Seahorse Club
Aquarium & Livestock

Feed Ezy Frozen Mysis

Seahorse Club
Aquarium & Livestock

Feed Ezy Frozen Mysis

Seahorse Club
Aquarium & Livestock

Feed Ezy Frozen Mysis

Seahorse Club
Aquarium & Livestock

Feed Ezy Frozen Mysis

Seahorse Club
Aquarium & Livestock

Feed Ezy Frozen Mysis

Seahorse Club
Aquarium & Livestock

Feed Ezy Frozen Mysis

Seahorse swollen eye

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    Hi – please bear with me as this is my first post on this site – I have a female seahorse that has for the past 4 weeks had a very swollen eye – it protrudes approx 1/16\" like a donut – having read LOADS of threads I dont think it is GBS I think it is more bacterial – she has had a course of myxazin over 5 days at half strength – 48hrs clear – then just started on 5 days at 3/4 strength – she is still eating (just) as she is finding it very hard to focus on any food as if she can\’t see it properly – she knows it\’s there but can\’t home in on it – we just can\’t get the swelling to go down to try and help her sight – a fellow reefer has kindly offered me some diamox to try and help her but I have no idea how to use this so any help, if this is a suitable treatment, would be greatly appreciated as I want to get it right if this will help her – I am also going to ring a fish vet tomorrow, Monday, to see if he will give me some advice but would also greatly appreciate yours – many thanks Judy

    Post edited by: Judy58, at: 2009/01/25 22:29

    Post edited by: Judy58, at: 2009/01/26 00:45

    Pete Giwojna

    Dear Judy:

    I’m sorry to hear about the eye problem your female seahorse has developed.

    That bubble-like protrusion of the eye sounds very much like Exophthalmia, a condition 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, and vision or depth perception is adversely affected (especially when both eyes are involved), making it difficult for the seahorse to accurately track and strike at its prey. When the swelling is doughnut shaped, that can be an indication that a bacterial infection is at work, but as long as you have the Diamox (tablet form of Acetazolmide), it doesn’t really matter whether an infection or a gas emboli or both is the cause of the problem — Diamox is compatible with antibiotics and you should be treating your seahorse with the Diamox and a good broad-spectrum antibiotic as soon as possible. (Even when GBS is not a component in the genesis of the Popeye, Diamox is still very useful in reducing the swelling because of its ability to control intraocular pressure and fluid buildup.)

    You have probably already seen the following information when searching through discussion threads, Judy, but I will repeat it for the sake of thoroughness anyway, and then discuss the proper treatment regimen for the Diamox later in this post.

    Popeye can result from a number of different causes, and the treatment varies accordingly, as described below:

    Popeye (Exopthalmia)

    I have seen a number of cases of Exophthalmos or Exophthalmia, more commonly known as Popeye, in seahorses over the years. It is not so much a disease as a condition or syndrome, and like GBS, when it crops up, it is often an indication that there is something amiss in the aquarium (Giwojna, Aug. 2003).

    We have already described the enormously enlarged, bulging eyes that are so characteristic of this disfiguring affliction in the section devoted to gas bubble syndrome. When both eyes are affected (bilateral Exopthalmia), vision and depth perception is adversely affected, making it difficult for the seahorse to accurately track and strike at its prey (Giwojna, Aug. 2003). This may leave the affected seahorse unable to feed.

    Popeye is ordinarily not at all contagious, and there is typically no danger of it spreading to the rest of the herd (Giwojna, Aug. 2003). As described below, a number of physical injuries, environmental factors, noninfectious and infectious diseases can cause Popeye to develop. In my experience, it can be the result of eye trauma, parasitic infestation, gas embolisms forming in the choroid rete behind the eye (a manifestation of Gas Bubble Syndrome), and rarely as a symptom of internal infection (Giwojna, Aug. 2003).

    Eye trauma: eye trauma can result from a scratch, scrape or bruise to the eyeball suffered during fighting, netting, handling, or swimming (Giwojna, Aug. 2003). In seahorses, it most often results when rival males snap at one other while competing for mates. When snapping at its adversary, a male will incline his head towards his rival and point his tubular snout directly at him, lining up his victim in his sights exactly as if staring down the barrel of a rifle. Once satisfied with his aim, the male will cock his head downwards and pull the trigger, delivering a sharp blow with a powerful upward ”snap” of its snout (Giwojna, Aug. 2003). The snap is usually directed at the gill cover or eye of the opponent — the only vulnerable spots or chinks in an armor-plated adversary’s exoskeleton (Giwojna, Aug. 2003). This maneuver looks as though the aggressive seahorse is headbutting its rival.

