Pete Giwojna

Dear designs:

I am very sorry to hear about the problems that your female has been having and the difficulty you have experienced in obtaining acetazolamide (brand name Diamox). The Diamox is a prescription medication that is often a challenge for the home hobbyist to obtain.

Are you sure that your female is having a problem with Gas Bubble Disease (GBD)? GBD is rather uncommon in female seahorses, and when it does occur it is typically in the form of gas bubbles that form just beneath the skin (i.e., subcutaneous emphysema) and look much like a blister if you had burned your finger (except that in GBD, the "blister" is filled with gas rather than fluid). The subcutaneous emphysema most often form on the tail of the seahorse and hobbyists typically refer to this condition simply as "tail bubbles." In short, I would expect to see GBD in a female seahorse in the form of discrete bubbles that form just beneath the skin on her tail.

That doesn’t sound like what you are describing when you say that her "tail is bloated." If the tail becomes bloated and enlarged, it is most often due to a bacterial infection rather than a problem with GBD. If the seahorse’s tail was bloated from a buildup of gas, it would be quite buoyant and the seahorse would be having trouble staying at the bottom and swimming normally. Is your female having any problems with positive buoyancy (the tendency to float), designs?

If the swelling of the tail is due to inflammation and infection, then the appropriate response would be to treat the seahorse in isolation using broad-spectrum antibiotics. If you will read the January 25, 2010 post on the first page of this forum titled "Seahorse worry," it discusses the most useful antibiotics for treating tail rot. Those are the same medications and procedures that I would recommend if your female’s bloated tail is the result of a bacterial infection.

This is what I recommend under the circumstances, designs:

Begin treating your seahorse in the hospital tank using the medications and procedures outlined in the "Seahorse worry" post as soon as possible. Use whichever of the antibiotics recommended for tail rot in that post that you can obtain, but begin treating the female immediately.

In the meantime, while she is undergoing antibiotic therapy, you can attempt to obtain the Diamox from the following sources:

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Unfortunately, obtaining Diamox (the tablet form of acetazolamide) can often be a Catch-22 situation for hobbyists. It is a carbonic anhydrase inhibitor — a prescription drug often used for treating glaucoma, hydrocephaly, epilepsy, congestive heart failure, and altitude sickness in humans, so you have to get it from your Vet or perhaps your family doctor. Unfortunately, Veterinarians are often unfamiliar with Diamox — it’s very much a people med and unless you find a Vet that works with fish regularly, he or she will probably never have heard of gas bubble disease or treating it with carbonic anhydrase inhibitors. Many pet owners are on very good terms with their Vets, who are accustomed to prescribing medications for animals, so it’s often best to approach your Vet first about obtaining Diamox despite the fact they may never have heard of it until you brought it to their attention. Your family doctor, of course, will be familiar with such medications and have Diamox on hand but it can sometimes be difficult to get your MD to jump that final hurdle and prescribe it for a pet. Either way, it can be tough to get the medication you need under these circumstances.

However, I would exhaust those possibilities first before I considered an online source for the Diamox. Print out some of the detailed information that’s been posted regarding pouch emphysema and gas bubble syndrome (GBS) on this forum, and how it’s treated using Diamox, and present that to your family veterinarian and/or your family practitioner. Bring photographs of the pony and be prepared to bring the seahorse in for a visit, if necessary. (Veterinarians are prohibited by law from prescribing medications to treat an animal they have not personally seen and examined. If you have had a close personal relationship with your vet over a period of years, they are often willing to bend that rule in the case of fish, but you may well have to bring the affected seahorse in for a quick checkup to get the desired results.)

If not — if neither your Vet or family physician will prescribe Diamox — then there are places you can order Diamox online without a prescription, but save that for a last resort. (You can’t always be certain of the quality of the medications you receive from such sources; in some cases, you even need to be concerned about counterfeit drugs, although Diamox certainly shouldn’t fall into that category.) The medications will take a week or two to arrive, which is troublesome when your seahorse is ailing and needs help ASAP. And, as you know, customs officials can confiscate such shipments, although that very rarely happens with this particular medication.

If you ultimately need to go that route, the following source is the one most seahorse keepers have found works best:

Click here: Inhouse Drugstore Diamox – online information

They offer 100 tablets of Diamox (250 mg) for around $20 US, but they ship from Canada by mail, which usually takes a little under two weeks for delivery.
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It will take some time to obtain the Diamox this way, but your female can be undergoing antibiotic therapy in the meantime. Diamox can be safely combined with antibiotics, so once the Diamox does arrive, you could treat the female with the Diamox along with the antibiotics. That way it won’t matter whether the underlying problem is a bacterial infection, tail bubbles, or a case in which GBD is complicated by a secondary bacterial infection — you will be treating the female appropriately regardless of which scenario is being played out…

Please let me know when you finally obtain the Diamox and I will be happy to outline the proper procedure for administering it to achieve best results. If it is a case of subcutaneous emphysema, designs, you can take some comfort in the fact that tail bubbles respond particularly well to treatment with carbonic anhydrase inhibitors such as Diamox.

Best of luck treating your female.

Pete Giwojna

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