arches on the main part of the body from behind the head, and another is lower down the body running in a straight line between halfway along the body to the base of the tail. If that's what you're seeing here, it's "all of a piece" with Hole-in-the-Head, unfortunately. See here: http://www.wetwebmedia.com/hllefaqs.htm Alternatively, fish sometimes damage one another, so do check no-one has attacked the Oscar. A photo might help.> If it is not could you please help me to figure out what it is that he may have? Thank you so much, your site is so helpful! Lena. <Glad to help, Neale.>

Re: Dave, my Oscar. HLLE   -02/20/08 Thank you so much once again for your quick response. According to your description of the lateral line, it sounds like that is the problem with my Oscar. How can I cure him? I am already treating him with medication for Hole In The Head, will that cure the damaged lateral line as well? <In theory, yes. The two diseases are probably caused by the same pathogen and/or environmental issues. But it *does* take a long time to get better.> I read that bad water quality and diet cause this, but I do at least a 20% water change once a week, now that he is sick probably more like 50%. <For big cichlids, 50% water changes are recommended. Nitrate may be the trigger; cichlids are sensitive to nitrate, and when the concentration goes up, the chances of HITH or HLLE increase. Anyway, big water changes help here, especially if your water has pretty high levels of nitrate to start with. Here in England, many cities will get water with 50 mg/l nitrate right out the tap, so you have to do BIG, REGULAR water changes to keep cichlids healthy.> All he will eat is peas, krill and shrimp. <Nothing really wrong there, but I'd add some squid, mussel and/or white fish to the mix. Squid is very cheap, most cichlids love it, and it is very protein-rich.> He still eats fine, and swims around, we have now added a bubbler to aerate the water better and upped the temp up to 86. The holes in his head, like I said, seem to be healing, but will he pull through all of this sickness <It sounds as if you're doing all the right things. With luck, he'll pull through. Cheers, Neale.>

Re: Dave, my Oscar. HLLE, reading...   3/6/08 Hello again, I know that I have written to you numerous times now, but I really don't know what to do. My tiger Oscar has HITH and does not seem to be improving. We are still treating him, and his water is fine, and for a long time he looked like he was getting better, the holes were shrinking and he ate and swam normally. We are still treating him, <... need data... treating him with what? Not Metronidazole/Flagyl... ongoing... I hope... is toxic> his water is fine and I do frequent water changes, but he is no longer eating, he hides almost all of the time and the holes are staying the same size now, it has also attacked his lateral line. Please give me some advice. Thank you, Lena. <... if the above-mentioned antiprotozoal is used too much/long it will destroy nephro/kidney tissue... Please, read here: http://wetwebmedia.com/metranidazole.htm and http://wetwebmedia.com/hllefaqs.htm and http://wetwebmedia.com/FWSubWebIndex/oscardisfaqs.htm and the linked files above... Bob Fenner>

