Re:Pete: air bubble

Dear Sam:

Yes, sir, you are not far off when you state that it feels like the air bubble is within the skin rather than within the pouch itself. Problems like that can occur when the gas that builds up in the marsupium is not released into the central cavity of the pouch, but rather becomes trapped within the lining of the pouch instead. When that happens, and prolongs the recovery time because the gas bubbles that are contained within a film of tissue cannot simply be manually evacuated or released when his pouch is burped or flushed. They have to be resorbed instead of released, which is a gradual process that takes time, and which makes it more difficult to resolve the seahorses problems with positive buoyancy. In short, Sam, I suspect you are dealing with gas that is entrapped within the lining of the pouch, and you will not be able to evacuate the trapped gas manually or by using a pouch kit.

If you can feel where the encapsulated gas bubble is located and it is readily accessible, you might consider aspirating the gas that is trapped within the bubble using a sterile needle and syringe, as described below, Sam:

Needle Aspirations

A needle aspiration is a very straightforward technique that simply involves inserting a hypodermic needle through the side of the pouch, tapping into the pocket(s) of trapped gas or fluid, withdrawing the plunger on the syringe and removing the fluid or gas. If you have never done a needle aspiration before, I know it sounds a bit gruesome, but it is a surprisingly painless procedure for the seahorse and is often easier and less stressful for both the aquarist and the patient than performing pouch flushes or repeatedly massaging the pouch. Not only is a needle aspiration less traumatic, as a rule, but it is also often more effective in removing the trapped gas and relieving the problem. A needle aspiration is easier to perform if you have a helper, since an extra pair of hands is very helpful when you’re ready to withdraw the plunger on the syringe and extract the gas from the encapsulated bubble.

In order to resolve this problem once and for all, you will also need to administer the acetazolamide (brand name Diamox) one way or another, Sam, regardless of whether or not you are able to aspirate the gas bubble. If you don’t have a hospital tank set up, you can administer the acetazolamide orally, providing your stallion is still eating, which will allow you to treat the affected seahorse in the main tank amidst familiar surroundings and in the company of its tankmates where it is the most comfortable. You get the acetazolamide into the food by preparing a solution of the medication, as described below, and then injecting it into live feeder shrimp or even the large Piscine Energetics frozen Mysis relicta. The medication is deactivated fairly quickly once you prepare the solution for injecting, so you must prepare a new acetazolamide solution each day during the treatment period. Here’s how to proceed:

Administering Acetazolamide Orally

I have found that acetazolamide is often more effective when it’s ingested and administering the medication orally allows you to treat the seahorse in the main tank where he’s most comfortable and relaxed.

If you can obtain a small syringe with a fine needle, the acetazolamide solution can simply be injected into feeder shrimp or even frozen Mysis. Mic Payne (Seahorse Sanctuary) used this method of administering acetazolamide successfully when he had recurring problems with GBD due to maintaining a population of Hippocampus subelongatus in shallow tanks only 16-inches (40 cm) deep:

"Seahorses maintained in this system are susceptible to gas bubble disease. Specimens with bubbles around the eyes or under the epidermis of the tail are readily treated with acetazolamide (Diamox tablets 250 mg). Mix a very small amount of crushed tablet with water and inject it into several glass shrimp that are then frozen. These are then fed to the target animal at the rate of two per day for four days. Bubbles disappear on the second day."

Hawaiian volcano shrimp or red feeder shrimp (Halocaridina rubra) work great for this. If a fine enough needle is used, they will survive a short while after being injected — long enough for their twitching and leg movements to attract the interest of the seahorse and trigger a feeding response.

Leslie Leddo reports that a 1/2 cc insulin syringe with a 26-gauge needle was ideal for injecting frozen Mysis or live red feeder shrimp. They plump up when injected and ~1/2 cc is about the most of the solution they can hold. There bodies will actually swell slightly as they are slowly injected and excess solution may start to leak out. The 26-gauge needle is fine enough that it does not kill the feeder shrimp outright; they survive long enough for the kicking of their legs and twitching to assure that they will be eaten.

Administering the Diamox orally in this way is the least stressful way to medicate the seahorse, Sam, and if you target feed your stallion with the medicated shrimp then you shouldn’t have to worry about the other seahorses ingesting the Diamox.

