Re:infection?

Dear pony designs:

I’m very sorry to hear that your male seahorse is also ailing. Judging from the photos, your stallion is suffering from ulcerative dermatitis or marine ulcer disease, a type of bacterial infection that causes bacterial lesions (open sores or ulcerations) to develop in the affected areas. If untreated, the tissue erosion will begin eating into the underlying musculature. Such infections are most often associated with Vibrio or Pseudomonas bacteria.

At the first sign of a problem like this, it’s important to isolate the affected seahorse so that the rest of the herd isn’t exposed to the same pathogens, and to begin treating the seahorse aggressively in isolation with potent broad-spectrum antibiotics immediately for at least 10 days. The medications that are most useful in resolving Vibrio infections are chloramphenicol (i.e., Chloromycetin), which you probably will not be able to obtain, Baytril, which is a prescription antibiotic that may also be difficult for you to obtain, or a combination of doxycycline + kanamycin, both of which can be obtained from National Fish Pharmaceuticals without a prescription. So you certainly did the right thing by isolating the male seahorse and treating him with antibiotics in your hospital tank, but Furan2 is only helpful in mild cases whether the infection is detected early. And if the Furan2 is to be of any help, you must just regard the dosage instructions on the package and use a stronger dose of the medication for a longer period of time, as outlined below (be advised that Furan2 is also often more effective when administered orally via bioencapsulation in feeder shrimp):

Furan2 is a good combo medication that consist of two nitrofuran antibiotics (nitrofurazone and furazolidone) plus good old methylene blue. That gives it both bacteriostatic and bactericidal properties, and makes it active against various gram-negative and gram-positive bacteria. The methylene blue stains the water in the treatment tank as and prevents the photosensitive nitrofuran antibiotics from being deactivated by light. Methylene blue is effective in preventing fungal growth, and it has antiprotozoal and antibacterial properties as well, by virtue of its ability to bind with cytoplasmic structures within the cell and interfere with oxidation-reduction processes. This makes the combination of methylene blue, nitrofurazone and furazolidone very broad spectrum and fairly potent.

However, pony designs, you have to take special precautions when administering nitrofuran antibiotics such as this because they are photosensitive and can be deactivated by light. That means you’ll need to darken the hospital tank while you treat the seahorse. Do not use a light on your hospital tank, and keep an opaque lid or cover on the aquarium during the treatments. Remove this cover from the aquarium only long enough to feed your seahorse.

You should also be aware that Furan2 will cause discoloration of the aquarium water, turning it a shade of blue-green. This is harmless and can be removed after the treatments using activated carbon filtration.

Here are the instructions for administering the Furan2 in a 10-gallon hospital tank, courtesy of Ann at the org:

FURAN-2 (immersion) Dosage and Preparation Instructions for a 10g/38L Hospital Tank
Active Ingredient: Nitrofurazone and Furazolidone
Indication: bacterial infection
Disregard package info concerning water changes and duration of treatment. Dose medication daily for
10 days.
Replace the medication in ratio to the amount of water changed daily as needed to control ammonia.
This product is best administered by feeding it to adult live brine shrimp, then in turn, feeding those
animals to the Seahorse. If this is not an option, it may be administered as follows.
DAY 1 of Treatment
• Thoroughly mix one packet of Furan-2 with about 1 cup of marine water.
• Pour the mixture into a high-flow area of the hospital tank.
DAYS 2 – 10 of Treatment
• Perform a 50% water change.
• Thoroughly mix one packet of Furan-2 with about 1 cup of marine water.
• Pour the mixture into a high-flow area of the hospital tank.

FURAN-BASED MEDS (immersion) Dosage and Preparation Instructions for a 10g/38L Hospital Tank
Active Ingredients: Nitrofurazone and Furazolidone
Indication: bacterial infection
Brand Names: Furan-2, Furanase, Binox, BiFuran+, Fura-MS, Furazolidone Powder
Dose daily for 10 days. Disregard package info concerning dosing frequency and water changes.
Replace the medication in ratio to the amount of water changed daily as needed to control ammonia.
This product is best administered by feeding it to adult live brine shrimp, then in turn. feeding those animals to the Seahorse. If this is not an option, it may be administered as follows.
DAY 1 of Treatment
• Thoroughly mix the medication with about 1 cup of marine water.
• Pour the mixture into a high-flow area of the hospital tank.
DAYS 2 – 10 of Treatment
• Perform a 50% water change.
• Thoroughly mix the medication with about 1 cup of marine water.
• Pour the mixture into a high-flow area of the hospital tank.

