Will Diamox treatment alleviate tail rot?

[sugartooth]

Hello,
I have a seahorse that has had 3 episodes of gas bubble in the pouch. Each time I have been able to release the bubbles. In the meantime, I have gone onto Aquavets website and requested some contact information for a veterinarian to see the seahorse.
I was planning to do a Diamox pouch flush in effort to fix this. Then I noticed the tip of the seahorse tail was whitish, kind of worn looking. It is still fully functional, and I'm worried that it may be tail rot.
I know a picture would be helpful, but in the meantime of getting it and posting the pic, I wanted to ask the question first.

Would putting Diamox in a hospital tank remedy the tail rot (if it is tail rot) and can anyone tell me the full protocol for Diamox treatment in the hospital tank?

Thank you.

[ReefNutPA]

Diamox will not help with tail rot or tail infections. You'll need antibiotics for that. Normal recommendation is Neomycin combined with Triple Sulfa. You can purchase this pre-packaged combo for a complete treatment from SeahorseSource.com

Treatment for the bubbles with Diamox would be one 250mg tablet per 10 gal for five days. A pouch flush with Diamax would be to follow the following instructions take from the seahorse.org website:

In cases of recurring pouch emphysema, diamox can be administered as a solution injected into the pouch via an narrow gauge irrigating cannula or narrow gauge IV catheter sleeve attached to a 0.5 or 1ml syringe (larger syringes should not be used).

Using a blender, mix 1/4 of a 250mg tablet with a cup of seawater at the same SG as the tank. Fill the syringe with about .5ml of this solution after it has settled, avoiding the residue at the bottom of the cup. The seahorse should be held as per the procedure for pouch evacuations.

Insert the catheter sleeve slowly and gently a small way into the pouch opening and inject this solution SLOWLY into the seahorse’s pouch, leaving the solution in the pouch. Make sure you are familiar with the location of the pouch opening.

Never use a metal needle for this procedure.

The procedure may have to be repeated twice (once every 24 hours) to be effective. In stubborn cases, it is recommended to concurrently administer water bourne broad spectrum antibiotics in a hospital tank.

Best of luck...

Tom

[NanoLurker]

if you can take him to an aquatic vet see if he will give you baytril for the tail rot. he'll probably be familiar with dr. noga's book "Fish Disease: Diagnosis and Treatment" which lists the bath dosage as 2 mg/L - seahorse.org is now listing his recommended bath dosage as 10 mg/L and i'm waiting on verification of that before i cross it out in my book. it can be combined with triple sulfa.

alternatively you can do the more "traditional" neomycin (which he can probably prescribe as well) along with triple sulfa.

good luck! i've taken mine to the vet myself :)

ETA: forgot to add that the baytril can also be administered orally but you'd have to tube feed it or inject it into feeder shrimp. if the horse is not eating then tube feeding with the med is the way to go. if the horse is still eating on his or her own you can inject into feeder shrimp but it's important that they receive the correct dosage every day. the dosage will be calculated by the vet based on the horses weight, those dosages are in noga's book and are also listed on seahorse.org.

arghh - i took three days off from work and just remembered it's friday. do you have neomycin and triple sulfa on hand? tail rot is pretty aggressive and treatment has to be started ASAP. if the horse isn't already in a QT tank get him moved over and start lowering the temperature (no more than 4 degrees per day) down to 68 degrees. if you don't have neomycin and triple sulfa you'll have to order it unless there's someone near you with it - do you have any antibiotics? furan2 perhaps?

[sugartooth]

Thank you Reefnut and NanoLurker. I really appreciate the advice.
I'm not quite sure if it is tail rot, that is the first thing that came to mind when I saw it
The tip of the tail looks whitish, like it was worn or scraped. He is using it without problems as of the time of my first post.

Reefnut- Should I do the Diamox in combination with the antibiotics in hospital tank? Is that safe? Also, I ordered this online as suggested in another thread, however I'm concerned about the quality control or just downright counterfeiting of the prescription drugs. How do I know I received Diamox, and in the appropriate formulation, etc? That is why I tried to find a vet, but it has been over a week and no real progress.

I went to Aquavets online, spoke with a Dr. that was part of the founding party (it was a stroke of luck!) and he referred me to the senior vet at the Shedd Aquarium. I was able to contact this vet, but understandably, we have been playing e-mail and phone tag. My last e-mail to him was just asking ANYone he knew that may be able to see my horse. That's is the current status.

