HLLE/Treatment And Nutrition 2/25/09
Hi there, thanks for the help.
<Hello Bob, and you're welcome.>
I have a 55 gal reef tank. I inherited a Yellow Tang from a friend to add to the tank along with my Flame Angel. Both the angel and tang contracted HLLE because I was feeding too much of a carnivore diet.
I have now switched to Formula II, Ocean Nutrition green algae, frozen mysis shrimp soaked in Selcon, and omega one freeze dried shrimp which is really good for soaking the Selcon in. They are fed the algae every day.
The HLLE is reversing noticeably on both fish. The Tang's tail was eroding and is now fully back and his top fin (dorsal?) had almost eroded completely away and is now growing back. Plus, you could see red lines on the body of the tang which are now gone. Both fish have regained much of their color.
<Great, nutrition is the leading cause of HLLE and water quality can/will play a part also.>
My question is that I don't want this to happen again so I'm trying to vary the diet as much as possible. Would it help to feed other colors of algae- red or brown, to help vary the diet?
<The ingredients found in Formula II should do the trick. See below.
Plankton, gel binder, spinach, shrimp, krill, clams, krill hydrolysate, lettuce, peas, sardine meal, salmon egg oil, squid, kelp, lecithin, casein, Spirulina, cod liver oil, paprika, vitamins (choline chloride, ascorbic acid including stabilized vitamin C, vitamin E supplement, niacin, thiamin mononitrate, folic acid, calcium pantothenate, riboflavin, menadione sodium bisulfite complex, vitamin A acetate, pyridoxine hydrochloride, vitamin B12 supplement, vitamin D3 supplement, beta-carotene supplement, biotin), amino acids (dl-Methionine, taurine, lysine) and trace elements of manganese sulfate, zinc sulfate, copper sulfate and sodium selenite. >
Also, I know freeze dried food has the least amount of nutrients but is good at soaking up supplements, is it worth doing?
<Just adding Selcon to the tank water should suffice. <<Saltwater. RMF>> Fish drink their surroundings, but no harm in adding to the food.>
Any other frozen, dried, or freeze dried foods or supplements would you suggest?
<New Life Spectrum Pellets is an excellent nutritional food you may want to add to their diet. Will definitely bring out more color in fish. Is one of the staples I use in my feeding program. May want to check this article out along with related articles and FAQ's.
http://www.wetwebmedia.com/foodsppt1.htm>
Thanks so much for the help.
<You're welcome, and thank you for sharing your apparent success with HLLE.
James (Salty Dog)>
Bob

Success in curing HLLE 05/30/2008
Hi WWM crew,
<<Good afternoon, Andrew today>>
I have always appreciated the fine work you do for the marine fish/reef keeping community, and keep up the excellent work!
<<Thank you for the kind words, much appreciated>>
This time I have something to offer. Not claiming to be an expert or anything, just one more success story and data point for the common HLLE problem among Surgeonfishes.
<<Ahhh...the best emails to receive, success>>
Some background: I have kept a Hippo Tang for several years, and he has always been healthy, active, and eats a lot. I have always fed him frozen brine shrimp, mysis shrimp, Spirulina pellets and krill pellets. However, due to bad LFS advice, he was stuck in a 37gal system for a while, which is way too small for such an active fish. A year later, he started developing HLLE. He had a small pit developing on both sides of his head, behind the eyes.
<<Such a shame>>
This year, I finally setup a 125g system with a 30g sump, and moved him over. He seems much happier, but the HLLE condition was still there, with no signs of improvement. Granted, it was only a very mild case, since the rest of the head and his body looked absolutely fine, but since this is not normal in wild specimen, I wanted to cure him. Two weeks ago, I started adding sushi Nori to his food. For the first day or two he refused to touch it. But persistence paid off when I shred the Nori in little pieces and mixed it to his favorite frozen mysis/brine shrimp, and he consumed everything with gusto.
<<Superb news>>
A week later, I saw blue color appearing on one side of the pit behind his left eye. It seems like the HLLE is starting to heal. I wish I could take pictures, but he wouldn't stay still for a portrait :-(
<<he he he he.. they never do stay still when you want them too>>
It seems HLLE is a diet related condition, but until he is fully healed, I will keep monitoring his progress for the coming weeks and report any more findings.
<<It is of my personal opinion, that diet is one of THE main contributors to HLLE, so, I agree>>
I thought the Hippo Tang is unique in Surgeonfishes due to it being a planktivore, but I guess having some more greens in his diet wouldn't hurt, and maybe the missing link to the mystery of HLLE.
<<I am really really glad you have been able to rectify the HLLE in the tang, such a beautiful fish, yet seen so often in captivity suffering from HLLE, along with the yellow tang, such a shame for them. I do hope that you email here will be a an invaluable read to others who are experiencing the same issue.>>
Hope this little piece of information is valuable!
Isaac
<<Many thanks for sharing your experience with us, and really glad you perceived to achieve a positive outcome. Kind regards, A Nixon>>

