SICK RAM, HELP PLEASE

[1mysterygirl]

It's 5 DAYS since my blue ram showed symptoms.  I've done a lot and he is hanging in but treatment has not resolved all issues.

I don't know what would be best to do now so need your help please...

SYMPTOMS:
- small soft white spot on forehead (not ich, more like a single spore?)
- 1 cm patch behind left eye with damaged tissue, looking whitish but not fuzzy/hairy like full on saprolegnia
- eyes a bit enlarged with white rings around the outsides.
- he was 'stress' dark.

DAY 1:
- INTO 5G HOSPITAL TANK (water from original tank + 25% treated tap water)
+ 3 TSP. SALT (in 5gal)
+ 1/4 CAP STRESS GUARD
+ ALMOND LEAF
+ AERATION
- STARTED DOSING KANAPLEX.

DAILY:
+ONE 30 MIN BATH WITH HOSPITAL TANK WATER (taking 1gal for it) ...+ 1/4 TSP. EPSOM SALTS...+ 1/4 TSP METHYLENE BLUE

EVERY 48 HOURS BEFORE KANAPLEX DOSE:
- RAN CHARCOAL + TOPPED UP WATER LEVEL WITH TREATED TAP WATER

STATUS NOW, END OF DAY 5:
- EYES NORMAL
- PATCH BEHIND LEFT EYE WENT TO RED (cleaner looking?), NOW HALF BETTER
- WHITE SPOT ON FOREHEAD STILL THERE (meth.blue swab did not help. maybe due to slime coat?)
*** BODY HAS SHOWN SWELLING SINCE DAY 2 (no dropsy...not sure if this is internal infection or osmoregulation related? Would swim but land back down)
- BREATHING A BIT PRONOUNCED, RAPID
- HE IS SUBDUED/WEAKER NOW
- IS IN 5G HOSPITAL TANK WITH MEDS OUT, TOPPED UP LEVEL 1G TO 5G WITH TREATED TAP (+stress guard, almond leaves) 
EDIT:  HAVE ADDED 1.25ml REPLENISH (=a half dose)

It's time to do the 3rd/final KANAPLEX dose IF I do it...  I kind of feel it has done what it will and something else needs to be done, or changed right away if he's to make it but this is where we need your help.

LEVELS: GH: 8-9   KH: 4    PH: 8-8.2    TEMP: 77    SALT: 2.8 tsp in 5gal

CONCERNS:
- that the PH is so high (aeration has driven it up) and isn't this very stressful for him?  I topped up 1 gal partly to help lower it (tap here is 7.4) Turned off aeration.

***Also, is so much fresh water 'okay;? He has a filter in the hospital tank with media + substrate from his original tank, but I'm thinking the bio-filter may be negligible given he hasn't eaten or pooped all this time.. and if so does this matter?

QUESTIONS: Should we do the last Kanaplex? Or is there another drug worth trying that he should tolerate? I have POLYGUARD but it's such a cocktail of things, seems a lot for him...?   What do you make of the swollen body?

* We have REPLENISH, also CALCIFICATION....  I know you'll say Wonder Shells but I don't have and can't get fast enough

Thank you so much for any suggestions you have for us!!! 

PICS ATTACHED

Attachments:

[devonjohnsgard]

Welcome!

How old is the fish? When did you get it?

He is very swollen. I wonder if the symptoms that your seeing are secondary and there's some osmoregulation issues, internal infection, or maybe a parasite.
Have you always been using Replenish?
I guess you said the swelling started to happen after the treatment.

I would finish the treatment since it's a antibiotic. You'll want to complete the full treatment.

It's hard to say what to do if the full treatment doesn't work. I would think something like Spectrogram would be the best choice since it's a broad spectrum antibotic. I would say you would have to treat with the Polyguard or even add the medication into the baths as well.

Here's some more help with baths.
www.aquarium-pond-answers.com/2009/07/fish-baths.html

I also know that Rams are hard from the get go. Sometimes it's just bad stock from the breeder.

I would try to get the pH stable, which your doing.

I guess I'm saying try a more board treatment with medicated baths.