FURAN-BASED MEDS (oral) Dosage and Preparation Instructions for a 10g/38L Hospital Tank
Active Ingredients: Nitrofurazone and/or Furazolidone
Indication: bacterial infection
Brand Names: Furan-2, Furanase, Binox, BiFuran+, FuraMS, Furazolidone Powder
Feed adult brine shrimp gut-loaded with medication to the Seahorse 2x per day for 10 days.
• Add a small amount of the medication to one gallon of water and mix thoroughly.
• Place the amount of adult brine shrimp needed for one feeding into the mixture. Leave them in the mixture for at least 2hrs.
• Remove the adult brine shrimp from the mixture and add them to the hospital tank.
• Observe the Seahorse to be certain it is eating the adult brine shrimp.

Here is some additional information regarding marine ulcer disease to give you a better idea of what you are dealing with, pony designs:

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MARINE ULCER DISEASE, A.K.A. ULCERATIVE DERMATITIS, A.K.A. HEMORRHAGIC SEPTICEMIA, A.K.A. "FLESH-EATING BACTERIA"

Marine ulcer disease is a particularly nasty type of infection that most hobbyists have come to know as "flesh-eating bacteria," and indeed it can often be attributed to bacteria, most notably Vibrio or Pseudomonas species (Giwojna, Nov. 2003). Vibrio in marine fish is the equivalent of the Aeromonas bacteria that plague freshwater fishes (Dixon 1999; Basleer 2000), causing external hemorrhagic ulcers (bloody lesions). Vibriosis is probably the most common bacterial infection of captive seahorses and one of the most difficult to eradicate from your system. Vibrio bacteria are motile gram negative rods, which measure about 0.5 X 1.5 micrometers (Prescott, 2001). When grown on suitable media they appear as shiny, creamy colored colonies (Prescott, 2001).

Marine ulcer disease or hemorrhagic septicemia can manifest itself in a number of forms. The most common of these are the external hemorrhagic (bloody) ulcers, which appear as localized open wounds on the body (Dixon, 1999). It may be helpful to think of this condition as a form of skin rot. The first symptoms are usually small, discolored areas of skin that often become red and inflamed (Giwojna, Nov. 2003). These may become large bloody spots or lesions (the characteristic ulcers) as the disease progresses, leading to sloughing of the skin and localized swelling (Giwojna, Nov. 2003). (I have found that many times hobbyists have a tendency to dismiss these ulcers as "heater burns," especially when they appear on the flanks or pouch of the seahorse, and to delay appropriate treatment on the basis of this misdiagnosis. Avoid this all-to-common mistake!) In severe cases, the underlying musculature also becomes infected, and the rapid tissue erosion that can result is one of the most alarming aspects of ulcer disease. At this advanced stage, the infected fish can longer be saved (Giwojna, Nov. 2003).

Badly infected fishes may develop a distended, fluid-filled abdomen due to internal bacterial infection (septicemia) of the kidneys, liver or intestinal tract (Dixon, 1999). This disrupts the normal circulation of the blood and lymph, causing fluids to accumulate in the intestine and abdominal cavity (Dixon, 1999).

The most dangerous form of hemorrhagic septicemia occurs when the bacteria spread internally and become septic, infecting the blood (Dixon, 1999). The bacteria release toxins into the bloodstream, making it the most virulent of these infections (Dixon, 1999). This insidious form of the disease does not produce the telltale external ulcers, and acute infections can kill quickly with little warning due to the lack of outward signs (Dixon, 1999). Affected fish become listless and lethargic (Dixon, 1999), which may be hard to pick up on with seahorses. Respiration is rapid and seahorses usually darken in color and go off their feed. These behavioral indicators are especially difficult to detect in seahorses due to their lazy lifestyle and habit of changing colors frequently. Seahorses may succumb to the acute form of this disease before the aquarist realizes anything is amiss, and hobbyist often ascribe such mysterious losses to Sudden Death Syndrome.

