Ned Help with Sick Horse

Dear Ken:

All of your readings are excellent so it doesn’t appear that water quality is an issue with this problem, sir.

I think you have assessed the situation correctly and taken all of the appropriate steps under the circumstances, Ken. Your male may have been been having a problem with intestinal flagellates or other internal parasites. As you know, the symptoms to look for in such a case are a seahorse that’s losing weight or not holding its own weightwise even though it feeds well, or alternatively, a lack of appetite accompanied by white stringy feces (Kaptur, 2004). When a seahorse stops eating aggressively and begins producing white, stringy feces instead of fecal pellets, that’s a clear indication that it’s suffering from intestinal flagellates or other internal parasites (Kaptur, 2004). The treatments you have administered with the metronidazole and praziquantel should have eliminated any such intestinal parasites, and you can discontinue further treatment with those medications. You certainly did the right thing but the medications should have done their job by now.

At this point, your stallions may be completely free of intestinal parasites but can still be producing white, stringy feces simply because it’s been a long time since he has had good meal. It’s quite typical for seahorses to produce white stringy fecal matter rather than the usual fecal pellets anytime they are off their feed or have fasted for an extended period for any reason. In such cases, it simply indicates that the seahorse is underfed at the moment and its gastrointestinal tract is empty rather than packed with food like it normally is when a seahorse has been eating well. So the white stringy feces may mean nothing more than your seahorse is malnourished and hasn’t been getting enough to eat.

I would concentrate on getting some good nourishment into him to help build up his strength again, Ken. Surrounding him with choice live foods he can eat at his leisure is an excellent way to fatten up an ailing seahorse, but if you do not see him eating any of the live Mysis or feeder shrimp, it may be time to consider force feeding him.

But before you resort to tube feeding, I would like you to try handfeeding your male erectus instead. By handfeeding in this case I mean holding one entire, intact (whole and unbroken) frozen Mysis that you have carefully thawed in your fingertips and then placing the head end of the Mysid directly in the mouth of the seahorse. Many times the seahorse will simply spit it out again, but often if you can insert the Mysis into its open mouth far enough, his feeding instincts will kick in and take over so that he slurps up the frozen Mysis almost reflexively. That’s a much less stressful and less invasive method of force feeding a seahorse that sometimes works well (especially if the seahorse is accustomed to being hand fed and doesn’t shy away from the aquarist).

So I would suggest attempting the handfeeding method of force feeding your stallion, Ken, and if that is unsuccessful and the seahorse still is not eating the live foods you provided as indicated by the white, stringy feces, then tube feeding him is the only other option. Let me know if you need me to repeat the instructions for tube feeding a seahorse, sir.

Best of luck getting some nutrition into your emaciated male, Ken.

Respectfully,
Pete Giwojna

Post edited by: Pete Giwojna, at: 2009/02/26 19:16

Dear Ken:

I’m sorry to hear that you are down to tube feeding as a last resort, sir, but I would be happy to provide you with some guidance in that regard

Yes, sir, some hobbyists prefer to sedate their seahorses before they tube feed and clove oil is the method of sedation that is most practical for the home aquarist. Other hobbyists feel that sedation only complicates the situation because if you don’t get the dosage correct, you can actually sedate the seahorse to death. (In fact, overdosing with clove oil is the recommended procedure for euthanizing seahorses when that becomes necessary in order to ease their suffering.) So just take care not to overdo it if you will be using the clove oil to sedate the seahorse before hand…

Here is some information regarding tube feeding that will help guide you through the procedure, Ken:

Force-feeding — a last resort when all else fails

Force feeding can save a seahorse’s life in an emergency, but it’s best reserved as a last resort. It’s not a long-term solution, but rather a stopgap measure to provide desperately needed nutritional support for a seahorse when all else fails. If the tube feeding has to be continued for more than two or three days, it is apt to do more harm than good. But it could buy you a little more time to line up choice live foods.

