Re:sea horse emergency/upside down

Pete Giwojna

Dear Mike:

I’m sorry to hear about the problem that one of your seahorses has developed. Is the upside down seahorse a male, sir? Swimming upside down indicates that he is having a problem with positive buoyancy, which is almost always due to gas building up within the pouch in male seahorses but can also be due to an overinflated swim bladder in some rare cases. Releasing the gas that is trapped within his pouch will resolve the problem and return them to normal, and that will be the end of it providing the problem does not return (many times gas continues to build up within the pouch and the pouch must be flushed out in order to set things right again). There are a number of good ways to evacuate the air or gas from a seahorse’s pouch, which I will explain shortly, and one of them should work well for you. I will also discuss different methods for flushing out his pouch if the problem recurs in the seahorse requires additional treatment.

I would be happy to explain a little more about this problem and the seahorse’s gas bladder or swim bladder, after which we will discuss treatment options and how best to restore your stallion to normal again.

When a seahorse swims upside down it is usually because it is struggling against positive buoyancy, and the only way it can stay submerged is to use its dorsal fin to push downwards in order to counteract the tendency to float. Positive buoyancy in a male seahorse is most often due to gas building up within its brood pouch, which becomes swollen and buoyant as a result, but it can also be due to an overinflated swim bladder in some cases, and the concern is that the problem will worsen until the seahorse is floating at the surface of the aquarium unable to swim or feed.

As in many other bony fishes, the seahorse’s gas bladder functions as a swim bladder, providing the lift needed to give them neutral buoyancy. In essence, the swim bladder is a gas-filled bag used to regulate buoyancy. Because the seahorse’s armor-plated body is quite heavy, this organ is large in Hippocampus and extends well down into the body cavity along the dorsal boundary.

When the swimbladder is inflated with just the right amount of gas, the buoyancy provided by this gasbag exactly cancels out the pull of gravity, and the seahorse will neither tend to float nor tend to sink. This condition is known as neutral buoyancy, and it makes it very easy for the seahorse to swim and maneuver almost effortlessly. But when the swimbladder is over inflated with gas, the seahorse will have positive buoyancy and must exert a lot of energy when swimming in order to counteract the tendency to float. And if the swimbladder is underinflated, the seahorse has negative buoyancy and must swim hard in order to avoid sinking.

The first indication of a problem with positive buoyancy is a loss of equilibrium. The seahorse’s center of gravity shifts as excess gas accumulates in brood pouch or its swim bladder, and it will have increasing difficulty swimming and maintaining its normal posture, especially if it encounters any current. It will become apparent that the seahorse has to work hard to stay submerged, as it is forced to abandon its usual upright swimming posture and swim with its body tilted forward or even horizontally in order to use its dorsal fin to counteract the tendency to rise.

There is an easy way to determine whether positive buoyancy in a male seahorse is due to gas accumulating in its brood pouch or is the result of an overinflated swim bladder, Mike. If the stallion’s brood pouch, located at the base of its tail right where its abdomen and tail merge, is bloated or enlarged, then you can be sure that the problem is due to a buildup of gas in the seahorse’s pouch (or marsupium, as it is also known). If the male’s pouch does not appear to be swollen or inflated, yet it is floating nonetheless, then the positive buoyancy is almost certainly do to a hyperinflated swimbladder, or gas bladder, as it is also known.

If the male’s pouch is swollen and bloated, then you must release the gas that has accumulated within the pouch in order to correct the problem. There are a number of different ways to evacuate the gas from the pouch, as explained below:

Bloated pouch, known as chronic pouch emphysema when the buildup of gas within the marsupium keeps recurring, is the most common ailment for our seagoing stallions and, as long as you address the problem early, it is also the easiest affliction to resolve. There are a number of different techniques for manually evacuating the air from his pouch and for performing pouch flushes to provide him with quick relief that we will discuss below. One of these methods should work well for you.

