an ill male kuda

Dear hobbyist:

The recurring pouch gas problems your male kuda has been experiencing are a form of gas bubble disease (GBD) known as chronic pouch emphysema (PE), and I suspect the three bumps or lumps he has developed on his tail are a different manifestation of the same disease. Subcutaneous emphysema, or external tail bubbles as they are sometimes known, typically appear as blisterlike bubbles of gas that form just beneath the skin, but sometimes deep-seated emboli form within the fatty tissue of the tail adjacent to the dorsal aorta or caudal vein instead. As they grow, these deep emboli will gradually migrate upward through the adipose tissue, appearing as lumps or bumps on the tail as they near the surface.

Fortunately, gas bubble disease in general responds very well to treatment with carbonic anhydrase inhibitors such as acetazolamide. Subcutaneous emphysema is the easiest form of GBD to cure and the tail bubbles usually respond very well to treatment with Diamox (the tablet form of Acetazolmide). I would recommend treating your male kuda in isolation with a three-day series of Diamox baths as soon as possible, as discussed below.

Diamox is a prescription med so you’ll have to get it from your Vet or perhaps your family doctor (it often used to treat glaucoma, altitude sickness and a number of other conditions in humans). 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 but it can sometimes be difficult to get your MD to jump that final hurdle and prescribe it for a pet.

Go ahead and try your family doctor, too. If you can get him (or a local Veterinarian) to look at the information on GBD below it should make perfect sense to them and, hopefully, persuade them to prescribe it for you. If not, 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.)

Here is some information on GBD in seahorses that you can print out for your Vet or family physician that explains why carbon anhydrase inhibitors such as Diamox are useful in treating gas bubble disease:

Gas Bubble Disease (GBD)

Your seahorse is suffering from a form of external Gas Bubble Disease known as subcutaneous emphysema. These blisterlike bubbles tend to form on the most distal portion of the tail first because that is where seahorses store their fat reserves (the gas emboli that cause GBD form more readily in adipose tissue) and that is where oxygen tension is the lowest (low oxygen tension drives the following reaction to the right):

HbO2 —> Hb + O2.

Subcutaneous emphysema, or tail bubbles as they are sometimes called, can also occur on other parts of the seahorse’s body, and are fairly common on the head, especially around the eyes and on the snout. Like the other areas where GBD is prone to occur, the head is well endowed with major vessels is order to keep the vital sensory organs and above all, the brain, well supplied with oxygenated blood. The subcutaneous bubbles are as easy to cure when they form on the head as when they occur on the tail.

Gas Bubble Disease (GBD) is believed to be caused by gas embolisms forming within the tissue of heavily vascularized portions of the seahorse’s anatomy — the brood pouch of males, the eye, the muscular prehensile tail–and it can take several different forms depending on where the bubbles or emboli occur. When it occurs in the brood pouch of the male, chronic pouch emphysema or bloated pouch results, leading to positive buoyancy, and this is by far the most common form of GBD. When it occurs in the capillary network behind the eye (choroid rete), Exopthalmus or Popeye results, and the eye(s) can become enormously swollen. When it affects the tail or snout, external gas bubbles form just beneath the skin and look like raised blisters. When the embolisms occur deep within the tissue and occlude blood flow, generalized edema results in the affected area, and gas may build up internally, often resulting in positive buoyancy. If untreated, the gas bubbles worsen and the condition is fatal. Not too long ago there was really not much a hobbyist could do for seahorses with GBD, but now, for the first time, there is a very promising new cure hobbyists can easily administer.

The etiology of GBD is still poorly understood, and there are many theories as to what causes the gas embolisms in the first place. Nitrogen gas supersaturation of the water, the unique physiology of the male’s brood pouch, inefficient degassing of CO2 in small closed-system-aquaria, low pH in the aquarium resulting in general metabolic acidosis, malfunctions of the pseudobranch or the gas gland of the swimbladder, stress-related changes in blood chemistry that affect the oxygen-carrying capacity of hemoglobin, infection with gas-producing bacteria–all have been advanced as mechanisms that could trigger the formation of the gas embolisms. Very likely GBD has multiple causes, but most experts now believe it is due to physical conditions in the seahorse tank rather than a pathogen.