Tube feeding is appropriate when a seahorse has gone without eating for a prolonged period and has exhausted its energy reserves. This can happen when a seahorse is beset with internal parasites and stops eating, or perhaps when a seahorse is undergoing extended treatment with a medication that suppresses the appetite. And, of course, it is very common — perhaps even the rule — in wild-caught seahorses that have run the gauntlet from collector to wholesaler to retailer before finally reaching the hobbyist (Lidster, 1999). In such cases, tube feeding can help strengthen the seahorse and keep it going until it has a chance to recover and resume feeding on its own.

The most common method of force feeding seahorses is better referred to as tube feeding since no force is involved. The following description is based on Leslie Leddo’s tube-feeding technique, as discussed in her online article (Leddo, 2002b). It is similar to the previous technique, except that a very fine catheter is attached to the syringe and inserted into the seahorse’s snout before the food is injected. Basically a small amount of food, very thoroughly mashed and diluted in distilled water, is very gently injected via a very small gauge plastic catheter inserted into the horses snout no further than the trigger. It works best if only a small amount of food — no more than 1-2 mm on the barrel of the syringe — is squirted into the seahorse’s mouth at one feeding. It’s invasive, but actually very gentle, and the seahorse is much more likely to keep the food down this way.

Whichever method of force feeding you try, it’s helpful to hold the seahorse cupped in your hand for a minute or two after a feeding session before you release it. Doing so makes it much less likely that the seahorse will regurgitate the food you so painstakingly put into it. Here are detailed instructions for tube feeding, as explained by the author (Leddo, 2002b):

<begin quote> "Tube Feeding: When All Else Fails, an Alternative to Starvation"
by Leslie Leddo

Is your seahorse on a hunger strike? Have you tried all the non-invasive methods and various of types of foods to no avail? Are you concerned you may lose him to starvation? There is another alternative that may help to jump-start his feeding response. Tube feeding is an option when all else has failed. It is actually easier than you might imagine. Sit back, relax, and read on.

What you need:

* Someone with access to medical supplies. A local sympathetic veterinarian is a good option.
* A high quality food. Frozen Mysis or a high quality flake can be used. My preference is Mysis relicta from Canada. It has an outstanding nutritional profile. It is 69.9% protein and rich in HUFAs.
* A very narrow catheter. I use a plastic intravenous catheter with the introducer needle removed from the center and properly disposed of in a Sharps container, perhaps prior to leaving the vet’s office with your supplies. I would suggest an 18 to 25-gauge depending on the diameter of your horse’s snout. I used a 20-gauge on my 6"-7" erectus. The smaller the horse or the narrower the snout, the smaller the catheter you will need. The catheter size is inversely proportional to the # gauge it is assigned. So an 18-gauge catheter has a wider lumen than a 24-gauge catheter
* A 1 cc syringe.
* A bowl. It should be wide enough and deep enough to allow for your horse to remain submerged while your assistant holds him and you administer the feeding.
* An assistant. Preferably someone who is not too squeamish.
* Tank water.
* A spoon.
* A small bowl.
* Distilled water.
* An area to work that is well lit.

What to prepare:

* Gather all your supplies.
* Review the anatomy of the GI tract of the seahorse, paying particular attention to the esophagus, stomach and intestines.
* Clear and clean a well-lit workspace.
* Wash and rinse your hands well.
* Prepare the food by placing a small amount of previously defrosted and enriched Mysis in the small bowl. With the convex side of your spoon, mash the Mysis into a smooth paste.
* Add a few drops of distilled water and mix thoroughly. You will need to experiment and play here a bit in order to get the paste to a consistency that will easily, smoothly, and consistently flow through the tip of the catheter when gentle pressure is applied to the plunger of the syringe. The smaller the diameter of catheter (the larger the gauge number) you are using, the more dilute and thinner the gruel will need to be.
Once you have a consistency you think is appropriate, draw some of the gruel into the syringe and attach the catheter to the syringe. The tip of the syringe is usually threaded and the catheter will screw on to it. Gently apply pressure to the plunger of the syringe to be sure the gruel flows through the tip of the catheter easily, smoothly and consistently. Adjust the consistency of the gruel as necessary by adding more distilled water or more Mysis paste until it flows smoothly through the catheter with VERY gentle pressure on the plunger. No force should be exerted at all.
* Flush the syringe and catheter several times by drawing a small amount of distilled water into the syringe and pushing it back out.
* Draw into the syringe a little more gruel than you intend to feed. I fed between 0.2cc and 0.25cc to a 6"-7" erectus. You are going to have to estimate the appropriate amount based on the size of your horse. This is where refreshing your knowledge of the seahorse’s internal anatomy will come in handy. Since the seahorse’s digestive tract is basically a straight tube from snout to anus, you can use their length as a general guideline to estimate the portion size.
* Start with the plunger of the syringe fully depressed, pull up on the plunger and draw about 0.3cc to 0.4cc of the Mysis mixture into the syringe. Any air in the syringe will need to be removed. Invert the syringe holding it vertically tip up, plunger down. Gently tap on the syringe several times. The air will displace the gruel appearing as a bubble at the tip of the syringe. Gently depress the plunger with the syringe remaining in the inverted position, so you will be pushing up on the plunger. Continue to depress the plunger until all the air has been expressed from the syringe and a small amount of gruel appears at the syringe tip.
* Attach the catheter to the syringe and prime it by depressing the plunger until a few drops of gruel emerge from the catheter tip.

