Emergent advice for traumatized puffer!

[Rouge]

Hello! We are seeking your advise for "Puffy" Arothron reticularis, 2.5 years old, 12.5 inches. 96 gal tank, wet-dry filtration with skimmer, ozone, canister filter, 3 power heads. Other fish in tank: 2 blue damsels.
Aug 5: ph 8.2, Nitrates 10, Nitrites 0, Ammonia 0. Tank care by professional fish caretaker of 10 years.

July 12: tank inadvertently overcleaned. Removed old silk plants that were clogging pumps, etc., changed filters, charcoal, partial water change. July 14: water turned cloudy, John arrived stat, Ammonia 1.2. Puffy began fasting.
Tank treated with "Aquarium Enzymes" (nitrofine bacteria) and "Prime" (water detoxifier). Weather very hot and tank temp spiked to 82 degrees. Using 5 fans & Air Conditioning dropped water to 74-78, which is now maintained daily.
20%-25% partial water changes every other day. Todate (Aug 5: water tested daily)
July 13-14: Ammonia 0.8, added bio media + two additional magnums with bio media.
July 19-20: Ammonia 0.4.
July 21-todate: Ammonia 0. Puffy offered food, for first time, eagerly ate Krill.
July 30: Nitrates: 40/million. Puffy listing to side, somewhat lethargic; refusing food.
July 31: Removed charcoal filter, added First Choice Triple Sulfa (sodium suldacetamide, sodium sulfathiazole,
sodium sulfamethazine) 1 scoop/10 gallons. Puffy more perky within 30 minutes; refusing food.
Aug 1: Tank within normal limits. Puffy feeling a little more mucousy. Very small pin-point white bumps
interspersed on his back. 2nd dose of Triple Sulfa. Puffy refuses food, listing, decorum very poor.
Aug 2: Tank within normal limits. Triple Sulfa reduced dose: 7 scoops, partial tank change. Added "Quick Cure"
(Formalin, Malachite Green) 1 drop/gallon, 96 drops. Puffy very lethargic, refused food. White pin-point
bumps more profuse.
Aug 3: Tank within normal limits. Triple Sulfa reduced dose: 6 scoops. Quick Cure reduced dose: 75 drops.
Puffy's decorum very poor, lying on bottom, listing, floating at odd angles; refusing food.
Aug 4: Tank within normal limits. Triple Sulfa reduced dose: 5 scoops. Quick Cure reduced dose: 40 drops.
Puffy more perky, refused food in morning but ate two Hikari Bio-Cure Krill!! (Wanted more but
I did not want to feed him too much since he had not eaten in 3 weeks.) White pin-point bumps
have increased around mouth and face. Decorum much perkier!
Today, Aug 5: Tank within normal limits. Partial water change. Triple Sulfa reduced dose: 5 scoops. Quick Cure
reduced dose: 40 drops. Puffy allowed 2 krill for breakfast, noon, and dinner. Praise GOD !
NOW WHAT REGIME SHOULD WE FOLLOW?
I am concerned about the white pin-point bumps.
Prior to this water catastrophe, Puffy has had a few thin red streaks (for almost a year) running through his
fins by his gills.
In the past five months a thick, sort of white line, has also appeared on the very edge of these same gills.

The caretaker says the white bumps are not ick. We have attached several (not too clear but the best
we could do photos). You can see Puffy's fins and perhaps discern the white bumps, a few of which we
circled.

We purchased Puffy, who arrived at our local tropical fish acquarium FedEx in an oxygenated bag from
Manila. He was about 1.5 inches long and I guessed he must have been about 1 month of age. Any opinion
on his age. We love him dearly, he is the center of attraction in our home which includes, dogs, an aviary,
and horses. Puffy is very precocious....we can pet him and I can pick him up!! He can count and he is
familiar with all the routines. He even smiles!! Everyone who seems him is amazed, we are always being
told that he should be on Animal Planet, or some such.

I have been so afraid that we were going to lose him. I am so appreciative and grateful for any information
and advise you can give to us. Thank you so very much for your wonderful, caring, compassionate web-site!
May GOD Bless You All.

Most sincerely, Dr. Joseph and Jacqueline (that's me, Jackie) Garamella, Puffy and friends!

[Boxermom]

Hard to tell from the photos but is it possible its just his spines?

