Best treatment for tail rot?

Dear Tom:

I’m sorry to hear about the problems your Brazilian seahorse (Hippocampus reidi) has been having, sir. If it’s any consolation, I believe that you are correct about this problem being noncontagious. It sounds very much like you are dealing with a secondary infection that set in at the site where the bristleworm spicules were embedded in your stallion’s tail. The bristleworm spicules are very irritating, but the good news is that the rest of the seahorses should not be affected.

Yes, sir, I know of a number of cases of tail rot that have been cured using the synergistic combination of neomycin sulfate + triple sulfa, Tom, so that is an appropriate treatment regimen. The usual treatment time is a 14-day regimen of the antibiotics, but the actual treatment time can vary anywhere from 7-21 days, depending on how long it takes the tail to heal completely. Treatment should continue until the seahorse’s tail is completely back to normal.

It is recommended that you change 30%-50% of the water in your hospital tank on a daily basis, replacing it with premixed saltwater that you have carefully adjusted to the same temperature, pH, and specific gravity as the treatment tank. You must also redose the tank with neomycin and triple sulfate on a daily basis proportional to how much of the water was changed. For example, if you change 50% of the water in the treatment tank, then add 50% of the recommended dose of neomyacin and 50% of the recommended dose of triple sulfate to the treatment tank after you perform the water change each day. Likewise, if you change about 30% of the water in the treatment tank each day, then you must add 1/3 of the recommended dose of neomycin sulfate and 1/3 of the recommended dose of triple sulfa to the treatment tank after the water change.

To be on the safe side, I would recommend daily water changes of at least 50%, Tom. Maintaining optimal water quality in the hospital tank is one of the keys to resolving cases of tail rot. If the water quality begins to deteriorate, it will be stressful to the seahorse and that will be counterproductive to its recovery. If you have any doubt, use your ammonia test kit to check the levels of ammonia in the hospital tank, and that can help you determine if you’re changing sufficient water to maintain good water quality.

Best of luck resolving this problem, Tom! It’s a good sign that your Brazilian stallion’s appetite has remained good throughout the setback.

Respectfully,
Pete Giwojna, Ocean Rider Tech Support

Dear Tom:

No, sir, bigger is not always better when it comes to a hospital tank. The bigger the hospital tank becomes, the more medication must be added to the water in order to achieve the proper concentration of the drug, which can become costly when you are re-dosing the medication daily following a water change. This can become a big problem when the medication involved is expensive to begin with or difficult to come by, as with prescription drugs such as the acetazolamide (brand-name Diamox) used to treat gas bubble syndrome in seahorses. For this reason, if the only spare tank that is available to use as a hospital ward happens to be a 20-gallon tank or larger, many hobbyists will opt to only fill the tank partially with saltwater (say halfway full for a 20-gallon tank). That allows the available medication to go further and helps to make the daily water changes more manageable.

In terms of water quality, a larger volume of water is more stable and allows a bigger margin for error when it comes to dangerous ammonia spikes, but to achieve any really significant benefits in that regard you have to jump up to one aquarium of 40 gallons or more, which is simply not practical for a treatment tank. I would say that the ideal size for a hospital tank for a seahorse keeper is about 10 gallons, but as long as you are only treating a single seahorse, a five-gallon treatment container should be more than adequate as long as you are diligent about performing the daily water changes and careful to adjust the pre-mixed saltwater to the same temperature, pH, and specific gravity as the treatment.

It would be worthwhile to set up a larger hospital tank if you are treating your whole herd at once for an outbreak of some contagious disease, in which case maintaining optimum water quality in a tank that is housing several ailing seahorses becomes much more challenging.

In this instance, Tom, I think your makeshift five-gallon treatment container is more than adequate. Just be sure to keep it well aerated and to be diligent in performing your daily water changes, and I don’t foresee any problems with regard to your treatment tank.

Respectfully,
Pete Giwojna, Ocean Rider Tech Support

Dear Tom:

I am sorry to hear that your seahorse’s infected tail has still not healed. Tail rot is a stubborn infection and prolonged treatment regimens of up to 21 days are often necessary to resolve the problem; sometimes more than one such regimen of antibiotics must be administered.

I would continue treating with the neomycin + triple sulfa for at least 14 days, Tom, but as long as you have kanamycin on hand, you may add the kanamycin to your treatment regimen to see if it helps. Like the neomycin sulfate, kanamycin sulfate is an aminoglycoside antibiotic and the two can be combined together and safely used with triple sulfa, so that is something you might consider. Go ahead and add the kanamycin to your hospital tank together with the neomycin and triple sulfa, and see if you notice any difference after several days.

If the addition of the kanamycin to the treatment regimen does not appear to be helping either, then you might consider performing a 100% water change to eliminate all of the medication, and then giving your seahorse a break from any antibiotics for a few days at least before you change medications.

The other medication you have on hand that might be helpful is the gentamicin, which is a very potent gram-negative antibiotic available from National Fish Pharmaceuticals:

Gentamicin Sulfate Powder 100%

USE: probably the most powerful gram-negative antibacterial on the market today. Effective in fresh and saltwater aquariums. Only a single dose is usually required. One of the few drugs that is absorbed into the bloodstream through the gills.

