Is he doomed?! :(

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As far as the digestive issues are concerned I am almost positive.its due.to stress from the illness. But there is definitely no.parasites to be found in his gut lining and stool.

Clearly something going on with his head and that one hole. It went from being nothing to a small grey white spot to a hole ( this is back in.may 2017). I treated for hith and ever since then something has been up. Kai on occasion will flash aka scratch his head area. Flipping upside down and rubbing on substrate.

Just days ago the small hole filled and a pimple was formed which popped 48 hours later. Leaving a hole similar to the first time.

This whole time his stool has been inconsistent. Some.clear and some.100% normal.

With everyone's feedback and my own experience with the fish first hand, I .pretty darn sure hith is still the issue. If it's not it's something creating very similar symptoms to hith.

The JBL med that was mentioned is going to cost over $100 to get to my door and see with clear. Both of these would be rolling the dice and not sure it would even make it past customs.

I feel like I'm Stuck with standard hith treatments that I can readily get here in Canada. Either I attempt that again or I leave him to fight it himself.

Previous capillaria issue he had was discovered months back and has been taken care of. Like I said, I regularly check him.stool to try and Id anything suspicious, but nothing has been coming up.

Debating trying another round of metro covered food. Possible adding Epson salt to the tank as a bath or a while and maybe Epson salt soaked food too.

If I'm not medicating I worry that it will continue to develope and cause him addition stress and slowly he will get worse.
 
[This is not a response to your last post. This I had already prepared. I'll respond to that in time. What is the JBL med btw???]

Personally, if I decided to do the swab thing, I'd do just the recently infected spot

+1

I noticed early on ... shortly after this first started, that Kai had very large sensory pits. I was trying to find a GT on google images with a sensory pit in the center of his head when I realized Kai's pits were much larger than most of the others. I do NOT believe this is due to erosion from HITH. If that were the case, I believe he would be in a much worse state, because it would need to have been going on for a long time. Erosion from HITH attacks the tissue leaving it white initially, IME, and I think you would have noticed this. I believe Kai just has large sensory pits as there is great variety in fish.

In any case, those pits do not look infected to me. They look the same size (in proportion to him, at least) as they always have when I look back at all the pictures of Kai since you first got him. So I don't think you missed anything and I don't see a need to swab them with peroxide unless you see something I do not.
 
I tend to agree with you. They have always been that way and I find it almost impossible to think I missed it as I spend over and hour right beside his tank a day
Sometimes 3-5 hours. I have a work desk beside him, so it's unlikely that i missed his pits rotting away.
 
I tend to agree with Ryan that it looks like there's been some erosion, but I've certainly seen much worse. Once it's cured, fish can live comfortably with much worse scars than that from HITH, so (once cured) it's more of a cosmetic issue than anything. Personally, if I decided to do the swab thing, I'd do just the recently infected spot, not much to be gained with old spots that were cured a while back imo.

I tend to agree. If those are simply enlarged sensory pits I would be surprised. There appears to be some erosion, past, or present, I've lost count. I don't recall what they looked like several months back. It could just be some old scar tissue at this point, let's hope so, because then it's simply a case of aesthetics. If it's just a case of larger than normal sensory pits, then even better.


in other words my preference would still be to rest him a bit and see how he does before jumping right into more meds-- just my opinion.

I totally agree. Once the Kanamycin treatment is complete, give your fish a break from meds, continue to keep the water pristine, and see how things go. As Cory stated, this battle is far from being lost.
 
Thank everyone for all the feedback and support. It means a great deal to have people willing to help me and my pet. I hope that Kai can get past all this at some point.

In case anyone was wonder I'm opting for the back to back treatment which will total 12 days on kanaplex. It's the max amount of time recommend by seachem. I personally don't think the 6 day period would be sufficient and at this time I would feel better to push it to the 12 day mark.
 
If Kai is currently being attacked by s. Vortens then why is it a good idea to stop.treatment after the kanaplex?

Shouldnt I attempt to medicated? Or is it best to let his immune system try and handle it?

I don't have access to these other treatments out of the Uk and such so metronidazole is really.my only option. Is it not worth going this route?

