Hexamita and/or hole in head in GBR?

[Tropical]

I have a male German Blue ram, I've had him for around 5 months. A few weeks ago I noticed that his fins were ragged (despite having perfect water conditions), and he had a few white spots on his head. I assumed it was fin rot and some type of fungus, so I started treating with Melafix. The Melafix hasn't been working at all, so I looked into in a bit more and discovered hexamita and hole in the head. He has 5-6 small white dots on his head, around the eyes and on the forehead area. He also has one near his tail. His color is faded, and his fins are ragged. He is eating normally.

Here's a picture of what it looks like, this is not my ram though. The spots on mine are slightly larger, and he is very dull colored. Does this sound like hexamita, and how is it cured?

 

[ae123]

I have a bottle of a product called vita chem. I recently began using it because I've read very good things about it. It's both a water and food multi-vitamin additive. On the back it indicates that it is "great for fin regeneration and lateral line disease". You may need something stronger, though.

ae123

 

[Tropical]

Any other suggestions? He's doing worse. I haven't been able to find much information on HITH, but I did just find this article. Hole in the Head by Adam Dagna of World Cichlids

It says that removing carbon, extra water changes, increased temperatures, and aquarium salt may fix the problem. Does this look legitimate?

 

[Nomadu571]

From what I've read carbon is blamed for hith. So sounds legitimate. However could it not be ich/white spot disease? Is there a hole forming on the head?

 

[ae123]

I read is cause by bacteria, parasite, or possibly some think that stray electrical current. I also read sometimes best the way is to give good diet, good water, & mix good vitamin supplement in water and with food.

My book "fish health manual" is good book to buy on fish disease pictures and different treatments for sick fish but i think the copyright is 2004, so maybe some newer fish concepts/solutions of other books. more than just water quality and diet--Injection with good medicine is the best but not many people but vets are good at this i don't think, medicated food is next, or water medicine additives.

Fish store, my lfs, has medicated food and water medicine additives & good variety of healthy foods & online is more options.

I'm not know very much by my fish book is very good and I can tell you what it says if you have any more more specific queries.

 

[Tropical]

Thanks to both, I'll take out the carbon and start looking for that food you mentioned. It definitely is HITH, I've dealt with ich before. Also, it's only affecting my GBR, none of my tetras.

 

[Fishguy2727]

HITH and HLLE are two different illnesses.

HITH is found in discus and angels. It IS caused by Hexamita spp. and/or Spironucleus vortens, both of which are cured by metronidazole. The holes with HITH are narrow, deep, and may include a white discharge.

HLLE is found in oscars and other fish. It is NOT caused by parasites. The holes with HLLE are wide, shallow, and do not have any discharge. It is usually caused by low quality food and water. In some rare cases it has been shown to be caused by carbon use, however this is very rare and the quality of the food and water should be addressed before carbon is considered. One idea is that it is the dust from carbon that is the problem, but I have NEVER seen any shred of evidence explaining HOW this is even possible, so IMO should be disregarded.

In my research I did not come across many cases with rams so I would love some more information.
What is the nitrate concentration?
What is your water change schedule?
Is the tank planted?
What ALL do you feed?
Are the holes wide and shallow or narrow and deep, possibly including discharge?
Do you use carbon in the filter?
What other fish are present?

 

[Tropical]

The nitrates are between 5-15, usually 10ppm.

I change about 30% a week.

The tank is not planted, the only plant is a single anubias.

I used to feed tetramin or aqueon flakes, with occasional bloodworms, but switched to Omega One and bloodworms once a week after noticing the symptoms.

The holes are pretty shallow I think. They are smalll and white dots, there are several on his head and 2 on his body. I haven't noticed discharge.

I do use carbon in the filter.

In addition to the ram I have 8 neon tetras in a 20g long tank.

 

[Fishguy2727]

The white spots bumps or holes?
I had some discus that had HITH that had so much discharge that it didn't look like HITH initially, but after starting the metro treatment I saw the discharge decrease to the point where it looks like more typical HITH.

Cutting the carbon is a good idea, but I would suggest treating with metro too. For the benefit of others it would be good to wait a few weeks between stopping carbon and starting metro, but that would not be in the best interest of the fish. At the least you could start carbon back up when all this is over to see if it returns.

I would increase the quality of the food. IME the best food by far right now is New Life Spectrum. Omega One is good, but not the best. I would also cut out the bloodworms, they are unneeded.

 

[Tropical]

Metro is metronidazole, right? Where would I get that, do they sell it at pet stores?

 

[Fishguy2727]

Some do. Aquarium Solutions has a product called Metro+, which yes is metronidazole. Seachem sells it as well. I think Jungle has it in at least one of their meds, maybe Parasite Clear. I have only used Metro+ and it worked very well.

 

[Tropical]

Ok, thanks for the help.

 

[Tropical]

I got API General Cure, it was the only medication my LFS had for HITH. It says to pour one pack per gallon, wait 48 hours, add one pack per gallon, wait 48 hours, and do a 25%pwc. It's the third day, and I've noticed little improvement. The ram seems more active and colorful, but the holes are still there.

 

[Fishguy2727]

Does it contain metronidazole?

 

[Brian_Nano12g]

I got API General Cure, it was the only medication my LFS had for HITH. It says to pour one pack per gallon, wait 48 hours, add one pack per gallon, wait 48 hours, and do a 25%pwc. It's the third day, and I've noticed little improvement. The ram seems more active and colorful, but the holes are still there.

Tropical... I know this thread is a bit old but what was the final result of your treatment? I have a Ram right now that's in the same type of predicament. Here's a picture:

 

[bs6749]

Ouch, your male is looking pretty bad. Not only does he have HITH, but his pelvic fins are shortened too. You need to medicate with metronidazole and get the tank temp up to 90 degrees and add an extra source of air to the tank. If you do this, you may see the holes shrink and gradually disappear, but they may be permanent.

 

[Brian_Nano12g]

Ouch, your male is looking pretty bad. Not only does he have HITH, but his pelvic fins are shortened too. You need to medicate with metronidazole and get the tank temp up to 90 degrees and add an extra source of air to the tank. If you do this, you may see the holes shrink and gradually disappear, but they may be permanent.

Thanks for your input! Didn't mean to hijack this thread but I have a similar situation and I was just trying to do some research.

I went to the LFS and all I found with that active ingredient is API General Cure. It's like $15! I don't know how far along my Ram is and if there's any hope in helping him out, I wouldn't mind picking up that med (even so it's more than the cost of the fish). But if the HITH is too far along and caused irreparable damage, I don't want to just throw that money down the drain. I don't have a quarantine tank so I'm not sure what's the risk to the rest of the fish/plants too?

It's weird too, all the HITH pics online look like actual holes... my Ram has what looks like puss filled pimples or cysts. I'm not sure if that's just secreted where the actual holes are or what?

Also, what does it mean when the "pelvic fins are shortened too?"

Anyway, here's another pic: