Bacterial hole

Dear Lisa:

It sounds like you are buying doing a remarkable job of keeping your female with the open wound or hole going, but that the wound it isn’t really responded well to your ongoing treatments anymore. It might be a good idea to try changing up your treatment regimen.

For instance, you might consider treating the wound using Debride Medicated Ointment either alone, or in conjunction with Bio-Bandage, if you are able to obtain some of the Bio-Bandage as well, as explained below:

Bio-Bandage is a special polymer impregnated with neomycin antibiotic that can act as if protective underwater bandage for treating open ulcers and other wounds. (Neomycin is an aminoglycoside antibiotic like the kanamycin sulfate, and both of these antibiotics can safely be used together.) Aquarists who keep fancy Koi will often use the Bio-Bandage after they have applied the Debride Medicated Ointment, because Bio-Bandage works well as a protective bandage when applied to a wound after using Debride Medicated Ointment.

The active ingredient in the Bio-Bandage is neomycin sulfate; both the kanamycin sulfate and the neomycin sulfate are aminoglycoside antibiotics, and they can be used safely together. In fact, when they are used together, Lisa, it produces a synergistic effect that is much more potent than using either of the antibiotics separately.

Biobandage is a combination of neomycin (a good broad-spectrum aminoglycoside antibiotic), a vitamin complex, and unique polymers that form a sort of “biological bandage” that binds the medications to the wound, thus helping to prevent infection and promote rapid healing. It is a good first aid measure that can be applied topically on a daily basis for problems like this, Lisa.

Here is some additional information regarding the Bio-Bandage and how to use it properly:

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Bio-Bandage by Hikari

Hikari’s Bio-Bandage Gel is an extremely effective topical treatment for the treatment of damage from injury or disease in all kinds of fishes. Bio-Bandage uses vitamin based polymers to bond its active medicine, neomycin, to your fishes’ wounds, ensuring longer contact time, which in turn promotes rapid healing and repair.

Bio-Bandage is also unique in that it has no negative side effects to your fishes, your tank or your filtration system.

Shake vigorously before use. Never handle fish with dry hands; always sanitize hands before and after handling.

Caution: Do not hold fish out of the water for more than 30-60 seconds (non-air breathing fish begin suffocating as soon as they are removed from the water).

For wounds on the body of the fish:

Working quickly and carefully, first clean the wound with a clean cotton-tip swab, cotton ball or paper toweling wrapped around a finger; partially dry the wound taking care not to damage adjacent healthy skin or scales on the fish; next apply enough gel to the wound to completely cover the wound and some of the surrounding tissue. Gently return the treated fish to the water; allow the fish to rest with little movement to assure that the mass of the gel stays in contact with the wound for as long as possible.

Apply at least every 24 hours as necessary.

Cleaning of large wounds may require the use of a blunt-tip tweezers or forceps to remove dead and damaged skin or scales or patches of fungal growth. Follow with swabbing with a cotton-tip swab, cotton ball or paper toweling. The fish may be returned to the water immediately after cleansing and before the necessary drying of the wound per the above instructions.

For fin rot:

Carefully snip away the eroded tissue and apply the gel to the cut edges of the fin. Be sure to spread the gel down on both sides of the fin at least 1/4″ from the cut area.

For lesions and cysts: Proceed as for wounds; for raised lesions it may be necessary to re-apply gel more frequently.

Specifications:
• 1 oz. topical gel
• Safe for freshwater and saltwater aquariums
• For treatment of wounds and external bacterial infections
• Safe for most invertebrates; quarantine fish while treating if necessary

Ingredients:

Neomycin sulfate, methylene blue, cyanocobalamin (vitamin B12), binder, adhesion agents in isotonic, aqueous solution.
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Okay, Lisa, that’s the rundown on the Bio-Bandage. In this case, you can use it for treating the hole for open wound exactly as explained above, applying it topically twice a day until the wound has healed. With seahorses, there is no great hurry to complete the topical application of the Bio-Bandage within 30-60 seconds so that you can get the seahorse back in the aquarium rapidly, since the seahorse’s enclosed gills will retain a small supply of water and allowed to breathe adequately for several minutes, but if you are organized and have all the items you will need arranged ahead of time, as well as a helper to lend a hand, if needed, you will find that the procedure will go more quickly and easily. In this case, there will be no need for you to clean the hole or wound prior to applying the Bio-Bandage Gel, but it may be helpful if you can gently pat it dry beforehand using a clean cotton swab or something similar.

Bio-Bandage is available from local fish stores and pet shops that carry Hikari products and can also be obtained online from a number of sources.