    Eye injuries from sparring seahorses are uncommon, but they have certainly been known to happen, as I have personally witnessed on a few occasions. Suspect eye trauma as the cause of the Popeye when only one eye is affected (unilateral Exopthalmia) and the water quality and aquarium parameters check out fine (Giwojna, Aug. 2003). Surprisingly, when Popeye results from eye trauma, the seahorse often appears relatively undistressed by its bulging eye and grotesque injury (Giwojna, Aug. 2003). It often remains in good appetite, eats well, remains active, and generally behaves as though nothing out of the ordinary has happened (Giwojna, Aug. 2003). It may continue to court or even mate in spite of its condition.

    In such cases, the Popeye will often resolve itself if the seahorse is left to its own devices in the display tank and the injury is allowed to heal on its own (Giwojna, Aug. 2003). Attempting to net it or otherwise remove the seahorse for treatment risks further aggravating the trauma or causing additional irritation to the eye. The enlarged eye will deflate as the injury heals, which may take anywhere from several days to several weeks depending on the severity of the trauma (Giwojna, Aug. 2003). In minor cases, it’s best just to let the seahorse be.

    However, as with any such injury, there is always a danger of secondary infections. To protect the seahorse against such complications, consider bioencapsulating or gut-loading live food (adult brine shrimp, red feeder shrimp from Hawaii, ghost shrimp, etc.) with a good broad-spectrum antibiotic such as doxycycline, kanamycin, minocycline, or nifurpirinol + neomycin and continue feeding the medicated shrimp to the seahorses until the eye has healed (Giwojna, Aug. 2003).

    Ectoparasites (monogenetic trematodes): these nasty parasites head right for the gills and eyes and cause many cases of Popeye in marine fishes, including seahorses. Both eyes are normally infested and the cloudy eyes that result are a dead giveaway that eye flukes or trematodes are involved (Giwojna, Aug. 2003). This was a common problem when the only seahorses available were wild specimens obtained from your local fish store (LFS), but the advent of captive-bred seahorses has greatly reduced the incidence of such cases. If you keep captive-bred seahorses that you obtained directly from the breeder, you will probably never see a case of Popeye caused by trematodes. If you get your seahorses from the LFS, then trematodes need to be considered as a proximate cause for any Popeye that occurs (Giwojna, Aug. 2003). It is while they are in the wholesaler’s or pet dealer’s holding tanks that most seahorses are exposed to monogenetic trematodes. When you bring them home and introduce the seahorses into your tank, you are introducing the trematodes to your system as well. Giving new seahorses from the LFS a 10-minute freshwater dip before they go into quarantine can prevent this (Giwojna, Aug. 2003).

    Suspect trematodes when both eyes develop Popeye and are cloudy, especially if your seahorse came from the LFS (Giwojna, Aug. 2003). Confirm your diagnosis by administering a freshwater dip to the affected seahorse. The trematodes will drop off their host after 7-10 minutes in the freshwater; they will be left behind in the dipping container, where they will appear as opaque sesame seeds drifting in the water — proof positive that trematodes are at work (Giwojna, Aug. 2003).

    If trematodes are confirmed, the treatment for Popeye is easy and wonderfully effective. A concentrated formalin bath will eliminate the trematodes and reduce the swelling almost overnight (Giwojna, Aug. 2003). Treat the seahorse in a hospital tank or a clean plastic bucket according to the bath instructions on any commercially prepared formalin medication. Be sure to use an airstone to aerate the treatment tank heavily throughout the bath (Giwojna, Aug. 2003). Watch the seahorse closely at all times during the bath, and if at any time the seahorse shows signs of stress, becomes listless, exhausted or loses its balance, immediately return it to the display tank (Giwojna, Aug. 2003). If necessary, the formalin bath can be repeated in subsequent days, but one treatment usually works like a charm. When eye flukes or trematodes are the cause of the problem, a formalin bath can produce miraculous recoveries (Giwojna, Aug. 2003).