[Carl]

I agree with Devon's thoughts

Here are my thoughts:
*The bath should also include sodium chloride

*For direct application, AAP Wound Control is much more effective for spots like your fish has than MethyBlu

Resource:
www.americanaquariumproducts.com/Aquatronics.html#wound

*I have my doubts that your ph was driven this high by aeration unless it was already was this high to start with.
Consider blended RO with tap water (& test tap water)
Consider using Alkaline buffer and/or Pillow Moss

Resources:
www.americanaquariumproducts.com/FrogMoss.html
www.americanaquariumproducts.com/Seachem.html#acid

*Kanaplex by itself is often not enough, usually best with Nitrofurazone (AAP Spectrogram is a better choice)

PolyGuard should be safe and is a good choice as is AAP Bettamax

*Replenish is for adding to RO or RODI water, it is not the same as using Wonder Shell for mineral Cation replenishment on a regular basis to improve osmoregulation and reduce oxidative stress

*I should also note that Ram Cichlids can be very difficult and often the original source (not your local store) is partly to blame for exposure to disease or permanent damage from exposure to high ammonia, heat, etc.

Further Reading:
www.aquarium-pond-answers.com/2016/09/how-to-treat-sick-fish.html

Carl

[1mysterygirl]

Apr 18, 2019 11:35:47 GMT -5 devonjohnsgard said:

Welcome!
Thank you

How old is the fish? When did you get it?

I got him 5 months ago and he was @ 1.5" nose to tail

He is very swollen. I wonder if the symptoms that your seeing are secondary and there's some osmoregulation issues, internal infection, or maybe a parasite.
Have you always been using Replenish?

No, I just added a small amount now out of concern for the minerals/electrolytes. I had some notes.. likely spoke to Seachem.. about remineralizing and using a half dose for hospital tanks.. was going by that

I guess you said the swelling started to happen after the treatment.

Yes, noticed first @ Day 2 or 3

I would finish the treatment since it's a antibiotic. You'll want to complete the full treatment.

There's been almost 24 hours since I filtered out the meds to bring him to clean water.  Still I should do that instead of going right to another?
(I was worried about how much med he could take, the time passing, and that the KANAPLEX was addressing other symptoms but NOT the internal infection which I'm thinking is the biggest issue at this point...?  Interested in your opinion, just mentioning these were my reasons/concerns).

UPDATE:

Since posting, I have:

- pulled out 2 gal water from hospital and replaced with 1 gal water from his original tank
- brought in new seasoned media from the original tank
- added a teeny piece of pillow moss to the filter

(his original tank's PH is 7.8 so a bit lower/better to get that down (from 8-8.2) I felt. Also did to reduce the salt level. I saw on a post Carl noted Rams should never have above 3 tsp/5g and I know I exceeded that a little.. thought better to reduce somewhat)


STATUS:

- IN 3 GAL HOSPITAL (media from original tank)
+ 1.12 TSP SALT
+ STRESS GUARD
+ almond leaves + ½" piece bit pillow moss

* waiting for your input to decide next move

It's hard to say what to do if the full treatment doesn't work. I would think something like Spectrogram would be the best choice since it's a broad spectrum antibotic. I would say you would have to treat with the Polyguard or even add the medication into the baths as well.

I only have POLY GUARD on hand at the moment.
Are you meaning treat with POLY GUARD PLUS  do baths with it in? Plus what else.. and is METH. BLUE still helpful? What about doses?

I'm so nervous about how much med he can tolerate.. I know, double edged sword  

Here's some more help with baths.
www.aquarium-pond-answers.com/2009/07/fish-baths.html

been there, very helpful thx

I also know that Rams are hard from the get go. Sometimes it's just bad stock from the breeder.

I did get him from a great private store here, they go to lengths to bring in the best. they'd brought these from Isreal that's all I know, and they were gorgeous!.. not hormone fed etc.. I know what you're saying about rams, it's a general concern. Still hoping it's fixable and if he's fighting' so am I  


I would try to get the pH stable, which your doing.

Stable, now slightly lower than before

I guess I'm saying try a more board treatment with medicated baths.

Ok, thanks so much Devon  !

