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Dr. B.
Dr. B., Veterinarian
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My betta has multiple symptoms/illnesses. Need diagnoses. Face

Resolved Question:

My betta has multiple symptoms/illnesses. Need diagnoses. Face is now swollen. =(
Submitted: 1 year ago.
Category: Pet
Expert:  Dr. B. replied 1 year ago.

Hello, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

 

To aid me in helping you with Turboberry:

 

Can you outline what these 'multiple symptoms/illnesses' that you are seeing specifically?

 

Have you checked the water parameters (ie ammonia, nitrites, nitrates, pH)?

When did you last check? What were your findings?

 

When you say he has facial swelling, do you mean that his eyes are poking out (pop-eye)?

Customer: replied 1 year ago.

I do not have a test kit. I can get one but not until the fifteenth. I am flat broke at this point. I do daily water changes but not the 100% after a couple of days ago because he is so stressed out that I think any more extreme things like that and he won't make it.

 

So I change part of his water every day. I had been using Maracyn 2 for the popeye but it wasn't working. I just discovered that the store sold it three months past expiration date. I don't know if that could be a factor.

 

Since stopping the Maracyn 2, and changing to lifeguard, he has now also developed little white spots, I believe to be ich.

 

In addition, as of last night, the sides of his face are a little swollen, with the right side more pronounced. I don't know if it's from wedging himself between his new heater and side of aquarium? It's like he's got a puffy face.

 

The stomach area turned a light grey a couple of weeks ago. It's a little swollen now. He's pooping fine though and eating.

 

He hasn't been getting around much, fins clamped, not happy.

 

I've read so much about bettas for months now with conflicting advice on every single website which is why I'm finally asking for professional advice. For example there is advice to use salt for swelling, and then from other people that say don't use salt because it will dehydrate them; use Maracyn 2 without the light because it will break down in light, and don't turn off the light because it won't matter; do daily water changes if there's ich, and don't do daily water changes if the fish is too stressed; use a heater for some conditions, and turn off the heater for others; lifeguard has helped some people with ich etc. and some people say it won't because the ich life cycle is three weeks, etc.

 

I need to know if I should continue the Lifeguard and if I can add Maracyn 2. I read in a lot of places not to use two medications at once then in some places they say to begin treatment with two medications at once if the illness is bad enough. Because of the multiple symptoms I am thinking I need to use both. There are also ones called QuickCure, and antibiotics, etc., but I need professional advice because I don't want to overmedicate him or undermedicate him, and I don't want to make his water toxic with two medications if he can't take it. I don't even know which medication to give him. So at this point I'm changing his water partly each day and using his heater and giving quarter doses of the lifeguard none of which is helping. As I said he's getting worse. Oh, and fin rot. Most of this all happened after I got some live plants from Petco. I didn't know until after the fact that I should have quarantined the plants for two weeks first. I had got a live plant before that which didn't cause any problems but it was individually wrapped, not from a plant aquarium.

 

So do I need an antifungal? Antibacterial? Both? Use Maracyn and Maracyn 2 at the same time? Turn off the light? Leave on the light? Raise his temperature? Lower his temperature? Do partial water changes? Do full water changes? Use epsom salt? Don't use epsom salt? Use aquarium salt? Don't use aquarium salt? Use one medication at a time? Use two? Try conservative approach since medications aren't working? I'm going insane and heartbroken that I am so completely inept at caring for this little guy whom I love.

 

Oh and finding local fish store that sells medications is hard. Even Petco which is where I got the plants that I believe started this has said they don't have medicine for popeye etc. (hence us going to pet barn here in san antonio)

Expert:  Dr. B. replied 1 year ago.
Poor little Turboberry!!

He does certainly have quite a few serious issues bombarding him at once. And with so much immunological stress, we need to appreciate that he does have a guarded prognosis at this stage. Therefore, we must do our best to address all of these issues but know that with so much already having transpired this will be a uphill battle.

Now first if possible, could you take a photo of what you are seeing? If you can do so and post them online, it will let me see what you are seeing. (To post them, you can either use the wee paper clip on the tool bar. Or you can post them on a 3rd party site (ie Flickr, Photobucket, etc) and paste the web address here.)

The reason I especially would like a look at Turboberry is these white spots you are seeing. Now it may be Ich (and goodness knows a non-quarantined plant would certainly be a potential carrier that could have lead to an Ich infection) but it sounds a bit strange to see this developing at a later stage. Rather if it was Ich, we'd usually see that first and then see secondary fin rot +/- pop-eye as the immune system is stretched thin. And because of that, I would be keen to confirm that you are seeing white sand-like cysts of the Ich parasite and not a secondary bacterial (columnaris) or fungal issue.

Since we have so many issues at hand, we do need to take care with how we are treating. Especially since we have a possible parasitic issue (Ich), definite bacterial (with the pop-eye, which is essentially an bacteriemia and early stage dropsy and the most worrisome issue for him), and possibly fungal (though often fin rot is just bacterial as well). The reason this is so complicated is because we do have a lot of different issues to tackle that unfortunately do not respond to the same treatments. And that means we do have to be aware of overmedicating but also the possible compatibility of our treatments themselves.

