Internal Issues

Humblefish

Guest
View Badges
Joined
Nov 9, 2014
Messages
22,157
Reaction score
31,345
Internal Issues

For simplicity’s sake, there are 6 basic problems a marine fish may experience on the inside:

1. Intestinal worms
Symptoms:
White stringy feces, pinched stomach, loss of color, fish eats voraciously but still seems to be losing weight.
Treatment of choice: Praziquantel
Alternative treatments: Fenbendazole, Levamisole, Piperazine

2. Internal parasites/flagellates
Symptoms:
White stringy feces, pinched stomach, loss of color, fish eats voraciously but still seems to be losing weight. Flagellates are more virulent than worms, and thus can kill faster.
Treatment of choice: Metronidazole
Alternative treatments: Albendazole, Flubendazole and Mebendazole all show promise.

3. Internal infections (bacteria)
Symptoms:
Bloating, and lumps or swollen areas on the body. Also, poor water quality can cause/aggravate an internal infection.
Treatment of choice: Metronidazole combined with Neomycin Sulfate in a medicated fish food slurry can be a very good full spectrum internal/gut infection treatment, treating both aerobic and anaerobic bacteria.
Alternative treatment: Seachem Focus claims to be an antibacterial polymer for internal infections of fish. The active ingredient found therein is nitrofurantoin.

4. Swim bladder disorder
Symptoms:
Fish swims vertically with its tail up. Basically, the back half of the fish will seem more buoyant than the front half, and the fish will swim in a way to compensate for that. The fish may also stay near the surface of the water (or even float), unable to swim downwards. A protrusion (i.e. gas bubble) may be visible near the swim bladder area. In most cases, swim bladder disorders are caused by improper decompression of deep water species of fish.
Treatment: If a gas bubble is present, you can lance the air out using a 30 gauge insulin syringe. For swim bladder infections, the following are possible treatment options:
(1) Dose magnesium sulfate (Epsom Salt) at 1 tablespoon per 5 gallons.
(2) Give the affected fish a 30 minute Methylene Blue bath.
(3) Dose Metronidazole in conjunction with Neomycin. (You can food soak this combination as well.)

5. Spinal injury
Symptoms:
Fish swims vertically with its tail down. Sometimes the fish just lays on the bottom of the tank; sometimes swims in a swirling motion. Most believe spinal injuries are caused when the fish jumps and hits a hard object (or swims/rams into one.) However, there is some evidence that internal flagellates and/or harmful bacteria which has migrated to the spinal canal may be contributing factors to spinal injuries. Wrasses seem most prone to spinal injuries, especially fairy & flasher wrasses.
Treatment: The injury can heal if the damage is not too severe. Sadly, this is most often not the case. Dosing Metronidazole (for internal flagellates) + Erythromycin or Enrofloxacin (for bacteria) may help. If the fish is still eating, food soak metronidazole + neomycin as well.

6. Fish constipation
Symptoms:
Bloated stomach, obvious anal obstruction, rectal prolapse, erratic swimming behavior. The fish will sometimes stay near the surface of the water, swimming in circles. Constipation is sometimes mistaken for a gas bubble in a fish’s swim bladder (or vice versa.)
Treatment options:
(1)
Feed peeled boiled green peas (high in fiber)
(2) Dose Epsom salt @ 1 tablespoon per 5 gallons (laxative)
(3) Dose Kanamycin (Seachem Kanaplex) in a Quarantine Tank (diarrhea is a side effect of kanamycin)

Internal parasites vs. intestinal worms Since these can be difficult to distinguish due to near identical symptoms, it is best to always treat with praziquantel + metronidazole so both pathogens are covered. You can combine different medications (e.g. Prazipro + Seachem Metroplex), or API General Cure contains both.

Does the color of the poop matter? Yes! It has to be white. Brown stringy poop, for example, can just mean intestinal irritation which requires no treatment.