As for the Debride, you cannot apply the Debride Medicated Ointment underwater, Lisa. It needs to be applied while the seahorse is held out of the water, and much of the salve will wash off when the seahorse is returned to the aquarium, but a thin residue of the cream will remain on the affected area as a greasy layer, keeping the medication in contact with the wound. The medicated ointment contains a topical anesthetic that will numb and soothe the affected areas, whereas the corticosteroids will reduce any swelling or inflammation, as explained below:

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Debride Medicated Ointment

Debride is a medicated ointment that promotes prompt and complete healing of ulcers, mouth rot, fin rot, and tail rot, all symptoms of Aeromonas and Pseudomonas. Koi Care Kennel conducted extensive field trials on this product in 2001. We sent samples of Debride to over 100 hobbyist and dealers who had requested these samples and who had sick fish. The user’s evaluation came back at a 90% success rate.

Debride® ointment is great at cleaning wounds and helping to speed healing when applying to an ulcer or body sore in Koi or Goldfish (or other large aquarium fish). In about 90% of cases, no injections were needed to bring about a full recovery.

It is a petroleum based medication containing anti-inflammatories and topical anesthetics. In order to apply Debride, you must be willing to handle the fish.

Before Debride, topical treatments for ulcers and body sores were treated with Iodine and then later potassium permanganate rubs and even more recently, hydrogen peroxide. These have one thing in common, they excoriate or burn the adjacent tissues. Debride cream does not. It can be relied upon to clean a wound, applied with a cotton ball or a clean gauze, without irritation. Then Debride results in accelerated healing. You have to try it for yourself. Debride comes with a money back guarantee.

Debride is safe to apply to the fish’s mouth and will not harm the gills. Debride contains Corticosteroide and topical anesthetic in a butylester copolymer Petroleum distillate carrier. Debride comes in two sizes, a 12 gram tube for approx. 20 applications and a 1 oz. (28.3 grams) tube for approx. 45 applications.

Suggested Retail Price: 12 gram tube $25.95 , 1 oz. (28.3 gram) $44.95

Debride Cream Frequently Asked Questions

Q: When using Debride®, do I need to use a waterproof seal over it, or does this topical stay on in the water?
A: Debride stays on “okay” in water, but not “great” —> For example, large chunks of it will simply drift away as soon as the fish gets back in the water. However, catch him up in a half hour because you forgot to give him an injection say, (I’ve done this, duhhhhh) and you’ll find the wound is still slimy with the Debride. ~ Dr. Erik Johnson
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Q: Would you recommend using Oil of Cloves to first knock the fish out and make handling easier?
A: Yes, for sure. If the fish is over 12-14 inches, you’ll have a struggle on your hands…What I do is put a few fish in the Oil of Cloves, and then wait for them to start to slow down. As the first one becomes peacable, I pick ‘im up and dress the wounds. Wait 1-3 minutes for drying (your call) then replace the fish in the pond. I usually run a few “lines” of the stuff on a plastic bag then dab up what I need with a fingertip. It’s easier than picking up the tube over and over. Also a little less wasteful with the fish wriggling in one hand and the stuff in the other. Of course, if sedated, it’s MUCH easier and less stressful for the fish. ~ Dr. Erik Johnson
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Q: Is Debride safe to apply to the fins and tail of fancy goldfish?
A: Debride is safe for any fish surface and has even been used on the gills during bacterial gill disease outbreaks without ill effect, except that I would not recommend that due to the type of infection that represents. The point is that there would be no precaution about applying Debride to fins, tail, or any other surface of even small Goldfish or Koi. ~ Dr. Erik Johnson
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Q: How many times should I apply Debride cream?
A: We would advise that you apply Debride cream at least twice. As soon as healing appears to be starting, suspend treatment.
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Q: Blotting the affected area with a paper towel….do you recommend using mercurachrome first on the area….or any thing else to clean it first?
A: It would be great to precede the Debride treatment with a “once-over-lightly” application (or rub) of plain hydrogen peroxide to remove strands of dead tissue. Also, any scales which are plainly loose, pull them out please. ~ Dr. Erik Johnson
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Q: The instructions say to lay the fish on a wet towel, and then cover it with another wet towel, apply the medicine and wait two minutes so the medicine can soak in. I’m new at fish handling…I assume you mean the fish is out of the water and covered with the towel for two minutes?
A: Wet, and cool, such as in a cold Fall rain, I have confirmed cases where fish have lived eighteen hours completely out of water. There are variables, so you would want to limit any treatment to ten minutes or less. Especially if the fish begins the treatments in an “already stressed” condition.
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Okay, that’s the quick rundown on the Debride Medicated Ointment, Lisa. As you can see, the Debride cream was initially developed for expensive Koi but it is equally effective in treating ulcerations and open sores in marine fish, including mouth rot and tail rot.