So, first consideration is the water status. Now I am glad you are not doing full water changes, because that is a major faux pas in fish keeping. Not only is it stressful as you have noted but it is detrimental to the tank's biofilter (the good bacteria). And if you destroy the biofilter, then you will be even more at risk of nitrogenous waste build up in the tank quicker because those good bacteria are not there to break them down. Therefore, partial water changes are always the way forward. And if Ich is present, then consider vacuuming the gravel or removing any gravel/plants/etc. alongside the partial water changes to help remove as much as the parasite as possible. As well, with frequent water changes and medication, you may need to use a biofilter bolus (ie Tetrasafe Smart Start) to address the tank's good bacterial levels. As well, you didn't note if you have a filter (I appreciate a lot of bettas aren't kept with them), but do be aware if you have one that the carbon filter needs to be removed to ensure that your drugs are not being removed from the tank before they can aid him. Furthermore, I understand you do not yet have a test kit (which is something you do want to have for situations like this since it will allow you to know how successful your water changes are and the state of your water) but most pet stores will check a water sample for free. Therefore, it would be ideal to get a water sample checked now while you are waiting for your kit. It will tell you the status of your nitrogenous wastes and give you a clue to whether your current water changing regime is enough for him this tank. So, even though the kit is on its way, consider getting a sample checked at the pet store now to get an idea of the tank's state right now.

After addressing water quality, then we can turn our thoughts to treatment for diseases at hand. Now if the Maracyn is out of date, then it is of no use to us (perhaps you can return this to the store). While it could still have some effect, we have to assume that by being out of date it will not be the full effect. And if its effect is compromised, then we have to question whether we are giving a proper dose to address the infection or if the lower dose is just aiding the bacteria in developing resistance to the drug. And since there is no way for us to ascertain what % functionality the out of date meds has, we cannot even amend dose to address this. Furthermore, I don't tend to treat with Maracyn alone with pop-eye or bacterial fin rot cases since we our most common bacterial culprit (aeromonas) does have some resistance to the erythromycin alone. Therefore, when I do use Maracyn, its typically in combination with Maracyn-2 (minocycline) to give the best chance of tackling all strains. Alternatively, Kanamycin would be a good choice for his ongoing issues. And if he is still eating and since you are struggling with water issues, then it would be ideal to use Medi-gold (LINK). Medi-gold is medicated food for goldfish that contains Kanamycin. It would get you around having to worry about further biofilter compromise and would take away some of the worry that you are properly managing your water parameters (which can be even harder to do and a bigger deal when you are medicating fish in their water). So, that would be an ideal option for addressing the pop-eye and bacterial differentials for the finrot.

Since there is a lot of medicating going on, I'd be tempted to initially withhold treating for fungal fin rot at least first off. Rather if you treat for the bacterial causes (since the aforementioned antibiotics will address both the internal bacterial infection and bacterial fin rot) and do not see the rot improving then I'd say to add in the anti fungal agent. And the one I'd tend to use alongside these antibiotics is Melafix. This is a natural antibacterial made from the melaleuca tree. It may help with the fungus if the water parameters are appropriate. So, I'd have the on stand-by initially but use it if the fin rot isn't responding to antibiotic treatment and therefore hinting that it is a fungus like Saprolegnia .

Now if he does have Ich, then there are typically two options for treatment: medication vs. salt therapy. (of course, alongside your water changes). Since we have an early stage dropsy, Ich present, and are already treating with medications (that we don't really want to mix with the typical Ich treatments), aquarium salt and alteration of the water temperature would be indicated in this instance to address the parasite. Furthermore, salt treatment (in moderation) will help pull some of the fluid from him and should reduce his swelling and pop-eye while you are treating the underlying agents. So, in Turboberry's situation, salt therapy would be indicated along with the other treatments.

Now the reason we change the tank water temperature during Ich infestation is because the increase does affect the rate of life cycle development for the parasite. This is important because not all life cycle stages are vulnerable to our treatments (this is also why we have to keep treating for another cycle length after signs have disappeared to make sure they are all destroyed). To speed up the lifecycle, you can increase the water temperature (gradually to not shock him) to ~78-80F, as this will quicken the Ich lifecycle to 3-5 days. That said, remember to do so slowly and monitor him to make sure he can tolerate the increased temperature. If he struggles while you are raising it, you may have to use a middle ground and treat for longer. As well, do make sure you have good tank aeration when you are increasing the temperature since his oxygen demands will increase with the warmer water.

For aquarium salt treatment against Ich, you usually you are aiming for a 0.3% salt concentration, which would be three teaspoons per gallon. To get to that 0.3% salt, I'd advise adding 1 teaspoon of salt per gallon of water to your tank 3 times, with each teaspoon being 12 hours after the last. When adding the salt, I usually pre-dissolve the salt in tank water before adding. And then do so slowly into a high water flow area of the tank. Alongside this, you want to keep up on the water changes and do at least 20% water change every 2-3 days. This coupled with hoovering/removing the gravel will l help decrease the amount of cysts hiding in the gravel and free swimming stages of the parasite in the water while you work to eradicate the infestation.