QUESTION:  POLYGUARD  -  DOES IT TREAT INTERNALLY?  
I don't see that info on the box. Also I neglected to mention he has not eaten since on treatment .. so that's 6 days that I know of

QUESTION:  WHAT ABOUT METROPLEX? This has been suggested to me also

[1mysterygirl]

Apr 18, 2019 12:11:41 GMT -5 Carl said:

I agree with Devon's thoughts

Here are my thoughts:
*The bath should also include sodium chloride

It actually did, as I used his hospital tank water for the bath which had 3 tsp/5 gal in it. 
( I didn't go higher as I wasn't sure about for Rams + I was adding the epsom salts. As I noted about I see you say no more than that for Rams. I did raise his hospital tank to 3.5tsp at one point.. as noted above also he's now down to 1.12 tsp in-tank)


*For direct application, AAP Wound Control is much more effective for spots like your fish has than MethyBlu

Will get.. I saw on your pages about it.. a new one to me but it sounds excellent

Resource:
www.americanaquariumproducts.com/Aquatronics.html#wound

*I have my doubts that your ph was driven this high by aeration unless it was already was this high to start with.

It was pretty high to start. My tap is 7.4 and gasses off to 7.8 but the community tank will run about 74-7.6 generally. It was higher at the moment, so 7.8 and it went up from there in the hospital one

Consider blended RO with tap water (& test tap water)
Consider using Alkaline buffer and/or Pillow Moss

(noted in my reply above to Devon)
I've now done a water change bringing water from his original tank (7.8) and added a bit of pillow moss to grad u a l l y drop it a bit.


Resources:
www.americanaquariumproducts.com/FrogMoss.html
www.americanaquariumproducts.com/Seachem.html#acid

*Kanaplex by itself is often not enough, usually best with Nitrofurazone (AAP Spectrogram is a better choice)
hmmmm... maybe not logical but I killed a ram with Furan-2. (or so it seemed).. so I'm scared of that one now that they can't take it.. I know there's so many factors.. just saying...

PolyGuard should be safe and is a good choice as is AAP Betamax
(also above) was asking if it treats an internal infection? and if so which do you think would be better POLY GUARD or METROPLEX? (*note, he's not eating)

*Replenish is for adding to RO or RODI water, it is not the same as using Wonder Shell for mineral Cation replenishment on a regular basis to improve osmoregulation and reduce oxidative stress

got it  Im about to order your shells for long term.. anxious to try them

*I should also note that Ram Cichlids can be very difficult and often the original source (not your local store) is partly to blame for exposure to disease or permanent damage from exposure to high ammonia, heat, etc.

Yep. 

Further Reading:
www.aquarium-pond-answers.com/2016/09/how-to-treat-sick-fish.html

been there.. lots.. and thank you for all the invaluable info.  


At this point, just really need help with which is better way to go.. POLY GUARD OR METROPLEX?  
I appreciate both you and Devon have spent time replying to me.... Im not asking you both now to play one off against the other, am just replying to both threads... and you seem to be in agreement so that's great.. am only asking about Metroplex as it has been suggested by my store and I do have it.

Thank you!

Carl

[Carl]

PolyGuard is primarily external infections, such as the spot on the head of the fish (especially Saprolegnia)


For internal infections, especially Cichlids, by far the best choice is AAP Discomed (which is mixed with fish food, so if the fish is not eating, it is useless)
Resource:
www.americanaquariumproducts.com/Aquatronics.html#discomed

As for Nitrofurazone, this has never been demonstrated to be hard on Ram Cichlids, only some invertebrates

Please read this article:
www.americanaquariumproducts.com/AquariumMedication2.html#nitro

QUOTE from above article:
"Serious adverse events related to nitrofurans are very rare. Acquired resistance of bacteria to nitrofurans during therapy has been rare and has not appeared on a significant scale in over 50 years of use.
Do not use in the presence of invertebrates.
Nitrofurazone is more effective at lower pH levels, which means use for marine fish is best in baths, NOT the display aquarium!"

Carl

[devonjohnsgard]

I think Carl's recommendations for medications are going to be the best. I do know with these fish, focusing on osmoregulation from the beginning is key to success.

Here's a care guild video:
www.youtube.com/watch?v=Z7osn0Um534

[1mysterygirl]

Apr 19, 2019 9:20:36 GMT -5 Carl said:

PolyGuard is primarily external infections, such as the spot on the head of the fish (especially Saprolegnia)

I noted that from the package, so as I hadn't heard back from you yet and needed to move forward, I decided to try Metroplex. My reasoning was it does treat internally even if not eating, and also targets anaerobic bacterial and I'd been guessing this was likely Aeromonas, which is anaerobic. My best resources here also tell me it's what they hands down have the best outcomes with for internal infections. 