In order to apply the Debride cream topically, the seahorse needs to be removed from the water, but there is no need to use clove oil as anesthesia on the seahorse beforehand because the ponies are so easy to handle compared to large Koi. Nor is it necessary or desirable to use hydrogen peroxide anywhere near the mouth, gills, or the snout of the seahorse beforehand.

Applying the antiseptic topically is a very simple procedure, Lisa, but it does require you to remove the affected seahorse from the water briefly. To prepare for this procedure, you will need to lay out a stack of paper towels in your work area, along with the Debride cream.

When you are ready to proceed, cup the stallion in the palm of your non-dominant hand and allow him to wrap his tail around your fingers so that he feels secure. When the stallion has a good grip on one of more of your fingers in such a way that the tail of the seahorse is readily exposed and easily accessible, lift him out of the aquarium and hold him over the stack of paper towels in the upright position, with his head higher than his tail.

Then gingerly apply a dab of the Debride cream to the affected areas of the tail (i.e., any suspicious white spots or open sores/ulcerations or bacterial lesions) and very gently and carefully smear it over those areas using your dominant hand (or have a helper standing by to carefully apply the claimant while you hold the pony).

After applying the ointment to the affected area of the seahorse’s tail, hold the seahorse out of the water for a couple of more minutes to allow the medication to soak in. (The seahorse’s covered gills will retain a small supply of water so it will have no difficulty breathing during this interim.) After this two-minute wait, the seahorse can be returned to the treatment tank, none the worse for wear.

That’s all there is to it, Lisa. It’s a simple procedure, which should take no more than 2-1/2 min. or so, and is completely noninvasive so there should be a minimum of stress on the seahorse. If the seahorse tolerates the handling and disinfecting process well, you can repeat these topical treatments as necessary, according to instructions.

Finally, as long as your female is still eating well, Lisa, you might consider administering antibiotics orally so that they can attack the infection from the inside. In my experience,
the antibiotics that seem to work best for most home hobbyists when treating seahorses are Furan2, which can be used all by itself, or a group of medications by SeaChem that can be used together and mixed with frozen Mysis in order to administer the medications orally, and even the Furan2 is often most effective when it is given orally.

The SeaChem medications that work best for this purpose are SeaChem KanaPlex, SeaChem NeoPlex, and Focus by SeaChem.

The active ingredient in SeaChem KanaPlex is kanamycin sulfate, a potent aminoglycoside antibiotic that is a very broad spectrum, and which can be combined with the neomycin sulfate (another aminoglycoside antibiotic) in SeaChem NeoPlex to create a synergistic effect that is more effective than either of these antibiotics used by themselves.

The SeaChem NeoPlex contains neomycin sulfate, a good aminoglycoside antibiotic that is very effective when ingested, and the SeaChem Focus contains a good nitrofuran antibiotics and is the perfect medium for mixing medications with frozen foods. I will explain more about how to use these two products together for you below.

Both the NeoPlex and the Focus come with little scoops for measuring out the proper dose of the medication, Evelyn, and preparing the frozen Mysis with the medications is actually pretty easy. First, you want to find out how much of the Mysis you are using amounts to a tablespoon. I imagine that several of the cubes of Mysis would be needed to fill a tablespoon after you have thawed it out as usual, if that’s the form of frozen Mysis you happen to have. (It’s important to find out how much of the thawed Mysis constitutes 1 tablespoon because the correct dosage for NeoPlex is one scoop or measure per tablespoon of Mysis.)

Once you have thawed out 1 tablespoon of the frozen Mysis, you then measure out one scoop of the NeoPlex and five scoops of the Focus and mix the two medications thoroughly so that they bind together. (You always add five times as much of the Focus as the amount of antibiotic you are using.) Once you have mixed the powdered NeoPlex and Focus together very well, you then add the resulting mixture to the tablespoon of thawed Mysis you have prepared and very gently but thoroughly mix the powder and Mysis together so that the medications bind to the shrimp. You can then either feed the medicated Mysis to your seahorses immediately or freeze it for later use.

Once you have prepared the medicated Mysis, you feed it to your seahorses twice a day for at least five consecutive days or as long as is takes for the symptoms to clear up.

Of course, you can prepare more than 1 tablespoon of the medicated Mysis at a time in order to make it more convenient, Lisa. For example, if you wanted to prepare 5 tablespoons of medicated Mysis’s at one time, you would thaw out 5 tablespoons worth of your Mysis in advance. Then you would take 5 scoops of NeoPlex (one scoop of NeoPlex per tablespoon) and 25 scoops of the Focus (5 times as many scoops of Focus as the antibiotic) and mix it together thoroughly with the five scoops of NeoPlex so that they blend together and bind. Finally, you would take the mixture of powders and gently but thoroughly combine the powdered medications with the thawed Mysis so that the medicine also binds with the shrimp.