    Gas Bubble Syndrome (GBS): when Exophthalmos or Popeye is related to gas embolisms or GBS, one or both of the eyes may be affected, the eyes typically remains clear, and the aquarium parameters are often off (Giwojna, Aug. 2003). In some cases, small, blisterlike bubbles just beneath the skin (subcutaneous emphysema) will accompany the Popeye(s) elsewhere on the seahorse’s body, especially its head, snout, or tail. The presence of any such external bubbles is an unmistakable indication that the Popeye is a manifestation of GBS (Giwojna, Aug. 2003).

    As previously described, the treatment for GBS-induced Popeye is always straightforward: a 7-10 day regimen of acetazolamide baths administered in a hospital tank in combination with a good, broad-spectrum antibiotic to prevent secondary infections, and accompanied by 50% water changes in the display tank as needed to restore water quality (Giwojna, Aug. 2003). GBS-induced Popeye is often associated with dirty tank conditions and poor water quality, and is frequently seen after the biofilter has been impaired for some reason, or when the death of a janitor (a Turbo snail or starfish, for example) goes undetected, resulting in ammonia/nitrite spikes (Giwojna, Aug. 2003). 50% water changes can be repeated daily until the water quality has been restored. Low pH, oh dissolved oxygen levels and/or high CO2 levels, and chronic stress can all contribute to GBS-related Exophthalmia.

    Bacterial/Fungal infection: finally, Popeye sometimes appears in seahorses as a symptom of an internal infection such as Ichthyophonus hoferi (fungal infection) or Vibriosis (bacterial infection). In such cases, it’s important to treat the underlying infection and not the symptom (Popeye); the Popeye will clear up on its own once the underlying infection is resolved (Giwojna, Aug. 2003).

    Suspect infection as the cause of the Popeye when more than one seahorse is affected or the swollen eye is accompanied by other symptoms associated with such internal infections: swollen body, lethargy, weight loss, lack of appetite (Basleer, 2000). (Other forms of Popeye usually don’t affect the seahorse’s normal behavior or appearance, other than the affected eye or eyes.)

    The affected seahorse(s) should be treated in isolation to prevent the possible spread of the underlying infection. If you are unsure whether the underlying infection is bacterial or fungal, a combination of drugs that’s effective against both is a good choice. Such combo drugs are available from fish stores, or you may combine nifurpirinol (Furanase) with neomycin yourself to create your own (Giwojna, Aug. 2003). If you are confident the underlying infection is bacterial, kanamycin (a potent gram-negative antibiotic absorbed through the skin) usually works well (Giwojna, Aug. 2003).

    In your case, Judy, since only one seahorse is affected, that suggests that the unilateral Exopthalmia is the result of either a mechanical injury or gas bubble syndrome (GBS) caused by a gas embolism or emboli forming in the choroid rete of the swollen eye. On the other hand, the doughnut shaped swelling around the eye is often seen as bacterial infections such as vibriosis. Either way, you need to treat the seahorse with the acetazolamide (brand name Diamox) in conjunction with antibiotics as soon as possible.

    Once the swelling comes down in her eyes and her vision is restored, your female should begin feeding normally again and we can concentrate on fattening her up a bit at that time.

    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, Velinda. 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, Judy, and fill it with freshly mixed saltwater that you have adjusted to the proper specific gravity, water temperature, and pH. Then transfer the female seahorse to the hospital tank and treat her with a regimen of broad-spectrum antibiotics as soon as possible.

    The antibiotics that I find our most useful in cases like this are chloramphenicol, which you will not be able to obtain, and ciprofloxacin or TMP sulfa, both of which can be ordered online.


    Manufactured by Eaten Laboratories (Vibriosis and columnaris)

    Ciprofloxacin is a synthetic broad spectrum antibiotic that is effective against gram-negative and some gram-positive bacterial pathogems of fish, e.g. aeromonads, flexibacteria, vibrios. Use for: Columnaris infections (Fin Rot, Saddleback, and Black Patch Necrosis Syndromes), Freshwater and Saltwater Furuncolosis (skin ulcers, systemic disease). Because it inhibits unique target enzymes needed for bacterial replication and DNA repair, it may be effective against bacteria unresponsive to other antibiotics.

    DOSAGE & ADMINISTRATION: Add one tablet per gallon of water in the hospital tank for a 1-hour immersion bath. Add crushed tablet to some water, then add this suspension to the hospital tank. Repeat every day for 5-7 days with daily water changes after each treatment. Ciprofloxacin chelates divalent cations water hardness (increase dose for marine fish) and high divalent cations in diet. Its activity decreases with high pH (>6.9). It can be bacteriostatic or bactericidal depending on the effective concentration at the target site.