Nanolurker- I do have some antibiotics I ordered from Seahorse Source way back "in case of emergency" I have to try and find them now, since we moved, I have not unpacked everything fish related yet. My problem is hospital tank space. I had two 10 gallon tanks that could have been used, but the other seahorse gave birth, leaving me with one tank unused, he gave birth again, so I needed the last tank for all the babies.
The baytril you mentioned, just curious, is it the injectable kind for dogs?
So would a small tank with rigid airline tubing be sufficient or do I need filtration? I would then think it would be filtered out?
The system the seahorses are in currently is about 72-74 degrees. So it can be lowered to 68 by tonight correct?

I'm getting nervous now. I will try and set up the hospital tank with pictures of the seahorse in question so people may confirm the tail rot. If it isn't tail rot, and I have started the medication, will it hurt the horse? Is this communicable? Should I be treating all 3 horses? This would than affect the size of tank I need to buy.
*ugh*

[NanoLurker]

my vet does not understand why other vets aren't willing to see/treat fish :( you can find one that will treat reptiles, rodents, etc. but ask about treating something that lives in water and they run for the hills.

what species of seahorses do you have? i've ordered the diamox online through the link as well in the past. i suppose it's a leap of faith, if you wish, that you're actually getting a reputable product. i've used it without issue and have given it to other keepers near me. the diamox can be combined with the neomycin and triple sulfa without issue. i've never tried the baytril/diamox combo so i can't comment on it.

i hear ya about space issues but 5 gallon buckets from the hardware store work in a pinch.

So would a small tank with rigid airline tubing be sufficient or do I need filtration? I would then think it would be filtered out? The system the seahorses are in currently is about 72-74 degrees. So it can be lowered to 68 by tonight correct? small tank with rigid airline or two would be sufficient along with some type of hitch (fake coral, plant). the antibiotics will kill any biofilter so barebottom is the way to go. never run carbon while treating with antibiotics.

The baytril you mentioned, just curious, is it the injectable kind for dogs? yep, regular enrofloxacin. i've also read of some people using the flavored tablets.

I'm getting nervous now. I will try and set up the hospital tank with pictures of the seahorse in question so people may confirm the tail rot. If it isn't tail rot, and I have started the medication, will it hurt the horse? Is this communicable? Should I be treating all 3 horses? This would then affect the size of tank I need to buy. generally you don't want to treat prophyllactically with antibiotics, once started you have to continue for the full course (generally 10 days). if your other horses display symptoms you'll have to treat (if it is in fact tail rot) so you may need a larger QT tank depending on the size of the horses. diligence with water quality is a must so i always recommend mixing up a bunch to have on hand during times like this. tail rot is communicable so if you can post a picture that would be great. i have a couple of horses who's tail tips turned pink (not cyano) and i sat there and debated whether it was anything or not. there was no sign of erosion/ulceration/general fuzziness so i opted to just lower the temp and watch them like a hawk. if the area looks abraded you can do a couple of other things in the interim: dip it in a solution of one part betadine to five parts fresh saltwater (since your problem is on the tail this doesn't apply but others might be reading this, it can be used on other parts of the body as well but don't get in their eyes or gills), apply a topical such as neosporin (human kind from drugstore, it's neomycin based), a topical like wound control (if you have it), or bio-bandage from hikari (it's also neomycin based).

are you familiar with the beta glucan/spirolina/chlorella speil?

ETA: there are some good threads and photos over on at seahorse.org and the search feature works well. it can give you a good idea of what different stages of tail rot look like.

ETA again: here's the link for some images of tail rot http://gallery.seahorse.org/main.php?g2_view=core.ShowItem&g2_itemId=919 they have a great emergency forum as well if you'd like to post there as well.

[sugartooth]

Thanks for the links and answers. I will go check the horse and see if there are similarities. I will post pics after a water change and I think I do have some biobandage (as part of my first aid kit for the seahorses when I bought the antibiotics) so at least I can do that without worrying about consequences,correct? I mean, before I try and treat with full blown antibiotics.
I'll be back later tonight.
Thanks again.

[sugartooth]

After checking the link pictures against my seahorse, I think it looks more like small external bubbles rather than skin erosion.
But, just be sure I will take pictures....I went to take pictures and I'm having problems with the camera so I will have to be a bit later.