The treatment protocol I usually recommend in cases of suspected pouch emphysema (PE) is as follows, Mike:

First Treatment: Manually Evacuating Gas from the Pouch

At the first sign of a bloated pouch accompanied by any indications of positive buoyancy, the pouch should be "burped" or the trapped gas should be evacuated using a fine catheter. That will provide the affected seahorse with immediate relief, and if this simple first-aid measure resolves the issue, all is well and good.

In that case, the problem was no doubt due to simple pouch bloat, a harmless sort of gas build up that is entirely unrelated to chronic pouch emphysema. Pouch bloat can be caused by gas produced by the decay of embryonic material and the remains of placental tissue or other organic matter (possibly even stillborn young) within the brood pouch, if the male is unable to flush it out and cleanse it properly by pumping water in and out during its pouch displays (Cozzi-Schmarr, per. com.). And in some isolated cases, it’s possible that a bacterial infection of the pouch may also be involved (Cozzi-Schmarr, 2003). But it is far more common for pouch bloat to result from air bubbles trapped in the pouch during courtship displays, especially if the male chooses to display in the bubble stream produced by an airstone or bubble wand or bubble curtain (Strawn, 1954).

However, hobbyists should be aware that even a case of simple pouch bloat can contribute to recurring pouch emphysema, a much more serious problem, if it is not handled properly. The simple act of of struggling against the positive buoyancy that results from pouch bloat can alter the seahorse’s blood chemistry, and result in full-blown PE via acidosis of the blood if the problem is not relieved promptly.

As we discussed previously, the first indication of pouch bloat (or pouch emphysema) is a loss of equilibrium. The seahorse’s center of gravity shifts as the gas accumulates in its pouch, and it will have increasing difficulty swimming and maintaining its normal posture, especially if it encounters any current. It will become apparent that the seahorse has to work hard to stay submerged, as it is forced to abandon its usual upright swimming posture and swim with its body tilted forward or even horizontally in order to use its dorsal fin to counteract the tendency to rise.

The uncharacteristically hard work it must do while swimming means the hard-pressed seahorse builds up an oxygen debt in its muscles, and the lactic acid that builds up as a result of anaerobic metabolism further disrupts its blood chemistry and worsens the situation. It will struggle mightily in a losing battle against its increasing buoyancy until finally it can no longer swim at all, bobbing helplessly at the surface like a cork whenever it releases its grip on its hitching post. At this point, its pouch will be obviously swollen and bloated.

It is imperative that the gas be evacuated and neutral buoyancy restored as soon as possible in order to assure that the affected seahorse is subjected to the least possible stress and does not have to overexert itself for an extended period. The longer it must fight against positive buoyancy, the greater the chances its blood will be acidified in the process and the more likely it becomes that a case of basic pouch bloat can progress into recurring pouch emphysema.

Breeding males are often especially susceptible to chronic pouch emphysema because of the placenta-like changes that occur in the lining of the pouch during pregnancy. Spongelike, its tissues expand as the capillaries and blood vessels swell and multiply. A film of tissue then forms around each embedded egg, providing it with a separate compartment (alveolus) of its own. The thickening of the wall of the marsupium and elaboration of pouch structures around the implanted eggs result in a dramatic increase in vascularization, and this increased blood supply (hence increased concentration of carbonic anhydrase) transports more dissolved gases to the pouch, increasing the risk of gas bubble syndrome accordingly.

Ideally, the air should be evacuated from the male’s pouch at the first sign of positive buoyancy. If this simple procedure does not cure the problem, then it is appropriate to move on to stronger measures once the problem recurs, as described below.

Second Treatment: Flushing the Pouch combined with administering Acetazolmide orally.

In my experience, acetazolmide (brand name Diamox) is much more effective in treating PE when it is ingested rather than administered as a pouch flush or a series of baths. Therefore, if pouch gas recurs a second time, I recommend treating it more aggressively with antibiotic/antifungal pouch washes while feeding the affected seahorse Diamox-injected shrimp (or Diamox bioencapsulated in live shrimp, depending on how badly handicapped the buoyant male happens to be when it comes to feeding).

