Is he doomed?! :(

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The best approach to keeping HITH away is frequent water changes and a good diet

Although hexamita/spironucleus can be kept in check with good food and good water conditions, it is a parasite, and needs eradicating. I believe the pitting on cichlids is when hex has spread from the gut. When still in the gut, it is easier to eradicate, also fish can manage it just fine at that stage as long as the water quality is good and the fish is fed good food regularly. Starvation can trigger the parasite to spread. I've also read that hex can infect the bloodstream and if that happens, the fish is doomed and dies rather fast.
 
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I was under the impression that the fish was already treated for hex, but if not, if it refused the medicated food, it certainly needs to be treated via meds in the water column instead.
 
I see this in discus a lot. A bump in the forehead ruptures and leaves a crater. A biologist friend of mine theorized this was likely a bacterial infection rupturing. He suggested it could be a secondary infection caused by clogged sensory pits, or sensory pits that are infected with hex/spiro.

This might sound crazy, but what I do for discus is net them, dip a Q-tip in hydrogen peroxide, and swab the wound really well to kill anything in it. Just don’t get it in his eyes. Then return the fish to a clean tank and do frequent water changes to keep things really clean until it heals. Sometimes it takes a few weeks to heal over.
Agree. And I've done the same Q-tip thing, either with hydrogen peroxide or meth blue, not crazy at all ime.
 
This fish was medicated with Metronidazole, lots of it. Ryan's suggestion of using hydrogen peroxide (3%) is another good option for cleansing wounds and neutralizing bacteria.

edited to add, redox would not come into play with Phillip's water. Neither would water quality, as Phillip stated he's pretty strict with water changes - frequency & amount.

Lots of past history with this fish, for those that that have not read all 11 pages. I have. lol
Which is why I am where I am regarding where to go next. Conventional treatments have not worked.
If one could still get CLOUT in Canada I would have suggested swabbing that sore with it.

And yes, swabbing meth blue on a head sore was suggested many threads back.
 
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The fish was treated with seachem metroplex on his regular NLS food bonded with the help of seachem focus ... a plentiful amount of metro and focus. It was gobbled up by the fish and this treatment was continued for 14 days (I believe). Initially, spironucleus was seen in the waste under a microscope and then, finally, no more.

I don't believe the water column was treated. I don't believe it was.

I also don't know to what extent metronidazole is absorbed into the body through the gut. I don't believe it's absorbed very much at all which is why it's used in humans for certain infections. If the water column is dosed, I wonder how well it will be absorbed into the the bloodstream (via the gills).

Note: After all the treatment with metronidazole, the fish still had white stringy waste as bad or worse than ever. Under the microscope philipraposo1982 philipraposo1982 discovered a nematode infestation (capallaria, I believe). He treated the water column with levimasole 2 ppm and that was the end of that. I had considered this over until this recent thread opened up.

I wonder ... since there's stringy white waste ... well, what does that have to do with the bloodstream. If it were me, and I trust levamisole as completely safe, I'd dose the water column at 2-3 ppm.

After having rested on it for 2 nights, I'd also seriously consider the advice given by RD. RD. regarding that asiain medication.

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This might sound crazy, but what I do for discus is net them, dip a Q-tip in hydrogen peroxide, and swab the wound really well to kill anything in it. Just don’t get it in his eyes. Then return the fish to a clean tank and do frequent water changes to keep things really clean until it heals. Sometimes it takes a few weeks to heal over

Not crazy at all. Dabbing the area with a Q-tip was recommended by other very respectable members. I believe methylene blue was initially mentioned weeks or months ago but the idea is the same ... kill the pathogen/s and let the wound heal. When the wounds are new they can still heal over ... I've seen this with a course of metro and a change to larger, more frequent water changes. Older wounds from HITH won't heal. So al least he's caught this early and there's still plenty of time.
 
This fish was medicated with Metronidazole, lots of it. Ryan's suggestion of using hydrogen peroxide (3%) is another good option for cleansing wounds and neutralizing bacteria.

In my personal experience, metro did nothing for my heavily infested livebearers. I don't trust metro at all because of that. It was my first choice of med due to its internet popularity. The med that knocked out majority of the infestation for me was JBL Spirohexol, active ingredient : 2-amino-5-nitrothiazole.

After that I've fed epsom salt soaked food and lately have a jar of NLS hex-shield in the freezer. with which I feed all new fish. The first time I dealt with hexamita, I had a full tank blown explosion because I let it out of hand, took some time to figure things out...
 
I wonder ... since there's stringy white waste ... well, what does that have to do with the bloodstream. If it were me, and I trust levamisole as completely safe, I'd dose the water column at 2-3 ppm.

Hex starts in the gut, but doesn't always stay there as is the case in HITH. If its in the bloodstream, this thread would not be here as the fish would have been dead long ago. They get the shimmies and die...
 
Spironucleus, and/or HITH that has developed due to a Spironucleus vortens infestation, is definitely not a one trick pony. Lots of causes, lots of potential treatments, lots of various stages of the parasite, and not all fish will react equally to any of the above. If/when it becomes systemic, all bets are off.
 
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That's not exactly true, Cory. Lots of fish have been successfully treated, and healed, that had systemic infestations of Spironucleus vortens. I'm not sure where you are getting your info from?
 
I'm not sure where you are getting your info from?

As I said, I read a lot about it. ...I'd be lucky if I dig out everything I read...I can try....

The info is bits and pieces I've gathered over the years. I did not say hex can't be treated? It can but not always with metronidazole....and not when in the bloodstream....if that's what you mean by "systematic". .
 
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