If you want to prepare extra medicated Mysis in advance, it’s best to spread it out on a piece of Saran wrap or Glad wrap or aluminum foil, or something similar, so that you can cover it completely to protect it from freezer burn until you’re ready to use it.

Here is some additional information on the Focus by Seachem Laboratories, which explains how to use it to combine medication with food:

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Seachem Laboratories Focus – 5 Grams Information

Focus ™ is an antibacterial polymer for internal infections of fish. It may be used alone or mixed with other medications to make them palatable to fish and greatly reduce the loss of medications to the water through diffusion. It can deliver any medication internally by binding the medication to its polymer structure. The advantage is that the fish can be medicated without contaminating the entire aquarium with medication. Fish find Focus™ appetizing and it may be fed to fish directly or mixed with frozen foods. Focus™ contains nitrofurantoin for internal bacterial infections. Marine and freshwater use. 5 gram container.

Types of Infections Treated:

Fungal
Bacterial

Focus
DIRECTIONS: Use alone or in combination with medication of your choice in a 5:1 ratio by volume. Feed directly or blend with fresh or frozen food. Feed as usual, but no more than fish will consume. Use at every feeding for at least five days or until symptoms clear up.

Contains polymer bound nitrofurantoin.

Active ingredient: polymer bound nitrofurantoin (0.1%). This product is not a feed and should not be fed directly. Its intended application is to assist in binding medications to fish food.
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And here is an excerpt from an e-mail from another home hobbyist (Ann Marie Spinella) that explains how she uses the NeoPlex together with the Focus for treating her seahorses, Lisa:

“When I bought the NeoPlex yesterday I also picked up a tube of Focus. According to the instructions, it says it makes the medication more palatable to fish and reduces the loss of the medication once it’s in the water.

So I followed the dosing instructions exactly. I used regular frozen Mysis instead of Piscine Energetics frozen Mysis. I figured it was softer and smaller. I was thinking along the lines of more surface area for the medication to adhere to, and with the softer shell, hopefully it would absorb into the shrimp a little better.

I used 8 cubes which came to just about 1 tablespoon. I thawed and rinsed the shrimp thoroughly in a little colander and let it sit on a paper towel to remove as much water as possible.

Then I put in it in a small dish and added the Focus and NeoPlex in the recommended ratio which is 5:1 (5 scoops Focus / 1 scoop NeoPlex). I mixed it thoroughly and added a few drops of Garlic Power.

Then I measured out 5 – 1/4 tsp. servings and 4 servings I placed on a sheet of Glad Press & Seal, sealed them and put them in the freezer, since it says in the instructions that you can freeze what you don’t use right away, and the remaining 1/4 tsp. I split in half and fed to them this morning. The rest I’ll give to them this afternoon and I’ll do this every day with the remaining shrimp that I already prepared and froze.

In the video you can see that the seahorses are eating it. Yea!!

Thanks for all of your help & I’ll keep you posted.”
Ann Marie

Okay, Lisa, that’s the rundown on using the NeoPlex together with the Focus so that you could administer the medication in the NeoPlex orally after adding it to the frozen Mysis for the seahorses daily meals. If you got the KanaPlex instead of the NeoPlex, it can be combined with Focus and administered in exactly the same way separately or together with the NeoPlex as outlined in the instructions for the NeoPlex above.

You can feed the medicated Mysis to your seahorses twice a day until they are back to normal again and all is well. Don’t worry that all of the seahorses will be eating the medicated Mysis because it won’t do any harm for the unaffected seahorses to ingest the antibiotics either, and could actually be beneficial for them by offering them some additional protection.

If you still have enough of the Furan2 antibiotic, it’s also a good option for this, Lisa, but it is ideally administered orally via gutloaded adult brine shrimp, and both the live adult brine shrimp and the Furan2 can hopefully be readily obtained from well-stocked fish stores.

Here are the instructions for gut loading live adult brine shrimp with the Furan2, Lisa, (courtesy of Ann at the org):

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.

In my experience, the best way to gutload the adult brine shrimp is to set up a clean plastic pail with 1 gallon of freshly mixed saltwater, add one packet of the Furan 2, add enough live adult brine shrimp for a generous feeding for all of your seahorses to the bucket after you have thoroughly and carefully rinsed them in freshwater to disinfect the shrimp. Leave the adult brine shrimp in the medicated bucket for at least two hours and then feed them directly to the seahorses. Repeat this procedure twice a day for 10 days.

Don’t worry that all the seahorses will be eating the medicated brine shrimp, Lisa – that’s a good idea in a case like this, since all of the other ponies may also have been exposed to the same bacteria that is causing the bacterial hole. Treating all of your seahorses with the medicated brine shrimp will help to assure that none of the others have the same problem.

Best of luck getting this stubborn wound to finally heal, Lisa.

Respectfully,
Pete Giwojna, Ocean Rider Tech Support