The pouch flush solution I prefer is a combination of nifurpirinol and neomycin sulfate, since that combo works together synergistically to forms a wide spectrum antibiotic with potent antifungal as well as antibacterial properties (Basleer, 2000). Nifurpirinol (Furanase) and neomycin sulfate (Neosulfex) are the active ingredients in two different commercial products designed for aquarium use, and both of them used to be readily available at your local fish store. Neosulfex has since been discontinued, I believe, but neomycin sulfate is still found in many aquarium medications and is also available online from the National Fish Pharmacy.

Because it is so difficult to distinguish chronic pouch emphysema (PE) from ordinary pouch bloat, which has virtually identical symptoms, many seahorse keepers delay treatment too long when their prize ponies are experiencing buoyancy problems. They will often continue to evacuate the air from the pouch repeatedly in the forlorn hope that their stallion has not developed a life-threatening form of GBS but merely trapped a little air during his pouch displays. Very often this is wishful thinking, which only delays the inevitable and subjects the seahorse to ongoing stress needlessly, while making successful treatment more difficult by increasing the risk that gas emboli will form elsewhere and cause more damage in the meantime. In many cases, all you accomplish by waiting and hoping for the best is to allow the PE to become more advanced, more entrenched, and more severe in the interim.

To avoid this sort of needless delay, I suggest flushing the pouch thoroughly with antibiotics at the first sign of pouch gas and positive buoyancy should your initial attempt to evacuate the air fail to cure the problem (Garrick-Maidment, pers. com.). The affected seahorse must be handled in order to "burp" its pouch or evacuate the air via pouch massage anyway, so I recommend administering an antibiotic pouch wash at the same time.

Not only is repeatedly evacuating the air from the male’s pouch counterproductive in most cases, the constant manipulation can be hard on the tissue of the pouch, aggravating the dermal layers of the marsupium and leaving them vulnerable to secondary infections. (The male marsupium is far more complex than most hobbyists realize, consisting of four separate layers of epithelial and connective tissue, with the innermost layers being heavily vascularized.)

The skin or integument of the pouch is of course its first line of defense against disease. It contains mucus glands, and the slime covering the skin acts as a barrier to ectoparasites and infection. The protective slime may even contain antibodies and antibacterial substances (Evans, 1998). Marine fish are always in danger of dehydration because the seawater they live in is saltier than their blood and internal body fluids (Kollman, 1998). As a result, they are constantly losing water by diffusion through their gills and the surface of their skin, as well as in their urine (Kollman, 1998). The mucus layer also acts as a barrier against this, waterproofing the skin and reducing the amount of water that can diffuse through its surface (Kollman, 1998).

Repeatedly burping or massaging the pouch removes this protective barrier, and the shearing pressures that are involved may aggravate the underlying tissue, resulting in secondary infections of the outer marsupium that can further complicate the picture.

Progressing directly to flushing the pouch plus oral Diamox after the first pouch evacuation helps minimize these repeated insults to the delicate marsupium.

Third Treatment:

If all goes well, as it usually does when the proper measures are performed in a timely fashion, a third round of treatments is normally not necessary. In fact, some experts report a 100% cure rate for pouch emphysema when such pouch flushes are properly administered during the early stages of the condition (Garrick-Maidment, per. com.).

However, if the pouch flushes and an oral Diamox should fail to resolve the problem, the recompression-decompression cure would be your next recourse. Paul Groves found pressurization to be an effective cure for pouch emphysema, as well as the other forms of GBS, while he was conducting his extensive series of trials with gas bubble syndrome.

And if they happen to have the necessary equipment already on hand, some hobbyists prefer to treat PE with recompression-decompression as their second form of treatment, skipping over the Diamox and pouch flushes altogether. I have not tried the latter personally, however.