Overall, Turboberry is in a very serious and advanced state. We do have to be quite concerned that his body's resources and immune system are already stretched very thin and therefore his prognosis is very guarded at this stage. Still to give him the best chance, we need to act quickly to see if we can get this under control for him. Therefore, I'd advise that Medi-gold would be ideal (if he is eating) to address the bacteria without putting further strain on the tank. If the fin rot doesn't seem to respond to antibiotics, then Melafix can be added. And if we are sure this is Ich, then our salt therapy and change or tank temperature would also be indicated. Finally, while you are waiting for your water parameter kit to arrive, do consider having the pet store check a water sample for you; as it will give you some important answers that are best to know sooner rather then later in trying to help Turboberry in his very compromised state.

I hope this information is helpful.

If you need any additional information, do not hesitate to ask!

Dr. B.

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Remember that if you have any lingering questions or concerns, please reply so that we may continue our conversation. I will be happy to work with your further and do everything I can to provide you with the service you seek. Please remember to rate my answer when you are satisfied (with 4-5 stars or a happy face) so that I may receive credit for my assistance. Thank you & have a great day. : )


Customer: replied 1 year ago.
Thank you. I will attach pictures asap, probably after an hour. I need to get help transferring them. Re filter - the aquarium originally had a filter with it but his fins would would get sucked into the intake, and the current stressed him, so i took it out. I have taken out the gravel because the tank seemed to be developing a thread-type algae, and that's with emptying it and cleaning everything and 100% water changes (which I've only done a couple of times but which i can't do anymore), so i don't know how to get rid of it or even if it's affecting him. (The other possibility is that it's columnaris in the water.) I use a turkey baster to remove waste from the bottom every day and add back in filtered water, and then medicate for the replaced water volume. I left in some bigger glass marbles because i heard he needs something for beneficial bacteria to stick to. The heater cannot be controlled with a thermostat, which i didn't realize I needed at the time i got it, so I will get that today. Do you have a suggestion for where to get a heater for a 2.5 gallon aquarium that has a thermostat? Re food: unfortunately, he will only eat his food. Am i supposed to starve him to get him to try his new food? Thats one tip i saw, but it seems cruel at his age and with his issues. One persons idea was to soak their betta's normal pellets in a medicine and then feed it. I will wait to hear from you re that because if i need to get a liquid medicine then i don't want to get the wrong thing. I will get the two Maracyn treatments this morning though. Update: I woke up this morning and found that things seen to be a LITTLE better: the white dots have fallen off of him and instead he has tiny pink spaces on him where they were, kind of like the layer of skin underneath. Also his swelling is down a little, and the water doesn't seem to have that algae-type stuff at the bottom. He also had had a brown kind of coating especially on head/front of his body, which has completely disappeared. So those are all improvements. He still doesn't feel good though and won't eat just now although he tried once, halfheartedly. That's very unusual for him. =( Since the lifeguard is working a little, are you saying i should add the Maracyn and Maracyn 2 *TO* the lifeguard? Re: melafix - you said to use it for antifungal but you said it's antibacterial. I'm confused. Sorry. =/I will take water to pet store today to get it analyzed.
Expert:  Dr. B. replied 1 year ago.
You are welcome.

Sorry, I was typing so quickly this morning that I meant to say that Melafix is both antifungal and antibacterial. That said, its an agent we partner with specific antibiotic therapy when dealing with specific issues as we are with him.

If his fins were already been traumatized from the filter, then that would have opened the door for the opportunistic bacterial or fungal agent causing his fin rot. And I agree that the thread material (esp. if its white) on the rocks is more likely to be bacteria overgrowth rather then true algae. If you are seeing less of it, then it does sound like your tank cleaning and water changing is starting to make a dent and needs to be kept up.

In regards XXXXX XXXXX for the biofilter you are correct. That said, the Ich also needs places to hide (which is where they go when the drop off him). In this instance, we are in an imperfect situation because we want those good bacteria but not those parasites. Therefore, in this case, especially since you will also be treating with antibiotics too (which is going to knock what biofilter is present for the short term and the reason why we often treat sick fish in hospital tanks rather then the established 'home' tank), I'd say that there is more value in removing Ich hiding spots then creating ones for good bacteria. In doing that, we do need to appreciate that you will be the sole manager of the nitrogenous wastes and will need to keep a close eye on keeping the water quality excellent (since the biofilter wont' be helping you). But once you are finished treating with the antibiotics, you will be better able to realistically get the biofilter online. And at that stage, biofilter boluses, substrate and perhaps a safe filter (since they will live in the filter sponge) would be ideal to start using. So, since establishing a biofilter under the influence of antibiotics is going to be difficult at best, XXXXX XXXXX on treating him and managing the water quality at this stage (with a view to addressing the biofilter once things are settled).

In regards XXXXX XXXXX a heater with a thermostat, you will need to check with local sources to see what you can get I will have a look online but with the delay it takes for postal time, local would be better if possible. And worst case scenario, even if we are not altering water temperature, we can still deal with the Ich but it just means we have to keep treating for another 14-16 days (the room temperature life cycle period).