hemexia hole in the head or something else... Using WWM   2/14/08 Thanks for taking the time to read about my problem. I don't have spell check <Do look on the Net proper... such programs can be downloaded for free> and I will do my best. I have a green Severum 4.5 inches and 3 Oscars all are about 10-12 inches long. I have had one of them for about 8 years. The other two I received from someone that didn't have room for them. All these fish have been in my care in this new environment for aprox. 1.5 years. I have a 220 gal tank upstairs that circulates into a 90 gallon tank in the basement. (overflow type) I also filter with a powerhead. I have a total of 310 gallons of water. I usually fill with a Reverse Osmosis filter <Mmm... the fishes listed prefer/need the mineral content... in the raw source water> when I have time but because of recent circumstances, I haven't been using it for my water changes. It takes too long and I am now on a new well that is 550 feet deep. Very good water compared to my last well. That's why I have a Reverse Osmosis filter. My new well is a little high is Iron and magnesium <How high is high?> but It has no taste or yellow tint . It passes all water drinking standards and If I would say "almost as good as spring water." <I would just use this water, w/o the RO for your tanks> My PH is 8- 8.2 Ammonia is 0, Nitrites 0, Nitrate is 10. ( not so good). I haven't tested for phosphates recently as I can't locate the test. As for my water temperature I don't usually have a heater. I did purchase one today.. My water has been aprox. 68 F now for about 3 months. In the summer it can be as warm as 79. I am raising that slowly to about 72 degrees unless you say otherwise. During my research I read that when a fish is sick that raising the temperature can sicken the fish faster. <Mmm, can, depending on actual cause...> Helping the hemexia or bacteria grow faster. <Hexamita... aka Octomita necatrix?> I am not so sure how true that is. About once a week I change out about 5 gallons of water and refill. Maybe that was not enough .Just yesterday I emptied the lower 90 gallon tank and cleaned all the rocks etc. and refilled. I have been treating my fish for Hemixia and now with Melafix.. <The "Fix" is worthless> I wonder if my fish have Hemexia because I used to feed them live wild shiners. <Not a good idea> I kept them in the lower tank for about 6 months. I caught them in my fathers pond.. They appeared to be healthy and I didn't seem to have the issues that goldfish do.( ich) My father has rainbow trout and he feeds them a high protein food. <This food may be of value to your cichlids> The shiners eat this for their nutrition so I thought maybe they would be a good food for my fish. The only reason my father has the shiners is because he thought the trout would like them. His trout won't eat them and there are so many it was ruining his water quality. His trout were starving for air etc.. He wanted to get rid of shiners and that is how I started using them for food. ( FYI after a lot <No such word> of work removing fish and pond bleaching etc.. my father did get rid of all shiners in his pond and the trout are much happier fish now) <Ahh!> My Oscars had a diet of these shiners and pellet food for about 6 months . I haven't fed them any shiners in about 4 months now.. And I wont ever again now that I realize the harm I brought to my fish.. Not all my fish are sick. Mostly just my tiger Oscar.. He has hole in the head recently progressing very fast in the last 2 weeks. Holes are now through his gills. I treated with a jungle Metronidazole treatment for about 2-3 days 2 weeks ago with no major improvement. <Mmm, you did remove carbon/charcoal... the product was used as directed, at full strength...> I know that medication is not always the answer and that maintaining my tank is probably the most important for him to get better. Recently I have noticed holes in his fins and possibly loss of scales. <Not Hexamita here, but water quality...> When I vacuumed my gravel today I did see fish scales ..Oh no!! I also have small white worms 1/8 - 1/4 inches long in the gravel in my tank. <These are a third item... unrelated to the others> In researching they appear to be somewhat harmless. Protozoa I think they were <Uh, no... Can't see such w/o magnification> and they are apparently eating debris in the rocks.. Should I remove or kill these small worms? <I would not> Another thing I have noticed recently is that my fish used to have brown pellet like stool. Now I have noticed that it is clear and stringy. Somewhat like a small clear intestinal track. More than one Oscar appears to have this symptom. all have some signs of slight hole in the head. One is really sick with hole in the head and other symptoms that I described earlier. All are still eating at this point. I don't overfeed my fish. I wonder if maybe I underfeed them. I feed usually once every other day. Sometimes I find a bug or moth and they eat that as a treat. They do have a boring diet. They don't like homemade foods or Krill. They spit it out. I don't want to treat my fish for the wrong thing. I realize that this can be harmful to their health. Hopefully you will have some suggestions for me. Thank you so much for your time it is much appreciated.. Amy L I will wait for your reply. Ty <I'd return to regular water changes, use the source water straight, and read here: http://wetwebmedia.com/hllefaqs.htm and the linked files above. See WWM re "feeding feeders", water quality... Much for you to gain there. Bob Fenner>

I Forgot to tell you... More/less re Hexamita Hello Again, I just emailed a few min. ago. So you know... I have had Oscars for about 10 years. They never really got sick on me. Occasionally they did of course ,but they got better too. I have also been adding Aquarium salt to my tank. I had put salt in the tank a long time ago upon setting up. It wasn't necessarily a large amount. I have not been adding salt as I make my water changes. I never knew that it was important for their health. I am concerned to over salt my fish now. But I am adding the recommended dose, slowly so I don't shock them. Thanks Again for your time in this matter My fish will thank you. I am working on getting you a nice picture in focus. I will send it as soon as I can. Much Thanks Amy L <Please read where you were referred to... and learn to/use the search tool and indices on WWM. Bob Fenner>

Pictures of my Oscar possible Hemexia Hello Again, <Hi there Amy> Last time tonight. I should have sent this the first time I mailed you. Here are some Pictures of my sick fish. <Good ones too> I marked the picture with Yellow arrows. Hopefully you can see the blemishes, scales and the holes in fins.etc.... It really looks much worse in person. It is hard to take the pictures and sending them so small that's another challenge. I hope this helps in your diagnosis. Thanks So Much, AMY <Some of this is neuromast destruction/HLLE... Read where you were referred to. RMF>

update since yesterday... Reading Hello guys Amy L here "Sick Oscars"  2/15/08 Thanks again, for helping me with my problems. I think things will get better soon. My water temp. is now at 72 degrees. Should it be higher? <I would keep it in the upper 70's F.> ammonia still 0 and Nitrate still 10 before this water change. I also changed more water today. I hope I don't change too much and really mess up my balances. I refilled the 90 gal. tank In my basement. The water changes are pretty easy for me to do because I just turn the valve in the bottom of the tank to empty. So I really have no excuse for not changing more than 5 gal a week. Before I circulate the tanks I also emptied another 32 gallons from upstairs tank, by filtering out my rocks. They seem pretty clean on the most part. Some areas are a little dirty. I timed how fast my overflow puts the water back in my upstairs tank. It seems that it pumps about 30 gallons in 5 minutes. So 350-360 gallons per hour. Is that a big enough pump for my tank? 310 gal total tank with 4 fish? <Mmm, marginal... ten or even twenty times turnover would be better> I also run a maxi jet 1200 that filters with fiber fabric to mostly get floating debris. <Oh! This water movement counts as well> I have not added any medications today. As I am not sure what the best one to add is. I will wait to hear from you. After reading some articles, I'm leaning toward treating with Metronidazole again and maybe a fungal medication for fin rot. What are your thoughts. <For you to read. I would NOT continuously expose animals to this powerful antiprotozoal> I'm closely watching my Oscars soars and maybe they are healing. Some are darkening. I think that's good. Thanks again AMY <Darkening is a bad sign... Again... reading on WWM re Oscar Disease, Flagyl... http://wetwebmedia.com/metranidazole.htm http://wetwebmedia.com/FWSubWebIndex/oscardisfaqs.htm and the linked files above. Bob Fenner>