OK, Mike, here are some instructions on how to carry out that first treatment to evacuate the air from your male’s pouch. If you can release the air that’s building up within his pouch, that should provide him with some immediate relief and hopefully no other treatments will be necessary.

Pouch Massage: Burping the Pouch

Pouch bloat is ordinarily easily resolved by evacuating the gas from the marsupium. This procedure is commonly known as pouch massage or "burping" the pouch and it provides immediate relief for the seahorse when successful. The first attempt or two at performing this procedure can be very intimidating, I know, but it is actually much easier than it sounds.

To expel the trapped air, wet your hands first and hold the seahorse upright in the water with your non-dominant hand, allowing his tail to wrap your little finger or ring finger so he has a good grip and feels secure (Burns, 2001). While the seahorse is thus restrained, use your dominant hand to massage the pouch firmly yet gently between your index finger and thumb, working upward with a circular motion from the bottom of the tail toward the top so as to work the trapped gas upwards toward the opening of the pouch (Burns, 2001). Don’t squeeze the pouch too forcibly, just maintain gentle pressure from below as you massage the pouch, always working from the base of the pouch toward the orifice at the top with your thumb and index finger to force the gas upward.

Hopefully, as your massage moves to the upper half of the pouch and approaches the top, the aperture of the pouch will begin to gape open, allowing a stream of bubbles to escape (Burns, 2001). This is the "burp" you’ve been hoping to produce, and when it happens, you can actually feel the bloated pouch slowly deflate as you gently force the bubbles out (Burns, 2001).

If that does not happen, however, you will have to modify your gas evacuation technique somewhat, this time using the thumb and index finger of your non-dominant hand to massage the pouch with a gentle back and forth motion, while you use a bobby pin or similar blunt implement in your dominant hand to carefully tease open the aperture of the pouch (Burns, 2001).

You are not trying to insert the bobby pin into the pouch at all (Burns, 2001). The idea is to use the rubber-coated end of the pin to gently manipulate the orifice of the pouch, using a sideways pressure on the mouth of the pouch to tease it open, rather than using a downward pressure to force the bobby pin into the opening (Burns, 2001).

Begin as before, holding the seahorse upright in the water with your non-dominant hand, allowing his tail to wrap your little finger or ring finger so he has a good grip and feels secure, while leaving your thumb and index finger free to perform the massage (Burns, 2001). Begin at the base of the pouch near the tail, and massage the pouch gently but firmly between your thumb and index finger, working upwards with a back and forth motion as though gently squeezing a toothpaste tube from the bottom to the top (Burns, 2001).

Meanwhile, using your dominant hand, position one of rubber coated ends of the booby pin at the mouth of the slitlike aperture, and use sideways pressure to prise the lips of the pouch open without actually inserting the pin into the pouch (Burns, 2001). This may take a surprising amount of pressure, so proceed gently but firmly, making sure you direct the brunt of the pressure sideways rather than downward (Burns, 2001). As your massage progresses to the upward portion of the pouch, a few small bubbles at a time will be expelled, and you can feel the pouch gradually deflate between your fingers.

Continue applying pressure from the bottom of the pouch up while prizing the mouth of the pouch open until the pouch feels flaccid and no more gas escapes (Burns, 2001). You may have to repeat this procedure two or three times to be sure you have evacuated all of the trapped gas (Burns, 2001).

If successful, it’s an instant cure and your seahorse should be back to normal immediately, able to swim freely and feed as usual. Burping the pouch is stressful, but seahorses are very forgiving and often will swim away and start eating immediately afterward as though nothing happened. This type of pouch gas is not a serious problem and poses no threat to the seahorse’s long-term health.

Eyedropper Pouch Evacuations

Rather than burping or massaging the pouch, some hobbyists find it easier to use an ordinary eyedropper to evacuate the air from a large seahorse’s pouch. This technique is fairly self-explanatory. Get a glass eyedropper (the smaller the better) from your drugstore — the glass kind that has a rubber bulb. The glass tip is much smoother than plastic droppers are and the rubber squeeze-bulb allows you to apply suction using the eyedropper with one hand while holding the seahorse with your other hand.