If he is stubborn about his food, then don't change it. We don't want to put him off his food because that will only weaken him and further strain his body. So, if that isn't an option, then water treatments would be the focus (Maracyn 1+2 or Kanamycin) but we just have to be aware that the tank's water parameters have to be monitored and managed closely. Again if your pet stores carries what we need then that is ideal for starting immediate treatment. If they don't or cannot order what you need in (which is typically quicker for them if they use distributors), then there are some online sites (example - though the kanamycin is in a huge tub as its intended for larger patient groups).

Overall, it sounds like you are on the right track with tank management and that is having a knock on positive effect for him. So, do get the parameters checked so you know where you stand and initiate treatment. Hopefully, his positive steps today will bode well for treating this advanced situation for him and you will be able to get him back on track.

All the best,
Dr. B.




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Remember that if you have any lingering questions or concerns, please reply so that we may continue our conversation. I will be happy to work with your further and do everything I can to provide you with the service you seek. Please remember to rate my answer when you are satisfied (with 4-5 stars or a happy face) so that I may receive credit for my assistance. Thank you & have a great day. : )
Customer: replied 1 year ago.
Hi. Thank you so much. I tried to get updated pictures but he won't come back over. I will send them asap when i can get them.

In the meantime, when we take the water to get tested (they just opened), i want to get the medigold (ill try it but not force him) and Maracyn treatments but need to ask, do i add Maracyn to the lifeguard?

I apologize for the amount of information I'm sharing. That question was lost in a lot of stuff.
Expert:  Dr. B. replied 1 year ago.
You are very welcome.

It is fine to keep using the Lifeguard (1-chloro-2,2,5,5-tetramethyl-4-imidazolidinone) with the antibiotics.

Let me know how you get on,
Dr. B.
Customer: replied 1 year ago.
Okay thanks. I appreciate it. You have been so helpful, and i wish i would have done this sooner. I have to hope that regardless, he knows i love him and am trying. =/

I would go ahead and rate this as great, btw, of course, but i think rating it closes out the "ticket" and then you won't get the pics. I have a migraine and got stranded. Will post pics/write later for your last opinion then close out ticket. Thanks again.
Expert:  Dr. B. replied 1 year ago.
You are very welcome.Smile
Hopefully, we can get these issues under control for him and get him feeling well soon.

Just to note, rating doesn't close the question. As you can see at the top, the query will be open for another 5+ days regardless and many people contact me months afterwards with no issues. So, there is no fear there.

Anyway, post the photo when you can and do rest your head, I know how awful migraines can be.

Take care,
Dr. B.
Dr. B., Veterinarian
Category: Pet
Satisfied Customers: 6296
Experience: I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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Customer: replied 1 year ago.
Oh okay thanks. I don't see that at the top but I'm on my cell phone so that might be why. =)
Expert:  Dr. B. replied 1 year ago.

Hi again,
No worries on that. I do suspect its the reduced screen size with the phone that's hiding that above. But as I noted before, we are still able to chat about wee Turboberry.

Take care & do let me know how you get on today,
Dr. B.
Customer: replied 1 year ago.

Thank you. I am attaching pictures.

 

The white spots are back. I don't see how I couldn't see them this morning. His popeye is worse tonight and he still has the swelling in his face. White skin around his eye sockets are showing. And there are very pale yellow spots on his fin, which you can kind of see in the above photo. He is now swimming in a weird jerky way. =( (He has no signs of columnaris or cotton or threads coming off of him by the way. That might be what's at the bottom of the tank, though...?)

 

I did a couple of partial water changes today, put in a second teaspoon tonight of aquarium salt, had put half of a packet of the expired Maracyn-2 earlier today, and put in the regular Maracyn tonight, and added Lifeguard. I will redo the new Maracyn 2 tomorrow so that I don't overmedicate on that.

 

The only place that I can find the MediGold is some goldfish aquarium online store. I can order it tomorrow but wanted to see if the Maracyn medications are the same thing?

 

I got Melafix and something called "QuICK Cure" (clever) but am not going to use the Quick Cure; just wanted to have it on hand if he gets better and you think he can handle it for the ich. I will wait to hear from you whether I should add Melafix (I think you were going to see if he needed it too right now, based on the pictures... or maybe I was going to wait a few days and then add it if he doesn't get better with fin rot.)

 

I didn't make it in time for the water testing part. I will get you the numbers tomorrow.

 

Maracyn pamphlet recommends concurrent use of CopperSafe. Is this a good idea? I've also heard before to use a garlic juice on his medicine to increase his immune system, which is obviously shot at this point. I think he needs a vitamin at least. Can you tell me if I need to put a vitamin solution into the tank? Does that affect medication at all? And if so can I give him a medicated pellet? I think I've read that Jungle has something like that. I think that would help a lot.

 

Expert:  Dr. B. replied 1 year ago.
Good morning,

He does look like a poorly boy indeed. The jerky does make me even more concerned (to whether the water ammonia is high and burning him or if he is starting to suffer with neurological signs as the bacteria infect his blood stream. This is especially something to keep a close eye on. As well, in the photo it seems that he is a bit bloated in the belly to me with a slight raise to his scales (pineconing). Are you seeing the scales slightly raised in person? If he is, then this is progression of the dropsy (which is what i causing the popeye, since the eye area is the least resistant to being displaced by fluid accumulation within the fish). In either case, the treatments are still as we have discussed before but this would be another negative prognostic indicator for our potential success at this late stage of his condition.