In seahorses, this disease sometimes takes the form of bilateral edema of the periorbital tissue (Bull and Mitchell, 2002, p19). The eyes themselves are not affected, as in popeye or Exopthalmia; rather, the tissue around both eyes swells up. The eyes are thus unaffected but are encircled by rings of swollen tissue. Hobbyists have described this condition to me by saying that their seahorse had developed "doughnut eyes." These characteristic doughnut eyes are often accompanied by swelling of the soft tissue around the tube snout (Bull and Mitchell, 2002, p19). Some cases develop this peculiar facial edema as well as the usual skin ulcers and tissue erosion (Bull and Mitchell, 2002, p19).

Hemorrhagic septicemia or marine ulcer disease can be a very stubborn and difficult infection to treat, especially when it is due to Vibrio and the disease is acute or advanced. However, if the condition is detected early and treatment is begun when the discolored patches of skin or other symptoms are first noticed, antibacterial agents are often helpful (Giwojna, Nov. 2003). The professional aquarists treat this disease aggressively, using bivalent Vibrio vaccines, immunostimulants such as a beta-glucan, and injections of antibiotics (Bull and Mitchell, 2002, p19).

Aside from administering beta glucan (a primary ingredient in Vibrance) orally, such measures are beyond the grasp of we home hobbyists. We must make do by treating the affected specimens in isolation using wide spectrum antibiotics such as chloramphenicol, Baytril, doxycycline, kanamycin, oxytetracycline (orally), neomycin sulfate, sulfonamide or streptomycin, or perhaps Furan2 or Nitrofuracin Green (in mild cases that are detected early). As with other bacterial infections, lowering the water temperature during the course of treatment can help a great deal. This is your best course of action when you are confident that the problem is due to a bacterial infection, such as Pseudomonas or Vibriosis (Giwojna, Nov. 2003).

Chloramphenicol is the treatment of choice. It can be given orally or used as a bath (Prescott, 2001c). Therapeutic baths lasting 10-20 hours are administered in a chloramphenicol solution consisting of 40 mg per liter of water (Prescott, 2001c). If the seahorse is still eating, the chloramphenicol can also be bioencapsulated by gut loading feeder shrimp or ghost shrimp with flake food soaked in the antibiotic solution. Even if the affected seahorses does not eat, feeding medicated shrimp to its tankmates is a good way to help prevent this contagious disease from spreading to the healthy seahorses (Prescott, 2001c).
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All things considered, pony designs, I would say that chloramphenicol (i.e. Chloromycetin) is the treatment of choice for marine ulcer disease (i.e., flesh-eating bacteria) and most Vibrio infections, in general. It is effective both as a bath for prolonged immersion or when administered orally. If the affected seahorse is no longer eating, then administering the chloramphenicol to the treatment tank would be a good option for you if your other seahorses develop any symptoms of this disease.

The treatment protocol for Chloramphenicol or Chloromycetin is as follows:

Chloramphenicol can be used to treat Vibriosis at 40 mg/ litre of water (which comes out to about 150 milligrams per gallon) in a bath for 10-20 hours. It is important to watch the quality of the water, and if it starts to become turbid, the water must be changed. It is best to treat in a separate tank. In stubborn cases, a series of such baths may be necessary to resolve the problem, in which case a complete water change should be performed before the medication is redosed.

Chloramphenicol can also be used as an additive to the feed, if the fish are still eating (all to often in a major infection they will refuse to eat, but this treatment may be most useful in preventing the horizontal spread of the infection). When used as an addition to the feed use 500 mg per 100 gram of feed. (In the case of seahorses, the flake food medicated with chloramphenicol in this way would first be bio-encapsulated in live feeder shrimp, which would then in turn be fed to the seahorses.)