In other words, despite its name, GBD is not a disease seahorses contract. Seahorses do not arrive with GBD, but they often develop the condition when kept in a system that exposes them to gas supersaturation, inefficient degassing of carbon dioxide, stress (especially if due to poor water quality and/or low pH), inadequate water circulation, a bacteria-laden substrate or other environmental factors conducive to the formation of gas embolisms.

In all its various forms, Gas Bubble Syndrome is probably the most common affliction among seahorses. Public aquaria, labs, and big institutions that display Syngnathids or work with seahorses are accustomed to dealing with it and have developed several cures for GBD over the years. This includes submerging the affected seahorses at depths great enough to recompress them (> 10 feet) and cause the gas to go back into solution; using hyperbaric chambers to accomplish the same thing (the same treatment used for divers with the bends); surgical removal of the pseudobranch; and injections with carbonic anhydrase inhibitors such as Acetazolamide and Ceftazadine. Note: carbonic anhydrase is simply a zinc-containing enzyme that catalyzes the following reversible reaction, which helps change carbon dioxide into bicarbonate ion, a form of CO2 that is more easily carried in the bloodstream, or vice versa:

CO2 + H2O <—–> H2CO3 <—–> HCO3- + H+
carbon dioxide carbonic acid bicarbonate ion
and water

As long as the body’s normal equilibrium is maintained, all is well, but when imbalances drive this reaction too far in either direction, gas emboli can result. For instance, an excess of CO2 in the system will drive this reaction to the right, resulting in the accumulation of carbonic acid. When the carbonic acid builds up sufficiently, it disrupts the body’s acid-base balance and lowers the pH of the blood, producing acidosis.

The decrease in blood pH reduces the oxygen carrying capacity of certain types of hemoglobin, resulting in the release of oxygen in the blood, which eventually causes gas emboli to form in the most vascular parts of the seahorse’s body. Low pH in the aquarium can also result in acidosis, with the same outcome. And chronic stress or prolonged exertion can also cause a decrease in the blood pH, producing emboli via the same mechanism.

Likewise, imbalances which favor the exchange of bicarbonate for carbonic acid can drive this reaction too far to the left, triggering physiologic processes which liberate C02, again causing gas emboli to form in the most vascular parts of the seahorse’s body which are richest in carbon anhydrase. In either case, inhibiting this enzyme seems to prevent the formation of such gas emboli and allows the body to restore its normal equilibrium.

Unfortunately, none of the methods developed by the professionals for treating GBD are available to the average hobbyist. But it has recently been found that Diamox, the tablet form of Acetazolamide, a potent carbonic anhydrase inhibitor, is nearly as effective as the injections for treating GBD, making it the first practical cure for hobbyists to combat this dread affliction.

The Diamox is used in different ways to treat the different forms of GBD. For instance, Diamox pouch flushes are effective for treating chronic recurring pouch emphysema. On the other hand, a series of Diamox baths works better for treating external GBD (tail bubbles), internal GBD, and Popeye.

Such baths offer a safe, noninvasive treatment that has proven to be effective in numerous cases like yours. Diamox is the tablet form of the acetazolamide professionals administer to seahorses with GBD via injections. Diamox is commonly used to treat glaucoma, altitude sickness and hydrocephaly in humans, and all you need is a few 250 mg tablets for the treatment regimen. It’s a prescription drug, but since you only need a few tablets, you can sometimes beg a free sample from your local pharmacist or Vet; once you explain what you need it for, they are generally happy to oblige. If not, just show your Vet a copy of this letter and describe your seahorse’s symptoms, and he should be happy to write you a prescription for the Diamox.

Providing you begin the treatments early, while the seahorse is still eating, the prognosis for complete recovery is very good, especially when dealing with external bubbles. Subcutaneous emphysema is the easiest form of GBD to cure and generally responds very well to Diamox. Here are detailed instructions for the Diamox treatments developed by Tracy Warland for external GBD (tail bubbles):
.
Acetazolamide Baths

The acetazolamide treatments are extremely effective in the treatment of external gas bubble disease and GBS-induced Popeye, and are helpful in treating internal GBS and hyperinflation of the swim bladder as well, especially when the affected seahorse has stopped eating. In such cases, instead of a pouch flush, a series of acetazolamide baths is used to administer the medication (Warland, 2002).