Food soaking vs. dosing the water Sometimes dosing the water with the above medication(s) can help clear an internal pathogen. After all, fish do drink the water, and their skin will absorb medications. However, I feel soaking fish food with medication(s) is the best way to treat internal problems for obvious reasons. Food soaking delivers meds directly into the gut where most internal pathogens live. In order to food soak, you should also use a binder (e.g. Seachem Focus, unflavored gelatin, agar) to prevent the medication from just leaching out into the water. Binding also makes the treatment reef safe.
:)
My recipe for food soaking metro (and prazi) can be found below:

Using a shot glass:
1 scoop (~ 1/8 teaspoon) of medication (Metroplex or General Cure)
1 scoop Seachem Focus (this makes it reef safe)
1 Tbsp food (preferably pellets or frozen food)
A pinch of Epsom salt to help expel dead worms/parasites
A few drops of saltwater or fish vitamins
Stir until a medicated food slurry has been achieved.
Feed after soaking for 30 mins.
Refrigerate or freeze any leftovers for future use.
You can feed this mix 1-2 times per day. Not recommend to exceed 2 feedings per day with medicated food.


Final Thoughts Due to the resilience of these critters, it is recommended to treat (or food soak) for a minimum of 10 days. However, it is not uncommon for symptoms to persist for up to 3 weeks.
:eek:
And just like with any other disease, you will sooner or later run up against a strain which seems resistant to the preferred treatment. In which case, you should seek out an alternative medication. (e.g. Using fenbendazole, levamisole or piperazine in lieu of praziquantel to treat stubborn intestinal worms.)
 
Last edited:
Corals.com
OP
Humblefish

Humblefish

Guest
View Badges
Joined
Nov 9, 2014
Messages
22,157
Reaction score
31,345
Is this to prevent a buildup of the medication in the water?
Its mostly applicable for Prazipro. In most cases, praziquantel dissipates after 72 hrs. However, Prazipro also contains Oxybispropanol (solubilizing agent) and this can persist in the water for weeks. Too high a concentration of Oxybispropanol can lead to a bacterial bloom.
 

DLHDesign

Ex-Noob
View Badges
Joined
Jun 7, 2016
Messages
3,257
Reaction score
5,321
Location
Lathrop, CA
It is preferable to food soak a medication in this situation...
Is this as easy as it sounds? Eg; If I'm using frozen food cubes - defrost a cube, add the medication, mix, and then broadcast feed into the tank as normal?
Is there an amount of time that should be given for the food to fully absorb the meds?
 

saltyfilmfolks

Lights! Camera! Reef!
View Badges
Joined
Feb 25, 2014
Messages
28,741
Reaction score
33,183
Location
California
Its mostly applicable for Prazipro. In most cases, praziquantel dissipates after 72 hrs. However, Prazipro also contains Oxybispropanol (solubilizing agent) and this can persist in the water for weeks. Too high a concentration of Oxybispropanol can lead to a bacterial bloom.
thanks. it contains a sugar, so accidental carbon "dosing"
 
Best reef aquarium LED lighting
OP
Humblefish

Humblefish

Guest
View Badges
Joined
Nov 9, 2014
Messages
22,157
Reaction score
31,345
Is this as easy as it sounds? Eg; If I'm using frozen food cubes - defrost a cube, add the medication, mix, and then broadcast feed into the tank as normal?
Is there an amount of time that should be given for the food to fully absorb the meds?
I like to wait 30 mins before feeding and be sure you use a binder to prevent the med from leaching out into the water column. Also, running carbon isn't a bad insurance policy just in case a little does leach out. ;)

thanks. it contains a sugar, so accidental carbon "dosing"
Exactly
 

saltyfilmfolks

Lights! Camera! Reef!
View Badges
Joined
Feb 25, 2014
Messages
28,741
Reaction score
33,183
Location
California
thus the blooms in QT I read about, and FWIW, likely why it goes quiet in bacterial bloom threads when I ask if the OP vapes....Aerosolized Glycerine and propylene glycol
 