    Because you would be using the ciprofloxacin in a saltwater aquarium with high pH, you should double the dose and add two tablets per gallon of water in the hospital tank. After you crush the tablets to a fine powder and dissolve them in a small amount of saltwater, add the resulting solution to your hospital tank for one hour. After the seahorse has been in the medicated water for one hour, change the water in your hospital tank and replace it with freshly mixed saltwater. The next day, crush up two more tablets and dissolve them, and then add them to the hospital tank, change the water after 60 minutes, and repeat this procedure every day for five to seven days.

    You can obtain ciprofloxacin for aquarium use online from Vet America at the following URL:

    Click here: Aquafish Ciprofloxacin Tablets 250 mg bottle of 30 – 4664

    TMP Sulfa (trimethoprim and sulfathiazole sodium)

    USE: for treating bacterial infections, both gram-negative and gram-positive. The combination of trimethoprim plus sulfathiazole sodium retards resistant strains from developing. It exerts its antimicrobial effect by blocking 2 consecutive steps in the biosynthesis of the nucleic acids and proteins essential to many bacteria.

    DOSAGE: add 1/4 teaspoon per 10 gallons of water every 24 hours, with a 25% water change before each daily treatment. Treat for a minimum of 10 days.

    (1/4 pound treats approximately 940 gallons of water.)
    *More effective than triple sulfa.

    TMP Sulfa is especially helpful when the Popeye is associated with kidney problems.

    You can get both TMP Sulfa and many other useful medications online without a prescription from National Fish Pharmaceuticals at the following URL:

    Click here: Fish Medications

    If you cannot obtain the ciprofloxacin or TMP sulfa, then scour the fish stores in your area and look for in medication that contains minocycline, or kanamycin, or neomycin as its active ingredient. Any of those antibiotics would also be useful. Tetracycline and oxytetracycline 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, Judy, you should also treat her with Diamox (the tablet form of acetazolamide) at the same time 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.

    This is how to administer the Diamox properly, Judy:

    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 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.

    Best of luck treating your female for Popeye and reducing the swelling in her eye, Judy. If she is having difficulty targeting the frozen Mysis, try handfeeding her, placing each of the Mysis directly into her mouth individually until the swelling in her eye goes down and she can feed normally again. Her feeding instincts may take over from there and she will hopefully snick up the shrimp as usual.

    Pete Giwojna


    Hi Peter – thankyou so much for taking the time to reply with what I can only say seems like excellent advice and I have asked my fellow reefer in England if she could send me the diamox asap so I can hopefully make a start on treating my pony with a further medication that will get her back to health – I will also let you know what the vet has to say tomorrow if I am allowed to speak to him !! kind regards Judy

    Post edited by: Judy58, at: 2009/01/26 00:44


    hi pete can you tell me how to treat popeye with chloramphenicol as over here we can get it without prescription.thank you lucy

    Pete Giwojna

    Dear Lucy:

    Excellent — chloramphenicol is the treatment of choice for Vibrio infections and a doughnut-shaped swelling around the eye is one way that such infections may present themselves.

    Chloramphenicol can be given orally or used as a bath (Prescott, 2001c). Therapeutic baths lasting 10-20 hours are administered in a chloramphenicol solution consisting of 40 mg per liter of water (Prescott, 2001c). If the seahorse is still eating, the chloramphenicol can also be bioencapsulated by gut loading feeder shrimp or ghost shrimp with flake food soaked in the antibiotic solution. Even if the affected seahorses does not eat, feeding medicated shrimp to its tankmates is a good way to help prevent this contagious disease from spreading to the healthy seahorses (Prescott, 2001c).
    <Close quote>

    All things considered, artchic, I would say that chloramphenicol (i.e. Chloromycetin) is the treatment of choice for marine ulcer disease (i.e., flesh-eating bacteria) and most Vibrio infections, in general. It is effective both as a bath for prolonged immersion or when administered orally. If the affected seahorses are no longer eating, then administering the chloramphenicol to the treatment tank would be a good option for you if your other seahorses develop any symptoms of this disease.

    The treatment protocol for Chloramphenicol or Chloromycetin is as follows:

    Chloramphenicol can be used to treat Vibriosis at 40 mg/ litre of water (which comes out to about 150 milligrams per gallon) in a bath for 10-20 hours. It is important to watch the quality of the water, and if it starts to become turbid, the water must be changed. It is best to treat in a separate tank. In stubborn cases, a series of such baths may be necessary to resolve the problem, in which case a complete water change should be performed before the medication is redosed.