However, unfortunately I lost the little guy later that day. 

For internal infections, especially Cichlids, by far the best choice is AAP Discomed (which is mixed with fish food, so if the fish is not eating, it is useless)
Resource:
www.americanaquariumproducts.com/Aquatronics.html#discomed

This one's new to me. I guess it comes down to what you think the villain is, right. Reading the blurb on it, I don't recognize a match to his symptoms, so I'm curious as to what you suspected it to be? (I guess too that the spot could have been saprolegnia but the internal infection something else) 

Re DISCOED it says: For treatment of Nematodes; Including Camallanus, Capillari, & Eustrongylid
* Treats parasitic causes of Color Loss, Weight Loss and Wasting, Darkened Body Color, Skinny Body, & Concaved Abdomen

As for Nitrofurazone, this has never been demonstrated to be hard on Ram Cichlids, only some invertebrates

This is great to hear, thanks

Please read this article:
www.americanaquariumproducts.com/AquariumMedication2.html#nitro

QUOTE from above article:
"Serious adverse events related to nitrofurans are very rare. Acquired resistance of bacteria to nitrofurans during therapy has been rare and has not appeared on a significant scale in over 50 years of use.
Do not use in the presence of invertebrates.
Nitrofurazone is more effective at lower pH levels, which means use for marine fish is best in baths, NOT the display aquarium!"
Yes, I'd read that thanks. Wasn't sure the kanaplex/furan combo was needed, but also as I'd mentioned was concerned about their sensitivity..

Carl

Thanks Carl

[1mysterygirl]

Apr 19, 2019 12:29:16 GMT -5 devonjohnsgard said:

I think Carl's recommendations for medications are going to be the best. I do know with these fish, focusing on osmoregulation from the beginning is key to success.

Thanks again, Devon.


If you see my notes above on Carl's reply, the update is the I lost the little guy. Still, have a couple questions for the sake of learning...

Here's a care guild video:
www.youtube.com/watch?v=Z7osn0Um534

Good little vid.  

You note in it about using REPLENISH for minerals/osmoregulation, and I (think I said above) I only used it in the hospital tank, not a regular thing.. and I wouldn't use ever in their display tank as it is planted and REPLENISH has sodium chloride in it. 


I'm a bit confused because in Carl's reply above, he said "*Replenish is for adding to RO or RODI water, it is not the same as using Wonder Shell for mineral Cation replenishment on a regular basis to improve osmoregulation and reduce oxidative stress"

I'm guessing the difference he's referring to here is the idea that I see you guys stressing over and over again, that because you have a positive test for minerals, it doesn't follow that they are 'active cations'... yes?

This post is so confusing to me, and I have read read your articles, watched the vids, asked others (pros I'd expect to know).. only to be told if you test and have minerals, you have the minerals. In a conversation here way way back, you'd explained to me (my understanding) that we can test the GH but don't know that what's present is active cations, therefore we want to supplement ongoing (using wonder shells which was the topic) so we know we have active cations. In doing that, we'll get a much higher test reading but expect that only the added level is active. (my wording).

What confuses me is this:  

This all seems to hinge on the fact that we cannot test minerals and distinguish between 'dead' and 'active' cations, yes?  If that's the case, how is it you decide that there is a difference.. that there are 'dead' and active.. in the first place?

Also:  

How do you know the ones you're adding are even 'active'?  Is it to do with minerals being 'active' when first introduced to the water.. but die off in time??? Or how is it (since you can't test reliably) that you can conclude these cations ARE active? 

Lets say we start with tap water that tests as 8 GH (as mine is) but we don't trust that, so we supplement with wonder shells and now the water tests as 18 GH.. so we decide (with your view as I understand it) possibly only the added 10 is 'active', so we decide our level is @10 and this is a good level. But WHAT IF the cations in the water at the start WERE active? Then in fact we have a GH of 18.. and this is waaaaay higher than what's wanted for the fish we're keeping?  