The baths should be administered in a hospital ward or quarantine tank. Acetazolamide does not appear to adversely affect biofiltration, but it should not be used in the main tank because it could be harmful to inhibit the enzymatic activity of healthy fishes. Treatments involving acetazolamide tablets are still fairly new to the hobby and the most effective dosages and methods for administering the medication are still in the process of being worked out and adjusted, largely by trail and error. But he recommended dosages are based on the work of Tracy Warland, who first pioneered the use of these treatments, and thus far they have proven to be quite safe for seahorses when used as directed.

The appropriate amount of the medication to use varies with the size of the seahorse. Also, please note that the dosages given for the acetazolamide baths are correct for a treatment tank containing 8 gallons (30 liters) of saltwater. If you are using a smaller hospital tank, be sure to scale down the dosage to suit the smaller volume of water you are dealing with.
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 isolation tank, minus the residue, of course, at Tracy’s recommended dosage:

RECOMMENDED DOSAGE

Type of Seahorse Size of Seahorse Acetazolamide (250-mg)
Mini up to 3 inches 1/16 tablet per bath
Small species 3 to 5 inches 1/8 tablet per bath
Medium species 5 to 8 inches 1/4 tablet per bath
Large species > 8 inches 1/2 tablet per bath

As you can see, the usual starting dosage for a seahorse size of your 8 inchers is 1/4 of a 250 mg tablet per 8 gallons of water, but treatments with Diamox have since become much more refined, and most people now find that a considerably larger starting dose is more effective in relieving gas bubble disease. For example, most people now recommend one full 250 mg tablet of Diamox for 8 gallons when bathing a medium-sized seahorse, and that’s the dosage I suggest you use in this case.

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 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 three treatments have been given. About 24 hours after the third and 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.

The same 3-day regimen of acetazolamide baths is the preferred treatment for eternal GBS, internal GBS, popeye and hyperinflation of the swim bladder.

However, in the case of external GBS or subcutaneous emphysema, also often referred to as tail bubbles, it is usually recommended that the external blisterlike bubbles be lanced prior to the first of the baths (Warland, 2002). This is not strictly necessary and should not be done when the bubbles are located on the head or snout. The bubbles (subcutaneous emphysema) will gradually deflate and disappear on their own as the medication takes affect. Lancing the bubbles does hasten the healing process, and it is important to release the air from any bubbles when they are so large and/or extensive that they cause buoyancy problems or otherwise interfere with the seahorse’s mobility.

Use a fine sterile needle for this and approach each bubble from the side at a very shallow angle, taking extreme care to pierce only the surface of the bubble, not the underlying skin of the tail (Warland, 2002). Once the bubble surface has been pierced, apply gentle pressure to the bubble to deflate it and release any air or fluid inside.

As with pouch flushes, 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.

This 3-day regimen of baths is extremely effective in curing external GBS. They also work fairly well in clearing up Popeye. (Exopthalmia can be result from several different causes, and acetazolamide is only effective when GBS is the cause). Internal GBS is generally more difficult to cure, particularly if the seahorse has stopped eating and the acetazolamide cannot be administered orally. I believe this is because internal GBS is difficult to diagnosis until it is well advanced and emboli have already done serious organ damage.

In stubborn cases, the regimen of acetazolamide baths may have to be repeated a second time. Don’t hesitate to increase the dosage if necessary to clear up the symptoms.

In short, you should consider treating your male kuda with a series of Diamox baths. Don’t treat the whole aquarium or any of the seahorses that have no symptoms.

Best of luck with your treatments. Let me know if you are having difficulty obtaining the Diamox from a local veterinarian or your family physician and I will suggest some other options.