If you do obtain the chloramphenicol, be sure to be very careful when handling it. Remember, in a few rare individuals exposure to chloramphenicol can cause a potentially fatal side effect (aplastic anemia). These are rare cases and almost always involve patients who were being treated with the medication, but I would use gloves when handling it as a precaution and if you crush crush up tablets of chloramphenicol, be very careful not to inhale any of the power.

Because of this side effect, which affects one in 100,000 humans, chloramphenicol is no longer available as a medication for fishes and can therefore be difficult to obtain. If you find that is the case, your next best alternative is to obtain doxycycline and kanamycin from National Fish Pharmaceuticals and use them together to form a synergistic combination of antibiotics that is often very effective in treating Vibrio infections.

Doxycycline hydrochloride

USE: broad spectrum antibiotic derived from oxytetracycline. Use for both gram-positive and gram-negative bacterial disorders, including fin and tail rot, septicemia, and mouth rot. Unlike tetracycline antibiotics, it will not be deactivated by the high pH levels found in marine aquaria. Works in a similar manner to chloramphenicol.

DOSAGE: add 1/4 teaspoon per 20 gallons, every 24 hours for 10 days. Do a 25% water change before each treatment.

Kanamycin sulfate

This is a potent broad-spectrum, gram+/gram- aminogylcoside antibiotic. It is wonderfully effective for aquarium use because it is one of the few antibiotics that dissolves well in saltwater and that is readily absorbed through the skin of the fish. That makes it the treatment of choice for treating many bacterial infections in seahorses. Kanamycin can be combined safely with certain other antibiotics such as doxycycline or neomycin (as well as metronidazole) to further increase its efficacy. Like other gram-negative antibiotics, it will destroy your biofiltration and should be used in a hospital tank only.

USE: gram-negative bacterial infections and resistant forms of piscine tuberculosis (mycobacteria). Works especially well in saltwater aquariums.

DOSAGE: add 1/4 teaspoon per 20 gallons. Treat every 24 hours and perform a 25% water change before each treatment. Treat for 10 days. (When treating piscine tuberculosis, treat for 30 days.)

Both the doxycycline and kanamycin can be obtained online from National Fish Pharmaceuticals at the following URL:

http://www.fishyfarmacy.com/products.html

Baytril is another good antibiotic for treating ulcerative dermatitis and tail rot, but it is a prescription medication that you would need to obtain from your family Vet. It would be your next best option if you cannot obtain the chloramphenicol or the doxycycline hydrochloride + kanamycin sulfate.

Baytril (Enrofloxacin) is a powerful new broad-spectrum antibiotic that increasingly used to treat infections of the urinary tract, skin, prostate, gastrointestinal system, liver, ears, and lungs in humans. It is affective against both gram-negative and gram-positive bacteria and is widely used in aquaculture to treat marine fish. It belongs to a relatively new class of antibiotics called fluoroquinolones, which are effective against a wide variety of bacteria, and is now being used in the aquaculture industry to treat bacterial infections in valuable fish. In liquid form, enrofloxin (Baytril) can be administered either by injection at around 10mg/kg bodyweight e.o.d. or as a bath at 30ppm for 1 hour daily for 5 days.

The Baytril can also be administered orally by tube feeding it to the seahorse, which is helpful when the seahorse is not eating, but it is a stressful procedure for the seahorse. Here are the instructions for administering the Baytril orally, again courtesy of Ann at the org:

ENROFLOXACIN Oral Dosage and Preparation Instructions
Active Ingredient: Enrofloxacin
Indication: bacterial infection
Brandnames: Baytril
The following information is based on the most commonly available tablet sizes for Enrofloxacin/Baytril
available in the US and abroad and an average sized seahorse of approximately 10 grams.
Tube feed the seahorse 0.1mg of Enrofloxacin once a day for 10 days.
Day 1 – 10 of Treatment
• Crush 1/4 of a 68mg or 50mg tablet into a fine powder.
• Use a mini-blender or small hand-blender to thoroughly mix the powder with marine water. Mix 1/4 of a
68mg tablet with 85mL of marine water. Mix 1/4 of a 50mg tablet with 62.5mL of marine water.
• Fill a small syringe with 0.5mL of the solution.
• Tube feed the seahorse just as if you were force-feeding the pony to provide nutritional support.
• Throw out the unused Enrofloxacin and marine water solution. You will need to make new solution daily
because Enrofloxacin breaks down quickly in saltwater causing it to become completely ineffective by the
next day.
Important Notes:
Enrofloxacin is available only by prescription from a veterinarian.
Enrofloxacin International Version – Tablets are produced in 15mg, 50gm, 150mg, & a 2.5% injectable solution
Enrofloxacin US Version – Tablets are produced in 22.7mg, 68mg, 136mg, & a 2.27% injectable solution
If you are able to ascertain the exact weight of your seahorse you may want to adjust the dosage as
necessary to get the most benefit from the medication. In such an instance you would dose Enrofloxacin
at 0.01mg of the medication per gram of body weight.
A veterinarian who works regularly with small exotics will be familiar with the proper way to dilute
injectable Enrofloxacin solution to fit your needs.