Regal Angel HLLE 3/19/07
Hello Wet Web Crew. I hope all is well.
<Quite well, thanks.>
I wanted to provide some input (maybe beneficial to some reader out there is the same boat) about a recent experience I had with a Regal Angel and IMO a 'miracle product'. <I usually hate that term but I cheated and read ahead, and am in agreement.> About 6 weeks ago, I obtained a regal angel from a tank at a restaurant that I frequent. The little guy was not looking healthy and had the beginning signs of HLLE. I spoke to the owner of the establishment and provided my observations. I told him that these fish are difficult at best to care for. He explained to me that they have a company come in every two weeks to service that tanks and he would let them know. I went back a week later and the situation was the same. I spoke to the owner and asked if I could take the fish. He agreed and I went the next day (before opening) and got the fish. <Good for you and the owner.>  I brought him home and placed him in QT for 3 weeks. <Good to hear.>  Initially, I could not get him to eat anything (I believe this also to be the problem at the restaurant). I tried Mysis, frozen angel formula, Nori, flakes, Formula products, fresh shrimp, clams, and squid. He would not eat anything. He would pick at LR, but that is about it. I was out of options, until I was cleaning out a cabinet where I store my dry products and came across some New Life Spectrum Marine Formula pellets. I think that these were about a year old, as I had not been feeding them to any of my tanks at the time. I had nothing to lose at this point and dropped a few in the QT tank. I watched them sink to the bottom and the regal was uninterested. I came back a while later, and noticed that they were gone. I dropped a few more in the tank and the regal went nuts. I started feeding him 3 times a day with the pellets. He was doing so well on the pellets, that I started feeding all of my tanks the pellets. He has now been in my 210 gal main display tank for 3 weeks now and is doing awesome. His color has returned, no signs of HLLE, and he is now eating Cyclop-eeze along with his pellets. Aside form that, all of my fish never looked so good.  IMO, the New Life Spectrum line is absolutely amazing stuff. This food should be a staple for anyone who owns a marine tank period. I have also started feeding my sun polyps the small fish formula and they seem to love it also. This stuff is truly incredible. I hope that someone from the New Life Company reads this. They should be proud of this product.
Best Regards,
Dean Oliver
<I agree, I really love this food.  All our tanks, both fresh and salt water get this line.  Makes a great staple food, some even claim to feed it exclusively, although I still won't go quite that far.  But don't minimize your work either, the QTing allowed the fish a chance to start eating which would not have happened if competing with tankmates.  Congratulations on your success with this difficult fish and thanks for sharing your story.>
<Chris>

Re: HLLE
How does one measure the skimmer's efficiency?
<By the quantity and quality of material removed, by the change in ones water quality measures, by the apparent improvement in the vitality of your livestock>
I have a small Berlin Airlift which produces about a quarter inch of waste per week in the cup.
But even if the yuck doesn't make it into the cup, it seems to collect on the walls of the tube prior to going over the edge.
  The pump is a Tetra Deep 24-2, which goes to a two levered bi-valve.  This provides for some under gravel bubbles as well as skimmer operation.
<Time to upgrade... big time. THIS is the tool (lacking) that is largely responsible for the HLLE you're experiencing>
For water quality, I keep an ammonia alert in the tank.
<This device is inaccurate and unreliable>
I thought for sure that the recent power outages during the Santa Ana winds were going to kill my bio filtration, but there was never any ammonia build up, and my ph always tests ok.  I used to let a lot of green algae grow on the rocks thinking that this would reduce my nitrates, but since my tang has taken up residence, he has seen fit to nibble it all away.
Are nitrates removed with the organic waste by the skimmer?
<To some degree (comma or no) yes. Bob Fenner>

Re: HLLE
I guess I should have prefaced my inquiry with the tank size.  We're only talking about a 30 gallon hex tank with 3 filter devices...the mechanical filter hanging off the back (Hot Magnum), the under-gravel filter, and the protein skimmer.  I know it's not a major league skimmer, but with only 3 inhabitants (5" puffer, 3" tang and 2.5" hawk) I figured the combination of filtration methods would be adequate.  No?
<Thanks for the further input, but no... the puffer and tang produce much more "gunk" than your present skimmer is removing... and it's malaffecting their health, particularly the more sensitive tang. I would upgrade the skimmer. Once you see the amount of material further removed, and the tang improve you'll be a believer. Bob Fenner>