OK now you are ready to actually feed the little bugger… whoops… sorry… your sweet little hunger-striking horse.

How to proceed:

Round up your assistant. Take a few deep breaths and relax.

Fill the large bowl with your horse’s tank water.

Remove your horse from the tank by gently scooting him into a small container and gently release him into the bowl of tank water.

Have your assistant firmly but gently hold the horse, keeping him submerged at all times. His head and neck should be between their thumb and forefinger, snout pointing up, with his body lying across their palm. Encourage him to curl his tail around their pinky. This will help to keep the horse calm. If you have never held a seahorse in your hand you may be surprised at how strong they are. He may struggle or even snick. Boy, oh boy — was I surprised at how powerful their snick is!

Take the previously filled and primed syringe into your dominant hand.

Loosely hold the horse’s snout between the thumb and forefinger of your other hand.

Closely observe the snout tip. It will open and close in synchrony with his respiration.

As the snout opens, insert the tip of the catheter into the snout about ½ way between the snout tip and trigger.

Slowly and gently depress the plunger. Try to time injecting tiny bits of the gruel just prior to the closing of the snout. If he is ingesting the gruel you will actually see him swallow and pass some of the food through his gills. He may snick, it will feel strange but don’t be alarmed. The first time my boy did it I thought for sure the catheter would break off in his snout. It never did. He did however dent it a bit. That snick is powerful!

If the gruel is coming back out of his snout either you are injecting the gruel too quickly, the catheter tip is not far enough into his snout or you are close to the end of the feeding and his GI tract is full. First check to see if you are close to the end of the estimated amount of the feeding. If so, he is probably full and you are done. If not, try injecting the gruel a little slower, taking care to try and synchronize advancing the plunger just prior to the closing of the snout. If the gruel continues to come back out try advancing the catheter tip just a tad further. Finish the feeding. You may need to give him and yourself a little break if either of the above situations occurs and too much of the feeding is lost. Refill the syringe and give him the rest of the estimated amount.

Wooooooo-Hoooooooo!!! That’s it! You did it! Tell him what a good boy he was, return him to the tank, give yourself a big pat on the back, thank your assistant and take the rest of the evening off in front of your tank with a cup of tea… well… OK, if you insist a cold beer, a glass of wine, or a good stiff drink of your choice. It wasn’t that bad now was it? I bet it was easier than you had anticipated. I thought it was.

Some tips:

Practice pushing the gruel through the catheter. If it is too thick it will stick and you will need to push harder. You will need to thin it with some distilled water so that it flows out smoothly.

Ask your veterinarian for several size catheters. Use the one with the widest diameter (lowest # gauge) that will easily insert into the horse’s snout.

Have the vet remove the introducer needle in his office, so you do not have to worry about needle disposal.

It may be necessary to do this several days in a row until the feeding response is initiated or returns. I would suggest offering a variety of foods prior to each daily tube feeding. If you have been tube feeding for several days and he shows no interest in eating, you may need to gradually decrease the amounts of the feeding so he is actually hungry or possibly fast him for a day or two. It is my feeling that, if at all possible, allowing him to remain in his own tank with other horses and offering a variety of foods (live as well as frozen) may be beneficial in helping to encourage him to eat.

