Antibiotic Advice for treating an ulcer on a Betta

[liam2317]

First off, thanks in advance for any advice you can offer, I am so happy to have found this forum. It looks like such a great community!

1~What type of fish is afflicted? In addition, please describe what is wrong with the fish to the best of your ability (i.e. cotton like growth, bloated, etc.).
Here's the problem, I've got a Betta fish named Raffi who isn't doing too well. He has an skin ulcer (open wound) on his face that just wont go away. Please see the end of this post after my answers to these questions for the details!

2~What are your tank parameters (ammonia, nitrites, nitrates, temp, pH)? Please give exact values.
Ammonia: 0ppm
Nitrites: 0ppm
Nitrates: ~ <5ppm
Temp: 25.5C (78F) - Heated
PH: 6.6 - A PH of 7.2+ is recommended for [FONT=Verdana, Arial, Helvetica]Erythromycin treatment but I think that tr[/FONT]ying to change the PH that much would likely cause more harm than good.

3~ How large is the tank? How long has the tank been set up?
5 Gallons, it's been setup for about a year

4~What type of filtration are you using? Please give the name and number (i.e. Fluval 304) and amount of gph if known.
No filter, tons of live plants though.

5~How many fish are in the tank? What kinds of fish are they and what are their current sizes?
Just the one betta and a few pond snails.

6~When is the last time you did a water change and vacuum the gravel? How often do you do this? How much water do you remove at a time?
Approx 50% water change weekly.

7~How long have you had the fish? If the fish is new, how did you acclimate it/them?
3+ years

8~Have you added anything new to the tank--decor, new dechlorinator, new substrate, etc.?
No.

9~What kind of food have you been feeding your fish, have you changed their diet recently?
Hikari Betta Bio-Gold Pellets - Some live mosquito larva in the summers .

Photos:
Click images for full size - they are very large

October:


This week - odd photo but it's just the front of his head sticking out of a cup he likes to rest in:


Details - Treatment so far:
First we waited about 2 weeks to see if the ulcer would just go away, it was quite small but then it got noticeably larger so we treated with 10 days of 1tsp/gal aquarium salt. At the end of 10 days the wound was just about entirely gone, just looked like a small hole, not white at all. A week later it was back and as large as it ever was. So we did some research and tried treating it with the antibiotic Kanaplex. I did the recommended dosage (I believe it was 3 treatments 2 days apart each) and he seemed to be doing better. The growth of the wound stopped and for a week or two it looked like it was actually getting a bit better/smaller in diameter. Raffi seemed more energetic too.
However in the last few days it seems to have switched and is now getting worse again. Raffi seems to be hiding a lot more than normal too and having some swim bladder issues with floating.

Today I bought some of the antibiotic [FONT=Verdana, Arial, Helvetica]Erythromycin hoping that it would be the solution, my reasoning being that the Kanaplex treats namely gram negative bacteria and since it did not solve the problem it is best to try a broad spectrum gram positive antibiotic like [/FONT][FONT=Verdana, Arial, Helvetica]Erythromycin which on the package states it treats "Open red sores".

The problem & Questions:[/FONT]
[FONT=Verdana, Arial, Helvetica][FONT=Verdana, Arial, Helvetica]Erythromycin is known to kill or damage the biological filter and since we have no real filter I'm quite worried about using it in his home aquarium, I would much rather do it in a hospital tank. The issue is that the instructions on the [/FONT][/FONT][FONT=Verdana, Arial, Helvetica]Erythromycin are to do a 25% water change every second day during treatment. In an uncycled hospital tank I am not sure that 25% every 2 days is going to be enough to keep ammonia and nitrates/ites down. Might it be better to do it in a hospital tank with a very large water volume to dilute any ammonia/nitrites? I do have an empty 20gal tank....

I am also wondering if it would be a good idea to try the Kanaplex again at the same time as the [/FONT][FONT=Verdana, Arial, Helvetica][FONT=Verdana, Arial, Helvetica]Erythromycin (this article says that is okay to do)? My understanding though, is that once you have used an antibiotic if it did not treat the problem the first time it will likely just be less effective the second time. That being said it seems like a one two punch of both gram positive and gram negative antibiotic could be a really good thing.

And lastly I'd like to try the aquarium salt again now as it's been at least a month since we did it originally. Would it be better to the the aquarium salt while doing the antibiotics or do the antibiotics and then immediately do the salt?

Thanks so much for any help you can provide!
[/FONT][/FONT]

 

[jlk]

Welcome to AA!!! Thank you for your comprehensive information! This is always immensely helpful in trying to help our fishy friends.

Ok, although bettas are not my area of expertise, what your betta appears to have does not appear to be an ulcer. Ulcers are pitted, open areas that may be red or grey in appearance (or red-ringed). Based on your picture, it looks more like a growth but perhaps it looks different in person? Or do you have a clearer picture of the area?