[Rouge]

Thanks for reading, however this is not just his spines. Hard to see in pics but they are much clearer live. These are bumps that actually stick up.

[vuphy]

not to criticize, but seems you're trying to take a picture to close to the tank, and your camera in focusing on the background. try backing up a bit and get the fish in focus, then crop out the area you want to show. if the file is too large to post i'd be happy to crop it and post it for you. he looks like a beautiful fish, but its really hard to tell whats going on in those images.

[Pufferpunk]

Puffer Queen is the resident Mentor here who is expert on treating SW puffers. I'll PM her to look at this. Very good notes!

[Puffer Queen]

Hello! We are seeking your advise for "Puffy" Arothron reticularis, 2.5 years old, 12.5 inches. 96 gal tank, wet-dry filtration with skimmer, ozone, canister filter, 3 power heads. Other fish in tank: 2 blue damsels.

What are the dimensions of this tank?

Aug 5: ph 8.2, Nitrates 10, Nitrites 0, Ammonia 0. Tank care by professional fish caretaker of 10 years.

July 12: tank inadvertently overcleaned.

What do you mean by overcleaned? What type of substrate and was it vacuumed - if so how much?

Removed old silk plants that were clogging pumps, etc., changed filters, charcoal, partial water change.

All plastic and silk plants should be removed as these can be ingested and cause intestinal obstruction.

July 14: water turned cloudy, John arrived stat, Ammonia 1.2. Puffy began fasting.

What was the pH? Fasting with ammonia spikes is not uncommon

Tank treated with "Aquarium Enzymes" (nitrofine bacteria) and "Prime" (water detoxifier). Weather very hot and tank temp spiked to 82 degrees. Using 5 fans & Air Conditioning dropped water to 74-78, which is now maintained daily.
20%-25% partial water changes every other day. Todate (Aug 5: water tested daily)
July 13-14: Ammonia 0.8, added bio media + two additional magnums with bio media.
July 19-20: Ammonia 0.4.
July 21-todate: Ammonia 0. Puffy offered food, for first time, eagerly ate Krill.

What else were you feeding the puffer?

July 30: Nitrates: 40/million. Puffy listing to side, somewhat lethargic; refusing food.
July 31: Removed charcoal filter, added First Choice Triple Sulfa (sodium suldacetamide, sodium sulfathiazole,
sodium sulfamethazine) 1 scoop/10 gallons. Puffy more perky within 30 minutes; refusing food.

Are you adding the medication to the tank? Porous material - substrate, rock, etc will absorb the medication making treatment difficult. Therapeutic levels will not be obtained and drug resistant bacteria can develop. There is also the possibility of the medications being leached back into the system at a later date if water parameters fluctuate and could lead to toxicity. If there is carbon in the system, that needs to be removed as well when adding medications. The skimmer and ozone should be stopped during treatment as well. Many medications will interfere with the biological filtration and lead to die off of the nitrifying bacteria and lead to ammonia spikes.

Aug 1: Tank within normal limits. Puffy feeling a little more mucousy. Very small pin-point white bumps
interspersed on his back. 2nd dose of Triple Sulfa. Puffy refuses food, listing, decorum very poor.
Aug 2: Tank within normal limits. Triple Sulfa reduced dose: 7 scoops, partial tank change. Added "Quick Cure"
(Formalin, Malachite Green) 1 drop/gallon, 96 drops. Puffy very lethargic, refused food. White pin-point
bumps more profuse.

What is normal? What is the pH? Mixing medications especially with substrate, skimmer, carbon & ozone is not advised.

Aug 3: Tank within normal limits. Triple Sulfa reduced dose: 6 scoops. Quick Cure reduced dose: 75 drops.
Puffy's decorum very poor, lying on bottom, listing, floating at odd angles; refusing food.
Aug 4: Tank within normal limits. Triple Sulfa reduced dose: 5 scoops. Quick Cure reduced dose: 40 drops.
Puffy more perky, refused food in morning but ate two Hikari Bio-Cure Krill!! (Wanted more but
I did not want to feed him too much since he had not eaten in 3 weeks.) White pin-point bumps
have increased around mouth and face. Decorum much perkier!
Today, Aug 5: Tank within normal limits. Partial water change. Triple Sulfa reduced dose: 5 scoops. Quick Cure
reduced dose: 40 drops. Puffy allowed 2 krill for breakfast, noon, and dinner. Praise GOD !
NOW WHAT REGIME SHOULD WE FOLLOW?
I am concerned about the white pin-point bumps.
Prior to this water catastrophe, Puffy has had a few thin red streaks (for almost a year) running through his
fins by his gills.
In the past five months a thick, sort of white line, has also appeared on the very edge of these same gills.