I hope you never need to use the information I presented here, but if you should I would like to wish you good luck and hope this information has proved useful (Leddo, 2002b). <end quote>

Force feeding can save a seahorse’s life in an emergency, but it’s best reserved as a last resort. It is appropriate when a seahorse has gone without eating for a prolonged period and has exhausted its energy reserves. This can happen when a seahorse is beset with internal parasites and stops eating, or perhaps when a seahorse is undergoing extended treatment with a medication that suppresses the appetite. And, of course, it is very common — perhaps even the rule — in wild-caught seahorses that have run the gauntlet from collector to wholesaler to retailer before finally reaching the hobbyist (Lidster, 1999). In such cases, tube feeding can help strengthen the seahorse and keep it going until it has a chance to recover and resume feeding on its own.

For example, during one such incident a hobbyist reported that his seahorse hadn’t eaten for over a week. This particular hunger strike started during treatment for internal parasites, so the seahorse was weak and debilitated to begin with. On that occasion, only one tube feeding was necessary before the seahorse began eating on her own again.

Dr. Marty Greenwell notes that syngnathids in general and seahorses in particular are vulnerable to emaciation in captivity because of their rapid intestinal transit time and very limited fat stores (Bull and Mitchell, 2002, p24). At the Shedd, he regularly tube feeds newly acquired seahorses that arrive badly emaciated. In such circumstances, Dr. Greenwell advises, "…syngnathids are at a high risk for loss of body condition. With this in mind, anorectic seahorses and pipefish almost always require nutritional support. At Shedd Aquarium, anorectic syngnathids are tube fed a high quality, commercial fish flake food gruel. Because of the very small, vestigial stomach, only limited volumes of gruel can be administered at any given time, i.e., 0.05 to 0.10 cc for most seahorses and up to 0.25 cc or more for the large Hippocampus sp., trumpetfish, and the sea dragons. Offering nutritional support can mean the difference between survival and death in sick and/or anorectic syngnathids (Bull and Mitchell, 2002, p24)."

That’s an introduction to force feeding that will hopefully allow you to get some food into your barb, Ken. It’s best used as a last resort, but in a case like yours, it can sometimes be a real life saver.

Some hobbyists feel it’s easier to tube feed their seahorses after they have been sedated, while others feel that sedation only complicates the procedure. Sometimes sedating the seahorse can make tube feeding a little less stressful for both the patient and the caregiver, and if you feel you would be more comfortable performing the procedure under sedation, that’s just fine, sir. In that case, Ken, there is an excellent discussion of the procedure with step-by-step instructions and photographs available online at the following URL:

http://forum.seahorse.org/index.php?showtopic=10975&hl=force+feeding

Clove oil is the best option for the home hobbyist when it comes to sedating seahorses, Ken, but professional aquarists prefer to use MS-222 as described below:

Sedation and Anesthesia

MS-222 at the standard fish dose of 50 – 100 ppm works quite well for most of the syngnathids.
In low-alkalinity water it is recommended to buffer the solution at a ratio of 2 parts sodium
bicarbonate:1 part tricaine (wt:wt). The seadragons have a prolonged recovery time at 100 ppm
and 50-75 ppm is the recommended dose for these two species. In a prolonged anesthetic
recovery situation, it is advisable to ventilate the animals with fresh seawater containing no MS-
222. Because of the long, rather narrow tube snout and the semi-closed nature of the branchial
cavities, assisted ventilation is easily achieved with a 3.5 to 5.0 French red rubber catheter
inserted through the tube snout to the level of the pharynx. A syringe filled with fresh saltwater is
then attached to the end of the red rubber catheter and pumped in a pulsatile manner every few
seconds until the animal is spontaneously breathing at a normal rate. The success of assisted
ventilation is easily assessed by watching the opercula move in and out. This technique has also
been successfully used to resuscitate animals in respiratory arrest.

Best of luck getting some nutrition into your male seahorse, Ken.

Respectfully,
Pete Giwojna