Take the seahorse in your nondominant hand, keeping it underwater, of course, and let it wrap its tail round your baby finger. Then take the eyedropper in your dominant hand, squeeze the rubber bulb and hold the bulb squeezed closed while you very gently insert the glass tip into the aperture of the pouch. Once you are just slightly inside the pouch, slowly release the squeeze bulb and the bubbles of trapped air will often be aspirated.

Remove the eyedropper, expel the bubbles it extracted, and repeat the whole procedure as necessary to remove all the trapped air and restore neutral buoyancy.

If you have a Pouch Kit from Ocean Rider, the flushing apparatus can be used in a similar manner to aspirate the trapped air.

Needle Aspirations.

It is also very practical to aspirate air or fluid from a bloated pouch using a small hypodermic needle and a syringe (and insulin syringe is ideal for this). The pouch can easily be penetrated from the side and is not harmed by the entrance of the needle. It is a painless procedure that causes the seahorse surprisingly little discomfort, if any.

Remember, when you perform a needle aspiration, you are not penetrating the seahorse’s stomach, but rather the brood pouch that is slung beneath its belly at the base of its tail.

You cannot release the gas or fluid that has built up in your male’s pouch simply by perforating the side of his pouch with a small needle. That’s not what the term "needle aspiration" means. Rather, you need a hypodermic needle and syringe in order to perform a needle aspiration. You must first depress the plunger on the hypodermic syringe to empty all of the air out of the barrel of the syringe, and then carefully insert the hypodermic needle into the side of the pouch, just far enough to penetrate into the central cavity of the pouch, and then gradually withdraw the plunger again, which will extract the gas or fluid from that area of the pouch.

You may need to perform this procedure twice, once from the left-hand side of the pouch and once from the right-hand side of the pouch, since male seahorses in breeding condition develop an septum or internal membrane that divides their pouches roughly into left and right hemispheres. So you may need to aspirate air or fluid from the left side of the pouch, and then repeat the procedure with your hypodermic needle on the right side of the pouch in order to remove all of the trapped gas or fluid from your stallion’s marsupium.

In addition to aspirating trapped gas or fluid, the hypodermic can also be used to flush out the pouch thoroughly either with sterile saline or a medicated solution (an antibiotic or Diamox dissolved in saltwater). Here’s how another hobbyist describes this procedure:

<Open quote>
dear pete, it was time to give the antibiotics due to recurrent swelling of his pouch and i had small iv catheters but i was unable to intubate the opening. either too small or voluntary tightening by the horse. only choice left was an injection with a needle. i used a 29g insulin syringe and first removed whatever air i could. then reinjected approx .5cc mix of neomycin sulfate plus bifuran until distended then withdrew approx half of that and left the remainder in his pouch. a couple of lethargic days followed with little food intake. then he started eating live brine shrimp then the usual Mysis. it is now 5 or 6 weeks later and all seems well. before that a diamox bath didnt do much but i stopped the diamox due to what seemed like unfavorable side effects. hard to believe the antibiotic injection worked so well. i gave only one injection as it seems to have worked. thanks again for all your help. he was certainly a goner without the intervention and we are most grateful. best regards sg
<close quote>

Whatever method you decide to use to evacuate the male’s pouch, be sure to observe the following precautions when manipulating seahorses:

Handling Seahorses

I do not like to use an aquarium net to transfer or manipulate seahorses, since their delicate fins and snouts can become entangled in the netting all too easily. I much prefer to transfer the seahorses by hand. Simply wet your hand and fingers (to avoid removing any of the seahorse’s protective slime coat) and scoop the seahorses in your hand. Allow them to curl their tail around your fingers and carefully cup their bodies in your hand to support them while you lift them out of the water. When you gently immerse your hand in the destination tank, the seahorse will release its grip and swim away as though nothing out of the ordinary has happened.