OP
Humblefish

Humblefish

Guest
View Badges
Joined
Nov 9, 2014
Messages
22,157
Reaction score
31,345
thus the blooms in QT I read about, and FWIW, likely why it goes quiet in bacterial bloom threads when I ask if the OP vapes....Aerosolized Glycerine and propylene glycol

Prazipro by itself usually isn't a problem. Its when you mix Oxybispropanol with other meds (especially Chloroquine) that the bacterial bloom occurs.
 

saltyfilmfolks

Lights! Camera! Reef!
View Badges
Joined
Feb 25, 2014
Messages
28,741
Reaction score
33,183
Location
California
Prazipro by itself usually isn't a problem. Its when you mix Oxybispropanol with other meds (especially Chloroquine) that the bacterial bloom occurs.
thank you. It'll take me a bit to figure that one out;)
 
https://www.omegasea.net/

imjedi76

Member
View Badges
Joined
May 28, 2015
Messages
60
Reaction score
34
would soaking prazi in a container with live brine and feeding that for 10 days be effective?
 

Ocelaris

Valuable Member
View Badges
Joined
May 3, 2016
Messages
1,526
Reaction score
930
Great info, thanks! Would you reccomend this as a part of most quarantine procedures, such as Anthias which I've heard often have worms? Are there any fish which are sensitive to these medications? Thanks as always for taking care of our fishy friends!
 
OP
Humblefish

Humblefish

Guest
View Badges
Joined
Nov 9, 2014
Messages
22,157
Reaction score
31,345
Great info, thanks! Would you reccomend this as a part of most quarantine procedures, such as Anthias which I've heard often have worms? Are there any fish which are sensitive to these medications? Thanks as always for taking care of our fishy friends!
Intestinal worms are not as common as, say, flukes. So I personally wouldn't treat for them unless you see white stringy poop.
 

imjedi76

Member
View Badges
Joined
May 28, 2015
Messages
60
Reaction score
34
Intestinal worms are not as common as, say, flukes. So I personally wouldn't treat for them unless you see white stringy poop.
if an anthias is eating well and very active yet stomach is shrunken, is that an indication of intestinal worms?
 
OP
Humblefish

Humblefish

Guest
View Badges
Joined
Nov 9, 2014
Messages
22,157
Reaction score
31,345
if an anthias is eating well and very active yet stomach is shrunken, is that an indication of intestinal worms?
It's possible, but it can also just mean the fish was malnourished before you got him. White stringy poop is the clincher.
 

aaron23

Valuable Member
View Badges
Joined
Jan 20, 2016
Messages
1,325
Reaction score
774
Location
New York NY
I saw white stringy poop on a new chromis and it died the next day. Intestinal worms seem to be very quick in killing the fish more so than other ailments, do you think this is true humble?
 
OP
Humblefish

Humblefish

Guest
View Badges
Joined
Nov 9, 2014
Messages
22,157
Reaction score
31,345
I saw white stringy poop on a new chromis and it died the next day. Intestinal worms seem to be very quick in killing the fish more so than other ailments, do you think this is true humble?
There are many different genera & species of intestinal worms, some more dangerous than others. A few are relatively mild. For example, I know a lady who had a tomato clownfish with stringy white poop for 9 years before she finally soaked his food in metro and it went away. So as with many diseases, hardiness and overall health of the fish also comes into play.
 
Corals.com

On a scale of 1-10 how much do you love or hate your tank right now? Be honest!

  • 10 - SUPER LOVE

    Votes: 116 11.8%
  • 9

    Votes: 85 8.6%
  • 8

    Votes: 242 24.5%
  • 7

    Votes: 171 17.3%
  • 6

    Votes: 90 9.1%
  • 5 - I have mixed emotions...

    Votes: 210 21.3%
  • 4

    Votes: 22 2.2%
  • 3

    Votes: 17 1.7%
  • 2

    Votes: 8 0.8%
  • 1 - Hate It

    Votes: 25 2.5%

Online statistics

Members online
1,823
Guests online
13,713
Total visitors
15,536
Best reef aquarium LED lighting
CWT Aquatics - Acrylic Sumps, Tanks, and More!
Top