    Chloramphenicol can also be used as an additive to the feed, if the fish are still eating (all to often in a major infection they will refuse to eat, but this treatment may be most useful in preventing the horizontal spread of the infection). When used as an addition to the feed use 500 mg per 100 gram of feed. (In the case of seahorses, the flake food medicated with chloramphenicol in this way would first be bio-encapsulated in live feeder shrimp, which would then in turn be fed to the seahorses.)

    If you do obtain the chloramphenicol, be sure to be very careful when handling it, Lucy. Remember, in a few rare individuals exposure to chloramphenicol can cause a potentially fatal side effect (aplastic anemia). These are rare cases and almost always involve patients who were being treated with the medication, but I would use gloves when handling it as a precaution and if you crush crush up tablets of chloramphenicol, be very careful not to inhale any of the power.

    Because of this side effect, which affects one in 100,000 humans, chloramphenicol is no longer available as a medication for fishes here in the US and can therefore be difficult to obtain.

    Best of luck resolving the exophthalmia or Popeye, Lucy.

    Pete Giwojna


    Hi Pete – just to let you know that unfortunatley Bonnie didn’t respond to the treatments and has died – I would like to thank you for all your advice and trying to help Bonnie through her illness – I have now decided to keep a few proper meds in for any future problems and wondered if you could give me a list of the main meds and their uses to keep in stock as I will do my best to obtain these from somewhere – thanks again Judy

    Pete Giwojna

    Dear Judy:

    I’m very sorry to hear that the seahorse with exopthalmia was unable to recover. That makes me think that it was indeed an underlying bacterial infection that caused the Popeye and ultimately killed the seahorse. All my condolences on your loss!

    It is a very sensible precautions to prepare a medicine chest or at least a first aid kit consisting of useful medications to have at the ready when trouble arises. Prevention is our first goal but is not always possible to achieve, of course, and when disease problems do crop up, early detection of the problem and prompt treatment are the keys to restoring health. Some diseases are remarkably fast acting, such as pathogens and parasites that multiply by binary fission and can quickly explode to plague proportions when conditions favor them. By the time a health problem becomes apparent, there is often no time to make the rounds of your local fish stores searching for the right medications, much less time to order the meds you need through the mail.

    Savvy seahorse keepers avoid such delays by keeping a few of the most useful medications on hand at all times so they’re right there when needed. For the greater seahorses, the following weapons should be in your disease-fighting arsenal at the ready, and I strongly suggest you stock your fish-room medicine chest will useful: first aid preparations such as methylene blue, a pouch kit; potent antiparasitic agents such as formalin and metronidazole; a good antifungal agent; and broad-spectrum antibiotics. And don’t forget the heavy artillery for emergency situations when you’re not sure what you’re dealing with — combination drugs with ingredients that are effective against protozoan parasites, bacteria, and fungal infections alike. I would be happy to recommend some must-have medications all seahorse keepers should keep on hand with you, Judy. For example, a basic seahorse First Aid Kit might include the following items:

    Methylene Blue (for reversing nitrite poisoning and relieving respiratory distress);

    Formalin (for treating ectoparasites and fungal problems);

    Antiparasitic for treating internal parasites (i.e., praziquantel or metronidazole);

    Broad-Spectrum Antibiotics (e.g., kanamycin sulfate and/or doxycycline for treating bacterial infections);

    Small Syringe with Needle and Cannula (pouch flushes, tube feeding, needle aspirations);

    Diamox (i.e., acetazolamide for treating Gas Bubble Disease);

    A good combo drug (e.g., Furan2 or Nitrofuracin Green) for when the diagnosis is uncertain;

    Vibrance (includes beta-glucan to boost the immune system and help prevent disease).

    Having these items on hand will allow you to address nearly all of the common afflictions of seahorses promptly and effectively, as discussed below in greater detail:

    Must-Have Meds

    methylene blue

    Commonly known as "meth blue" or simply "blue," this is a wonderful medication for reversing the toxic effects of ammonia and nitrite poisoning (commonly known as "new tank syndrome"). Since hospital tanks are usually without biological filtration, and ammonia and nitrite can thus build up rapidly (especially if you are not doing water changes during the treatment period), it’s a good idea to add methylene blue to your hospital ward when treating sick fish.

