I have been feeding my dwarf puffers chopped clam meat. It's the only thing I've found that they'll eat, picky little beasts that they are.
They absolutely love it, though. They get so excited when I bring the meat and start chopping it up into fine little pieces.Anyway, I picked up a bit of the meat and was going to put it in the water, and one of the puffers (Jewel) was already at the surface, anxious to get at the meat. She was lunging for it before it even got into the water.
I don't know exactly how it happened, but it looked like she took a bite, but she promptly started swimming downwards towards the bottom of the tank, frantically. As soon as I saw her flip upside down and start floating to the top of the tank, I knew what the problem was. Somehow, she swallowed some air, most likely while trying to bite the meat before it was even in the water.
I grabbed her after a short chase (which wasn't difficult, considering she had a hard time not floating up) and started gently shaking her back and forth, hoping the air bubble would come out. I tried pushing on her tummy as gently as I could, and some bubbles did come out, but I couldn't get them all. She kept floating to the surface of the tank.
She puffed with water a few times and that helped expel more bubbles, but there must have been a fair bit of air in her, because even after trying to help her for 10 minutes, with tummy massages and gentle shaking, it was still no good. She was getting really dark and I was getting more and more upset and I wasn't at all sure I was doing her any good, so I nudged her into a cave so she could at least rest without floating to the surface of the water.
I found her dead an hour ago in the cave. I feel absolutely awful.
I just this evening lost a GSP to the same thing and am just now coming into this forum hoping to find out how to prevent/cure this should it happen to my other puffer. Surely, there is a way to get them to un-puff. How do they survive in the wild if they can't unpuff and it sounds like a pretty common problem. My puff didn't have it so easy. She lived with it for 4 days! I tried everything you mentioned, plus Iodine. Not one bubble 
What if you were to turn them upside down, then right side up frequently? Would that maybe dislodge whatever is stuck? What exactly does happen that they can't unpuff? What mechanism is it exactly? I don't know puffer anatomy as well as you all so maybe if I understood that, I could come up with a solution to this. I just can't believe that there is not another way to help them release. Mine wasn't air (pretty sure) it was water and she just couldn't get unstuck. Any ideas would be very helpful. Oh yeah. parameters. BW - SG = 1.004/5, PH=8.0, temp 80, ammonia, nitrate and nitirite=0 t0 0.01 respectfully, 30 gln then moved to own 10 gln with same parameters, so no stress. I actually saw her puff at a dinosaur eel that was flipping out because I put my face up to the tank to check on everyone. I think that was the beginning of the end. And I was so excited that I got to actually see her puff. I hadn't seen that yet. So much for that! Oh something I did notice about her was that at the same time she bloated up, her anus became very distended and red. Could that have been something I missed? Is that an indicator of something else. Could she have been constipated? She was fed Freeze Dried Krill, and pond snails. I tried a pea, but by then she wasn't eating anything. So what do you all think? Thanks for any input.
