puffy eyes

Dear Brad:

I am not quite sure what you mean by "puffy eyes," sir. Seahorses have protuberant, turreted eyes that can swivel independently, making it possible for a pony to be looking into different directions at the same time. This gives seahorses a very wide field of view and they have acute vision, even under low light conditions. If you are not familiar with seahorses, it’s possible that their protuberant eyes may look swollen or puffy to the uninitiated at first glance. If that’s the case, Brad, then the eyes of your Sunburst may well be normal.

But the eyes of Sunbursts do not protrude any more than the eyes of any other seahorse, so if your Sunburst’s eyes appear more swollen or puffy than other seahorses you have seen in photographs or in person, or if your Sunburst’s eyes have become noticeably more puffy recently than they were when you first got the Sunburst, you may well have a problem. In that case, sir, your Sunburst could be suffering from the initial stages of the condition known as exophthalmia, which is more commonly known as Popeye, for obvious reasons.

The most striking symptom of this malady is that one or both of the eyes enlarge and bulge out of their sockets as if under pressure. The affected eye(s) look as though air or fluid is building up within, around, or behind the eyeball. In severe cases, the eye(s) can become enormously, grotesquely swollen, affecting the vision of the seahorse and making it difficult or impossible to feed normally.

If you suspect that your female Sunburst may be developing exophthalmia, Brad, you should set up a hospital tank and transfer your female to the hospital ward so that she can be treated with antibiotics and Diamox in order to clear up this problem and return her eyes to normal.

A bare-bottomed, 10-gallon aquarium with plenty of hitching posts will suffice for a hospital tank. Ideally, the hospital tank should have one or more foam filters for biofiltration along with a small external filter, which can easily be removed from the tank during treatment but which can hold activated carbon or polyfilter pads when it’s time to pull the meds out. It’s important for the hospital ward to include enough hitching posts so that the seahorse won’t feel vulnerable or exposed during treatment. Aquarium safe, inert plastic plants or homemade hitching posts fashioned from polypropylene rope or twine that has been unraveled and anchored at one end are excellent for a hospital tank. No aquarium reflector is necessary. Ambient room light will suffice. (Bright lights can breakdown and inactivate certain medications and seahorses are more comfortable and feel more secure under relatively dim lighting.)

So just a bare 10-gallon tank with hitching posts is all you need for your hospital ward, Brad. No heater. No reflector. No lights. No substrate. You can even do without the sponge filters or external filter in your case, just adding a couple of airstones to provide surface agitation and oxygenation. That’s it.

In a pinch, a clean 5-gallon plastic bucket (new and unused, NOT an old scrub bucket!) can serve as a makeshift hospital tank. It should be aerated and equipped with hitching posts and perhaps a heater, but nothing else. This makes a useful substitute when the Quarantine Tank is occupied or in use and a seahorse needs treatment.

Stay on top of water quality in the hospital tank/bucket with water changes as often as needed during treatment, and redose with the medication according to directions after each water change.

Set up your hospital tank or treatment container as described above, Brad, and fill it with freshly mixed saltwater that you have adjusted to the proper specific gravity, water temperature, and pH. Then transfer the female male Sunburst to the hospital tank and treat her with a regimen of broad-spectrum antibiotics as soon as possible.

The antibiotic I would recommend in this case is minocycline, sir. Minocycline is the active ingredient in Maracyn-Two, manufactured by Mardel Labs, which is readily available from local fish stores. Minocycline is known to be effective in treating Popeye and you should be able to obtain locally, Brad, so that you can begin treatment promptly.

If you cannot obtain the Maracyn-Two, then scour the fish stores in your area and look for the Furan2 or another medication that contains minocycline, or kanamycin, or neomycin as its active ingredient. Any of those antibiotics would also be useful. Tetracycline and erythromycin will not be helpful in treating Popeye, but most other antibiotics that are designed for aquarium use with marine fish may be worth a try if you cannot obtain the other antibiotics I recommended specifically.

In addition to treating your seahorse with a good broad-spectrum antibiotic, Brad, you should also treat her with Diamox (the tablet form of acetazolamide) at the same time, if possible, for best results. (Diamox is safe to use in conjunction with antibiotics.)

Acetazolamide or Diamox belongs to a group of medicines called carbonic anhydrase inhibitors.

Carbonic anhydrase is a chemical in the body that is responsible for the production and breakdown of carbonic acid. Part of this reaction results in the production of bicarbonate. Acetazolamide acts to inhibit the action of carbonic anhydrase and thereby decrease the production of bicarbonate

Bicarbonate is required for the production of the fluid that fills the back of the eye (aqueous humour). By decreasing the production of bicarbonate, acetazolamide decreases the amount of aqueous humour produced in the eye. This helps reduce the pressure caused by the fluid within the eye in conditions such as glaucoma in humans or Popeye (Exopthalmia) in fish.

In addition to reducing the fluid build up within the swollen eye, the acetazolamide will also help to eliminate any gas emboli from the choroid rete, which may have triggered triggered the problem in the first place, making Diamox especially helpful for treating cases of Popeye.

Unfortunately, obtaning Diamox (the tablet form of acetazolamide) can often be a Catch-22 situation for hobbyists. It is 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.

Print out some of the information above regarding Exopthalmia and how it’s treated using Diamox and present that to your family veterinarian and/or your family practitioner. Bring photographs of the affected seahorse 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 the seahorse in for a quick checkup to get the desired results.)

This is how to administer the Diamox properly, if you can obtain it, Brad:

Acetazolamide Baths

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 acetazolamide at the dosage indicated above (250 mg/10 gal) (Dr. Martin Belli, pers. com.). Continue these daily treatments and water changes for up to 7-10 days for best results (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 3-5 treatments have been given. (In stubborn cases may require a second regimen of Diamox used in conjunction with antibiotics, which would make a total of 7-10 days of treatment, if necessary.) 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.