The caretaker says the white bumps are not ick. We have attached several (not too clear but the best
we could do photos). You can see Puffy's fins and perhaps discern the white bumps, a few of which we
circled.

We purchased Puffy, who arrived at our local tropical fish acquarium FedEx in an oxygenated bag from
Manila. He was about 1.5 inches long and I guessed he must have been about 1 month of age. Any opinion
on his age. We love him dearly, he is the center of attraction in our home which includes, dogs, an aviary,
and horses. Puffy is very precocious....we can pet him and I can pick him up!! He can count and he is
familiar with all the routines. He even smiles!! Everyone who seems him is amazed, we are always being
told that he should be on Animal Planet, or some such.

I have been so afraid that we were going to lose him. I am so appreciative and grateful for any information
and advise you can give to us. Thank you so very much for your wonderful, caring, compassionate web-site!
May GOD Bless You All.

Most sincerely, Dr. Joseph and Jacqueline (that's me, Jackie) Garamella, Puffy and friends!

The white bumps coupled with the fact that in the pictures, there appears to be redness in the pectoral fins, I would be inclined to say it is a bacterial infection. I would recommend treating with antibiotic baths in a separate container for one hour a day for 7 - 10 days. I would recommend in order of preference: Nitrofurazone, Kanamycin, Mardel's Maracyn-2. I would also suggest adding vitamins and beta glucan to the diet to boost the immune system and promote healing. Since adding the medications to the tank, you should be concerned about disruption of the biological filtration.

Best of luck

[Rouge]

Hello Tina, vuphy and Pufferpunk . . .

Thank you for your prompt replies to my quest. Tina, you responded in less than 10 minutes after we posted the e-mail. That was very heart warming!

Vuphy, I was so touched that you actually immediately offered to help me with the photos, and your advise about shooting further away from the tank is very interesting, I will definitely do that. Thank you so much! Right now I cannot send you photos (or I would) for two reasons. 1. I do not know how to get them out of my digital camera, 2. I do not know how to attach them to this site. I am not very computer, certainly not internet literate. Yesterday I called a good friend and she dropped everything and made an 1 1/2 round trip drive to take the photos, put them on the computer, and then atach them to this site. I do not want to impose on her again...atleast not for the next few days! I am actually good with a camera, I need further education on how to get the darn pictures in the computer and how to attach them. All very frustrating when they are right in front of your nose! Thank you for the shooting advise, I will definitely try it. Thank you, too, for your compliment on Puffy...he truly is a beautiful fish with a lot of personality...I have taken a few excellent photos of him (out of about 60) but I do not know how to send them to the Puffer Gallery. Your photograph of your Dwarf Puffer is really outstanding!!

Pufferpunk: Thank you so much for notifying the Puffer Queen of my query. I was hoping I would be able to communicate with her. I have read about her on many websites just after acquiring Puffy. I have printed out her commentaries and given them to Puffy's fish caretaker, and will be responding to her after he has read her comments and I know what we can, and cannot, do.

The white spots on Puffy are somewhat diminishing. The caretaker thinks they are little mucous pouches that seem to be slowly sluffing off of his skin. Rather as if you were peeling from a sunburn. Have any of you seen something like this? Apparently Puffy's caretaker has after a bout with Ammonia similar to Puffy's.

Meanwhile, I am delighted to say that Puffy appears to be more active each day and he is eagerly eating his carefully doled out Krill. The answer to prayer..Puffy has had many people praying for him!

Thank you so much for your interest and concern. I shall keep you posted.

Jackie

[Puffer Queen]

The white spots on Puffy are somewhat diminishing. The caretaker thinks they are little mucous pouches that seem to be slowly sluffing off of his skin. Rather as if you were peeling from a sunburn. Have any of you seen something like this? Apparently Puffy's caretaker has after a bout with Ammonia similar to Puffy's.