Can HLLE Be Reversed? Testing A Theory
Scott-
Thanks for getting back to me so quickly!
<My pleasure- we all try to get back to our WWM readers as quickly as we can...>
I just have one more question, how long should I wait to try a medication treatment if what I am doing now doesn't show any improvement with the head erosion?
<Well, it's tough to be certain...There is a certain amount of controversy on this subject, with a fair number of hobbyists asserting that HLLE cannot be reversed...I, personally, have seen a number of cases where tangs with HLLE had the damage heal up considerably with time and positive environmental manipulation. I have not personally tried medication for this-its effectiveness is not conclusive... Now, I did mention that medication is thought by some to be a potential remedy for this condition (assuming it is a bacterial or protozoan malady- remember, that's just another theory), but I failed to mention that it is not always a great idea to subject an otherwise healthy fish to medication on a continuous basis...If you are inclined to experiment with medication, I would a) Do it in a hospital tank and b) give the fish a month or so of good environmental/nutritional enhancement before attempting this experiment. After a brief (we're talking a week or two) of treatment, I'd call it a day and return the fish to it's tank...Best not to cause the fish any additional stress...Especially if it is otherwise healthy! Hope this helps! Scott F>

Reversing HLLE?
I noticed what appears to be the very first signs of lateral line disease in my newly added blue regal tang. It looks like a few very small white spot down the lateral line of his body. it is a very small fish and shy so very difficult to really get a good look. He is very active and eating voraciously. Either way I would like to feed him the best possible diet to head off this disease before it gets more serious.
<Agreed...Diet is just one element thought to contribute to this condition, however. Environmental conditions are also thought to be a factor>
I currently feed the flake version of formula one and a product called Omega One Super Veggie (Because it was recommended over formula two to me) back and forth because I have 3 pairs of clown fish and 2 tangs. (should I feed them both at once instead?) I feed Nori every few days.
<Omega One makes some fine flake foods...You could use either one of them. However, I am a big fan of frozen foods, myself. Nori is a nice supplemental food. Although largely planktivorous, the Regal Tang is also fond of Gracilaria macroalgae (which is one of my favorite tang foods!). Try a little of everything- quality and variety are important>
I was wondering a couple of things.
Are HUFA based vitamins the kind they need, I have a powdered form I sprinkle over mysis shrimp for my sea horses. Or another type or more than one, I haven't really ever used the different types of vitamins other than Vibrance II for the sea horses, so I am really not sure which type to pick.
<I have used Ocean Rider Vibrance on lots of different fishes with great results! I also like to use Boyd VitaChem, and Selcon liquid on frozen foods...All of these are effective enhancers>
I have read your some of the posted e-mails and articles suggesting home made food which sounds great! Is there a recipe for it somewhere and what kind of things could I put in home made food that would really be the most beneficial for tangs and reversing/staving off HLLE?
<Bob has a great recipe in his "Conscientious Marine Aquarist" book, for what he calls his "Wonderful Mash"- good stuff- albeit a bit "pungent"! There are a number of other recipes out there...Do a little searching and you're bound to find something...>
And could I make a good mixed food for clowns and tangs without
suffering the tangs nutrition?
<Well, variety is important...Remember, however, as mentioned above- that nutrition is just one aspect of the HLLE condition- environmental conditions need to be addressed>
The other question I had was it said on one of the articles the use of carbon was a possible contributing factor to HLLE. I was just curious why that was? I have heard a lot mention to not use carbon in salt water tanks, but they never gave me any reason why.
I have bio wheel filters and they have the removable inserts that
contain carbon.
<I don't really buy into that one, myself. I guess that the thinking is that carbon removes trace elements and other components of the water, which can cause some deficiencies over time. While I don't argue with the statement that carbon is capable of removing these substances, it is also removing dissolved organics, etc, and contributing to better water quality. The key is regular "replenishment" of trace elements via...water changes! If you employ regular small water changes, then the whole "carbon contributes to HLLE" argument is a bunch of fish poop, IMO. My advice to prevent and reverse HLLE: Feed quality foods, maintain excellent water conditions, and use grounding probes to help zap stray electrical voltage (another one of the theoretical "contributors" to HLLE). Monitor water chemistry carefully and regularly, and keep things stable...Change that water...I'm sure that these practices will help arrest, or possibly even prevent HLLE...>
Thanks in advance. It is hard to get really solid advice out there when most of the time the person giving it to you wants to sell you things.
<Yep- I can relate...The only thing I want to "sell" people is the adoption of a regular water change regimen! I know that the salt and RO/DI system manufacturers must love me!>
Between your staff and Syngnathid.org, you guys have really made my reef/fish keeping experience much less troubled! Kelly Peters
<Glad to hear that, Kelly! Best of luck to you! Regards, Scott F>