The fact that he improved after treatment with kana indicates there is a bacterial component here. The issue is with the dosing schedule suggested. It's not sufficient to treat an infection and often, an infection will return with greater virulence and be more resistant to treatment. Risk with dosing correctly is that can cause kidney damage.

Proper dosage rates are 400(+)mg/10g, dosed once every 24hrs following a 25-50% water change. Treatment with any antibiotic is bare minimum of 7 days. Recommended is a minimum of 10 days then assess the situation and decide if further treatment is necessary.

You can dose of low amount of salt if you wish- I would personally keep it at no higher than 1 level tsp/g. Dissolve the salt in some conditioned water and add solution gradually over 24hr period. If you have live plants, reduce the amount to 1/2tsp/g. Only add back the amount of salt you remove with water changes. If you have any questions about using salt, please ask!

Erythromycin has a very (very) limited spectrum of fish issues that it may help with as it's a gram positive antibiotic, not a broad spectrum antibiotic. Your ph is within acceptable range for its use though.

In general, if a med is not within a compatible range for your ph that means you need to use an alternative med that will work within your tank specs. Trying to alter your tank parameters drastically in order to dose a specific med is very counter productive to what one is trying to accomplish in the first place (returning fish to healthy state) and will likely result in further stress and greater health issues.

Hope this helps a bit! Feel free to ask any questions!




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[liam2317]

jlk, thanks for your reply.

To clear things up, it is defiantly a hole, not a growth. I would describe it as grey/white in the middle and pink around the edges and in the newest area. I wouldn't really call it red though. The white/grey area looks like it may be dead tissue. It really just seems like something is eating away at the flesh and making a hole as it goes.

At this point what would you recommend doing? I really just have no idea.

• Retreating with the Kanaplex for 10 days at your specified dosage?
• Treating with both Kanaplex and Erythromycin for 10 days?
• Try the Erythromycin on it's own, for 10 days?
• Something else?

I agree with you, that trying to change the PH is probably a bad idea.

 

[jlk]

Thanks for the info! What your describing sounds like a classic ulcer description. And, yes, the white/grey center area is necrotic (dead) tissue. Because you saw some improvement with the first try with kana, I would opt for trying this again along with a low dose of salt. If you have a decent store near you, you can dose a fura antibiotic (such as Furan or Furan2) along with the kana for a more broad spectrum treatment. You can also consider a kana-medicated food instead of a tank treatment if he is eating well (med foods are more effective than tank meds).

Alternately, Hikari makes a product called 'Bio Bandage' which is a mix of fura antibiotics and methylene blue in a water resistant base. You apply this directly to the area but just be careful not the med in his eyes or gills. Let us know if we can be of any further help and please keep us posted!


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[liam2317]

I think we'll skip the 'Bio Bandage', that just sounds way too traumatic and it's so close to his eye that it would be really hard to do.

I haven't found any food that has Kanaplex in it but on the Kanaplex package it does say that you can mix one scoop of Kanaplex with 1tbsp of food. All this fish has ever eaten is pellets though and I'm not sure what else to try feed him. I've found a few other posts with people mentioning that you can moisten some pellets and mix with Kanaplex. I'm worried though that doing it that way the pellets would go moldy or it might effect the Kanaplex. This fish only eats about a tbsp of food a year! Do you think freezing them would be detrimental?

I will be sure to keep you posted, nothing is worse than finding a forum post useful to you and the person never came back to mention if the fish recovered or not!

Thank you so much for your advice, it's really appreciated!

 

[liam2317]

I promised an update so here we go.... We tried the Kanaplex again but it didn't seem to do anything this time so we tried the Erythromycin after that. It seemed to help and the ulcer seemed to stop growing again but by this time it had gotten quite large and he was having trouble eating, he would often miss the pellet the first couple tries. Since then it seemed like there was no real worsening but I really can't be sure of that. This thing progressed so slowly it was hard to tell. He still seemed fairly active and alert up until today when unfortunately we came home to find him dead at the bottom.

If I had to do it again I suppose I would have just tried to act more quickly on it. Not much else that could have been done I guess.

Raffi was a cool fish and he will be missed.

Thanks for the help jlk, it was very much appreciated.

 

[jlk]

I am so sorry to hear this

Best of luck with your future endeavors and please do not hesitate to ask questions!


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[Mercy]

I had this EXACT thing happen to one of my female bettas. The injury looked just like your photos.

It started off looking almost like a raised scale/infected pore on her nose, and then popped open and began slowly working it's way toward her eye. I settled for regular water changes and some salt, but she eventually died of it anyways. No idea why it happened, but it definitely started in her "nostril" and worked it's way out.

 

[Dotrskeeper]

May have been tuberculosis.


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