Composed of solid muscle and endowed with extraordinary skeletal support, the prehensile tail is amazingly strong. Indeed, large specimens have a grip like an anaconda, and when a 12-inch ingens or abdominalis wraps its tail around your hand and tightens its hold, its vise-like grip is powerful enough to leave you counting your fingers afterwards!

In fact, it can be quite difficult to remove an attached seahorse from its holdfast without injuring it in the process. Never attempt to forcibly detach a seahorse from its hitching post! When it feels threatened, it’s instinct is to clamp down and hold on all the tighter. When you must dislodge a seahorse from its resting place for any reason, it’s best to use the tickle technique instead. Gently tickling the underside of the tail where it’s wrapped around the object will usually induce the seahorse to release its grip (Abbott, 2003). They don’t seem to like that at all, and will quickly let go to move away to another spot. Once they are swimming, they are easy to handle.

In your case, Mike, if you have the necessary apparatus on hand, it might be better for you to perform a thorough pouch flush right away, since that method of releasing the trapped air is often more effective in preventing a recurrence of the problem. Here are detailed instructions from Leslie Leddo, myself, and other experienced seahorse keepers explaining different ways to perform a pouch flush:

"Pouch Flush Techniques and Tips"
By Leslie Leddo

You will need:

•A small syringe. I like to use a 1-cc syringe.

•A catheter of some sort. It needs to be something that is plastic, very narrow, cannulated, blunt tipped, semi pliable, but not so soft that it bends from just a bit of pressure, on one end and fits snugly on to the tip of a syringe at the opposite end. Some suggestions would include an a plastic intravenous catheter, with the center introducer needle used to puncture the skin and vein order to introduce the catheter removed, a plastic pipette, or the syringe tips that come inside some of the aquarium test kits. If you have access to an IV catheter any size, between an 18 and 25g will work well.

•A bowl. I like to use something with a wide rim so I have space to move freely and have enough room should I need another pair of hands…i.e., an assistant. The syringe and pipette/catheter are both used to flush the pouch as well as to aspirate the previous days flush from the pouch.

How to prepare the Syringe and Catheter:

Draw about 1cc of the medicated flush solution into the syringe by pulling back on the plunger.
Invert the syringe so the tip is pointed up. With the syringe inverted, gently tap it until all the air bubbles come to the surface just below the syringe tip; with the syringe still inverted depress the plunger until all the air is removed from the syringe and a small amount of the solution is emerging from the syringe tip.

Attach the catheter or pipette to the tip of the syringe, depress the plunger of the syringe to fill (prime) the catheter or pipette with the solution.

Okay, now you are ready to flush the pouch. Proceed as follows:

Gently place the horse in the bowl filled with his own tank water. Very gently and slowly introduce the tip of the catheter through the pouch opening, into the pouch. When you enter the pouch you may meet some resistance. If you encounter resistance when inserting the catheter, I have found that it helps to try different angles, rather than pushing forcefully. I have never dissected a seahorse, but from all the evacuations and flushes I have done it feels to me as if the opening to the pouch is more than a simple opening. It feels like a short tunnel, with folds or pockets of tissue along the walls of the tunnel. I have had to flush/evacuate several different horses. They all seem to be built a bit differently.

I have had success entering the pouch opening straight and then angling the catheter down a bit as well as entering at an angle from the start.

Once you have the catheter tip inside the pouch, depress the plunger of the syringe, flushing the pouch until you see some of the solution coming back out of the pouch. Continue to flush the pouch with about .2 to .3 cc.

Once the pouch has been flushed, you want to leave a small amount of flush inside the pouch. Pulling back on the plunger aspirate the some of the fluid until some of the solution has been removed from the pouch, leaving enough so that the pouch remains softly full, but is not at all taught or tight. Place your horse back in his tank

The next day, prior to the new flush, aspirate the previous days flush from the pouch. Using the syringe with the catheter/pipette attached to the tip, insert it as described above. Pull back on the plunger of the syringe withdrawing the flush from the day before.