In the meantime, here are some precautions and preliminary measures to observe, when possible, which can help to eliminate problems with GBS: Observing these precautions is probably the best thing you can do to prevent the rest of your seahorses from simple link to the same sort of problems.

Preventing Gas Bubble Syndrome

Since GBS is caused by physical factors in the seahorse setup, when the affliction crops up, it’s a red flag that indicates that there’s something amiss with the conditions in your tank. With that in mind, I would like to quickly review some of the preventative measures aquarists can take to minimize problems with Gas Bubble Syndrome:

(1) Aquarium options (Giwojna, Jan. 2004):

Taller is better. When shopping for a seahorse setup, opt for the tall or high model of the largest aquarium you can reasonable afford and maintain. If the tank is too short, male seahorses may not be able to get enough pumping action in as they ascend and descend during courtship displays and mating (the copulatory rise) to flush out their pouches and cleanse them properly (Cozzi-Schmarr, 2003). This can contribute to bloated pouch, a type of pouch emphysema.

As a rule, your seahorses require a minimum of 2-3 times their height (total length) in vertical swimming space in order to mate comfortably and help avoid this sort of pouch gas problem.

Other forms of GBS are also believed to be depth related, but the aquarium must be greater than 30 inches deep to provide any significant protection against them, which is not feasible for most hobbyists (Giwojna, Jan. 2004). A depth of at least 3 feet is known to protect the Hawaiian seahorse (Hippocampus fisheri) against GBD (Karen Brittain, pers. com.).

If you’ve had a problem with GBS in the past, look for a tank at least 20-30 inches tall, reduce your water temp to 70-degrees F, and avoid overly tall hitching posts that reach near the water’s surface (Cozzi-Schmarr, 2003). You want to encourage the seahorses to hang out near the bottom in order to take advantage of every inch of depth the aquarium can provide.

(2) Filtration options (Giwojna, Jan. 2004):

Gas supersaturation of the water can occur whenever the dissolved gas pressure in the water is greater than the atmospheric pressure. When that happens, the dissolved gases in the seahorse’s tissues are no longer in equilibrium with the surrounding aquarium water, causing gas to move into the area with lower partial gas pressure — the tissues and blood of the seahorse – and come out of solution, forming gas emboli! Providing proper filtration, circulation, and aeration can prevent this.

Add:
Trickle filter (acts as a de-embolizing tower or degassing column).
External filter that returns water as a "water fall."
Sump with strong aeration.
Overflow drains, as opposed to siphon/suction tubes.
Surface agitation to facilitate efficient gas exchange.
Increased circulation and water movement.
Extra airstone(s) just below the surface of the water.

Having a trickle filter, water "falling" into the tank as it’s returned, or strong aeration in the tank or the sump will help off-gas any supersaturated dissolved gases (Giwojna, Jan. 2004). This will also help off-gas a build up of CO2 and the associated pH drop that some tanks experience when the lights go off (Giwojna, Jan. 2004). The off gassing or degassing takes place only at the very air/water interface, so you want to spread the water into very thin sheets and let it be in contact with the atmosphere for an extended period (Robin Weber, pers. com.). That is precisely what a degas column does by trickling water over solid media open to the atmosphere, and if properly maintained and operated, a wet/dry trickle filter can perform the same function (Jorge A. Gomezjurado, pers. com.). For best results, the outflow from a trickle filter should go into a baffled chamber that will allow bubbles to dissipate before they enter pumps or plumbing restrictions (J. Charles Delbeek, pers. com.).

Avoid:
Airstones, air lifts, bubble wands, etc., if submerged deeper than 18 inches.
Leaky pumps.
Subsurface entry of the inflowing or recirculating water.

On small, closed-system aquariums, supersaturation is often due to the entraining of air on the intake side of a leaky pump, which then chops the air into fine microbubbles and injects it into the water (Cripe, Kowalski and Phipps, 1999). Water and air are thus mixed under high pressure and forced into the water column, which can result in gas supersaturation. An air leak in inflowing or recirculating water that enters the tank below the surface can cause the same thing (Cripe, Kowalski and Phipps, 1999). Allowing the water to splash before it enters the tank is a simple way to prevent this from happening. The splashing helps the water to expel excess gas and reach equilibrium with the ambient air pressure (Giwojna, Jan. 2004).