Head & Line Lateral Disease
I have a 55 gallon fish only tank containing a Blue Line Grouper, a Sohal Tang, and an Emperor Angel. The water parameters are all well within acceptable limits, with excellent water clarity. I do frequent water changes. I have been feeding 4 times a week a varied assortment of frozen and freeze dried foods including Marine Supreme, Krill, Mysis Shrimp, Squid, supplemented with Spirulina and sheets of Marine Algae. The problem - my Emperor appears to be developing H&L Lateral Disease and is losing some of his caudal fin. From what I have read of this disease, it is attributed to diet and/or water quality. I am going to start feeding more frequently to see if that has any affect. The Emperor is very active with a VERY healthy appetite but this is starting to concern me. I have been trying to reverse this for about three months with no luck. Do you have any suggestions? 
>>
Two principal ones, both related to the probable causes as you list them:\
1) Supplement the animal's diet. It's widely held that HLLE is tied to/directly attributed to avitaminoses... Apply a liquid vitamin AND iodine additive to the Angel's food prior to offering it. These preparations can be bought "for fishes" or made from human-intended materials.
2) For improving water quality, do try an "algae and mud" filter in a sump if you can (versus right in the tank)... In a sump, with its own light, some live rock, and Caulerpa Algae... leave the light on continuously IMO, or put it on a reverse light photoperiod... this growth will greatly improve water quality, adding some necessary items to the water... that your fishes drink continuously.
Bob Fenner

Getting around the website
Hi Bob,
I've been looking around your website for answers regarding HLLE with my juvenile Emperor Angel and I can't seem to locate the article on Environmental Diseases regarding HLLE you also mentioned
<http://wetwebmedia.com/marenvdi.htm>
iodide and algae filters it seems I am only able to access FAQ's
<Ah, yes, sorry. This is all that is currently posted... these articles/book sections are pending publication elsewhere... and just serve as place markers for the FAQs to date... these FAQs are what I am encouraging you to peruse>
I know I'm doing something wrong but if you would be so kind, could you explain or direct me how to build this filter and the brand of vitamins and iodide to give my angel?
<See "Oz's Reef" link on WWM Links pages re the filter, the vitamins: Selcon, Zoecon, Microvit are my faves>
Thanks so much,
Tom
<You're welcome my friend. Sorry for the confusion. Bob Fenner>

Sailfin Tang/HLLE
Hello,
<<And hello to you, JasonC at your service...>>
My Sailfin tang has developed a pretty serious case of HLLE. Most of its face is worn away, and his lateral line is worn away too. Is there any way to cure this. He has been living with this for a long time now and is doing fine. It is just ugly looking. I have vitamins, and iodine. I also have one of those metal rods that remove extra electricity from the tank. Is there any way to cure this? <<HLLE is typically caused by nutritional deficiencies. What are you feeding? I'd begin here. Do also read through the HLLE faq on our site:
http://www.wetwebmedia.com/hllefaqs.htm 
Cheers, J -- >>

Re: HLLE
I feed frozen algae formulas, the algae sheets you put on a clip, Spirulina pellets, I also feed brine shrimp that is mixed with Spirulina. I soak the food in vitamins also. Thank you for your help!!!
<<Sounds pretty good except for the brine shrimp - less nutrition than potato chips, even with the vitamin enhancements. You might try substituting these with mysis shrimp. The algaes are good, but you might want to try and get some live algal material in there as well. Perhaps more, or renewed live rock... these fish like to pick at the fauna on live rock all day long. Cheers, J -- >>

Diet
Recently, I started feeding my marine fish mysis shrimp together with Spirulina soaked in Zoe. Soon thereafter, having switched from Formula One & Two to this, the Purple Tang developed Lateral Line or Hole In the Head Disease.
<Probably not the cause, but not helping matters either.>
Though the mysis has lots of protein, might this be the cause of this affliction and should I cease using it in deference to a greater mixture of frozen food along with lettuce occasionally?
<Lettuce is terrible. Keep feeding what you are, plus add the Formula II back and get some Nori and vitamins to soak your food in addition to the Selcon.>
THANKS, Stephen Pace
<You are welcome. -Steven Pro>

Adult Emperor Angel with hole(s) in the head - getting worse
Hello,
I have a 6 " adult Emperor who has been in a QT for 10 weeks. First he came down with ich, then gill flukes (fresh water dips took care of those problems). For the past 6 weeks he has been suffering from HLLE. He has deep holes just around his head and especially around the mouth (nothing along the lateral line, though) and he is getting worse. QT is a 40 gallon with a Remora skimmer, Penguin 300 filtration, 20% water changes weekly, no meds, his diet comprises of mostly Formula II soaked in Zoe, Mysid shrimp w/Zoe once or twice a week, Nori once daily, occasional shaved prawns. I tried Hexamit and it helped him a little bit for a while, but he is worse now. What is wrong?
<It sounds like simple HLLE. I would add sponge matter to this diet and perhaps switch your food additives to Boyd's Vita-Chem and American Marine Selcon.>
Thank you.
<Good luck! -Steven Pro>