    Methylene blue also transports oxygen and aids breathing. It facilitates oxygen transport, helping fish breathe more easily by converting methemoglobin to hemoglobin — the normal oxygen carrying component of fish blood, thus allowing more oxygen to be carried through the bloodstream. This makes it very useful for treating gill infections, low oxygen levels, or anytime your seahorses are breathing rapidly and experiencing respiratory distress. It is the drug of choice for treating hypoxic emergencies of any kind with your fish.

    In addition, methylene blue treats fungus and some bacteria and protozoans. Methylene blue is effective in preventing fungal infections, and it has antiprotozoal and antibacterial properties as well, by virtue of its ability to bind with cytoplasmic structures within the cell and interfere with oxidation-reduction processes. A "must" for your fish-room medicine cabinet. However, be aware that it is not safe to combine methylene blue with some antibiotics, so check your medication labels closely for any possible problems before doing so. (The Kordon brand of methylene blue is best, in my opinion, if you can obtain it.)


    This is basically a 37% solution of formaldehyde and water. It is a potent external fungicide, external protozoacide, and antiparasitic, and seahorse keepers commonly use formalin to cleanse new arrivals of ectoparasites during quarantine. Formalin (HCHO) is thus an effective medication for eradicating external parasites, treating fungal lesions, and reducing the swelling from such infections. It is a wonder drug for treating cases of Popeye caused by trematodes, and also eradicates nematodes as well as bacteria.

    Formalin has a limited shelf life and degrades to the highly toxic substance paraformaldehyde (identified as a white precipitate on the bottom of the solution); avoid using any formalin product that has such a precipitate at the bottom of the bottle.

    When using formalin, beware that it basically consumes oxygen so vigorous aeration must be provided during treatment. It can be administered as a 1-hour bath at a concentration of 200 ppm (l ml per 5 liters of seawater or about 1/5 teaspoon per 1.33 gallons). Again, the Kordon brand of formalin is a good product for hobbyists.

    Formalin is guaranteed to knock your biofilter for a loop, so confine its use to the hospital tank only!

    Metronidazole (Hexamit/Flagyl)

    This medication was originally developed to combat the parasites that cause amoebiasis and giardiasis in man and wreak havoc on the human GI tract (Kaptur, 2004), and it remains the treatment of choice for eradicating internal parasites (intestinal flagellates, digenetic trematodes, etc.) in seahorses. It is extremely effective in treating wasting disease (weight loss despite eating well) and loss of appetite when they are due to such intestinal parasites (Kaptur, 2004).

    Metronidazole is most effective when ingested (Kaptur, 2004), and is best administered orally via gut-loaded shrimp. If administered in a hospital tank, it will be absorbed from the water through the gills.

    Metronidazole is only active against anaerobic bacteria, so it is one drug that can be used safely in your main tank without impairing the biofiltration (Kaptur, 2004). This is a very safe with medication with little to no danger of overdosing.

    Metronidazole can be combined safely with aminoglycoside antibiotics such as Kanamycin and neomycin to create a potent synergistic treatment that’s effective against both aerobic and anaerobic bacteria.


    This is a very effective antiparasitic that works equally well against external and internal parasites alike. Like metronidazole, this is a very safe medication that works best when ingested, hence it is best administered by bioencapsulation — i.e., gutloading live shrimp or injecting them with a solution of the medication.

    When treating ectoparasites, it can be added directly to the water in the treatment tank (dose one time and leave in the water for 5-7 days). However, in order to do this, it must first be mixed with ethyl alcohol (e.g., vodka) in order to make it water soluble.

    Broad-Spectrum Antibiotics

    If you could only keep one antibiotic in your fishroom medicine cabinet, kanamycin sulfate (e.g., KanaPlex or Kana-Pro) is the one I would choose because of its excellent solubility in saltwater and effective absorption.

    Kanamycin sulfate

    This is a potent broad-spectrum, gram+/gram- aminogylcoside antibiotic. It is wonderfully effective for aquarium use because it is one of the few antibiotics that dissolves well in saltwater and that is readily absorbed through the skin of the fish. That makes it the treatment of choice for treating many bacterial infections in seahorses. Like other gram-negative antibiotics, it will destroy your biofiltration and should be used in a hospital tank only.