With the history of the white spots and the lesions from when they disappeared (its hard to tell their nature in the photo since fish struggle to stay still for pictures at the best of time), it is very suspicious of Ich. (You are correct in noting that Columnaris is more like fuzz when on fish tissue. And as I have said before the fronds in the tank are likely similar bacterial blooms arising because of high volume of water wastes present and a lack of tank filtration. So, keep water changing and hoovering this away along with the Ich). And because it is, we cannot be surprised that we are seeing more spots. They are not actually back again, its the next generation reaching the on-fish cyst lifestage. So, its just a continuation of what we are facing and what the salt/water changes/hoovering is working against since our aim with treatment is to clear the free floating life stage (pre-cyst) to prevent the parasite getting to cyst phase and latching on to him. So, its not unexpected (and if we increase the water temperature we will see a short term rise in numbers before they start dying of with our treatment) and rather is the next wave of the parasite.

In regards XXXXX XXXXX the medications, Medi-gold is not the same as the Maracyns. As I noted before it is kanamycin (which usually doesn't need combo treatment like the Maracyns will) and the preparation is obviously not a water treatment and instead the fish version of taking antibiotic tablets. For the Quick Cure, I would not use it at this stage with everything else on board. Furthermore, it isn't uncommon to see Bettas be sensitive to the formalin component of the drug and to have moralities on that score. If you want to add in a vitamin supplement that is fine. Copper is an option but I am just a bit worried about over stressing him with too many treatments in potentially less the ideal water. And as his case looks quite mild for Ich, we should really get the response we want from the less taxing treatment we have already discussed. So, it is an option but I'd be happier using it if we didn't have bacterial issues as well for him. And for Melafix, I'd hold off just now because the fin rot doesn't look particularly fungal. And while it would be useful, I just don't want to over bombard him since we are treating him with antibiotics (which will cover the fin rot anyway) and all the Ich support. Finally, a vitamin support would be fine to use. It should cause an adverse issues for him and shouldn't interfere with the medications at all. So, that would be something that could be added into his treatment course at this stage.

So, do let me know what you water parameters show and hopefully we will see these issues get in hand as your treatments get underway and stabilize. And hopefully the wee lad will respond and recover for us in the face of all these serious issues he is being accosted with.

Take care,
Dr. B.
Customer: replied 1 year ago.
Slight pineconing on the head starting maybe yesterday. Is there anything i can do about the ammonia tonight? I've changed out maybe six cups of water today. I don't leave food or waste in there. I'm about to cry. I'm going to just pray for him. I'll write you tomorrow with numbers. I didn't get there on time tonight
Expert:  Dr. B. replied 1 year ago.
Hi again,

Hopefully, the pineconing won't progress any further then it has, and as we work the salt levels up this will help with his fluid balance. Otherwise, you are already doing everything you can treatment-wise. For ammonia (which I just have to suspect since they will often jerk or flash in the water), its really just a case of water changes as you have been doing. And Murphy's law, this is when we'd want to have a test kit at home to just give us an idea of the ammonia (and other nitrogenous waste) levels. And you have been so diligent with the water changes, its difficult to say that the ammonia is still an issue without testing. The only other option is there are ammonia blocking treatments (ie Ammo-Lock or Ammonia Remover Blocks, etc) that the pet store or even walmart might carry that could be added in. But again we'd be speculating and not sure how much ammonia we need to be blocking, if you know what I mean.

Just to confirm, you are using a decholorinator and treating the water before you add it?

Do you think he is breathing faster since the jerking started (which would be another wee hint that ammonia might be the issue)?

Is he still clamping his fins?

Any ulcers (white or black) on the skin?

Dr. B.
Customer: replied 1 year ago.
Hi. Thank you for your quick reply. I don't know how much they're paying you but i need to change my question to the more expensive one so you can get more. I can't tell you how much i appreciate your help.

Yes, i treat water with Top Fin Betta Water Conditioner, and put in a few drops of Nutrafin Cycle Biological Aquarium Supplement.

He doesn't seen to be breathing faster right now but he's asleep. I'm not sure about other times. I think I'm losing my mind from stress. I keep staring at him. His tank is next to my bed because he likes company.

Yes re fins clamped. He is sleeping on his nt right now which is a good sign (I'm grasping at any hope at this point), because for several days he has been trying to wedge himself between his heater and the wall. Apparently he's been trying to "hide". Those pink spots on his skin might be little ulcers? I don't know.

Dropsy is (almost?) always fatal, so I'm very sad now. I told him if he can just hang in there for me, i promise to do a better job.

I agree re water testing kit. I should have had a betta "first aid" kit too.
Expert:  Dr. B. replied 1 year ago.
Hi,

You are very welcome and I do thank you for your kind words. We aren't paid by the website, just a wee commission when our answers are accepted/rated. But I just try to do my best for the wee fish since they are a species that doesn't get much in the way of vet care (even in my practice I am the only one who will treat fish, which always makes me sad since they are such a lovely species).