more information about my well water quality. Hi Bob, Amy here with the Oscars with "HLLE"  2/15/08 <Howdy> Thanks so much for your time. I will read where I was referred thanks. I'm starting to understand your sight better now. You asked how high my Iron is in my water. My water test shows that the Sodium is 61 Do I still have to add Aquarium salt? <... you still have to read> This isn't the same as city water. So here it is let me know what you think. All these say mg / l is that milligrams per liter? <Yes, equivalent to ppm> Iron 0.27 My Manganese is <0.03 Lead <0.005 Chloride <10 Hardness 24 Alkalinity 150 Conductivity 280 Nitrite Nitrogen <0.01 Nitrate Nitrogen <0.5 pH 8.28 Copper < 0.05 Fluoride <0.2 Okay thanks once again. Amy <Read... RMF>

Treating An Oscar with Hole-In-The-Head -- 1/04/08 I have an Oscar that has hole in the Head Disease. I have treated him on two different occasions over a three month period with Fish-Zole. The places on his head just don't seem to want to heal. He is in a 75 gallon aquarium with a canister filter which gets cleaned once a week. He gets a 25% water change once a week. His water quality is in the good range on everything. He gets a variety of foods (no feeder gold fish). He gets pellets, sticks, krill and a mixture of beef hearts, garlic, spinach, vitamins and other ingredients twice a week. He also gets Vita-Chem added to his pellets 5 times a week. He has a very good appetite and seems to be growing. Should I treat him with the Fish-Zole again or is there something else That I can use to heal the places on his head. I don't want to loose him. Your help will be greatly appreciated. Thanks in advance. Nancy < This disease takes its own sweet time to heal. If the lesions are not getting any bigger then you fish is probably cured. The wounds left behind are typically very slow to heal. They first turn black and then slowly start to close up. Check the nitrates. Try and keep them under 20 ppm. Your treatment methods are very sound and hopefully caught in time.-Chuck>

Treat Oscar With Hole-In-The-Head Part II  1/5/08 I checked the nitrates they are 10 ppm. Some of the places seem to be turning black but he has a few places that seem to be getting deeper. The largest one is about 1/8 across and the others are smaller. They are white in color. I have enclosed a couple of pictures. Maybe you can get a better idea of my problem. Thanks again. Nancy < This infection is pretty severe. Never seen it this wide spread before. Look for a medicated food with Metronidazole in it. Add it to your fishes regular diet. Keep the water clean and the diet nutritious like you have been. Drs FosterSmith.com sell a medicated food called Anti- Parasite. It has Metronidazole in it. Add this to the diet. Keep tract of the disease by taking pictures of your fish once a week. Date them and compare them over time to see if he is getting better.-Chuck>

Oscar With Hole-In-The-Head Gets Treatment  1/7/08 Thank you for your quick response. If you look at the picture that I have attached. The places midway up toward his dorsal fin and midway down his side are not the holes that I am talking about. He did those places on the gravel in the bottom of his tank. The holes are located beneath his gills and to the right of his eye which seem to be healing and the small ones on top of his nose. I have started him on the medicated food and also added some MelaFix to his water. Will see how this does. He really doesn't know what to do with those little pellets of food but I am sure he will find out. Thanks again for your help. Nancy <Don't feed him for a few days and he will be hungry enough to eat the new medicated food. It looks like you are doing everything you can possibly do.-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>

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>

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>

Repeated hole in the head disease, Metronidazole Treatment For HITH - 6/1/07 > My T bar Cichlid is suffering from his 3rd bout of hex this time he has a small visible pin sized hole above his eye and the usual white strongly pooh. Last time in September 2006 I treated the tank with Metronidazole 5mg/L and he recovered well. I have done a water exchange today and added metro at 5mg/L. Is this repeated dosage likely to harm my other fish? 2 cat fish 3 rainbows, 2 giant Danios and 1 rosy barb? < If treated as recommended this medication should have no effect on the other fish.> > Also do I need to do 50% water changes in between adding the dosages on the 2nd 4th and 6 days? < Metronidazole is affected by organics in the water. The cleaner the water the better the medication will work. Water changes also reduce organic waste. The tank is getting cleaner. The water is getting better and the medication is getting more effective. Sound pretty good to me.-Chuck> > Many thanks for your help

