Re:Pouch Emphyzema

Pete Giwojna

Dear Tammy:

it sounds like you did a fine job of manually evacuating the air from your male’s pouch. Burping the pouch is always scary the first time you attempt the procedure, but it sounds like you handled it very well, Tammy. Such a procedure is always a little stressful for the seahorse, so it’s normal for them to exhibit rapid respiration and stress coloration as a result. But that should return to normal shortly afterwards.

I know how discouraging it must be to see how persistent and determined your stallion is to go right back up to the top and seek out his favorite perch even after you have wrapped the centipedes to try to prevent that. If he is so determined to perch up there that he’ll even expose his tail to the air through the overflow for the wet/dry trickle filter, I don’t know what you can do about it short of constructing some sort of perforated barrier that walls of that entire area and allows water to pass freely through but denies him access to the centipedes and the slots the water flows through. And I can’t imagine how you would accomplish something like that…

But I am afraid his problems with pouch gas are going to be a recurring theme as long as the little bugger insists on perching up at the top like that. It sounds like he already has some more gas accumulated in his pouch if he is still swimming tilted forward and almost upside down at times. I think you are correct Tammy — if you have to release the gas from his pouch again, and it sounds like that’s going to be necessary sooner or later — I would avoid doing another pouch massage. That procedure can be too rough on the delicate tissues of the male marsupium if it has to be performed repeatedly.

An eye dropper evacuation may be a better option. It is easier on the pouch in several respects, since you can use a little suction to help remove the trapped gas, rather than compressing or massaging the sides of the pouch to force the bubbles out. But unless the aperture of the seahorse’s pouch is relaxed or dilated, as it is shortly after a male gives birth or performs vigorous displays of pumping during courtship, it can sometimes be difficult to insert the tip of the eyedropper past the sphincter muscle at the mouth of the pouch.

During the breeding season, a septum or wall of tissue forms in the middle of the marsupium of mature males that divides their pouches into left and right halves, so if you are inserting an eyedropper our small pipette into the pouch to help release the trapped gas, try to angle it to the right of the pouch once and to the left of the pouch once when you evacuate the bubbles so that you removed them from both sides of the seahorse’s pouch.

And instead of merely releasing the trapped gas next time, Tammy, I would recommend performing a pouch flush using Neil Garrick-Maidment’s technique, which we discussed in a previous post. If you don’t have a pouch kit, you could use your eyedropper as the pipette won performing the pouch flush. Just cut off the bulb from the end of the eyedropper so that you can use a handheld spray bottle to direct a stream of water down the barrel of the eyedropper in order to flush both sides of the pouch thoroughly with clean saltwater that is the same temperature as your seahorse tank. For best results, you should repeat the pouch flushes once a day for three consecutive days.

I would also suggest that you purchase a Pouch Kit (see "Accessories" under the "shop online" link at the top of this page), which would make the pouch flushes a bit easier. Here are the instructions for using the Ocean Rider Pouch Kit, Tammy:

Pouch Kit Instructions

Click here: – Seahorse, Sea Life, Marine Life, Aquafarm Sales, Feeds and Accessories – Pouch Wash

The antibiotic pouch kit should be like a fire extinguisher in the kitchen and used only in an emergency and NEVER as a prophylactic. Please perform this procedure in a separate vessel so that the antibiotic wash does not flow into the holding tank. You may wish to trim the plastic tip of the syringe attachment to accommodate the orpheus of your seahorse. You can express the air in the pouch by gently inserting this tip into the opening.

PLEASE KEEP REFRIGERATED shake well before using

What you need to do:

First: Find someone to help you!

Second: Keep the head and gill area of the seahorse submerged at all times! You may cut the end of the tip to fit your needs.

Third: The Procedure should be preformed in a separate hospital tank where the antibiotic flush will not harm your biological filter:

*Have one person hold the seahorse upside down with the head in the water and his tail and abdomen out of the water. He may wrap his tail firmly around your finger. Insert the tip of the pipette into the opening in the pouch being careful not to insert it too far. (You may cut the end of the tip to fit your needs.)

*Gently massage out any air bubbles into the pipette.

*Remove the pipette and express the air bubbles from the pipette.

*Rinse the tip of the pipette with alcohol and let dry.

*Withdraw approximately 2 ml’s of pouch wash into the pipette. The quantity will actually vary according to the size of the males pouch. The extra large males can easily use 2 mls of pouch wash and the smaller males less than one.

*Reinsert the tip into the pouch and gently force the liquid into the pouch and then gently suck it out. Do this twice and then release the male into his tank.

*He may seem slightly stunned or shocked. Don’t panic! Simply turn off the lights and allow the male to rest. If you have any red shrimp he may enjoy them at this time.

*You may have to repeat this procedure again the following day.

*Return him to his normal diet of frozen mysis shrimp enriched with Vibrance the day after the procedure. <Close quote>

This would also be a good time for you to line up some Diamox (the tablet form of acetazolamide), Tammy, because if an ordinary pouch flush doesn’t resolve this problem once and for all, the next step would be to perform a medicated pouch flush using Diamox.

Obtaining Diamox (the tablet form of acetazolamide) can often be a Catch-22 situation for hobbyists. It is 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. But if you have a good relationship with your family Vet or family physician, they may be willing to oblige you since all you need is a handful of 250 mg tablets, not a full prescription.

If not — if neither your Vet or family physician will prescribe Diamox — then contact me off list and there are other options you can try. You can reach me at the following e-mail address anytime, Tammy: [email protected]

Best of luck resolving the pouch gas problem once and for all, Tammy!

Pete Giwojna

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