    Best of all, kanamycin sulfate can be safely combined with certain other antibiotics such as doxycycline or neomycin or triple sulfa to increase its efficacy, as explained below. If you can keep more than one antibiotic in your fishroom, make it one of the antibiotics that can be combined safely with kanamycin to produce a synergistic effect. For example, kanamycin + doxycycline is an effective combination for treating certain Vibrio infections. Likewise, combining an aminoglycoside antibiotic (e.g., kanamycin or neomycin) with triple sulfa works well for combating some bacterial infections in seahorses.

    Doxycycline hydrochloride

    USE: broad-spectrum antibiotic derived from oxytetracycline. Used for both gram-positive and gram-negative bacterial disorders. Fin and tail rot, septicemia, mouth rot. Will not be deactivated by high pH levels in saltwater like ordinary tetracycline. Works in a similar manner to chloramphenicol.

    WATER DOSAGE: 1/4 teaspoon per 20 gallons, every 24 hours for 10 days. Do a 25% water change before each daily treatment.

    FOOD DOSAGE: doxycycline may be mixed into frozen or pelletized food by using 2 teaspoons per ounce of feed. For seahorses, you’ll want to use frozen Mysis for this purpose. Thaw out one ounce of the frozen Mysis and, gently but thoroughly, mix in 2 teaspoons of the doxycycline hydrochloride after the Mysis thaws. Then put the medicated food in a Ziploc bag and lay flat in the freezer until frozen. Feed the seahorses their fill of the medicated frozen Mysis as usual once a day for the next 10 days. This makes it especially useful for treating seahorses since they can be fed the medicated Mysis in the main tank where they are the most comfortable, giving the hobbyist a stress-free treatment option for some conditions.

    neomycin sulfate

    Neomycin is a very potent gram-negative aminoglycoside antibiotic. Most of infections that plague marine fish are gram-negative, so neomycin sulfate can be a wonder drug for seahorses (Burns, 2002). As mentioned above, it can even be combined with other medications such as kanamycin, nifurpirinol or sulfa compounds for increased efficacy. For example, kanamycin/neomycin is tremendous for treating bacterial infections, while nifurpirinol/neomycin makes a combination that packs a heckuva wallop for treating mixed bacterial/fungal infections or problems of unknown nature.

    Neomycin will destroy beneficial bacteria and disrupt your biological filtration, so be sure to administer the drug in a hospital tank.

    Combination Drugs (Nitrofuracin Green, Furan2, etc.)

    Combo medication — that is how hobbyists refer to the drug cocktails that combine antiparasitic, antifungal and antibacterial agents in one commercial preparation. Look for a product that combines the following ingredients in one potent mixture: antiparasitics such as nitrofurazone and metronidazole, effective antibiotics like neomycin, and kanamycin or nitrofuran antibiotics, possibly methylene blue, and antifungals such as nifurpirinol. The result is a powerful combination drug that’s effective against protozoans, fungus, and many kinds of bacteria. When combined together, these medications cover all the bases and the formulation acts as a particularly strong broad-spectrum antibiotic.

    A good combination drug is the ultimate weapon in your medicine cabinet. It is effective against a wide range of diseases, making it a versatile shotgun for restoring order when trouble breaks out in your tank. When you suspect an infection is at work, but don’t know whether you’re dealing with fungus, bacteria, protozoan parasites or a mixed infection, don’t hold back — break out the heavy artillery and give the bugs both barrels! Use them with caution in a hospital tank only.

    Some examples of combo meds that are commonly available in pet shops and fish stores are Furan2 and Nitrofuracin Green:


    Furan2 is a good combo medication that consist of two nitrofuran antibiotics (nitrofurazone and furazolidone) plus good old methylene blue. That gives it both bacteriostatic and bactericidal properties, and makes it active against various gram-negative and gram-positive bacteria. The methylene blue stains the water in the treatment tank as and prevents the photosensitive nitrofuran antibiotics from being deactivated by light. Methylene blue is effective in preventing fungal growth, and it has antiprotozoal and antibacterial properties as well, by virtue of its ability to bind with cytoplasmic structures within the cell and interfere with oxidation-reduction processes. This makes the combination of methylene blue, nitrofurazone and furazolidone very broad spectrum and fairly potent. Furan2 is especially effective for treating mild skin infections, but serious infections such as vibriosis or marine ulcer disease should be treated with stronger antibiotics, such as doxycycline + kanamycin.

    Best of all, Furan2 can be safely combined with Aquarium Pharmaceuticals antiparasitic medications such as Acriflavine to increase its effectiveness and guard against secondary infections when you are treating for parasites.

