Buble on Nect

Dear Moon Valley:

Female seahorses are, of course, never plagued by pouch bloat or chronic pouch emphysema — which are by far the most common form of gas bubble disease — but even the highly resistant females do occasionally develop problems with external GBD (subcutaneous emphysema) or internal GBD. The blisterlike bubbles (i.e., subcutaneous emphysema) are most often seen on the tails of the seahorses, but they may occur on the snout, head, neck, or elsewhere on the seahorse less commonly.

I suspect you are correct and that your female has developed external GBD, Moon Valley, and if you can send me a digital photograph of the seahorse off list via e-mail ([email protected]) that shows the large bubble on her neck, then I can confirm that for you.

In the meantime, I suggest that you try to obtain some of the acetazolamide (brand name Diamox) at this time, if you do not already have some on hand for treating pouch emphysema, Moon Valley.

Unfortunately, obtaining Diamox (the tablet form of acetazolamide) can often be a Catch-22 situation for hobbyists. It is a carbonic anhydrase inhibitor — a prescription drug often used for treating glaucoma, hydrocephaly, epilepsy, congestive heart failure, and altitude sickness in humans, so you have to get it from your Vet or perhaps your family doctor. Unfortunately, Veterinarians are often unfamiliar with Diamox — it’s very much a people med and unless you find a Vet that works with fish regularly, he or she will probably never have heard of gas bubble disease or treating it with carbonic anhydrase inhibitors. Many pet owners are on very good terms with their Vets, who are accustomed to prescribing medications for animals, so it’s often best to approach your Vet first about obtaining Diamox despite the fact they may never have heard of it until you brought it to their attention. Your family doctor, of course, will be familiar with such medications and have Diamox on hand but it can sometimes be difficult to get your MD to jump that final hurdle and prescribe it for a pet. Either way, it can be tough to get the medication you need under these circumstances.

However, I would exhaust those possibilities first before I considered an online source for the Diamox. Print out some of the detailed information that’s been posted regarding subcutaneous emphysema and gas bubble syndrome (GBS) on the Seahorse Life and Care discussion forum at seahorse.com, and how it’s treated using Diamox, and present that to your family veterinarian and/or your family practitioner. Bring photographs of your female with the large bubble on her neck and be prepared to bring the seahorse in for a visit, if necessary. (Veterinarians are prohibited by law from prescribing medications to treat an animal they have not personally seen and examined. If you have had a close personal relationship with your vet over a period of years, they are often willing to bend that rule in the case of fish, but you may well have to bring your stallion in for a quick checkup to get the desired results.)

If not — if neither your Vet or family physician will prescribe Diamox — then 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.) The medications will take a week or two to arrive, which is troublesome when your seahorse is ailing and needs help ASAP. And, as you know, customs officials can confiscate such shipments, although that very rarely happens with this particular medication.

If you ultimately need to go that route, Moon Valley, the following source is the one most seahorse keepers have found works best:

Click here: Inhouse Drugstore Diamox – online information
http://www.inhousedrugstore.com/neurological/diamox.html

They offer 100 tablets of Diamox (250 mg) for around $20 US, but they ship from Canada by mail, which usually takes a little under two weeks for delivery. That’s why it’s best to plan ahead and line up the medication now, before it’s actually needed.

If you can obtain it, the acetazolmide/Diamox can be administered either orally via feeder shrimp bioencapsulated with the medication or as baths (prolonged immersion) in your hospital tank when treating external GBD (subcutaneous emphysema).

I will discuss all three methods for administering the Diamox below, Moon Valley.

Acetazolamide Baths (prolonged immersion)

The recommended dosage is 250 mg of acetazolamide per 10 gallons with a 100% water change daily, after which the treatment tank is retreated with the sole light at the dosage indicated above (Dr. Martin Belli, pers. com.). Continue these daily treatments and water changes for at least 3-5 days, or up to 7-10 days in stubborn cases (Dr. Martin Belli, pers. com.).