Dosage: 1/4 teaspoon per 40 gallons. Only one dose is necessary. Treat one time and leave in water for 7-10 days. If water changes are done, replace the medication according to how much water was changed.
25 grams for $40.97

You would need to redose the treatment tank with the gentamicin proportionally to how much of the water in the treatment container is changed daily to maintain water quality.

If you’re going to be applying topical treatments to the affected area of the tail, Tom, you must do so very carefully because the tissue is very delicate and the affected portion of the seahorse’s tail is very tender and sensitive. I do not like to use Bio-Bandage for this purpose because it does not appear to be helpful in cases of tail rot.

The medication that used to work very well for treating tail rot topically was Wound Control, which included merbromin as the active ingredient. This was the recommended procedure for treating the affected portion of the tail with the merbromin once a day, Tom:

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Fill a small custard dish or similar receptacle with clean saltwater. Holding the patient upside down, place the head of the seahorse into the container of saltwater so it can breathe freely, and wait until the seahorse relaxes and lowers his tail over the edge of the dish. Dribble on merbromin for wound control and let it drip down the tail, being very careful not to let any of it get into the container of water or otherwise come in contact with the fish’s gills or eyes (Giwojna, Oct. 2003).

If the seahorse refuses to relax, then quickly upright him and dribble merbromin onto the tail, allowing it to run down the entire length of the tail and cover the tail tip (Giwojna, Oct. 2003). If the seahorse is also infected on its body, hold the horse upright and dribble or gently apply merbromin to the affected area with a new or sterilized artist’s soft bristle brush (Giwojna, Oct. 2003). The mercurochrome will soak in immediately and stain the infected tissue dark red.

Merbromin only needs to be applied once a day.
<close quote>

Nowadays, Wound Control is no longer available, and you will probably not be able to locate merbromin either.

But you can still consider applying a topical antiseptic to the discolored area of the tail if you can obtain a suitable product. The antiseptic I recommend for this is povidone iodine (brand name Betadine).

If you cannot obtain it from your local drugstore, it is available online without a prescription from National Fish Pharmaceuticals:

Povidone Iodine Solution (similar to Betadine)

USE: disinfecting of open wounds. Good net dip.

DOSAGE: add 1 ounce to 1 gallon of water and apply topically.
1 pint for $14.99

The topical applications of Betadine should be performed once a day, Tom, while holding the seahorse over a separate bowl of tank water to prevent any excess Betadine from entering the aquarium. While carefully holding the seahorse out of the water in the upright position, dribble the Betadine antiseptic over the affected area, being very careful not to let any of it get into the container of water or otherwise come in contact with the fish’s gills or eyes.

The idea is to dribble the antiseptic over the infected area from a short distance above the wound without actually touching the injury or contacting the seahorse with any sort of a swab or applicator. If you cannot control the application of the Betadine accurately enough by dribbling it on, then you can VERY gently apply the Betadine to the affected area with a new or sterilized artist’s soft bristle brush. If you use the latter technique, apply the antiseptic using as little pressure as possible. The discolored area is very fragile and sensitive, and you must be very careful to avoid aggravating the injury or damaging the delicate tissue any further when applying the antiseptic.

I have never heard of anyone using the Debride Medicated Ointment to treat a seahorse for tail rot, Tom, but I have investigated it and I think it may be another useful option as a topical treatment. The corticosteroids contained in the medication could certainly help to resolve any swelling and the topical anesthetic would reduce pain and discomfort. I was dubious about its usefulness initially, since it could not be dribble onto the affected area of the tail, but rather would need to be directly applied to the tender tail. My concern was that this could be painful and irritating to the seahorse, but I see that the Debride Medicated Ointment contains a topical anesthetic to numb the affected area, so I think it should be all right to use. It can even be applied to the mouth of a fish and would not be harmful to its gills, so I think it may be worth a try.

I would also recommend gradually lowering (no more than 2°F daily) the water temperature in your treatment tank, Tom. One simple way to drop the water temp in your hospital tank is to leave the treatment container uncovered and to position a small fan so it blows across the surface of the water continually (Giwojna, Oct. 2003). This will lower the water temperature a several degrees via evaporative cooling (just be sure to top off the tank regularly to replace the water lost to evaporation). Leaving the cover/hood and light off on your treatment tank in conjunction with evaporative cooling can make a surprising difference.

When reducing the water temperature via evaporative cooling, I should also caution you to observe all the usual precautions to prevent shocks and electrical accident when you are using an electric fan or any other electrical equipment on your aquarium, Tom.

One such precaution is to install an inexpensive titanium grounding probe in your aquariums. That will protect your seahorses and other wet pets from stray voltage and should also safeguard them electrocution in the event of a catastrophic heater failure or similar accident..

But the best way to protect you and your loved ones from electrical accidents around the fish room is to make sure all the outlets are equipped with Ground Fault Circuit Interrupters. And it’s a good idea to make sure all your electrical equipment is plugged into a surge protector as well to further protect your expensive pumps, filters, heaters, etc. from damage. Some good surge protectors, such as the Shock Busters, come with a GFCI built right into them so you can kill two birds with one stone. So when you set up your cooling fan(s) on the aquarium, be sure they’re plugged into a grounded outlet with a GFCI or a surge protector with GFCI protection.

Best of luck controlling this infection and restoring your seahorse to good health, Tom.

Respectfully,
Pete Giwojna, Ocean Rider Tech Support