In summation, pony designs, I would recommend isolating the affected seahorse and treating him aggressively with antibiotics in your hospital tank. The following antibiotics have proven to be effective in treating such infections when they are detected early (I have listed them in order of preference):

Chloramphenicol (i.e., Chloromycetin)
Doxycycline hydrochloride + kanamycin sulfate
Baytril
Furan2 (if the dosage and duration are increased and early treatment is possible; preferably administered orally)

In your case, since the Furan2 has not proved to be very helpful, the more potent antibiotics listed above would be a better option for you at this point. However, the prognosis is very poor when the seahorse has been weakened to the point that it can no longer hitch or hold itself upright, so it may be pointless to invest more money in medications at this stage and the medications may not arrive in time to be helpful…

For best results, consider treating the bacterial lesion topically in addition to the antibiotic therapy. In your case, I would suggest applying Neosporin to the open sores daily, as described below:

NEOSPORIN Dosage and Preparation Instructions for Topical Application
Active Ingredient: Neomycin Sulfate
Indication: open external lesions.
Brandnames: Neosporin and generic triple antibiotic ointments are available at pharmacies and discount
stores.
Note: Please do NOT use ointments that list Pramoxine HCl or other pain relievers in their ingredients.
• If the lesion is on the body, hold the head underwater and gently apply the ointment with a cotton swab.
Try not to disturb the wound with the applicator.
• A thin coating is enough.
• Apply twice per day .
Note: Do not use ointments that list Pramoxine HCl or other pain relievers in their ingredients

Your male seahorse may be more comfortable if you darken the hospital tank and include a few hitching posts to provide him with some limited shelter and something his tail can cling to, even if he is too weak to perch properly anymore. And the time may be approaching when it’s best to consider ending the seahorse’s suffering. When the seahorse is unresponsive and displays a lack of eye movement, no longer tracking the movements of the aquarist with its eyes, that’s usually an indication that the end is near.

If euthanasia should become necessary, the "clove oil and tank water" technique discussed below is a perfectly painless procedure that can be performed by the home hobbyist:

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Humane Euthanization
Article by Aquatic expert, BuddyHolly

http://www.aquariumcorner.com/euthanization.htm

Clove Oil and Tank Water Method

Buy pure clove oil. You can get it at a health food store. For a larger fish such as a goldfish, you’ll want to make sure you have enough on hand. Two ounces minimum. Put the fish in a medium to large sized mixing bowl (depending on the size of the fish) in his own water from his tank. In a small jar or or something with a lid (I use a cleaned out jelly jar – about 6 ounces) mix the clove oil with tank water. Use ? ounce for bettas, an ounce for larger fish, and have more on hand for really large fish such as goldfish, oscars, pacus, etc. Put the lid on and shake it like crazy over and over until the liquid in it is white. Then pour a little into the mixing bowl with the fish. Swirl it with your hand. The fish might fight it just a little bit and then slow down. Then pour a little more in and swirl again. He should just go to sleep and appear dead. If he doesn’t, try a little more of the clove solution, always shaking very well before an addition to the bowl. When he goes to sleep, leave him in the solution for a good 10 minutes and then put him in a small cup or ziplock baggie and put him in the freezer. Pain free death. Very humane. We should all go so easily.
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Respectfully,
Pete Giwojna