The acetazolamide baths should be administered in a hospital ward or quarantine tank. Acetazolamide does not appear to adversely affect biofiltration or invertebrates, but it should not be used in the main tank because it could be harmful to inhibit the enzymatic activity of healthy seahorses.

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 hospital tank, minus the residue, of course, at the recommended dosage:

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 at the same dosage 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 up to 7-10 treatments have been given. About 24 hours after the 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.

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.

The seahorse usually show improvement of the tail bubbles within three days. Dr. Martin Belli reports they nearly 100% success rate when this treatment regimen is followed for 7-10 days, and most cases clear up in less than a week. For best results, the Diamox should be used in conjunction with a good broad-spectrum antibiotic to help prevent secondary infections. A good aminoglycoside antibiotic such as kanamycin or neomycin would work well for this.

If you prefer, you can also administer the acetazolamide orally, providing seahorse is still eating, which will allow you to treat the affected seahorse in the main tank amidst familiar surroundings and in the company of its tankmates where it is the most comfortable. You get the acetazolamide into the food by preparing a solution of the medication, as described below, and then injecting it into live feeder shrimp or even the large Piscine Energetics frozen Mysis relicta. The medication is deactivated fairly quickly once you prepare the solution for injecting, so you must prepare a new acetazolamide solution each day during the treatment period. Here’s how to proceed:

Administering Acetazolamide Orally

I have found that acetazolamide is often more effective when it’s ingested and administering the medication orally allows you to treat the seahorse in the main tank where he’s most comfortable and relaxed.

If you can obtain a small syringe with a fine needle, the acetazolamide solution can simply be injected into feeder shrimp or even frozen Mysis. Mic Payne (Seahorse Sanctuary) used this method of administering acetazolamide successfully when he had recurring problems with GBD due to maintaining a population of Hippocampus subelongatus in shallow tanks only 16-inches (40 cm) deep:

"Seahorses maintained in this system are susceptible to gas bubble disease. Specimens with bubbles around the eyes or under the epidermis of the tail are readily treated with acetazolamide (Diamox tablets 250 mg). Mix a very small amount of crushed tablet with water and inject it into several glass shrimp that are then frozen. These are then fed to the target animal at the rate of two per day for four days. Bubbles disappear on the second day."

Hawaiian volcano shrimp or red feeder shrimp (Halocaridina rubra) work great for this. If a fine enough needle is used, they will survive a short while after being injected — long enough for their twitching and leg movements to attract the interest of the seahorse and trigger a feeding response.

Leslie Leddo reports that a 1/2 cc insulin syringe with a 26-gauge needle was ideal for injecting frozen Mysis or live red feeder shrimp. They plump up when injected and ~1/2 cc is about the most of the solution they can hold. There bodies will actually swell slightly as they are slowly injected and excess solution may start to leak out. The 26-gauge needle is fine enough that it does not kill the feeder shrimp outright; they survive long enough for the kicking of their legs and twitching to assure that they will be eaten.

Subcutaneous emphysema usually responds very well to Diamox administered orally, Moon Valley, and that is what I suggest in this case, since it’s the least stressful method of ministering the medication and allows the seahorse to be treated in the main tank where it is the most comfortable.

Best of luck returning your female to normal again as soon as possible. Please do send me a photograph showing the neck bubble so that I can confirm the diagnosis.

Respectfully,
Pete Giwojna

Dear Jeff:

Acetazolamide (brand name Diamox) is a carbonic anhydrase inhibitor. It is not toxic to seahorses at the recommended dosages but the medication should not be administered to healthy seahorses because it is undesirable to inhibit the enzymatic activity of the healthy animals.