If the affected stallion is not eating, or if you cannot obtain a suitable syringe for injecting a solution of the Diamox into the shrimp, then your next best choice will be to set up a makeshift hospital tank and administer the Diamox as a bath, as explained below:

Acetazolamide Baths (prolonged immersion)

The recommended dosage is 250 mg of acetazolamide per 10 gallons with a 100% water change daily, after which the treatment tank is retreated with the sole light at the dosage indicated above (Dr. Martin Belli, pers. com.). Continue these daily treatments and water changes for up to 7-10 days for best results (Dr. Martin Belli, pers. com.).

The acetazolamide baths should be administered in a hospital ward or quarantine tank. Acetazolamide does not appear to adversely affect biofiltration or invertebrates, but it should not be used in the main tank because it could be harmful to inhibit the enzymatic activity of healthy seahorses.

Using the tablet form of acetazolamide (250 mg), crush the required amount to a very fine powder and dissolve it thoroughly in a cup or two of saltwater. There will usually be a slight residue that will not dissolve in saltwater at the normal alkaline pH (8.0-8.4) of seawater (Warland, 2002). That’s perfectly normal. Just add the solution to your hospital tank, minus the residue, of course, at the recommended dosage:

Place the affected seahorse in the treatment tank as soon as first dose of medication has been added. After 24 hours, perform a 100% water change in the hospital tank using premixed water that you’ve carefully aerated and adjusted to be same temperature, pH and salinity. Add a second dose of newly mixed acetazolamide at the same dosage and reintroduce the ailing seahorse to the treatment tank. After a further 24 hours, do another 100% water change and repeat the entire procedure until a total of up to 7-10 treatments have been given. About 24 hours after the final dose of acetazolamide has been added to the newly changed saltwater, the medication will have lost its effectiveness and the patient can be returned directly to the main seahorse tank to speed its recovery along.

One of the side affects of acetazolamide baths is loss of appetite. Try to keep the affected seahorse eating by plying it with its favorite live foods during and after treatment, until it has fully recovered.

The seahorse usually show improvement of the tail bubbles within three days. Dr. Martin Belli reports they nearly 100% success rate when this treatment regimen is followed for 7-10 days, and most cases clear up in less than a week. For best results, the Diamox should be used in conjunction with a good broad-spectrum antibiotic to help prevent secondary infections. A good aminoglycoside antibiotic such as kanamycin or neomycin would work well for this.

The following information will explain how to set up a makeshift hospital tank in order to administer the Diamox as a series of baths, Sam, if that is your best option:

The Hospital Ward or Treatment Tank

Live sand and live rock are not necessary in a hospital tank. A bare-bottomed aquarium with plenty of hitching posts will suffice for a hospital ward or Quarantine Tank (QT). Ideally, the hospital tank should have one or more foam filters for biofiltration along with a small external filter, which can easily be removed from the tank during treatment but which can hold activated carbon or polyfilter pads when it’s time to pull the meds out. It’s important for the hospital ward to include enough hitching posts so that the seahorse won’t feel vulnerable or exposed during treatment. Aquarium safe, inert plastic plants or homemade hitching posts fashioned from polypropylene rope or twine that has been unraveled and anchored at one end are excellent for a hospital tank. No aquarium reflector is necessary. Ambient room light will suffice. (Bright lights can breakdown and inactivate certain medications and seahorses are more comfortable and feel more secure under relatively dim lighting.)

So just a bare tank with hitching posts is all you need for your hospital ward. No heater. No reflector. No lights. No substrate. You can even do without the sponge filters or external filter in your case, just adding a couple of airstones to provide surface agitation and oxygenation. That’s it.

In a pinch, a clean 5-gallon plastic bucket (new and unused, NOT an old scrub bucket!) can serve as a makeshift hospital tank. It should be aerated and equipped with hitching posts and perhaps a heater, but nothing else. This makes a useful substitute when the Quarantine Tank is occupied or in use and a seahorse needs treatment.

Stay on top of water quality in the hospital tank/bucket with water changes as often as needed during treatment, and and when you are treating the occupants for a health problem, re-dose with the medication(s) according to directions after each water change.

Best of luck resolving this tricky pouch gas problem, Sam. It always complicates matters when the gas builds up within the lining of the pouch rather than within the central cavity of the marsupium.

Respectfully,
Pete Giwojna