Likewise, airstones, air lifts, bubble wands and the like can cause problems if they are too deep because they will cause gas to dissolve in water to match the ambient pressure (the current atmospheric pressure) PLUS the pressure of the water column above the stone. If they are immersed at a depth greater than 18 inches, the pressure of the water column above them may be sufficient to cause gas supersaturation of the water, especially when there is little atmosphere/water interface (Colt & Westers, 1982). For example, Robin Weber found that airstones submerged in reservoirs 3 feet deep produced excessive gas supersaturation at the Monterey Bay Aquarium. The airstones produced supersaturation at a level of about 104%, and the only cases of GBS she has ever observed at the aquarium occurred in the most supersaturated exhibits. So keep your airstones shallow!

(3) Eliminate stress (Giwojna, Jan. 2004):

Avoid overcrowding.
Avoid aggressive tankmates.
Install a titanium grounding probe to eliminate stray voltage.
Avoid exposing the seahorse tank to excessive noise or heavy foot traffic.
Use a cork or Styrofoam aquarium pad beneath the tank to deaden vibrations.

Stress has been linked to GBS in seahorses via the following mechanism: chronic or prolonged stress causes changes in the seahorse’s blood chemistry (acidosis), which in turn affects the oxygen-carrying capacity of certain types of hemoglobin, and the reduced oxygen-carrying capacity of hemoglobin can then causes embolisms to form in the blood.

The excess of protons (H+) under acid conditions also causes carbonic anhydrase to shift to producing CO2 from carbonic acid in the bloodstream, and the CO2 that results can likewise lead to gas embolisms under certain circumstances (Giwojna, Jan. 2004).

Mic Payne is one of the professionals who feel GBS is most likely a stress-related affliction. He believes it is often a result of chronic stress due to antagonistic behavior by overaggressive males, particularly if they are overcrowded (Payne, pers. com.). Exposing our seahorses to any type of stress may leave them predisposed to GBS (and vulnerable to many other diseases as well). Reduce the stress levels on our seahorses and we reduce the incidence of GBS accordingly (Giwojna, Jan. 2004).

(4) Maintain optimum water quality (Giwojna, Jan. 2004):

Don’t overfeed and remove leftovers promptly.
Employ an efficient cleanup crew.
Practice sound aquarium management and maintenance.
Monitor the aquarium parameters regularly.
Maintain total alkalinity and keep your pH between 8.1-8.4
Maintain a strict schedule for routine water changes.

When he was experimenting with possible treatments for GBS, Paul Groves (Head Aquarist at Underwater World in Perth, Australia, at the time) was able to produce all the different forms of GBS in a control group of Hippocampus breviceps simply by exposing them to a dirty, bacteria-laden substrate. His seahorse setup was far better than any hobbyist could hope for — an open system with 100% flow through from the ocean and a live sand base, yet all the seahorses in the tank eventually developed GBS (Groves, pers. com.). Males with chronic pouch gas were the first to appear, followed by specimens with internal GBS, and finally subcutaneous gas bubbles appeared on the tails and snouts of the others Groves, pers. com.). The weakness of Paul’s setup was poor circulation, and for experimental purposes, he deliberately allowed fecal matter and uneaten nauplii to build up on the bed of live sand. (Groves found that antibiotics were totally ineffective in treating GBS, but he eventually cured 10 of the 12 affected seahorses using pressurization-followed-by-decompression at a depth of 4 meters.)

It is not clear whether stress from the dirty conditions or exposure to such a high density of bacteria triggered the problem in this case, but the lesson is loud and clear all the same — it pays to keep those aquariums clean (Giwojna, Jan. 2004)! If we keep our seahorses setups clean, we will keep our problems with GBS to a minimum (Giwojna, Jan. 2004).

Maintaining the proper pH is especially important for seahorses, since low pH in the aquarium can result in general metabolic acidosis, leading to gas embolisms via the same mechanisms as stress-induced GBS (Giwojna, Jan. 2004).