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>

Chocolate Cichlid With Hole-In-The-Head Disease   3/27/07 Hello; I thank for the great website. My experiences as an aquarium keeper have been greatly enhanced by what I have learned on your site. I purchased a 4 inch black ghost knife, and a 3 inch chocolate cichlid two days ago. They are both in quarantine in a 30 gallon tank;  79F, 0 ammonia & nitrites, nitrates 10-15. The tank has been running with a Pleco and Synodontis (and a few other temporary 'guests') for about a year an half. The BGK and chocolate cichlid are to eventually move into a 100 gallon Amazon tank. The problem and question:  After looking at the chocolate cichlid closely, he appears to have HLLE small lesions behind the eyes on both sides of his head. Three or four holes on each side. If I do a treatment with Metronidazole on this tank will I be endangering the black ghost knife? < The BGK should be unaffected by the treatment.> I've read about their sensitivity to medications. < They are mainly sensitive to dyes.> I plan to treat the tank every two days, after 30% water changes, as the package instructions state, for ten days. Then, follow up with a good diet and added vitamins. Any other suggestions or information greatly appreciated. Thank you very much in advance, Anna < Should like a solid game plan.-Chuck>

Angelfish With Hole-In-The-Head  -- 2/25/07 Hello! I have a freshwater angelfish with HLLE for approximately 8-9 weeks.   I have read over your FAQs, and have begun supplementing her food with  vita-chem.   I don't know if I missed this information, but do you use  iodide as a supplement in freshwater aquariums? Thanks, Lea < In FW situations the HITH disease is usually associated with poor diet, dirty water and stress. Start by doing a 50% water change, vacuum the gravel and clean the filter. Treat with a combination of Metronidazole and Nitrofuranace. The vitamins can't hurt and try a new high quality food that your fish will eat.-Chuck> Re: FW Angelfish With HITH II  -- 2/25/07 Thanks for your response.  I probably should have been more specific  with my original question.  I have kept aquariums for years and I currently  have 5.   My problem lies with my 90 gal fresh water tank.  I do weekly  partial water changes with a python gravel vac.  I have two Emperor 400  filters with 4 cartridges, of which I change only 2 at a time whenever they  become dirty.  My temp stays about 78-80 and my pH stays around 7.2 -  7.4.  I have well water with a very low pH  and I use a couple of  handfuls of crushed coral scattered in the gravel to buffer the pH up.  No  ammonia, nitrites, or nitrates.  My water is crystal clear.  Only  artificial decorations ; no live plants.  The tank has been set up for  about 18 months. My fish include 4 large angels and a much smaller one (the sick one).   All were purchased at the same time from the same tank at the same size.   The sick one appears to be the only female and she has paired with a male.   She is the most aggressive, and she was laying eggs regularly until about the  time she began to show lesions about two months ago.  The other fish are 5  large rainbowfish, 4 clown loaches, 5 blue Gouramis, 1 Otocinclus (the only one  to survive the angels) 2 Chinese algae eaters, and 6 Corydoras catfish. All seem healthy and all eat well, including the angelfish with HLLE.   I feed a variety of commercial foods including tetra flakes, tetra crisps,  shrimp pellets, algae wafers, Tubifex and bloodworms.  I recently began supplementing with a beef liver, chicken liver, shrimp, spinach, carrot, green  pea, and garlic mixture which they all seem to love.  However it stinks and  clouds my water (which does clear after about 1-2 hrs).  I have also begun  using vita-chem soaked food as an additional treatment for the HLLE. When I was reading your FAQs I realized you mentioned iodide as a  supplement for HLLE.  I didn't notice if it was to be used as a supplement  in freshwater tanks.  I saw it in the marine section.  I was  wondering if this was an additional step I needed to take to treat my  fish? < No documentation of iodine working on HITH in FW.> I have had all my fish for a long time.  The last fish I added were  the blue Gouramis around last July.  None of my fish seem stressed.   None of them lurk in corners or hang out at the top of the tank nor around the  filters.  The paired angels do like to hang near the magnet algae cleaner  where they usually lay their eggs.  Just thought you might have some  additional information for me if you knew I had already taken care of the  obvious ones.  I like pristine water and my fish actually seem to enjoy the  whole water change process. The angelfish with lesions has a large one (sort of gray no pink color,  like her skin is just eroding away) around her head on one side, and several smaller places along her lateral line on the other side.  No other fish has  any marks.  Would appreciate any advice you can offer for additional  treatment.  I have not tried any medicines yet. Neither have I  isolated her, as of yet. Thank you very much for your time, Sarah < When I responded to your question I said that three things are at work to cause HITH. Your water quality sounds good, although angelfish prefer soft acidic water. The diet sounds good but I would skip the livers. The female has been stressed from spawning and was weak and susceptible to disease. I still would recommend the earlier treatment in a hospital tank.-Chuck> Re: FW Angelfish With HITH. Nitrofuranace Vs Nitrofurazone  -- 2/25/07 In addition to my first reply, is Nitrofurazone the same as  Nitrofuranace?   If not, where do I find Nitrofuranace? < Same stuff.-Chuck>