While you are treating your female in the hospital tank, Brad, I would concentrate on performing a series of partial water changes in conjunction with a good general aquarium cleaning to assure that you have optimal water quality in the main tank, as discussed below:

At the first sign of a health problem:

Because diseases are so often directly related to water quality, or due to stress resulting from a decline in water quality, when trouble arises the first thing you should do is to break out your test kits and check your water chemistry. Very often that will provide a clue to the problem. Make sure the aquarium temperature is within the acceptable range and check for ammonia and/or nitrite spikes first. See if your nitrate levels have risen to harmful levels and look for a drop in pH.

Be sure to check your dissolved oxygen (O2) level too. A significant drop in O2 levels (6 – 7 ppm is optimal) is very stressful yet easily corrected by increasing surface agitation and circulation to promote better oxygenation and gas exchange. At the other extreme, oxygen supersaturation is a red flag indicating a potentially deadly problem with gas embolisms (Gas Bubble Syndrome).

If any of your water quality parameters are off significantly, that may well be the cause of the problem or at least the source of the stress that weakened your seahorses and made them susceptible to disease. And correcting your water chemistry may well nip the problem in the bud, particularly if it is environmental, without the need for any further treatment.

Clean Up & Perform a Water Change

After a quick check of the water chemistry to assess the situation, it’s time to change water and clean up. In most cases, the surest way to improve your water quality and correct the water chemistry is to combine a 25%-50% water change with a thorough aquarium clean up. Siphon around the base of your rockwork and decorations, vacuum the top 1/4 inch of the sand or gravel, rinse or replace your prefilter, and administer a general system cleaning. The idea is to remove any accumulated excess organic material in the sand/gravel bed, top of the filter, or tank that could degrade your water quality, serve as a breeding ground for bacteria or a reservoir for disease, or otherwise be stressing your seahorses. [Note: when cleaning the filter and vacuuming the substrate, your goal is to remove excess organic wastes WITHOUT disturbing the balance of the nitrifying bacteria. Do not dismantle the entire filter, overhaul your entire filter system in one fell swoop, or clean your primary filtration system too zealously or you may impair your biological filtration.]

At first glance your aquarium parameters may look great, but there are some water quality issues that are difficult to detect with standard tests, such as a decrease in dissolved 02, transitory ammonia/nitrite spikes following a heavy feeding, pH drift, or the gradual accumulation of detritus. A water change and cleanup is a simple preventative measure that can help defuse those kinds of hidden factors before they become a problem and stress out your seahorses. These simple measures may restore your water quality and correct the source of the stress before your seahorse becomes seriously ill and requires treatment.

Best of luck treating your female for Popeye and reducing the swelling in her eyes, Brad, and good luck improving the water quality in your seahorse tank to prevent such problems in the future.

Respectfully,
Pete Giwojna

Dear Brad:

Thank you for clarifying the situation, sir. When you say that the area around the eyeball is what is swollen, I have a better idea of what the problem is. It sounds like what you are describing is periorbital edema, which is a symptom of certain bacterial infections. The minocycline in Maracyn-Two is often helpful for treating such infections, so I think we’re on the right track.

If the seahorses whole body was bloated due to gas bubble disease (GBD), Brad, your seahorse would be having difficulties with positive buoyancy, and would be having great difficulty swimming because of the tendency to float. In severe cases where the entire body is bloated due to the buildup of gas within the coelom or abdominal cavity, the affected seahorse is left bobbing helplessly at the surface, unable to swim or to feed. If your seahorse is not having any problems with positive buoyancy, then the puffiness of its body is not the result of internal GBD.

If your seahorse is having problems with GBD and is left untreated, the condition worsens progressively and is ultimately fatal. Diamox is the treatment of choice for gas bubble disease, in general, as well as for exophthalmia or Popeye, sir.

Yes, sir – at mating time, seahorses inflate their brood pouches with water to the bursting point and perform pouch displays known as "Pumping" and "Ballooning" for the benefit of the female they are trying to impress. If successful, and the female is able to transfer her clutch of eggs to the male’s pouch, the male’s pouch can become quite distended over the next couple of weeks due to the fetal fry and embryonic young he is carrying. The photos you saw in the premier issue of Coral magazine no doubt showed courting males performing pouch displays and/or gravid males who were almost ready to give birth. I am thinking that the puffiness in your seahorse is something quite different, Brad, and I would encourage you to treat your pony as we discussed yesterday.

You should be able to obtain Maracyn-Two at one of your local fish stores, and the minocycline in the medication should be helpful in treating the periorbital edema or swelling around the eyes of your seahorse. Likewise, the acetazolamide (brand name Diamox) will help to reduce swelling in around the eyes, and is the treatment of choice for gas bubble disease, in the event that GBD is involved with the Sunburst’s plight.

Best of luck resolving the situation, Brad, and rejuvenating your main tank so you can return it to optimal water quality.

Respectfully,
Pete Giwojna

Dear Brad:

Excellent – good job obtaining the Diamox, sir!

Yes, it is perfectly acceptable to fill the 10-gallon hospital tank with 5 gallons of saltwater and then to use 1/2 of the 250 mg Diamox tablet or 125 mg for each of the treatments. Proceed as explained in my previous post, performing a 100% water change in the hospital tank each day and then re-dosing with the Diamox (250 mg per 10 gallons or 125 mg per 5 gallons of water). Treat the affected seahorse for 3-5 days successively, and be prepared to repeat the treatment regimen, if necessary, for a total of 7-10 days treatment.

For best results, combine the Diamox therapy with a good broad-spectrum antibiotic, as we have discussed previously.

Good luck!

Respectfully,
Pete Giwojna