(5) Water changing precautions (Giwojna, Jan. 2004):

It’s an excellent idea to use Reverse Osmosis (RO) or Deionized (DI) or RO/DI water for your changes because it’s much more pure than tap water. However, water purified by such methods is very soft and must be buffered before it’s used so it won’t drop the pH in your aquarium when it’s added (Giwojna, Jan. 2004).

When mixing saltwater for your marine aquarium, it’s important to fill your container with all the water you will need BEFORE adding the salt mix. In other words, if you are mixing up 5 gallons of new saltwater, fill the mixing container with 5 gallons of water and then add the salt. If you do it the other way around — dump the salt mix in the container and then start filling it with water, the water can become saturated with salt to the point that the calcium precipitates out. This calcium precipitation will turn the water milky and can also lower the pH to dangerous levels (Giwojna, Jan. 2004).

Water changes can also be a problem because of the supersaturation of gases in tap water. Tap water distribution systems are maintained under pressure at all times, both to insure adequate flow and to prevent polluted water from outside the pipes from entering in at leaks. Any additional gas introduced into these pipes (from a leaky manifold, for example) will be dissolved at these higher partial pressures, and will often be supersaturated when it emerges from the tap (Giwojna, Jan. 2004). Also, gases are more soluble in cold water than warm, so when gas-saturated cold water emerges from the tap and warms up in an aquarium, or is warmed up and preadjusted to aquarium temps prior to making a water change, the water can become supersaturated (Giwojna, Jan. 2004). This must be avoided at all costs because gas supersaturation is one of the factors that can contribute to Gas Bubble Disease in seahorses and other fish.

To prevent this, tap water should be allowed to sit for several days beforehand or gentle aeration can be used to remove gas supersaturation before a water change (just make sure your airstones are not be submerged greater than 18 inches while you’re aerating your freshly mixed water; (Giwojna, Jan. 2004)). Some brands of artificial sea salt also produce low levels of ammonia immediately after mixing with water, and aging or aerating the newly mixed water as described above will dissipate this residual ammonia.

Most of the above is mentioned for future reference — I realize there aren’t many modifications you can make after the fact, once your system is already up and running (Giwojna, Jan. 2004). But there are a few things you can try with your existing system that should help.

First of all, whenever you find yourself dealing with an environmental disease such as GBS, a water change is an excellent place to start. At the first sign of GBS, I suggest you combine a 25%-50% water change with a thorough aquarium clean up (Giwojna, Jan. 2004).

Secondly, consider adding an ordinary airstone to your tank, anchored just beneath the surface of the water. That will add surface agitation, extra aeration, and better gas exchange at the air/water interface (Giwojna, Jan. 2004). Unless you’re quite certain your system already has plenty of water movement, it is also advisable to add a small powerhead for extra circulation (Giwojna, Jan. 2004). Seahorses can handle more water movement than most folks realize, and you can always turn it off during feedings. Just screen off the intake for the powerhead as a precaution so it can’t accidentally suck up a curious seahorse (Giwojna, Jan. 2004).

Another factor the hobbyist can control is water temperature. Heat stress must be avoided at all costs so it is vitally important to keep seahorses in their comfort range at all times. If you’ve had an episode of GBS in your tank, consider reducing the temperature. Hippocampus erectus will fry that temperatures between 70-74°F (of course they can tolerate considerably warmer temperatures than those, but it is healthier to maintain seahorses nearer the lower end of their comfort range for a number of reasons).

Finally, use shorter hitching posts and holdfasts that will confine your seahorses to the bottom half of the aquarium along with reducing the water temperature. Shorter hitching posts will get the maximum benefit from whatever depth your tank can provide, and lowering the water temperature allows the water to hold more dissolved gases, which can help avoid any tendency toward supersaturation (Cozzi-Schmarr, 2003).

Those simple measures may make a big difference. Just maintain good water quality, add a shallow airstone and perhaps an extra power head to provide better water movement and gas exchange, and keep things cool and you can reduce your risk of GBS considerably (Giwojna, Jan. 2004).

Best of luck with your Hippocampus kuda!

Respectfully,
Pete Giwojna