Fresh Water filtration, HLLE questions   1/2/07 Hi Folks. <<Hello, Jim, and Happy New Year. Tom here.>> I have two large Blood Red Parrot Fish in a 55 gallon tank and am wondering what I can do to remove dissolved waste from the water like my Berlin airlift skimmer does for my 55 saltwater tank. The other day I noticed algae growth in the fresh water tank and cleaned out the tank.  Currently I am using two large filters on this tank.  One is a Bio wheel filter (pinquin <<Penguin>> I think)  and the other is an Aqua Clear 500. My question is what can I do to lower the algae growth and improve the over all water conditions and prevent  hole in the head worms from ever showing up? <<As with any 'problem', Jim, eliminating the root cause is key to success. In your case, as you most likely realize, excess nitrates and phosphates 'feed' the algae but lighting is, of course, another major consideration. In a great many cases, simply reducing light levels or the duration of lighting exposure can greatly reduce algae build-up in the tank. Ensuring that the aquarium isn't exposed to natural sunlight should go without saying. As for overall water conditions, vacuuming the substrate deeply in conjunction with regular water changes is an absolute must. (When I suggest 'deeply' vacuuming the substrate, I mean to the bottom of the tank.) Now, by way of explanation, Hole-in-the-Head disease (HITH) is the degeneration of the sensory organs in the head and/or lateral lines of the fish (you'll also see reference to HLLE which is Head-and-Lateral-Line-Erosion). Even though the disease has been arguably tied to high nitrates (>40 ppm)/poor water conditions, there aren't any 'worms' involved. In reality, improper diet and lack of appropriate vitamins/minerals are the commonly-held culprits of this illness. In a nutshell, regular water changes and substrate cleaning to keep your fish stress-free along with a varied, high-quality diet will all but guarantee that your Cichlids will never suffer from HITH/HLLE.>> Would a UV light help?    <<Not worth the money, in my opinion, Jim. You have little to no-cost options available to you -- might even save some money if you reduce lighting -- that make a UV sterilizer unnecessary. If, on the other hand, you have money burning a hole in your wallet and you find a unit suited exactly to your tank, water conditions, etc., it can help in reducing the 'suspended' algae and microorganisms in the water. Worthless for anything that  doesn't make it to the contact chamber, however.>> What about a canister filter with a built in UV?      <<A better option but you've plenty of filtration now and, again, there are more cost-effective options to exercise here.>> Would adding sand and live plants help? <<Now we're on  to something. The sand, in itself, isn't really necessary but the plants would be an excellent consideration if your Parrotfish will leave them be. Certainly a natural and inexpensive way to go if you're looking for something to out-compete the algae for nutrients. I wouldn't go crazy with this without a little experimentation to see if your fish will keep from tearing them up, though.>> Jim <<Well, now you've got my two-cents-worth, Jim. Hopefully, I've given you something to work with. Good luck with your tank. Tom>>

Experts Asking Experts, Hole-In-The-Head On A Flowerhorn   12/19/06  Good morning, Crew! I hope this day finds you well. Inspired by your example, I have been helping people with their fishy questions by volunteering at AllExperts.com. So far, everything has been very straightforward, but yesterday a gentleman overseas asked me about his Flowerhorn. I hope you don't feel that I am asking you to "do my homework" for me, but before I suggest any other treatment besides salt, I wondered if you wouldn't mind sharing your opinions on what appears to be wrong with this cichlid. Before he sent me the pictures, I told him it was probably Head and Lateral Line Erosion (HLLE). Although the pattern of erosion is not what I expected to see based on his descriptions, I still believe that HLLE is the causative agent here - but I wanted to double check with the real experts! Thank you so much for your assistance, you have always been so reassuring and helpful. There are so few free resources like this on the web at large...what you have here is remarkable. Happy holidays to all of you! I hope that a fab getaway is in your future! Nicole < The exact cause is not known. Generally a 50% water change, vacuuming the gravel and cleaning the filter improves the water quality and slows the progression of the disease. Treatments of a combination Metronidazole and Nitrofurazone have had some success. Some aquarists have also had good luck with Clout. After treatments have arrested the disease, a more nutritious diet with fresh ingredients and high vitamin and mineral contents speed the recovery. Vitamin C seems to be a key vitamin in getting a full recovery. many Flowerhorn breeders are obsessed with color and developing the fatty hump on the males. These high fat diets usually develop into diseases like bloat and the hole in the head that this Flowerhorn seems to have.-Chuck>