It is a fine idea to administer the Diamox orally by the use of feeder shrimp that have been injected with a solution of the medication, since that allows the seahorse to be treated in the main tank where it is the most comfortable, amidst familiar surroundings and in the company of its tankmates. But you will need to take care and target feed the ailing seahorse to see that the right pony receives the medicated shrimp. Here is a quick rundown on the usual methods for target feeding seahorses, sir:

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Target Feeding Seahorses

The individual personalities of seahorses naturally extend to their feeding habits. Some are aggressive feeders that will boldly snatch food from your fingers, while some are shy and secretive, feeding only when they think they’re not being observed. Some like to slurp up Mysis while it’s swirling through the water column, and some will only take Mysis off the bottom of the tank. Some are voracious pigs that greedily scarf up everything in sight, and some are slow, deliberate feeders that painstakingly examine every morsel of Mysis and stare it down forever before they accept or reject it. Some eat like horses and some eat like birds. So how does the seahorse keeper make sure all his charges are getting enough to eat at mealtime? How does the hobbyist keep the aggressive eaters from scarfing up all the mouth-watering Mysis before the slower feeders get their fair share? And how can you keep active fishes and inverts with seahorses without the faster fishes gobbling up all the goodies before the slowpoke seahorses can grab a mouthful?

Target feeding is the answer. Target feeding just means offering a single piece of Mysis to one particular seahorse, and then watching to see whether or not the ‘horse you targeted actually eats the shrimp. Feeding each of your seahorses in turn that way makes it easy to keep track of exactly how much each of your specimens is eating.

There are many different ways to target feed seahorses. Most methods involve using a long utensil of some sort to wave the Mysis temptingly in front of the chosen seahorse; once you’re sure this has attracted his interest, the Mysis is released so it drifts down enticingly right before the seahorse’s snout. Most of the time, the seahorse will snatch it up as it drifts by or snap it up as soon as it hits the bottom.

A great number of utensils work well for target feeding. I’ve seen hobbyists use everything from chopsticks to extra long tweezers and hemostats or forceps to homemade pipettes fashioned from a length of rigid plastic tubing. As for myself, I prefer handfeeding when I target feed a particular seahorse.

But no doubt the all-time favorite implement for target feeding seahorses is the old-fashioned turkey baster. The old-fashioned ones with the glass barrels work best because the seahorses can see the Mysis inside the baster all the way as it moves down the barrel and out the tip. By exerting just the right amount of pressure on the bulb, great precision is possible when target feeding with a turkey baster. By squeezing and releasing the bulb ever so slightly, a skillful target feeder can keep a piece of Mysis dancing at the very tip of the baster indefinitely, and hold the tempting morsel right in front of the seahorse’s mouth as long as necessary. Or if the seahorse rejects the Mysis the first time it drifts by, a baster makes it easy to deftly suck up the shrimp from the bottom so it can be offered to the target again. In the same way, the baster makes it a simple matter to clean any remaining leftovers after a feeding session. (You’ll quickly discover the feeding tube is also indispensable for tapping away pesky fish and invertebrates that threaten to steal the tempting tidbit before an indecisive seahorse can snatch it up. And it’s great for tapping on the cover to ringing the dinner bell and summon the diners for their gourmet feast!)

In short, target feeding allows the hobbyist to assure that each of his seahorses gets enough to eat without overfeeding or underfeeding the tank. And it makes it possible to keep seahorses in a community tank with more active fishes that would ordinarily out-compete them for food, since the aquarist can personally deliver each mouthful to the seahorses while keeping more aggressive specimens at bay.

The key to keeping active specimens like firefish or compatible clownfish or cleaner shrimp successfully with seahorses is to feed the other fish and inverts with standard, off-the-shelf aquarium foods first, and once they’ve had their fill, then target feed the seahorses.
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Okay, Jeff, that’s the lowdown on target feeding seahorses. In your case, I would feed the other specimens in the tank their fill of untreated frozen Mysis and then target feed the ailing seahorse with the feeder shrimp that have been injected with Diamox using a turkey baster or similar implement. If that is not feasible, then consider isolating the ailing seahorse in the main tank within a Critter Keeper while you offer him the medicated shrimp.

Diamox does not have any affect on me beneficial nitrifying bacteria that carry out biological filtration, but you don’t want to medicate the main tank because it can be harmful to inhibit the enzymatic activity of the healthy seahorses with the acetazolamide. I don’t know if it might have any toxic effects on the invertebrates in your cleanup crew since I have never treated invertebrates with this medication…

Best of luck administering the Diamox, sir.

Respectfully,
Pete Giwojna