Now you are ready to administer the newly mixed flush by repeating the steps described above.

Antibiotic Pouch Washes

If you can obtain a suitable small glass eyedropper with a rubber squeeze bulb, the tip of which you can insert into the pouch orifice, you can use the eyedropper to flush the pouch instead. Otherwise, you’ll have to obtain a small pipette or use a small syringe and catheter for the flushes, as previously described in Leslie Leddo’s pouch flushing tips. You will be flushing the male’s pouch once a day for three consecutive days, using a medicated pouch flush solution.

The first thing you’ll need to do is prepare the pouch flush solution. I recommend using a combination of nifurpirinol and neomycin sulfate for the pouch flushes, since that combo works together synergistically to forms a wide spectrum antibiotic with potent antifungal as well as antibacterial properties (Basleer, 2000). Nifurpirinol and neomycin sulfate are the active ingredients in two different commercial products designed for aquarium use, and both of them should both be readily available at your local fish store. Prepare a 50:50 solution by taking approximately 1/10 teaspoon of nifurpirinol and 1/10 teaspoon of neomycin powder (from a capsule) and mixing them together with about 40 cc (or 2-1/2 tablespoons) of tank water from your seahorse setup. (Nifurpirinol comes in tablet form, so you’ll have to crush a tablet into as fine a powder as possible, using a blender if necessary, and then use 1/10 teaspoon of this nifurpirinol powder for the mixture.) Mix the nifurpirinol powder and neomycin sulfate powder with the tank water very well until the medication is thoroughly dissolved. Avoid any undissolved residue that remains. (You will have to make up a new batch of this solution each day for 3 days.)

If you can’t find both nifurpirinol and neomycin, then you can use either one alone, or substitute kanamycin capsules alone, to make your medicated pouch solution. In that case, just use 1/10 teaspoon of the antibiotic powder and mix it thoroughly with about 20 cc (or 1-1/2 tablespoons) of tank water. Again, make a new batch of pouch-flush solution each day.

And here are instructions from Keith Gentry explaining how to do a pouch-flush directly with Diamox:

Pouch Flush

In cases of recurring pouch emphysema, diamox can be administered as a solution injected into the pouch via an narrow gauge irrigating cannula or plastic 26 or 28 gauge IV catheter sleeve attached to a 0.5 or 1ml syringe (larger syringes should not be used).

Using a blender, mix ½ of a 250mg Diamox tablet with a cup of seawater at the same specific gravity as the tank. Fill the syringe with about .5ml of this solution, avoiding the residue at the bottom of the cup. The seahorse should be held as per the procedure for pouch evacuations.
Insert the catheter sleeve slowly and gently a small way into the pouch opening and inject this solution SLOWLY into the seahorse’s pouch, leaving the solution in the pouch. Make sure you are familiar with the location of the pouch opening.

Never use a metal needle for this procedure.

The procedure may have to be repeated twice to be effective. In stubborn cases, it is recommended to concurrently administer broad spectrum antibiotics. Diamox and antibiotics have been used simultaneously and successfully without appararent side effects.

I believe the dosage of antibiotic is one 250mg tablet of neosulfex per 10 gallons. It’s important you treat the horse in a quarantine tank. Diamox and neosulfex can kill your

For neomycin and sulfa you can use up to 4 times the marine dosage listed on the instruction or are up to 8 times the recommended freshwater dosage. [End quote]

Finally, here are Neil Garrick-Maidment’s instructions for performing his extremely successful pouch flushing procedure:

[open quote]
Hi Pete,

Hope you don’t mind me interjecting on the point about gas bubble in the
pouch but it is important to emphasise a few things.

When I devised and developed this treatment quite a number of years ago, I
was shocked to hear some of the ways people were clearing the bubbles within
the pouch, from cocktail sticks to straws, which caused irreparable damage
to the pouch and the Seahorse. It is vital that great care is taken when
doing this process and the purchase of a fine blunt ended pipette from the
chemist is the best way.