Cichlid May be Getting Hole-In-The-Head 10/10/06 Thanks for taking this question, I have a tank of various Cichlids and I noticed a round hole on the surface of the gill on my Brown/Black Cichlid. He seems to act fine and is eating well. Any idea what it might be? The hole looks pretty deep and I worry it may spread to other fish. Thanks for the help. Shaun < Many cichlids come down with hole-in-the-head disease. It starts as little clear openings around the gills and head. Sometimes the entire head erodes away it not treated. The cause is not clearly defined. Some say water quality while others think it could be nutrition. Cover your bases by doing a 50% water change, vacuum the gravel and clean the filter. Change the diet and try to include more nutritious foods. Try to add more vegetable matter to the diet in the form of veggie flakes or pellets. It starts to get really bad then treat with Metronidazole.-Chuck>

Oscar With Hole-In-The-Head  9/12/06 Hi crew. I have an Oscar which appears to have a hole in the head. I am not sure whether it is HITH disease. It appears to be very dull. Can you help me out with the cure and other things to cure it. Thanking you <Do a 50% water change, clean the filter and vacuum the gravel. Upgrade the diet top include more live and frozen foods. Treat with Metronidazole and keep the lights off.-Chuck.> Gold Severum.........is this hole in the head? Asymmetrical? No   8/14/06 hey guys, first off, great site as always. I have had a 150 gallon(6 foot tank)) setup for quite some time. Currently housing 6 inch gold Severum 7 inch Jack Dempsey 3 inch Oscar 4 inch Red jewel 3 1/2" Green terror (2) 5 inch banded Leporinus 4 inch Gibbiceps Pleco 8 Buenos Aires tetras <Must be fast!> I have 2 Emperor 400's for filtration <And lots of big regular water changes I hope> Recently I had a aggression problem that caused me to have to give away my 6 inch Green Severum, as he was attacking the Gold Severum often, and when he wasn't, he was extremely aggressive going for food. Since then I noticed that  what I originally thought was a bite wound on the side of the Gold Severums face has not healed. As i look at it now I am thinking that either the wound is not healing or they may just have been open sores from the beginning. Both are on the left side if the head, behind the eyes, and before the gills. There is no "pitting" as i have seen HITH described, however it does look like the larger sores I have seen in HITH pictures online. <Mmm...> Would treatment of non-healing wounds be much different than a treatment for HITH (if that's what this is?). <Are identical... improved nutrition, and water quality... sometimes coupled with the use of a protozoacide> I will add that i had been lax with maintenance these last 2 months the last 2 months of my wife's pregnancy), however, It had always been top-notch until now. <Oh> Hopefully i can solve with increased maintenance, and frequent water changes for a few weeks. Since i prefer not to have to set up a hospital tank if I can avoid it. <I would not here> Also, one last question. Regarding stocking. Will this tank be able to handle another Oscar without having to displace the current inhabitants? <Not a good gamble, no> I realize that having two fish that will be 12 inches long each may tax even this tank. Thanks in advance for any help you can throw my way! <If the pitting is not "symmetrical... bilaterally", that is, about the same on both sides of the fish, this is not likely HLLE, HITH... but "just" sores or pitting from poor water quality. Bob Fenner>

Gouramis With Hole-In-The-Head  - 05/23/2006 Hi there. OK. My eyes hurt.  Been reading your FAQ's.  Can't find definitive info on what I'm looking for.  I seem to have a Hole in Head "outbreak" in my aquarium.  I have a 60gal, heavily planted, tank; plenty of lava stone and wood for hiding.  Penguin 400 filter, CO2 diffuser, 17 Gouramis, a Pleco and a small Cory.  Water changes are every other week, (sometimes weekly if I think it needs it) Filter cartridges rinsed bi-weekly, changed monthly (per advise of LFS). Ammonia 0, Nitrite 0, Nitrates tend to be in the hi 20's, touching 30,  but I attribute part of that number to plant fertilizers.  Some products tote amazing cures, some say nothing helps Hole in Head.  Any suggestions on how to rid the fish of this?  Also.. is this contagious like Ick?  I do see it on 2 or 3 fish, but not the  other tank mates... at least not yet. Thanks. You guys are great John < Usually this is a problem with some New World cichlids and not associated with Gouramis. Do a 50% water change, vacuum the gravel and clean the filter. Treat the tank with Metronidazole and see if that helps. It could just be a bacterial infection and it may respond to antibiotics like Kanamycin. If you do decide to use antibiotics then watch for ammonia spikes because it may affect the biological filtration.-Chuck>  