I also dug up a box and found my seahorse first aid kit. Here are the contents:
Triple sulfa
Gel based Bio Bandage
Neomycin Oral Solution (looks like Hydrogen peroxide bottle)
Finquel

Should I use the finquel (scared to do so) to lightly anesthetize the seahorse before putting bio-bandage on it? Will bio bandage help with the small bubbles?

I'm scared of stressing the horse further than necessary. Tonight, I noticed that he is still floating a bit when he tries to swim. However, he is able to hitch and I saw him eat a piece of mysis.(and he was looking for more)
At this point I decided to leave him alone, because I fought with him for almost 25 minutes to get the bubbles out yesterday.
Do you think I need to act faster or can I give him a break before trying to handle him again?

I will be working on setting up a hospital tank, but will only be for Diamox, correct?

Reefnut: Would a catheter that comes with butterfly cannulas be an okay size? Do I have to worry about abrasion to the pouch from cutting the cannula end? How would I "round" it out?

Nanolurker: Thanks for the great information. My seahorses are all Reidi, approx. 10-11 months old.
Should I dip the Betadine solution and biobandage the tail as a preventative measure?

Thank you both.

[NanoLurker]

i haven't figured out if it's more stressful for the horse or more stressful on the keeper at times like this.

if the bubbles are clear it's probably EGBD, if the bubbles are yellowish, whitish, or orangish then it's something else and will require antibiotics. diamox is the only thing that will treat the EGB. crap - after looking at the link i sent you i totally forgot that renee (seahorsedreams) busted her behind and created a whole new gallery with pictures that is way, way, way, way better than the one i posted earlier. this is it here http://forum.seahorse.org/index.php?showforum=63 sorry about that, take a look at these photos instead.

you know your horse and if he's hitched for the night and doesn't appear to be in distress from bouyancy issues, i would probably leave him alone for the night. if you review the "Disease Pictures" and there's no doubt that what you're seeing is tail rot then i would apply a topical. if you use the finquel to sedate him, remember you have to wear gloves as you will absorb it through your skin.

my own personal belief is that keeping the horse as stress-free as possible during times like this is one of the most important things we can do. remember stress affects the immune system, when they're sick and immunocompromised we don't want to aggrevate the problem with unnecessary handling/procedures.

[sugartooth]

Hahaa...yes Nanolurker, it may very well be that it is more stressful for the keeper than the horse. Even though he cannot properly swim (sometimes completely upside down, sometimes a little tilted, until I do the pouch evac) he is still graceful.
Sounds funny to say that, but he does not thrash around trying to right himself. I have noticed that he just waves the tail around until he is able to grab on to something.
Could this be the reason the tip of the tail is worn looking? I am watching it to make sure it doesn't spread.

Nano- those pictures from the updated link are very helpful. That is clearly quite a bit of work done by seahorsedreams.

I have to re-read everything posted. I also went to Seahorse.org and browsed some of the disease forum and everything makes sense, and there is a lot of good information. However, I need to re-read everything that has been written so I feel very clear about what to do.

Another question I had is, once I get the hospital tank set up, do I :

- put meds into the established hospital tank (with original tankwater)
- acclimate the horse in a bucket to hospital tankwater that has meds already in it?


I noticed that you are supposed to do 50% daily water changes when treating. So, are you supposed to do a water change with water + meds premixed ? For instance, if I do a 10 gallon water change, and the dosage is 250 mg/10 gallons.....then I take 10 gallons of freshly mixed saltwater, add the 250 mg to the mix, then pour all of it back into the hospital tank.

Or do you do your water change, then dose the entire tank? So if I do a 10 gallon water change on a 20 gallon tank, perform the water change and put in 500 mg. to dose the whole tank?

I'm sorry if I come across as hesitant or slow to move on this. This is my first time having to treat seahorses and I am very nervous to do it correctly. There is so much information that I need to go over it repeatedly for me to feel clear and confident to go ahead with the treatment.

I guess that is why I sought a veterinarian in the first place. I figure I would just leave it to the professionals. But now, I feel I have no choice but to move on it.

Thanks again.