Sounds to be characteristic of a bacterial infection - really need to administer antibiotics at a therapeutic dose - no substrate, carbon, skimmer or ozone.

Meanwhile, I am delighted to say that Puffy appears to be more active each day and he is eagerly eating his carefully doled out Krill. The answer to prayer..Puffy has had many people praying for him!

Thank you so much for your interest and concern. I shall keep you posted.

Jackie

Besides the krill, what else are you feeding the puffer?? A diet of only krill will lead to nutritional deficiencies which when symptoms become apparent, irreversible damage has occurred.
Best of luck,

[Pufferpunk]

Thank you so much for notifying the Puffer Queen of my query. I was hoping I would be able to communicate with her. I have read about her on many websites just after acquiring Puffy.

Yes, we are extremely lucky to have Kelly on board as a Mentor here.

[Rouge]

Dear Puffer Queen, Pufferpunk and Friends . . .

My husband, a Thoracic Cardio-Vascular Surgeon, said to me as I was discussing with him Puffy's multible tank changes: "when I was in Medical School we were taught "the solution to pollution is dilution"! Then I began reading this site and what do you suppose I saw! I told my husband to come and look at your site - he laughed and quite amazed that you are using, and endorsisng, the same theme! He was very impressed.

Puffer Queen, I am answering the questions you asked in your commentary:
Puffy's tank is a 96 gallon "bow" tank: sides 34", height 25", bow/curve 54'.
The water surface on the top is quite generous, it has the standard glass cover
which I leave cracked open by setting a small lego between the hinged glass lid,
and the top ledge of the tank. There are 3 power heads in the tank.

By "overcleaned" I meant at that particular cleaning (12 July), we inadvertantly removed almost everything with his natural bio bacteria. We took out 5 silk plants, changed the charcoal, cleaned out and replaced the water in the tsump tank (25 gal tank with 5 gallons of water in it). We changed his 350 magnum that we fill with de*nitrate (since the "crash" it has bio media in it). Also a partial water change of 25%. Things looked great for 1 1/2 days, then "bang" the cloudy water and ammonia spike. John vacuums the substrate in the front half of the tank to remove old decaying food. The back of the tank he does not. Also there is a "trickle" filter.

The ph during this entire episode never varied, always 8 or 8.2. I used the term "within normal limits" meaning that during this entire episode the ph did not change, nor did the nitrates or nitrites: 0, only the Ammonia as I described. And the Nitrate, 1/2 day, 40/million, 30 July.

Puffy fasted: John told me not to feed him. Luckily he was a little overweight
(something positive to say about overweight!). Six days after the crash John told me I could begin feeding him, I gave him two small Krill which he somewhat reluctantly ate, after that he refused all food until 4 August. He went without food for 3 weeks.
This is Puffy's usual diet: Formula One or Two, 1 cube, + Spirulina Discs 4, in am, 6 Spirulina Discs at noon, Krill, 3/day in evening. Three evenings a week I substitute
from a high quality grocery butcher, 2/3 small cooked shrimp or 1 small bay scallop. These I only buy frozen, I thaw just before serving, cut up and flush thoroughly with filtered drinking water. The shrimp is by far his favourite, but I think he sometimes has some kind of reaction to it because the next day he is a little off. I cannot really describe this but I have observed it, the only reason I let him have the shrimp (much less often that the scallop) is because he absolutely delights in it. Lately, I have been thawing fresh frozen green peas as a sometime substitute for the Spirulina Discs, he love peas too.
I am VERY VERY interested in any foods you feel he should have, or should not!

I neglected to mention that at the time of the first administration of Triple Sulfa both the ozone and skimmer were stopped.

Regarding the white pin-point bumps, the fish caretaker (John) describes them as looking like small muscus capsules. There are some thin filmy little webs that seem to run between the ones around his face. All of these seem to be slowly disappearing. John thinks this is the sluffing off of and extra mucous coating he thinks Puffy developed as a protection agains the Ammonia. I do not know what to think, I have no opinion, it is not my area of expertise {I am a Nurse Anesthetist], however, I do think they are going away.
The medication in a separate tank I am mulling over. I am very concerned about traumatizing him trying to catch him, exchanging him back and forth. He is a real scardy-cat. Just changing his environment at 9 months from his 20 gallon tank to the 92 gallon, he hid on the floor with the darker green patchy spots for over a week.