Cichlid With Hole-In-The-Head    4/8/06 I have a 9' red flame cichlid that has developed raw spots on its head (above the eyes and below the dorsal fin, and between his eyes) they developed after his tank mate died about 3 weeks ago.  The spots seemed to have blood circulating to them because I see red within the areas. I do 25 -30 % water changes about every 10 days (55 gal whisper 3 filter) I have also been adding aquarium salt (1 tablespoon a day for three days now). I have had the water tested and is within the norm.  He is the only fish in the tank and has stopped eating for at least 4 days, spends a lot of time on the bottom.   When I turn on the light he comes to the top to eat, if he even bothers to take any Hikari cichlid gold pellets, he just seems to swim backwards any spits them out. These spots are not deep; they seem to be just on the surface.  The one above his eyes is approx ½' across and slowly getting bigger.  He has had these spots before but this big and not for this long. Any help you can provide would be much appreciated Thank you Dave < Do a 50% water change, vacuum the gravel and clean the filter. Treat with Metronidazole and Nitrofuranace. When he starts to eat , offer some live food live washed earthworms, and watch for ammonia spikes because the medication will affect the biological filtration.-Chuck> Hole in the Head and Eye Problems ... Oscars - 03/27/06 Hi WWM Crew, I have had Oscars since 1980 and never had any problems with them before. I believe that is because I pay such careful attention to water quality and diet. However, just recently one of my two 12" Oscars starting laying on the bottom and gasping for air. This has gone on about a week. The pH, Nitrates and Ammonia are perfect. I feed them Hikari pellets. The one in question has one boated eye and lays on the bottom of the 80 gallon tank. If I reach in and touch him he has good energy and swims strongly across the tank. He can also come up for food but lately I can tell it is getting harder for him. The only other symptom is a slight hole in the head which I treat but can never seem to make go completely away. I have tried Maracyn TC as I thought it was bacterial. Then MarOxy as the Maracyn TC did nothing so maybe it was fungal. This also did nothing. I have tried salt and several water changes but nothing seems to work. Any thoughts? Art <Most eye problems, as well as Hole in the Head, start when too much organic matter starts to build up in a tank. Please re-test the water. After a few rounds of meds you have probably lost your cycle. Also, when doing a water change always use a gravel vac to remove as much waste as possible. Hole in the Head is caused by a protozoa. Metronidazole is the drug of choice. However the wounds caused by the protozoa can become infected by bacteria or fungus. Keeping your system pristine will help greatly. This will also help with his breathing and eye problems. Should the eye begin to swell, add Epsom salt at the rate of one tbls per 5 gallons. Replace the Epsom salt in the new water when doing a change until the swelling goes down. Don>

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>

Oscar... human health/siphon Problem   2/9/06    I've been reading the page, very helpful. I have one Oscar that is a foot long and he has hole in the head, I ordered Flagyl and it should be coming in a few weeks. when I was changing the water, I got some in my mouth while sucking on the tube to create suction for the water. does this disease of the one celled organism effect humans also? <Good question... I don't believe so... and unless you have an ulceration in your stomach or small intestine, I don't think you need to be concerned here. I do suggest that you develop a "non-sucking" method of starting siphons though... I hold up the end of the hose, vacuum and get water started down, then dip the end back in to prevent siphon loss. Many techniques... Bob Fenner>

Cichlids With Hole In The Head  1/16/06 I have a problem with four of my Cichlids and I was hoping you might be able to shed some light on it for me. The fish involved are 1 Aurora (3-4 inches), 1 Daktari (3-4 inches), 1 Hajomaylandi (3-4 inches), and 1 Venustus (6-7 inches). All four have developed a kind of indentation on their back, between the eye and beginning of the dorsal fin. It is apparent on both sides of the fish. They are all still eating well but do seem to be swimming somewhat slower. This has appeared since new years day when, unfortunately, we lost eight fish to a temperature spike. The other fish, eight surviving originals and four new ones (purchased after the loss) all seem to be fine. I have searched for an answer but haven't found one as yet, when I found your site I thought you might be able to help. Kind Regards, Michelle. :) < When cichlids get stressed from bad water , aggression or temperature extremes they sometimes will get a symptom or disease often referred to as Hole-In-The-Head. It is often seen in discus and many larger South American species but actually quite rare in African cichlids. Keep the water around 75-77 F. Make sure that the pH is up around 7.5. Do a 50% water change, vacuum the gravel and clean the filter. Get a fish food with Spirulina algae in it. I would try to treat the tank with Metronidazole. If you can. Try and find a medicated fish food with Metronidazole in it.-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> 

