Pouch evacuation

Dear Carol:

Yes, I think you may be right — I suspect that you are having so much trouble burping or massaging his pouch, or inserting a cannula or small catheter into the opening of the pouch because your male is pregnant again and has the ringlike sphincter muscle that circles the aperture of the pouch tightly sealed. The clear liquid that you withdrew from the pouch with the syringe is not saltwater but is a special placental fluid that bathes the embryonic young, and is equivalent to the amniotic fluid in humans.

Needle aspirations or Diamox administered orally are the best ways to deal with pouch gas problems in a pregnant male, Carol. A diabetic needle and syringe is ideal for performing the needle aspirations, and if you need to do so again, I would do the aspiration from the opposite side of the pouch this time. Pregnant males do have a septum or wall of tissue that divides their pouch into left and right hemispheres, so it is quite possible for the gas to be building up on only one side of the pouch. Remember that when a pregnant male has pouch gas problems, his marsupium is filled with the placental fluid as well as the gas or air, so perform the needle aspiration accordingly. In other words, tried to penetrate the pouch with the needle where you believe the pocket of gas has collected (the gas, of course, will rise toward the top of the pouch when the seahorse is upright).

The other alternative is to treat your gravid male with Diamox (the tablet form of acetazolamide), Carol, and that may be the best approach if you are having difficulty tapping into the pocket of air with the needle aspirations. If the seahorse is still eating, it’s best to administer the Diamox orally by feeding the seahorse shrimp that have been injected with a solution of the medication. You get the Diamox into the food by preparing a Diamox solution, as described below, and then injecting it into live feeder shrimp or even the large Piscine Energetics frozen Mysis relicta. The Diamox is deactivated fairly quickly once you prepare the solution for injecting, so you must prepare a new Diamox solution each day during the treatment period. Here’s how to proceed if you can obtain the medication and prefer to treat your stallion with the Diamox rather than a needle aspiration:

Administering Acetazolamide/Diamox Orally

I have found that the Diamox 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 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 has cured seahorses with tail bubbles and pouch gas 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 treating your seahorse, 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 very small quantity of water.

Use the resulting solution to inject two of the live feeder shrimp or frozen Mysis relicta and feed them to the affected seahorse immediately after injecting them. Don’t allow any healthy seahorses to eat the medicated shrimp instead of the ailing pony, since it could be bad for them. To prevent this, you may have to target feed or isolate the sick seahorse when feeding it the gut-loaded shrimp. Isolating the patient briefly in a Critter Keeper or something similar when feeding him the medicated shrimp often works well.

Diamox doesn’t dissolve especially well in water; there’s always a residue of undissolved material left behind. Try to avoid this residue when you draw up the medicated solution in your syringe, the particles can sometimes clog up the fine bore needle when you are trying to inject the shrimp.

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).

The length of time it takes for chronic recurring pouch emphysema (PE) to respond to medication and clear up varies depending on how long the seahorse has had the condition and whether or not it’s complicated by subcutaneous emphysema and/or internal GBS in addition to the PE. Seahorses suffering from more than one form of GBS take longer to recover, and as a rule, the longer a seahorse has been suffering with PE the longer it takes to resolve the problem.

Unfortunately, neosulfex is no longer available. Hobbyists will often combine neomycin sulfate with triple sulfa to make an equivalent combination of antibiotics that works well in some cases, Carol, but it will only be effective in relieving pouch gas when it is used as a pouch flush, which is not a good option for you if you cannot insert a small pipette or cannula or tiny catheter through the tightly sealed mouth of the pouch…

Once your male gives birth, the sphincter from his pouch will be stretched out in order for him to deliver his brood, and you will find it a great deal easier to insert a small catheter and perform a pouch flush at that time. So I would recommend using the Diamox (or another needle aspiration, if you can locate the pocket of trapped gas) to help your seahorse maintain neutral buoyancy until he delivers, and then performing a thorough pouch flush after he gives birth using one of the methods explained in my previous post in order to make sure that his pouch is thoroughly cleansed this time.

Best of luck resolving this problem, Carol!

Respectfully,
Pete Giwojna