Bumps on puffers nose

Oh no! Sick fish?! Come here and see if someone can help!
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Since this board has been up, we have found there are several questions that routinely get asked in order to help diagnose problems. If you can have that information to begin with in your post, we'll be able to help right away (if we can!) without having to wait for you to post the info we need.

1) Your water parameters - pH, Ammonia, Nitrite, Nitrates and salinity (if appropriate). This is by far the most important information you can provide! Do not answer this with "Fine" "Perfect" "ok", that tells us nothing. We need hard numbers.

2) Tank size and a list of ALL inhabitants. Include algae eaters, plecos, everything. We need to know what you have and how big the tank is.

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One of the easiest and best ways to help your fish feel better is clean water! If you are already on a regular water change schedule (50% weekly is recommended) a good step to making your fish more comfortable while waiting for diagnosis/suggestions is to do a large water change immediately. Feel free to repeat daily or as often as you can, clean water is always a good thing! Use of Amquel or Prime as a dechlor may help with any ammonia or nitrite issues, and is highly recommended.

Note - if you do not normally do large water changes, doing a sudden, large water change could shock your fish by suddenly changing their established water chemistry. Clean water is still your first goal, so in this case, do several smaller (10%) water changes over the next day or two before starting any large ones.
gella81
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Post by gella81 »

Ok. So I rush ordered Cupramine and its corresponding Seachem copper Test kit. Should I continue with his copper treatments until it's received (probably not until tomorrow)? Or should I wait, do a couple water changes and then begin treating with cupramine when it comes?

Can ich become copper-resistant?
Just wondering
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Post by Puffer Queen »

gella81 wrote:Ok. So I rush ordered Cupramine and its corresponding Seachem copper Test kit. Should I continue with his copper treatments until it's received (probably not until tomorrow)?
I would use the copper you have if the test kit is appropriate.
Or should I wait, do a couple water changes and then begin treating with cupramine when it comes?

Can ich become copper-resistant?
Just wondering
When the cupramine comes in - large water change (80+ %) and then run carbon for a couple hours. Remove the carbon and then dose cupramine according to the directions on the bottle.

There has been a "rumor" about copper resistant parasites - but there has been no documented reports.....many are truly failed treatments due to improper dosing, duration, etc.
Kelly
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Copper Treatment Technique

Post by gella81 »

Ok now I have a question about quarantining and copper treatment. Now Tiki is in his 30 gallon bucket and being treated with Cupramine. We treated him for the first time last night with the Curpamine after we did an 80% water change (new distilled RO unit water) and got the copper ion concentration to 0.5 mg/L (or ppm, since it's a 1:1 conversion) and the chelated copper concentration looked like it was about 0.15 mg/L. Now the Cupramine says that its concentration in the water should remain stable for the next 48 hours and that we should only have to re-dose after this 48 hours. But this morning the water in Tiki's QT tank looks like it has around 0.15 mg/L of ammonia and the free copper ion and chelated copper ion concentrations both look to be at 0.15 mg/L. So should we do a water change and then re-dose the QT to maintain a constant level of copper ion? I'm just nervous because I don't want to overdose and create toxic copper levels for the poor guy.

Also as a bit of an update, we anesthetized Tiki again last night and fed him shrimp and mussel mixed with vitachem. We also used an 18 1/2 guage needle to successfully aspirate some of the junk from his nose and were able to extract some pus.

Should we continue to give him antibiotic baths during the course of the copper treatment? Cupramine says not to mix it with other meds, but if we move him to another bucket will that be bad for him? We haven't given him a seperate bath yet but now that his infection has been opened a bit, I'd like to get some drugs in there to help clear it out.
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Post by Puffer Queen »

You can dose maracyn-2 with cupramine but I prefer to do antibiotic baths.

I would do an hour bath with antibiotics daily (separate container) and return to bucket with cupramine.

Are you running a culture on the pus aspirated?

Might consider a topical antibiotic on the area that was aspirated -http://www.drsfostersmith.com/product/P ... m=1&N=2004 2032
Kelly
gella81
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Post by gella81 »

Hi again,

Another Tiki update...so we have been treating him with Cupramine since my last post. The white spots on his gills have definitely diminished in numbers but there are still a few visable when we look in (maybe 3 or 4 per cm^2 of gill as opposed to 10-12 per cm^2). He is definitely breathing easier than before, but not as easily as I would like to see..it looks like he take 4-5 'normal' breaths and then opens his mouth and takes one large breath. He is now basically just sitting on the bottom of the quarantine tank and he puffs up when ever we come near him, sometimes even when we're just looking at him through the glass. He swims around sometimes but not much. HIs bumps are unfortunately still on his nose, we anesthetized him again two days ago & force fed him (he did eat a large live crab on his own after our last force feeding but no food since then..we've been offering him mussels and shrimp from the seafood dept at the grocery store soaked in vitachem and garlic). As of yesterday his left eye looks generally cloudy and the inside bottom has a white slightly protruding portion that looks like it is pushing out into the clear eye covering.

I've been reading on wetwebmedia that cloudy eyes are often caused by stress or poor water quality. Do you think it is stress from him being sick? The water quality right now is perfect: 0 ammonia, 0 nitrites, 0 nitrates.

Also, beginning yesterday he started lying on the bottom but his tail is lifted off the ground an inch or two. sometimes he readjusts so that he is lying flat but mostly he just lies there with his chin on the ground and his tail slightly floating.

*sigh* I'm really not sure what to do. It seemed like he WAS getting better about a week ago when he ate on his own, but now I'm not sure.

Any suggestions about the eye and weird floating/lying thing he is doing? Has anyone experienced that before?

Also, if this is bacterial (which Im' still not sure it is-we didn't run a culture on the pus we got last time and we haven't taken another sample yet although I guess we should) what do people think about antibiotic injections??

Sorry this is so long. I really REALLY want to help the poor guy.
Thanks everyone
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Post by Nick »

Copper does burn the gills, so some of his lethargy and occasional gasps might be from the cupramine, even if the original source is gone.
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gella81
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Post by gella81 »

Hi again,

This is probably going to be more for Puffer Queen or anyone else with some medical knowledge, but feel free to let me know what you think.
Well Tiki is still sick but hanging in there. We were able to take him to a vet who had SOME experience with fish (mostly Koi) who biopsied the bumps on his nose and sent it for analysis. It came back that the bumps contain "severe, diffuse dermal necrosis and...abundant macrophages" and mixed "within areas of lytic necrosis and granulomatous inflamation are cholesterol clefts and multifocal colonies of basophilic gram positive coccobacilli"

So now I'm stumped, I was thinking that maybe he had fish TB, but this analysis came back negative for acid-fast stain. I've been trying to find what bacteria are gram + coccobacilli that infect fish but no luck so far. Does anyone have any ideas what this infection could be? Also what antibiotics should we use?

Right now he's still in his 75g quarantine tank. We're dosing it with Kanamycin and we were using Isoniazid and vitamin B6 when we thought it might be TB before the results came back. I think the Isoniazid took care of the ich or whatever he had because he's breathing much easier now. He's also made a big improvement in that he is eating on his own now and is responsive when we hold a glass in front of the tank, although he's kind of being picky and only wanting live food. he does eat some thawed frozen food, but usually only a bite and then turns away.

So my big questions are:
1. gram positive coccobacilli? anyone have an idea what species that might be?
2. what are some good antibiotics for gram positive infections
3. he also has a cloudy eye right now which I'm sure is related to the nose infection. as of today it has maybe 3 or 4 white spots on it. i guess I'm wondering if anyone has had this before, whether it might clear up with antibiotic treatment etc

thanks so much guys!
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