Thank you for confirming your water treatments. I just wanted to double check that you were, since we hadn't discussed that (and every so often I will speak to someone who doesn't do so). Just wanted to make sure there wasn't anything I was missing (since I can't just come over and see him) ;)

I am glad his respiration is not elevated and hopefully with that we can assume that the ammonia level is not out of control. It does means that we do have to consider that this might be related to the systemic bacterial infection but we do have him on the best treatment course we can for that and really we'd not want to just have that one more stress (ammonia) pushing him over the edge, if you know what I mean.

The pink spots are likely secondary ulceration where the parasite had adhered. While obviously we don't like them being there, I am not overly concerned about them at this stage since he is on antibiotic and the tank is salt treated. These should keep any other opportunists away and we just want to make sure we don't see any cotton fuzz appearing on them at any stage while they are open and unhealed.

It is true that dropsy is a very serious issue for these wee ones. It can be difficult to treat much of the time but is not always untreatable. It just does depend on what the underlying disease is, whether we can get it in check, and what residual damage it causes for them. So, we do have to appreciate that we are in a difficult fight and that his prognosis is guarded, but I would say that if he is fighting this (eating, coming back out of hiding) then we do want to keep trying to fight it with him. And hopefully we can give him the aid he needs to get through this.

About the hiding, it is a species that likes to have its little safe haven. So, they do naturally have the inclination to hide. But as you noted, when they are poorly (and feel they couldn't defend themselves from predation) they will be even more inclined to try and hide away. So, if he usually sleeps out and is doing that now, then that is a wee positive sign.

Overall, we do have to accept that we are fighting a difficult battle for Turboberry and that at this advanced stage it is an uphill battle. And I know it is heartbreaking that so much has bombarded him in such a short period of time. Still I do think that he does still have a chance and that its worth fighting (as long as he appears to be willing to fight with us) to see if we can gain some ground against all these agents.

Take care,
Dr. B.
Customer: replied 1 year ago.
Thank you for giving me hope.
Expert:  Dr. B. replied 1 year ago.
You are very welcome but do know that I'd not say it if I didn't mean it.
He is a 'fighting fish' after all and it does sound like he is certainly trying to keep going despite these parasites and bacteria causing havoc. We just need to persevere and see if we can help him in that fight.

Take care,
Dr. B.
Customer: replied 1 year ago.
Thank you. You are very kind. I'm glad you're our doctor. Just to update: he ate pretty well last night but just a couple of pellets today. More pieces of his fins are coming off but he's in the Maracyn treatments so hopefully that will reverse...? I changed to a silk plant today from the plastic one to see if that helps. I do see new growth on his fins. Ordered medigold this morning. They don't have an expedited shipping option. His body seems to be a little puffy today in addition to his tummy. Should i be using epsom salt? Is the swelling just post the dropsy and just a symptom to not be too worried about as a stand-alone symptom (in that i can't do much about it except the salt treatment)? And his eyes seem worse. I put a lava lamp next to his aquarium so he has something interesting to watch while he's sick. Maybe it can be like Betta TV. Got water tested. Only high level was nitrate. She said to stop changing the water so often to let the nitrogen cycle establish, so i told her briefly what he's going through. She said the only treatment they have for high nitrate is some kind of additive for slime but that it won't work unless i stop changing the water, which she agreed is an option right now. I asked her over the phone to write the numbers down, but she gave the store's phone number instead.I did have one question: do i continue to add 1tsp of aquarium salt every twelve hours? Or do i just replace what i change out at this point (the three tsp/2.5 gallon ratio)? I am changing out about six cups per day (four easier in the day, then another two cops at bedtime... Any faster than that, and gets stressed and has trouble breathing.) to get out food, waste, and the stuff on the bottom. (i know you've told me twice what it is. I just can't remember what its called. Sorry.)
Expert:  Dr. B. replied 1 year ago.
Good morning,

We will see fin loss continue as the bacterial infection is being addressed, but with the treatment this should slow (and with time, potentially regrow though we may always have some signs of 'scarring' from the infection). Can you tell me more about the 'new growth' you see on his fins? Do you mean fin tissue, more Ich, or a new mass?

The belly swelling is part of the dropsy along with the other distensions we have seen so far. While some people do use Epsom salt for these cases, if you are using the aquarium salt at 0.3%, then you don't need Epsom salt as well. And if you have already added 3 sets of salt 12 hours apart, then from here on in you just would be replacing what you have removed rather then continuing that dosing regimen if you know what I mean. But in regards XXXXX XXXXX belly, it isn't a new issue but rather progression of the current ones that we are fighting.

Finally, the nitrates. I appreciate her suggestions but that would be our goal if we weren't dealing with the issues that we are. So, it is a case of water changes to address the Ich and lower the nitrates in the place of a viable biofilter (since we are using antibiotics at the moment and wouldn't be likely be able to maintain a happy biofilter at this stage). That said, if he is stressed with the water changes, then do continue the frequent smaller ones. Often when fighting high nitrate in tanks we will do small water changes all through the day (have the water made up but dividing our 25% water change over 24 hours). The slow changes tend to be better tolerated as you have seen and avoid unnecessary stress (which is something we don't want) for him.

