Discus bloating and Metronidazole

[Amazon Sword]

Hello guys, I'd really appreciate your help with this one.

1. Please explain the problems with your fish.
My most active fish that would always come up to the glass began to become lethargic and then passing white/milky faeces, whilst also becoming very bloated.


2. Symptoms.
White faeces, bloat, lethargic behaviour.

3. What medications/ treatments have you already tried and what were the results.
Upon seeing the white faeces, I began dosing Metronidazole at 500mg per 10 gallons, and also dosed Epsom salts at 2 Tbsps per 10 gallon, assuming the bloating may have been from constipation. The fish has only become more bloated. Now is day 3 of treatment.



Tank/Water

4. Tank size and ages, numbers and sizes of fish.
65g aquarium with 9 wild discus and 9 f1 altums


5. Water change regime.
50% daily.


6. How long has tank been running? Is it bare bottom?
The tank has been running for about a year and a half now and is barebottom.

7. Do you age your water? If you do for how long and what is the ph swing.
I age it and there seems to be no pH swing.


8. What type/brand water conditioner do you use? Do you add it to the tank or aging barrel? How much do you use?
I do not use any.


9. Parameters and water source;

Note: Water Parameters are important in diagnosing problems within a tank. If you don't own test kits for the following information, you can purchase them, test your parameters and post this info as soon as possible.


- temp 84.2 F

- ph 6,5

- ammonia reading 0 ppm
- nitrite reading 0 ppm
- nitrate reading 5 ppm

What type of water or combinations of water sources do you use? If it is an RO/tap/well water mix, please list percentages in the mix.
RO blended with the RO waste water to get the desired levels of pH and kH.


10. Any new fish, plants or inverts added recently.
None.


11. Please tell us what you feed your fish and how often. This can be critical information for solving the problem so be as specific as you can.
The fish are fed multiple times a day with all sorts of discus pellets, spirulina pellets and flakes. Rarely, I also feed frozen daphnia and artemia.


What perplexes me is that after dosing the Metronidazole, the poor thing is getting even more bloated (looks like it's swallowed a small chestnut!) and it's still passing white/mucous faeces. Not having used Metronidazole before, I' m wondering if the bloating may be caused by the death of whatever is inside its intestinal tract and if this is common to see. If not, should I be using anything else to treat the issue with?
In case the Metronidazole isn't killing whatever is it that's bothering the fish, I also have diflubenzuron that is supposedly sold as being able to treat Capillaria, amonst other things.

Thank you for all the help in advance.

[Amazon Sword]

IMG_20200614_114439.jpgIMG_20200614_114437.jpg

[danotaylor]

That looks like an intestinal blockage given the location of the bulge. Are you treating the whole tank or did you separate the sick fish to a hospital tank?
3 days is early in the treatment and I have read here numerous times that it's can be right at the end of the treatment, even after, that things return to normal.
If you are suspecting hex, I would push the temp up to 90F for the duration of the metro treatment as higher temps disrupt the life cycle of the parasite. I am just not certain if swollen abdomen is consistent with hex though, so I hope All, Pat, Liz or Brian chime in this morning sometime...
Nitrates of 5 with a 50% daily WC with 18 fish in a 65gal being fed multiple times daily seems a little unusual...is your test kit in date?

[Amazon Sword]

Thank you for your swift reply. Being a bit fearful that the problem is Capillaria/Hex or whatever, I decided to treat the entire tank just to make sure to purge the entire community. I understand moving the fish over to the quarantine tank is a better idea, but I'm seriously afraid that whatever has caused this issue may still be lurking in the water... It definitely is a blocking of some sort, I'm just not sure what it's caused by either so I'm not sure what to do :/ I know 5 ppm NO3 looks a bit bizarre but I can assure you the kit is correct, I only got it a few weeks ago. I just have 4 gigantic pothos vines in the water along with a nitrate absorption resin, precisely to keep all the organics in check

[danotaylor]

Ok cool, glad your kit is good.

I have heard of dry pellets causing intestinal blockages if they're gobbled up and swallowed whole, they can absorb moisture from the stomach and dry it out and block up. I'm not sure if that happens with discus, but it can happen with other cichlids. If the moisture content of the pellets you fed is low you may try soaking them in tank water for a few minutes before feeding.

[Amazon Sword]

Thankfully I've never had it happen with mine, but I've always soaked their food in pellets for a minimum of 5 minutes, so it can't have been that I don't think.

[danotaylor]

Good to know. Checkin the boxes, lol

[jeep]

White stringy feces is usually a sign of hex. What you see is the shedding of the the intestinal lining and it's usually pretty distinctive. White and milky or mucus looking feces could very well be an internal infection. It's not really feces, but infection oozing from the fish. With bloating like in the photo, combined with an increase after treating for hex (did you raise the temp during treatment?) I suspect internal infection, in which case I would reduce the temp to 81-82 and treat with kanamycin or neomycin in a hospital tank.