[NanoLurker]

i understand you wanting to take it slow and do everything right but we seem to be going back and forth from abraded tail to bubbles to abraded tail. the treatment for both of these conditions is very different so if you can get a picture posted that would help enormously. if not, are there any pictures in the link i sent you that show what you are seeing on your horses tail? each photo is labelled so tell us which one looks most like what you are seeing. if they're bubbles we have a bit of time, we're not so fortunate with bacterial infections - tail rot takes precedence over air in pouch.

until we can nail down the diagnosis on the tail, at least get him moved over to a seperate QT tank as soon as possible. my preference is to use fresh, aged, parameter matched SW for QT.

if the tail is eroded, ulcerated, abraded, fuzzy, or discolored get the temp lowered to 68. what's the plan for obtaining antibiotics? if you're ordering neomycin or can get a prescription for baytril in the next few days at least get him started on the triple sulfa, you can add the neomycin or baytril when you get it. if for any reason you can't get either of those meds quickly then at least see if your LFS has furan2 (don't use triple sulfa with the furan2).

do you have diamox (acetazolamide) on hand? it's not something you can get overnight, it will take about two weeks, possibly more to get to you unless a vet or physician can prescribe a small amount (5-10 tablets). if you don't have it at least do an evac using the catheter or bobby pin and see if that helps him http://www.seahorse.org/library/articles/pouchevac.shtml if it occurs again then i would recommend a medicated pouch flush - tom (reefnutpa) posted the procedures above. this is different from a diamox bath - here's the link for that http://forum.seahorse.org/index.php?act=Attach&type=post&id=14342

as for replacing antiobotics - i remove water, replace with parameter matched, aged SW, then replace meds in proportion to what was removed. i'll use neomycin as an example - it's dosed at 250 mg PER gallon. if you use a 10 gallon QT tank total dosage is 2500 mg. do a 50% water change then replace 1250 mg of neomycin.

seahorse.org has a book in their shop entitled, "Working Notes: A Guide to Seahorse Disease". it's inexpensive and is an excellent reference to have on hand, common seahorse ailments are spelled out along with how to treat. i know a second edition is supposed to come out shortly but i'm not sure when that will happen. it is also available from seahorsesource.com - you can also get antibiotics from them.

looks like i forgot to hit the "submit" button :eek:

[sugartooth]

I agree, a picture would be best. I keep trying to get a clear macro picture of it, but the camera won't let me take the picture. I don't know why and haven't figured it out yet.

Yes, I was going back and forth between the external bubble and erosion. The reason being that it looked a little different everytime I looked at it. (first time looked like bubble, then after the first link, I thought it was close to the early stage erosion picture. ) After looking at your new links from Seahorsedreams, it certainly looks like external bubble.
There is a small clear bubble at the tip of the tail.
No, I currently do not have Diamox. I reluctantly ordered online because of the uncertainty of obtaining a quality controlled product. This was the reason for trying to get a veterinarian in my area to either:
prescribe Diamox
or see my seahorse as a patient as a consulting/attending vet.

This has taken over a week and no progress has been made so I went ahead and ordered the Diamox.

The neomycin I have on hand is liquid. Is there dosage recommendation for that? I also have triple sulfa, 16 caplets. Since the main problem is gas bubble, do you think I should still go through the antibiotics because of all my prodding I have done for the pouch evac?

One more question, when doing water changes, it would be an estimate of how many gallons I have changed. Would it be better to err on the higher number? For example, round up in gallons, and dose accordingly?

[NanoLurker]

phew - a bubble. i'll have to call dan tomorrow about the dosage for the liquid neomycin. i would hold off on the antibiotics for now unless you see any discoloration on the pouch. generally the problems i've read about are when people literally "massage" and rub the tender pouch tissue.

i'll double check on something else. if you haven't been able to get the air out and have to do a medicated pouch flush, it may be effective on the tail bubble therefore negating the need for a diamox bath. maybe reefnutpa, seahorsedreams, or someone else knows that answer.

i'm pretty sure my 10 gallon tank isn't exactly 10 gallons :) i have a 5 gallon mark on the bucket i use for water changes. you could also split the tank in quarters and place a piece of tape at each mark and call it good. if anything, i tend to round up.

i'll get back to you tomorrow on what i find out.

what kind of camera do you have?

[sugartooth]

Thanks so much Nanolurker.
I really appreciate your help! I feel so much better with your input.

My camera is a Nikon D70, I know it can do many things, I just don't know how to use it properly!
The pictures that are able to take, from farther away, come out clear and I can blow it up on my desktop. But I can't save it that way. I have played with cropping, etc. But it just sucks away so much time that I gave up.
When I try to get close, in macro (both auto and the flower setting) it doesn't take the picture when I push the button. Or it simply won't focus enough to be clear.

