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Gas Bubble Disease?

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  • #698
    gdietz
    Member

    My male seahorse has a problem swimming normally for several days now. He either swims horizontally or upside down. His pouch looked somewhat swollen, and after a couple of failed attemps at burping his pouch I finally got air bubbles to come out. He seemed some better but still not normal So I burped the pouch again several hours later and more air came out. The pouch looks flaccid when he is upright, but when he is upside down it seems to puff out. He seems to be eating OK and is alert.

    It seems that the burping has not solved the problem so I am wondering what the next step is. I must apologize as I\’m sure I have skimmed past posts addressing this bu not saved them.

    #2173
    Pete Giwojna
    Guest

    Dear hobbyist:

    Initially there’s no way to differentiate between a simple case of pouch bloat, which is easily cured simply by evacuating the air from the pouch, or pouch emphysema (PE), which is a chronic form of gas bubble syndrome (GBS). The diagnosis of chronic pouch emphysema (i.e., GBS) is made if the problem keeps recurring after the gas is emptied from the pouch.

    In your case, since repeatedly burping the pouch has not resolved the problem, it’s appropriate to move on and try a different form of treatment at this time. I would suggest thoroughly flushing out his pouch with an antibiotic solution and administering Diamox orally, as discussed below.

    First I’ll outline the treatment protocol I recommend in cases like this, and then I’ll provide instructions on how to perform the pouch flushes and inject frozen shrimp or feeder shrimp with a Diamox solution so they can be fed to your seahorse:

    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.

    The first indication of both pouch bloat and PE 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 long before that happens 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 and GBS in general 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 GBS 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 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.

    Okay, here are Leslie’s and my instructions for performing pouch flushes. Basically, if you have the Ocean Rider Pouch Kit, you perform the flushes with the pouch kit the same way as described below, only using the apparatus provided in the pouch kit rather than a syringe and a catheter:

    "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 proceed exactly as if you were cleansing the pouch with acetazolamide for GBS. This more aggressive treatment for pouch bloat will often nip the problem in the bud.

    Administering Diamox Orally

    The easiest way to get your ailing seahorse to ingest Diamox is to inject frozen Mysis for feeder shrimp with a Diamox solution and administer the medication orally in this way.

    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 Diamox 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."

    Volcano shrimp or red feeder shrimp from Ocean Rider (iron horse feed) 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 recently cured a seahorse with tail bubbles using this technique. She found 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. So if your Vet or family doctor will prescribe the Diamox for Apollo, who is after all a member of your family, ask them also to provide a 1/2 cc insulin syringe with a 26-gauge needle.

    If you are using 250-mg tablets, Leslie found that 1/8 of a tablet provides enough Diamox for several days’ worth of injections. In other words, 1/8 of a 250-mg Diamox tablet provides enough of the medication to inject two shrimp daily for about 5 days. So each day, I would take 1/8 of a tablet and shave off approximately 20%-25% of it to make the Diamox solution for that day’s injections. (NOTE: if you are using 125-mg Diamox tablets, adjust your dosage accordingly — that is, start with 1/4 of a tablet and then shave off 20%-25% of it to make the Diamox solution.) Then crush the Diamox you have shaved off and to a very fine powder and dissolve it in a small quantity of water. Use the result solution to inject two of the live feeder shrimp and feed them to the affected seahorse immediately after injecting them. You don’t want the healthy seahorses to ingest the medicated shrimp, so f it’s a good idea to isolate the ailing seahorse in a critter keeper or something similar while you feed him the medicated shrimp. [Note: when sucking up the Diamox solution in the syringe, it’s very important to avoid any of the undissolved residue. Diamox does not dissolve completely in saltwater so there will be some granules or fine powder residue on the bottom after you mix up the solution, avoid this residue! It is very bitter and the seahorses will like the taste of it all. You don’t want them to reject the injected shrimp because they that.]

    Each day you will have to prepare fresh Diamox solution to inject the shrimp for that day’s treatment, so just repeat the steps above each day. He should show improvement rapidly, with 2-3 days. If not, after you have fed him injected shrimp for 3 straight days, give him a break from the Diamox for a few days and try again. (Diamox can suppress the appepitite, so feed him unmedicated/uninjected shrimp for a few days to keep him eating and help restore his appetite.) Then feed him Diamox-injected shrimp again at the rate of 2 per day for a total of 3 more days, but this time increase the dosage of Diamox slightly (shave off a bit more of the tablet each day when you mix the new Diamox solution).

    When administering the pouch flushes or transferring the seahorse for feedings, be sure to observe the following precautions for 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.

    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). 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 disease:

    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.

    Best of luck treating your male’s buoyancy problem! Let me know if if you have any difficulty obtaining the Diamox or understanding the treatment options outlined above.

    Respectfully,
    Pete Giwojna

    #2174
    gdietz
    Guest

    Thanks for the info Pete. I’ll be sure and save it this time!

    I may have lucked out. Just after posting my original message, I tried burping the pouch one more time since the seahorse never really showed signifiacant improvement the first few times I tried and there was obviously still air in the pouch. This time it seemed more air came out and the seahorse swam upright. A day later he still seems OK.

    So i’ll hold off on the pouch flush for now and keep my fingers crossed. Thanks again!

    #2175
    Pete Giwojna
    Guest

    Dear hobbyist:

    That’s a positive development and very welcome news! I know pouch evacuations are tricky, intimidating procedures, especially the first time you attempt them. It takes a little bit of practice to become proficient at burping the pouch. It sounds like you’re getting the hang of it and that you did a good job of evacuating all of the air from his pouch this time. Hopefully, it was just a simple case of pouch bloat and you have now resolved the problem. Good job!

    If the problem does recur and he develops positive buoyancy again, we can always treat him more aggressively with pouch flushes and Diamox at that time. But, if your luck holds, that won’t be necessary (crossing my fingers).

    In the meantime, you might try rounding up pouch kit (or a small syringe and catheter) along with some Diamox just in case. Those are very handy items for seahorse keepers to keep on hand for if and when they are needed.

    Best of luck with your seahorses!

    Respectfully,
    Pete Giwojna

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