Dr. B.
Customer: replied 1 year ago.
Good morning. =) Good news is he hasn't gotten any bigger or pineconing yet and has lots of new growth this morning! I meant the clear growth at the ends where new tissue is forming. All the ends are clear webbing today where it's regrowing. Sorry about that.

His color seems paler. I'm not sure if that's okay or a bad sign.

Thanks re salt.

Right re nitrate... She had started giving me the advice before she knew what was going on. I still think it's funny that she gave me the store's number. =)

I will continue his treatment and update you if it changes. Otherwise I'm assuming we are in a holding pattern for awhile. He's still eating a little and he hasn't been swimming like that one time i told you about. Going to add vitamins tomorrow. =)

Thanks again so much.
Expert:  Dr. B. replied 1 year ago.
You are very welcome.

Thank you for clarifying the growth you were seeing. That is a much more positive one and I am glad to hear that is what you are seeing. As well, I am glad that he hasn't repeated that worrying swimming pattern. In regards XXXXX XXXXX color loss, we do see this in times of illness with them and/or if they are eating (since fish food often has pigment supplements like beta carotene) but it is often temporary. Clinically, it sounds like he is treading water at this point (which a lack of progression is good), so it is a case of continuing treatment to help him continue to fight these agents.

So, keep up the good work and hopefully he will gain some ground against these agents and we can get him through this.

Take care & all the best for the wee lad,
Dr. B.
Customer: replied 1 year ago.
Thanks. =) i just tried feeding him and he took the pellet in his mouth, then started gaping really big like seven or eight times in a row, and breathing hard with his gills. Then he like froze and then finally started chewing and swallowed. Is that the fish equivalent of choking? I swear.... =)
Expert:  Dr. B. replied 1 year ago.
Good evening,

It is possible that it was a wee choking situation (he does like to keep us worried). I would keep an eye on him, and if he shows any further struggles then it might be worthing halving his pellets to prevent this for him.

Have a lovely evening,
Dr. B.
Customer: replied 1 year ago.
Sorry. I need to replace salt for 4 cups of water. I've been doing the math for ten minutes and can only come up with 2tsp/cups which is obviously not right. Do you know how much salt i should replace for the four new cups of water?
Expert:  Dr. B. replied 1 year ago.
Hi,

I'd need to know how many mls were in the cups you are using to work our the salt dose.
-Dr. B.
Customer: replied 1 year ago.
A cup seems to be approximately 225mL. I figured .3 tsp per four cups of water is close. I don't know.

There were a few white spots on the walls of his aquarium last night. Today they are covering the walls. Its the same slimey stuff on the bottom of the tank. Its never happened before. Am i supposed to do anything? I know I'm just supposed to be manually removing it but its all over the tank now. Do i just do like fifteen partial water changes today
Expert:  Dr. B. replied 1 year ago.
Hi,

The bacterial bloom needs to be removed manually on top of the water changes. It is something that just needs to be managed until you are through medically treating (when you can then use a proper filter and set up your proper biofilter). There are some tank clearing agents, but I'd be reluctant to add anything else into the tank with so many fish based treatments.

In regards XXXXX XXXXX salt, as I noted before we tend to use 3tsp per gallon (which means 15 grams of per gallon). If we are only replenishing 225ml at a time, then you would only be replacing 0.7 grams of salt per change which is 0.14 tsp per 225mls (or ~0.6 tsp per 4 cups).

Hope that helps,
Dr. B.
Customer: replied 1 year ago.
Three tsp per GALLON? oh no! I though you said to add one tsp every twelve hours, three times. He is in a 2.5 gallon tank. But i don't fill it all the way to the top. So he needs at least six teaspoons in there? Sorry. Re the white stuff, i just found this: "I recently had this issue after using powder medication. I looked it up and found that some meds that are powder based have sugar, which as john said feeds bacteria causing the slime, some meds also work well when the temp is turned up, so all of that is perfect for growing that bacterial slime you see. I just did a water change every day and wiped down the glass while I was medicating and then just kept up water changes after i was done with the meds and it went away."
Customer: replied 1 year ago.
Three tsp per GALLON? oh no! I though you said to add one tsp every twelve hours, three times, which is what i did, for his 2.5 gallon tank. I have two gallons in there right now, at the 3tsp per tank percentage (because i just siphoned a lot of water out). Need to raise it to 6tsp per tank so i just now put in a half teaspoon per four cups that i'm replacing right now (slowly). How fast do i add the other 2.5 tsp today?

Re the white stuff, i just found this: "I recently had this issue after using powder medication. I looked it up and found that some meds that are powder based have sugar, which as john said feeds bacteria causing the slime, some meds also work well when the temp is turned up, so all of that is perfect for growing that bacterial slime you see. I just did a water change every day and wiped down the glass while I was medicating and then just kept up water changes after i was done with the meds and it went away." So maybe its the meds that have sugar. =)
Expert:  Dr. B. replied 1 year ago.

Hi,

In regards XXXXX XXXXX potential of sugar in the medication, this is something that you will need to double check for in the ingredient list of the drugs you are using. It may be a possible issue but more commonly its an issue secondary to nitrogenous wastes. In any case, it sounds like you are approaching this properly and it may just be a side effect to manage while getting his infections under control.