When handling the Seahorse make sure you have a
firm grip with the pouch facing outwards under the water, its best to have
the tail curled around the little finger to add stability. Then insert the
pipette almost vertically, through the pouch opening so the pipette goes
down into the pouch (almost parallel with the body) and not in towards the
body which will cause major internal and secondary problems.

Once the pipette is safely in the pouch then a fine nozzled hand spray (it must be
fine to fit into the end of the pipette) must be used to flush down through
the pipette, you will notice bubbles of gas being vented from the pouch as
you flush the pouch, initially with water from the tank, this stops shock to
the animal and at the same time clears the pouch. This same method (do not
remove the pipette in between stages) should then be used to add medication

When withdrawing the pipette use a slight twisting motion and remove in
exactly the same direction as it has gone in. The Seahorse will seem a
little shell shocked after this but the immediate release from floating etc
will provide instant relief.

I have had 100% success with this process but
you must be in mind of the Seahorse and its discomfort at all times.
Just before starting make sure you have all your equipment and medication in
place, there is nothing worse than getting part way through and realising
you have forgotten something.

Hope this helps

Best wishes

Neil Garrick-Maidment [close quote]

One of these techniques will hopefully work well for you, Mike, depending on what medications and equipment you have on hand or have access to for performing the pouch flushes. But no matter what method you use, the first step is to try manually releasing the trapped gas from your male’s pouch. I find the easiest way to do that is to carefully insert a small catheter or cannula or tiny pipette into the aperture of the pouch, as previously described, and then apply firm but gentle pressure to the outside of the pouch. This usually causes the air to escape through the catheter or pipette. This method works very well but it’s easier if you have three hands or a helper to assist you.

If your stallion’s pouch is not bloated and swollen, Mike, then you are most likely dealing with a hyperinflated brood pouch, which requires a different form of treatment. Many times an overinflated swim bladder will correct itself as excess gas is gradually reabsorbed into the bloodstream through the "oval," an oblong region of the swim bladder that is covered with a meshwork of thin blood vessels designed especially for this purpose. But that has not happened in your case, so if the positive buoyancy is due to a hyperinflated swimbladder rather than gas building up in the pouch of the seahorse, you may need to try to deflate the swimbladder manually using a hypodermic.

Manually deflating the swimbladder is accomplished much like a needle aspiration, except the needle is inserted into the gas bladder rather than the pouch. This is how Dr. Marty Greenwell from the shed aquarium describes this procedure in the 2005 Seahorse Husbandry Manual:

"If a hyperinflated swimbladder is suspected, a bright light can be directed from behind the animal to visualize the location and borders of the distended organ. This is useful when attempting to deflate the bladder. The needle should be directed between the scute/plate margins for ease of penetration through the skin. The external area can be rinsed with sterile saline or a drop of triple antibiotic up all my appointments can be applied prior to penetration."

The seahorse’s swimbladder is a large, single-chambered sac that begins in the band of its neck and extends 1/3 of the length of its body cavity along the dorsal surface. It’s a large organ so if you can visualize it clearly using a bright light (just like candling an egg), releasing some of the gas to partially deflate the swimbladder is fairly straightforward and uncomplicated.

If the problem is a hyperinflated swimbladder, this simple procedure will provide your seahorse with immediate relief and cure the problem. But if you cannot make out the swimbladder clearly, Jennifer, then you can try treating the seahorse with Diamox (the tablet form of acetazolamide) or even try pressurizing the seahorse a homemade decompression chamber to correct the problem. Please let me know if you need to resort to either of the latter two options, and I will provide you with complete extractions explaining exactly how to proceed.

Best of luck returning your topsy-turvy seahorse to neutral buoyancy again, one way or another, Mike!

Pete Giwojna, Ocean Rider Tech Support

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