[Amazon Sword]

Hello, the temperature here was really hot during the past few days and the aquarium reached 93F naturally, so I didn't have to increase the temperature on my own, but the water was very warm, yes. I have the hospital tank ready to go, but want to make sure what I'm doing is correct before taking any more actions. Do you think that hexamita or capillaria are not the suspects here? Also, anything similar to kanamycin or neomycin that would be effective? I don't think I would be able to find those here at all...

EDIT: I just noticed another fish excreting the same mucous just now...

[jeep]

EDIT: I just noticed another fish excreting the same mucous just now...

Well that certainly confuses things... Is there any way you could have access to a microscope? I still think it has an infection but it could be secondary because internal infections don't usually spread to other fish. It could be capillaria creating the infection if the infestation is large enough.

Diflubenzuron is actually an insecticide used for external parasites. I'm not overly familiar with this but I would think if it's used to treat internal issues you would risk liver damage.

Where are you located? I may look around to see what may be available in your area.

[Amazon Sword]

Well that certainly confuses things... Is there any way you could have access to a microscope? I still think it has an infection but it could be secondary because internal infections don't usually spread to other fish. It could be capillaria creating the infection if the infestation is large enough.

Diflubenzuron is actually an insecticide used for external parasites. I'm not overly familiar with this but I would think if it's used to treat internal issues you would risk liver damage.

Where are you located? I may look around to see what may be available in your area.

About the sample, I was going to mention it but I forgot. I have a good friend who owns a fish store and he owns a microscope. I was intending on gathering a sample and bringing it over to him tomorrow, I haven't been able to collect anything yet though. I'm in Cyprus, getting these things is pretty difficult around here, although I have the suspicion that I may be able to find Seachem's kanaplex. The only "good" thing is that the fish is a pretty strong dude, seems to be ok-ish so far, but I definitely want to get it healthy as soon as possible.

[jeep]

This would be my plan. Take a feces sample to your friend. If he can't provide a photo, use his best judgement. I still think an infection is present, so after consulting with him I would see if you can get the Kanaplex. It's not as strong as Kanamycin but perhaps you can double dose? Kanamycin is actually pretty easy on discus and the regular strength dosages are pretty wide spread. ARC instructions are 1tsp per 20-40 galllons, lol.. Since he owns a fish store he may be able to recommend the correct treatment for capillaria if he see it's present. It's pretty common in aquarium fish so I imagine it is. I notice you don't use a water conditioner, are there no chlorine or chloramines in you water? If there is then I would pick up conditioner as well.

This could be a long term treatment program. If the swelling is caused by infection then there is a lot in there. Don't expect a full recovery for quite some time and several treatments may be necessary.

[Amazon Sword]

As long as the fish starts to get better I don't really care how long it takes, I just want the pain to go away for the poor thing and make sure it doesn't die. In case my friend can't identify what it is, he works with an ichthyologist who specialises in aquarium species so we'll be able to get a proper specialist's opinion. I don't use any conditioner as my water is processed by an R/O filter dedicated to the aquarium, plus I age it anyway. I'll try my best to find Kanamycin, but in case I can't seem to find neither that nor the Kanaplex, is there anything else you would recommend?

[jeep]

Kanamycin is very good in these situations because of its ability to enter the body and cells. We're lucky here that we still have access to pure forms of meds so I really don't have much experience with over the counter meds. You may see if you can find a penicillin or amoxicillin based med. I just don't know what's available in your area. Maybe your friend or the ichtyologist can point you in the right direction. Just make sure it's for internal issues. Other antibiotics are excellent for external issues but do little for internal issues. If the fish is still eating, perhaps you can find a medicated food. It can be hard to get them to eat a change in foods though. I think Kanaplex is your best shot. However, Cary Strong told me about a product called Microbe Lift that he's impressed with. I think it's the Artemiss. It's not a drug so it may be available through mail order.

[smsimcik]

A few things to consider here:
If you can find Seachem Kanaplex it comes with a small scoop to dose with. If you use kanamycin powder, the proper dosage is 500-750mg per 20 gallons every 48 hrs. with a 25% water change prior to each treatment. You dose kanamycin by weight, not volume. You may need to buy a gram scale. Overdosing kanamycin can cause kidney failure. I've seen it happen. A good alternative to kanamycin if you can't find it is Furan-2. It's usually easier to find.
If your friend can find capillaria eggs in a feces sample, you need to treat it with Levamisol, a dewormer.
Hex is a protazoan parasite and is treated with metro. Capillaria are worms and needs to be treated with a dewormer like Levamisol.
Lastly, no reason not to try epsom salt at 1 tablespoon/10 gallons just to see if it clears the bloat. It won't hurt anything to try.