Internal Issues

Humblefish

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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. (More treatment options for internal parasites)

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 dewormers can be found below:

Using a shot glass:
  • 1 scoop (~ 1/8 teaspoon) of medication (General Cure or Fenbendazole + Metroplex)
  • 1-2 scoops Seachem Focus (this makes it reef safe + binds the medication to the food)
  • 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.
  • Feed daily for 2-3 weeks, or until poop returns to a solid brown or green color (no white).
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:

Ruppertsreef

New member
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.
In the above recipe would you also add prazipro to the food soak or just use the prazi in the water
 

Humblefish

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Ruppertsreef

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Thanks. I’m getting things ready to start restocking and wanted to have everything I needed before hand. I have metroplex so I will pick up some powdered parazi or gc.
Going to try the hybrid tt with some zebra dart fish or cardinals first and then attempt some fairy or flasher wrasses. I have three molly in my current coral only 28 which I will use as a observation tank after tt. Was just worried about flukes and internals on wrasses as you have them under the hard to qt list
 

Humblefish

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Also what brand pellet food do you find is accepted by most fish you qt
Sustainable Aquatics Hatchery Diet:



Sometimes anthias & wrasses will eat that even before frozen. :eek:
 

Ruppertsreef

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Does the medication freeze well. If different types of food were mixed up with the recipe and frozen would this have a negative effect on the meds
 

Ruppertsreef

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Cool I just figured like if they didn’t like the food to try another food and you weren’t wasting the medication.

so if I were to bring in some wrasse. And were to do a hybrid ttm while feeding this food. What else should I be doing. This should cover external and internal and then just watch for signs of issues in observation tank. Or should I follow any other procedures?
 

Humblefish

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so if I were to bring in some wrasse. And were to do a hybrid ttm while feeding this food. What else should I be doing. This should cover external and internal and then just watch for signs of issues in observation tank. Or should I follow any other procedures?
For wrasses, Hybrid TTM + food soaking GC ought to cover it.
 

Tamberav

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Idk how you get fish to eat this stuff. I tried adding garlic and selcon but it smells like how crushed Tylenol tastes.
 

Humblefish

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Idk how you get fish to eat this stuff. I tried adding garlic and selcon but it smells like how crushed Tylenol tastes.
Are you using Focus to bind the General Cure to food? Also, what food are you offering? I like to use brine or mysis shrimp to entice them to eat it. I use 1 scoop of GC per 1 tablespoon of food.
 

Tamberav

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Are you using Focus to bind the General Cure to food? Also, what food are you offering? I like to use brine or mysis shrimp to entice them to eat it. I use 1 scoop of GC per 1 tablespoon of food.
Mysis with focus. I may try to add more food to try and cover it up more but keep in mind I am trying to feed picky leopards (as a precaution) so they seem to know the med is in it vs normal food. They like to taste the food before they swallow :rolleyes:
 

Jessican

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I’ve done a couple rounds of food soaking with GC, and I’m still seeing white stringy poo with some clownfish. I have fenbendazole - is it reef safe if combined with food and focus? These fish are all in DTs and otherwise healthy, I’d hate to have to pull them into quarantine now just for this.
 

Humblefish

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I’ve done a couple rounds of food soaking with GC, and I’m still seeing white stringy poo with some clownfish. I have fenbendazole - is it reef safe if combined with food and focus? These fish are all in DTs and otherwise healthy, I’d hate to have to pull them into quarantine now just for this.
Yes, provided you use Seachem Focus to bind the medication to the food. Also remember it can sometimes take 2-3 weeks of daily feeding to fully eradicate intestinal worms.
 

Jessican

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Yes, provided you use Seachem Focus to bind the medication to the food. Also remember it can sometimes take 2-3 weeks of daily feeding to fully eradicate intestinal worms.
Cool, thank you. I'd read something somewhere that made it sound like fenbendazole wasn't reef safe even bound to food, so I hadn't tried it yet. I did two rounds of GC food soaking, feeding for 10 days each, with no change, so I'm thinking it might be time to try the fenbendazole.
 

kyley

New member
@Humblefish , do you think this fish (pink spot watchman goby) has internal parasites? Others on Reef2Reef did, but in this thread you say white stringy poop is the symptom, and this clearly isn't white... Thoughts? Side note, it pooped this out while doing the hydrogen peroxide bath before the first transfer. Also, I noticed a short (a few millimeters), thin brown thing on the bottom of the tank later that looked like it wiggled slightly (could have been the flow from airstone?). I didn't have time to observe any more than that though before leaving for the night. Thanks,
--Kyle
615
 

kyley

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@kyley I think that poop was caused by dying intestinal worms. Have you been food soaking General Cure or some other medication??
No, I haven't yet. I'm on my way to Petsmart to buy some General Cure now actually. Then I'll feed them with food soaked in it as you describe in this thread. The picture above was on the first transfer. I'm doing the 2nd transfer in an hour or so (so I've only had the fish for 6 days).

Also, after that transfer, I dosed the tank with Methylene Blue (because I found the ammonia had risen at the end of the transfer!). I saw you mentioned it's a mild anti-parasitic too. I wondered if it would help with worms at all? Thanks,
--Kyle
 

Humblefish

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No, I haven't yet. I'm on my way to Petsmart to buy some General Cure now actually. Then I'll feed them with food soaked in it as you describe in this thread. The picture above was on the first transfer. I'm doing the 2nd transfer in an hour or so (so I've only had the fish for 6 days).

Also, after that transfer, I dosed the tank with Methylene Blue (because I found the ammonia had risen at the end of the transfer!). I saw you mentioned it's a mild anti-parasitic too. I wondered if it would help with worms at all? Thanks,
--Kyle
I wouldn't count on anything that you dose into the water to completely eradicate internal pathogens. Anti-parasitics and dewormers in the water do help though, because fish drink a lot of water so the medication passes through the GI tract.
 
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