In regards XXXXX XXXXX salt, I am sorry you got confused. I appreciate this has been a stressful time for you and we are having to address so much with him. As I am sure you can understand, when I first outlined salt treatment I couldn't tailor the dose any further then I had since I hadn't known the size of tank you were housing him in. Anyway, what I said before was to aim for a total salt treatment of 0.3% with any tank. This means a total of 3tsp per gallon but done gradually. That means the 1tsp per gallon (0.1%) in 3 separate doses spaced those 12hrs to gain a total of 0.3%. If you have a 2.5 gallon tank that isn't totally full --perhaps we may assume its 2 gallons then-- then he will need 2tsps per 12 hours (a total of 6 tsp to get to the full dose) for his tank size. So, from what you have noted, it sounds like you have just reached a 0.15% salt level. So, not to worry, but you can consider slowly increasing this since he does still have some pop-eye and belly distension (if he hadn't, then we might stay at that lower dose) at this stage.

Dr. B.

Customer: replied 1 year ago.
Thank you. Yes i have had chronic daily migraines and fibromyalgia for fifteen years so my mind isn't what it used to be. Thank you. I will calculate the added dosage now. =)
Expert:  Dr. B. replied 1 year ago.
You are very welcome.

I am so sorry to hear you have so many migraines (I loathe the three day long ones I get from time to time. I can't imagine daily onesFrown). But its no harm done, and easily mended now that we realize the wee mistake there.

Take care,
Dr. B.
Customer: replied 1 year ago.
Thank you. They're transformed now which means they're almost constant but less severe. I'm sorry for yours. =/ that kind was much worse.
Expert:  Dr. B. replied 1 year ago.
You are welcome.

I think neither are fun for either of us. Sadly, I've not figured out a way to treat migraines yet (luckily we don't see to have the same issues for pets).

Have a lovely afternoon (I think). :),
Dr. B.
Customer: replied 1 year ago.
Hi. The Medigold is here!!! It didn't have kana-something in it. It says sulfadimethoxine and ormetorpin sulfa. I wanted to make sure its the right thing. I gave him a few pieces which i had to break up because they are heavy and sink immediately. He tried to eat one of the pieces that floated but spit it out. He's been doing that today a lot. He's maybe eaten one piece of his normal food and hasn't pooped today. I'm not sure how to get the Medigold down if he's not going to eat.Also, i don't know how this is possible but his fins are shredded as of tonight. They were growing back yesterday. How would the fin growth reverse so completely, overnight? Is there anything i can do? =( i missed his Biological Aquarium Supplement yesterday so all i can think of is an ammonia spike? Added extra tonight. They look really, really bad and pieces are falling off. By the way, the ich has fallen off again, so there are tiny pink holes in his skin on his head, but i know you said the antibiotics should keep it from getting infected. It looks like there are other pieces of his skin missing on his face, but those places don't go down to the tissue. I don't understand how the more i treat him, the worse he is getting re the fins and eating... It's like one step forward, two steps back with all this stuff. (He was the most active he's been in DAYS today. Came out to see me a lot, watched his lava lamp, swam around, had longer attention "span" (i don't know the fish version).)
Expert:  Dr. B. replied 1 year ago.

Hi,

I am surprised that its not listed on the preparation you have. Kanamycin, oxolinic acid, Ormetoprim, and Sulfadimethoxine are the usual ingredients for both the Medi-gold (for smaller fish) and Medi-koi (for larger fish). In this situation, I would suggest giving the company a ring to confirm the situation. If there isn't a kanamycin component (if they've changed their product), then it can be used but we'd want to consider continuing the Maracyns as our alternative therapy if Kanamycin is not present.

In regards to the eating, we do have to consider that if he is weak with his being poorly or if the dropsy is putting pressure on his guts, then we can see the appetite decline. In these cases, we do have to keep tempting them to eat (while making sure not to let food waste fester). And if he isn't eating much, then we do have to appreciate that he won't have much to pass as feces. And if there is progressing abdominal distension, we can see fecal frequency decrease as they need to work the feces through the fluid compressed gut. So, if he is struggling to eat (appreciably he is a small species of fish for the even the smaller gold pellets), then perhaps trying to half the pellets. And if he refuses them, then the water treatments need to be maintained as our alternative treatment approach.

Overall, as you know, this is serious situation for him and it means an uphill battle for us. His signs are quite multi-factorial and advanced, but you are treating as much as you can as best as you can. The frayed fins are a step back, and the skin on his face sounds concerning (perhaps if you could photograph this so I can see what you are seeing there) but under the circumstances you are doing all that we can to try and fight all these issues plaguing him.

Dr. B.

Customer: replied 1 year ago.

Hi, again. I haven't written because there is nothing new to report. The maracyn and aquarium salt and Lifeguard treatments are not working that I can tell. I am going to see if I can open a new ticket. I hope you can respond since you've already worked with me on him. I will send a picture with that question; it is a picture of his face. You can kind of see the holes in it, on the top right side of his face/head. I purchased Kanaplex and Focus and need your help with dosing it. =)

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