I fear that leaving it could allow for this to progress.
 
The JBL med that was mentioned is going to cost over $100 to get to my door and see with clear.

If you want to try JBL spirohexol, I can perhaps send it out to you? The weather conditions are bad at the moment but next week things should be back to normal. PM me your address and don't worry about the money. I don't see a reason why it wouldn't pass customs....
 
Well ... I understand your reasoning for wanting to treat with something. It would be great if you could swab the area to see if you could see anything under your scope. If you could identify say .. spironucleus vortens, then you'd definitely know which direction to go in terms of treatment.

I believe you haven't tried epsom salt in the water. I'd probably want to try that considering it's quite harmless to Kai. It could be helpful. RD. RD. just finished a very complete and detailed post on the thread below.
Treating Hexamita aka Spironucleus. There is mention of the magnesium sulfate in-tank dose at 1% (after treatment with 3% epsom salt food). I've forgotten what the standard in-tank dose is in terms of teaspoons per x gallons.
 
The below is a text from the extended information sheet about a med called Esha Hexamita. I have not mentioned it because I have not personally tried it, plus it's a combo med, claiming to treat several other issues besides hex.

Anyway, the information is interesting and well laid out:

What symptoms will my fish display when they have Hole in the Head disease?

Typically, the first sign of infection is:
The infected fish is cast out from or separates from the group.

Symptoms of the second stage of infection is:
Loss of appetite
Dull eyes
Darkening of colour of the skin
Apprehensive behaviour
Slow reactions
White stringy feaces(only sometimes)

Symptoms of the final stages of infection are:
Enlarged sensory pores on the head that become filled with a whitish puss
Tubular skin eruptions(whitish pus substance emerges from lesions which can be mistaken for worms)
Rapidly spreading skin decay
Emaciation and distended body
Lesions near the head, lateral line and the base of the fins
Thin body with a tucked in abdomen
Small holes in forehead and body
"Flaky" skin

It is important to note that sensory pores are not always affected and hence if this visible sign is not present, then a hexamita infection can go unnoticed. Death can occur by infection of internal organs as the parasite can spread to them from the intestine, where it often resides.

Here is the link:

http://www.eshalabs.eu/europe/products/esha-hexamita.html

Active ingredients are:
Ethacridini lactas
Cuprum
Acriflavin
Methylrosanilinii-chloridum



 
Canada Border Control randomly x-rays/checks parcels and any form of medication/powder etc. can potentially be checked, and possibly confiscated, especially if a safety data sheet isn't included with the item shipped, or if any portion of the med is considered a controlled substance here. I once had a powdered water conditioner turned back at the border due to a lack of safety data sheet. The active ingredient in the JBL med, 2-amino-5-nitrothiazole, is not used in Canada or the USA for treating ornamental fish. One page stated the following for a similar German product. (Hexamor): This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA.
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3052fe15-9413-4859-aee8-ace2c9b16ef4



Spironucleus found within the gastrointestinal system of a fish can usually be kept in check by a healthy fish, with no need for medication. It's generally only when the number of flagellates begin to reproduce in rapid amounts, typically when a fish is under stress, and the immune system becomes compromised, that medication is required. That may not be the current case. If this is S. vortens, what you might be seeing in this sore is the tail end of this infestation, which has travelled to the head region. This is quite common in certain cichlid species, and ultimately manifests as what most refer to as HITH. You may have beaten the initial outbreak with your previous treatment, and with a follow up of deworming, and a boost to the immune system, your fish is slowly winning the battle.

The fact that you are not currently seeing any S. vorten in fecal smears is very positive, and is why at this point I would not medicate further with Metronidazole. I would hold off on that and allow the fish to rest, and regroup, after treating with the current medication. Monitor the sore on the head, keep the bacteria count low, so keep water quality high, and filter media in check. Give your fish a chance to fight this off by himself. That might be all you need to do, and your fish will do the rest. The fact that he is active, eating, and otherwise doing well is also very positive.

If things don't improve, his head sore become worse, or more sores break out, or any other symptoms show up, or something in a fecal smear, then you can decide how best to proceed.
 
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