F/W Angelfish, Hole-in-the-Head - 10/28/2005 I have a black angelfish that has a white lesion above one eye. It started out as a simple spot a week or two ago, but now it looks as if it's grown and is protruding out from under the skin. Meanwhile, it also has some pinholes appearing in the area behind his eye and gills.  <A very classic description of "hole-in-the-head" disease, or "head and lateral line erosion" (HLLE).> His fins (and the rest of his body) are fine. None of the other fish have been affected. The attached photo isn't great (the tank background is black) but you can see the brightness of the spot (part of it is glare; the spot itself is probably about 2mm in diameter) and maybe the pinholes if you look closely.  <Your description is actually a little clearer than the pic - thank you for sending the image as well.> <<Photo...??>> <<<Photo was lost in the recent webmail weirdness we've experienced.  -SCF>> The system: 50 gallon tank with two angels, two Balas, 2 rainbows, 1 zebra loach, 5 T-Bone Rasboras, some live plants. The tank has been established for 2 1/2 years, with the most recent livestock (Rasboras) being added about six months ago. I have a Penguin 170 hang on/BioWheel filter and a Magnum 350 canister filter. I vary their food: flakes, granules, freeze-dried brine and frozen bloodworms and vegetable matter. Any idea what it is and/or what I can do for it? <First, I note that you make no mention of your water quality. Test ammonia, nitrite, and nitrate, and maintain ammonia and nitrite at ZERO, nitrate less than 20ppm, with water changes. Next, take a look here: http://www.wetwebmedia.com/FWSubWebIndex/fwhllefaqs.htm  and here: http://www.wetwebmedia.com/hllefaqs.htm  for further information and ideas. Make sure to take the opportunity to check out the links in blue at the tops of those pages, as well.> Thanks, -Melissa <Wishing you well, -Sabrina>

Oscar with Hole-In-The-Head  9/13/05 My Oscar has hole-in-the-head. I treated him before and he looked ok. I put him into my 125 gallon tank about two weeks later the holes are back, mucus is back. The holes are in his cheeks and he has a puffy eye. On my second 9.5oz bottle of hole-n-head guard by Jungle. Won't eat the medicated food after 2 days but will eat other food. I change the water every other day with RO water. What can I do to help him. He is six inches long if that makes any difference. <First of all, if you want your questions answered you need to include some punctuation with your sentences. I know this takes a little time but it helps us understand exactly what the situation is so we can give you the best advice possible. Secondly, we only have so much time per day to answer questions and we much rather be answering questions and helping people than correcting grammar or trying to figure out what is being said. Put you Oscar in a hospital tank with clean water. Treat with Metronidazole and Nitrofuranace for three to four days as per the directions on the packages. Change the diet to include some live or frozen food. Keep up on your water change and clean the filter often.-Chuck> Oscar With Hole-In-The-Head  8/30/05 Hey WWC! I have an Oscar that I'm afraid that has HITH.  What are the symptoms of this disease and how can I treat it if it is  HITH? < Look for pitting around the head, behind the eyes. Change 30% of the water, vacuum the gravel, clean the filter. Treat with Metronidazole as per the directions on the package. Feed a high quality food.-Chuck>

Red Oscar HITH 8/25/05 I lost one 3 years ago to HITH disease although "Rocco" is still hanging on. I just treated him with Metronidazole. Forget about it that stuff made all my fish ill and killed 3 silver dollars immediately. <Is toxic... and many folks don't treat it, realize how much so> please let people know that liquid Baytril is what helped "Rocco" in his earlier days! <You have done so here> That was 5 years ago. Now he's worse than ever and I am unclear if he's just ready to go. Is this Old age or just the disease. <Perhaps a bit of both... how about nutritional inputs?> He is 6 years old. Is he still young? <Mmm, no... more like "middle-aged"> His hole is increasing in size, he didn't want to eat, his eyes are starting to get cloudier by the day, he lays at the bottom of his 55 gallon tank and vibrates his tail, what is that? <Bummed> Should I go get the Baytril again? An will it harm my other 2 cichlids, Pleco, and silver dollars?-Thanks! <I would try improving nutrition, water quality... Please read here: http://www.wetwebmedia.com/hllefaqs.htm and the linked files above... Oh, and yes, the marine references also apply. Bob Fenner>

Re: Red Oscar HITH  8/26/05 Thank you for your input! My tank is eating Spirulina cubes and plankton cubes, brine shrimp, blood worms, etc. Should I get something different or continue and then add vitamins and perhaps Baytril as well. I appreciate any information you can give me. Thank you. <Please read here: http://www.wetwebmedia.com/hllefaqs.htm and the linked files above. The root of your problem is likely nutritional primarily, environmental secondarily. Bob Fenner>

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>

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

Flowerhorn Treatments Dear Sir, I really appreciate for your valuable answer. According to your answer you recommended me to use Nitrofuranace. My question is Can I use Tetracycline instead, Sir? < Tetracycline will work in clean soft acidic water. It is not as effective in hard water.> The black marks spreads gradually on his fin. And I also see some hole in his head.  So, what shall I do for this hole? < The hole in the head is a matter of sanitation and quality food> I'll be waiting your reply. Thank you so much for you help. I'd also be glad if you reply me in a very sooner time as I'm so worried for my baby fish. Thanks a lot! < Clean the tank as recommended and add some live food to the diet such as washed earthworms, shrimp and a quality fish pellet. Keep the nitrates under 25 ppm with water changes. If the hole in the head gets worse then treat with Metronidazole.-Chuck> 

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