    Thus, when combined with a good antiparasitic medication like Acriflavine, a good combination drug like Furan2 can be the ultimate weapon in your medicine cabinet. It is effective against a wide range of diseases, making it a versatile shotgun for restoring order when trouble breaks out in your tank.

    Nitrofuracin Green

    A special formula of nitrofurazone, furazolidone, methylene blue, and sodium chloride.

    USE: anti-microbial, anti-protozoan, antibacterial, and anti-fungal. Wide spectrum. Good for newly arrived fish in quarantine situations. Also be good for healing wounds and ammonia burns on newly arriving fish. Widely used for shipping or packing water. Works well for sores on fish in Koi ponds.

    DOSAGE: add 1/4 teaspoon of Nitrofuracin Green per 20 gallons every 24 hours, with a 25% water change before each daily treatment. Treat for 10 days.

    However, for best results, the hobbyist should take special precautions when administering Furan2 or Nitrofuracin Green such as this because they are photosensitive and can be deactivated by light. That means you’ll need to darken the hospital tank while you treat the seahorse(s). Do not use a light on your hospital tank, cover the sides of the tank with black construction paper or something similar, and keep an opaque lid or cover on the aquarium during the treatments. Remove this cover from the aquarium only long enough to feed your seahorses.

    You should also be aware that Furan2 and Nitrofuracin Green will cause discoloration of the aquarium water, turning it a shade of blue-green. This is harmless and can be removed after the treatments using activated carbon filtration after the treatment regimen has been completed.

    Diamox (acetazolamide)

    This prescription drug is an effective carbonic anhydrase inhibitor that is commonly used to treat glaucoma, hydrocephaly, and altitude sickness in human. In tablet form (125 mg or 250 mg), it is the only practical treatment for Gas Bubble Syndrome (GBS) in seahorses available to the home hobbyist. Depending on the form of GBS you are treating, it can be administered orally, as a series of baths, or as a pouch wash. It is also useful in treating cases of Popeye (e.g. exopthalmia) by virtue of its ability to help control intraocular pressure. Few medications have saved more seahorses’ lives than acetazolamide and it needs to be in your fish room.

    Pouch Kit

    Bloated pouch is the most common ailment of seahorses and every seahorse keeper should have the equipment needed to treat the condition on hand. This includes a small syringe with catheter, suitable eyedropper, pipette or the like for rinsing the pouch, as well as a medicated pouch-flush solution. (The small syringe and catheter are also useful for tube feeding seahorses that are on a hunger strike.) Ready-made kits consisting of special antibiotic solution, flushing apparatus and instructions are available from the Ocean Rider seahorse farm in Hawaii, or you can easily assemble your own kit from the necessary components. Acetazolamide combined with kanamycin sulfate or neomycin makes a superior pouch wash for cleansing the marsupium and stopping the formation of excess gas.

    Small Syringe & cannula

    Every fish-room medicine cabinet should include a small, clean syringe with a fine-gauge needle. They are indispensable for flushing pouches, tube feeding seahorses that have gone on a hunger strike, and injecting frozen Mysis or live shrimp with medications when administering them orally. Leslie Leddo finds that a 1/2 cc insulin syringe with a 26-gauge needle is ideal for such purposes. For best results, a small diameter cannula or catheter that will fit on the end of the syringe and place of the needle is especially useful for pouch flushes and tube feeding.

    Okay, Judy, that’s the quick rundown of the most useful medications for the seahorse hobbyist to keep on hand. Some of the medications mentioned above are available from well-stocked pet stores or local fish stores.

    And you can get a wide range of antiparasitics, anti-fungals, and antibiotics, including pretty much all the medications on my list without a prescription from National Fish Pharmaceuticals (aka the Fishy Farmacy) at the following URL:

    Click here: Fish Medications

    Diamox (the tablet form of acetazolamide) will be the toughest of the most-have medications to obtain, since it’s a prescription drug. Most hobbyists will need to obtain it via their family physician or local veterinarian.

    If neither your Vet or family physician will prescribe Diamox for a fish, as is sometimes the case, 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, Judy, the following source is the one most seahorse keepers have found works best:

    Click here: Inhouse Drugstore Diamox – online information

    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.

    Having the items above in your medicine chest, ready to use, will enable you to respond to almost any emergency or disease problem that may arise quickly and efficiently.

    Best wishes with all your fishes, Judy!

    Pete Giwojna

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