I am just thinking that he seems to be progressing well, perhaps we should give him a "tincture of time" to recoperate without stress. My avian vets say this is critical with birds, he said he killed many birds in his early career being too eager to "fix". I know this can be true with humans too. Believe me, in no way am I being critical of anything you are suggesting...I just hate to stress him more. What are your thoughts?

Thank you, thank you for your interest and expertise. We are so grateful, and we will support this wonderful website. Looking forward to hearing from you!

Jackie

[Rouge]

Dear Puffer Queen:

I am uncertain of the exact protocol but I would love to hear from you very quickly.

I answered your questions (see above).

I discussed the logistics of transferring Puffy to a small tank to medicate with John. We think we have figured how to do it with a minimal amount of stress. I would very much appreciate information from you personally, or a suggestion of where I can read any information on this subject of transferring puffers, and the medication procedure for the tank.

Secondly, a new development has occured. I thought for sure Puffy was dying about 2:00 am when I was checking on him and his tank temp. He was flat on his back on the bottom of the tank, breathing. He struggled to correct himself about 7:00 am, without luck.
At that time he developed lump as if he had a large marble under his skin just above his anus and slightly to the left (considering he was upside down). At this point he was tilted with only the base of his back by his tail on the tank floor the rest of him was elevated upward at about a 45 degree angle. He was breathing and moving his eyes. I thought for certain he was dying. 1 1/2 hours later he was up swimming and eating.
However, his equilibrium barely working. He is ofter vertical with his face straight up, once just the opposite with his face on the tank floor. Frequently he is lying upside down on the bottom.
When he is upright he is somewhat perky and eager to eat.

Do you have any suggestions, different from original, that we medicate him preferably with Nitrofurazone (we have access to this) for one hour a day for 7-10 days.

I hope someone reading this can refer this to you very quickly.

Thank you so much.

Jackie

[Boxermom]

Duplicate post deleted.

[Puffer Queen]

I discussed the logistics of transferring Puffy to a small tank to medicate with John. We think we have figured how to do it with a minimal amount of stress. I would very much appreciate information from you personally, or a suggestion of where I can read any information on this subject of transferring puffers, and the medication procedure for the tank.

I would check all the water parameters of the tank. I would do a water change and run carbon in it to remove all traces of medications. The porous materials could be leaching medication back into the - ?toxicity? I would recommend keeping him in his tank to reduce stress. I would administer antibiotic baths daily in a separate container. Baths would consist of adding medication to a bucket usually a couple of gallons with airstones for circulation. The dose would be whatever the medication packet says for 10 gallon added to a gallon. I would perform at least 7 - 10 days treatment. If you have access to veterinarian medicines - injectable enrofloxacin is a good antibiotic that would work faster.

After the antibiotic bath, return the puffer to the system. I would keep the tank on the cooler side as bacteria do not grow as well in lower temps, lower temps also increases available oxygen in the water for the puffer.

Secondly, a new development has occured. I thought for sure Puffy was dying about 2:00 am when I was checking on him and his tank temp. He was flat on his back on the bottom of the tank, breathing. He struggled to correct himself about 7:00 am, without luck.
At that time he developed lump as if he had a large marble under his skin just above his anus and slightly to the left (considering he was upside down). At this point he was tilted with only the base of his back by his tail on the tank floor the rest of him was elevated upward at about a 45 degree angle. He was breathing and moving his eyes. I thought for certain he was dying. 1 1/2 hours later he was up swimming and eating.
However, his equilibrium barely working. He is ofter vertical with his face straight up, once just the opposite with his face on the tank floor. Frequently he is lying upside down on the bottom.
When he is upright he is somewhat perky and eager to eat.

Sounds as if he has an internal infection. The marble could have been a blockage in the intestinal tract - the intestines do slow down with bacterial infections.

Do you have any suggestions, different from original, that we medicate him preferably with Nitrofurazone (we have access to this) for one hour a day for 7-10 days.

I hope someone reading this can refer this to you very quickly.

Thank you so much.

Jackie

See above.
Best of luck.

[Pufferpunk]

If you have access to veterinarian medicines - injectable enrofloxacin is a good antibiotic that would work faster.

Would that be instead of the antibiotic baths or in conjunction with?

[Puffer Queen]

As sick as this puffer is - I would do both.