I know it's not the camera, it's my inability to properly use it.

[Fredfish]

You should be able to manually focus on your subject. I don't know DSLR cameras, so I have no idea whether you have a specific manual focus setting on your camera or not. How about going to the shop you bought the camera from and have them show you how to properly take a macro picture?

Better yet, send me your camera and I'll figur it out for you. :D

Fred

[sugartooth]

Well, I tried tonight to insert a catheter and push the bubbles out..working from bottom to top of the pouch. I tried for 20 minutes and had no sucess. So I switched to the bobby pin and was able to release the gas after about 15 minutes.

I am worried that I have possibly scraped up the inside of the pouch with the catheter? Even though it is soft, I had to cut it, and I didn't round it out before inserting.

How much damage could I have caused, and how would I know if I did? Does the color of the pouch change?

I wanted to try to use the camera again, I am just plain tired from fighting the horse and taking care of babies. (The other male had babies last week)

I will try tomorrow. I will also find out tomorrow if I was able to convince a local vet to prescribe Diamox.
Keep my fingers crossed.

[sugartooth]

I forgot to add that he is looking pretty thin, although I saw him eat 3 pieces of mysis today.

Another item left out was that I thought maybe I was hurting the horse with the catheter, because he was REALLY fighting me, thrashing around trying to get me to let go of him. That's why I ask about scraping the inside of the pouch....

[sugartooth]

Success! I convinced a vet to prescribe Diamox!
I will do the pouch flush tonight.
Do I have to do the whole treatment as well or just the pouch flush should be fine?
Hooray!

[NanoLurker]

good news on getting the diamox!

you know, i haven't found an answer to my question so i went a head and posted it elsewhere to get their input.

also, just to be on the safe side in case we need to use it - where did you purchase the biosol and what does the label say? it probably has something like "each mL contains Neomycin Sulfate 200 mg".

[sugartooth]

Thanks!
I checked and that is exactly what it says.
I bought it from Seahorse Source.

Also, I tried to do the flush. I crushed 1/4 tab in a mortar/pestle and added 1 cup saltwater and ground it up some more.
I took a 1 ml syringe attached to a butterfly catheter with the end that had the needle cut off.

I tried repeatedly to get it in to do the flush and again I was having trouble with him ripping it out or thrashing about. How can you be sure if any got in? I think a total of 1 ml. may have gotten in his pouch. This took 1 hour.
Also, I was able to release many bubbles with a bobby pin after about .1 ml flush. I did it because I wasn't sure if any got in.

Hopefully you will be able to find out soon. Thanks for posting it!

[NanoLurker]

i did find out that diamox is definately absorbed through the tissue in the pouch. let's see how the little guy does with it, hopefully within a couple of days the bubble on the tail will disappear. you may need to do it again but let's see how it goes, also since he's quite the little fighter, if you do have to readminister maybe we'll sedate him just a tad.

i forgot to add that some people (like me) have reported decreased appetites in their horses when they've treated with diamox. in my case it was when treating for EGBD and IGBD on a species that is known for being rather sensitive to all things.

[Fredfish]

I'm glad you are making progress. Nanolurker. Many thanks for walking sugartooth through this.

I hope I never have to go through this myself.

Fred

[sugartooth]

Yes, many thanks. Especially since this comes up in forums repeatedly, you have been very patient!

My question is:

Is there a good way to tell if some got in the pouch? With the fighting and twisting, I'm not sure.
Also, when I inserted the catheter, sometimes it just seemed like putting a straw to closed lips. It may seem that I inserted it far enough, but when I try to look in or spread open the entry, I don't see a clear way into the pouch.
Is this correct?
Just in case I need to do this again.
Today he seems to not have the bouyancy problems as displayed earlier. I haven't seen him eat, but I have watched him hone in on some mysis, but hesitates and does not eat yet.

Update on the vets:

Although I was able to get 1 tablet of Diamox. (my precious) Still no veterinarian wants to touch this once I mention seahorse.

The senior vet at the Shedd Aquarium got back to me, and he was very apologetic that he couldn't be of more help. He stated although his expertise is marine mammals, he is not well equipped to offer advise. He hoped I would be able to get someone to prescribe the Diamox, but he couldn't say if that would remedy the problem since this condition is still not well understood. He also offered to give me contact info for a colleague that may be able to offer some more advice.
Very nice person that he even took some time out of his busy schedule to get in touch with me.