I'm just hoping to clear up this whole thing for myself once and for all. I hope/think you won't take it as challenging you, because I am not. I'm just trying to make sense of it all and so far it just doesn't make sense to me :'/

Thanks Devon

[Carl]

The reason I suggested Discomed is becuase it has ingredients that address a very wide spectrum of internal issue from bactieria to osmoregulation and especially parasitic
From Discommed page:
"Ingredients: 250 mg Capsules of Water Soluble Levamisol, NaCl, Piperazine, Magnesium Sulfate and Neomycin Sulfate Activity (pharmaceutical grade)"

Your fish did not have any one identifying symptom, and most likely it had internal issues, quite possibly organ failure from some past cause (quite possibly past ammonia exposure, lack of oxygen, extreme temperatures or simply bad genetics) that were showing with some of the observed external issues.

As for mineral Cations, I do not think you are quite understanding these. These are not active or inactive, they are either there or not there
These are a positive charge. As well these actually can be tested for, just not easily. The test is rH
This article deal with this subject in great detail for better unserstanding:
www.americanaquariumproducts.com/Redox_Potential.html

I also suggest reading this:
www.americanaquariumproducts.com/AquariumKH.html#gh

As for Wonder Shell use, with fish such as Rams, you only need to keep small sizes or fragments, if your GH is nearly doubling, you are using too much (although harm from high GH is over rated as per the last article I provided here)

As for Replenish, it can be dripped for mineral Cations, but again its primary use is for mineral replenishment for RO/RODI water

Carl

[devonjohnsgard]

Apr 23, 2019 18:21:02 GMT -5 1mysterygirl said:

Apr 19, 2019 12:29:16 GMT -5 devonjohnsgard said:

I think Carl's recommendations for medications are going to be the best. I do know with these fish, focusing on osmoregulation from the beginning is key to success.

Thanks again, Devon.


If you see my notes above on Carl's reply, the update is the I lost the little guy. Still, have a couple questions for the sake of learning...

Here's a care guild video:
www.youtube.com/watch?v=Z7osn0Um534

Good little vid.  

You note in it about using REPLENISH for minerals/osmoregulation, and I (think I said above) I only used it in the hospital tank, not a regular thing.. and I wouldn't use ever in their display tank as it is planted and REPLENISH has sodium chloride in it. 


I'm a bit confused because in Carl's reply above, he said "*Replenish is for adding to RO or RODI water, it is not the same as using Wonder Shell for mineral Cation replenishment on a regular basis to improve osmoregulation and reduce oxidative stress"

I'm guessing the difference he's referring to here is the idea that I see you guys stressing over and over again, that because you have a positive test for minerals, it doesn't follow that they are 'active cations'... yes?

This post is so confusing to me, and I have read read your articles, watched the vids, asked others (pros I'd expect to know).. only to be told if you test and have minerals, you have the minerals. In a conversation here way way back, you'd explained to me (my understanding) that we can test the GH but don't know that what's present is active cations, therefore we want to supplement ongoing (using wonder shells which was the topic) so we know we have active cations. In doing that, we'll get a much higher test reading but expect that only the added level is active. (my wording).

What confuses me is this:  

This all seems to hinge on the fact that we cannot test minerals and distinguish between 'dead' and 'active' cations, yes?  If that's the case, how is it you decide that there is a difference.. that there are 'dead' and active.. in the first place?

Also:  

How do you know the ones you're adding are even 'active'?  Is it to do with minerals being 'active' when first introduced to the water.. but die off in time??? Or how is it (since you can't test reliably) that you can conclude these cations ARE active? 

Lets say we start with tap water that tests as 8 GH (as mine is) but we don't trust that, so we supplement with wonder shells and now the water tests as 18 GH.. so we decide (with your view as I understand it) possibly only the added 10 is 'active', so we decide our level is @10 and this is a good level. But WHAT IF the cations in the water at the start WERE active? Then in fact we have a GH of 18.. and this is waaaaay higher than what's wanted for the fish we're keeping?  

I'm just hoping to clear up this whole thing for myself once and for all. I hope/think you won't take it as challenging you, because I am not. I'm just trying to make sense of it all and so far it just doesn't make sense to me :'/

Thanks Devon

Your understanding is very close! It comes down to the electrical charge that could be measured with a Redox meter or a rH test.

There could be the electrical from the tap, but if it's enough to keep up with the ever present acids in the aquarium. Adding minerals is like a constant water change, like a river. Unlike a closed aquarium. Constantly replenishing the electrical charge as the acids constantly wear away. Like an alternator on a car. Just relying on the tap is like charging your car battery every two weeks and driving hoping you have enough battery to last until the next two week recharge.

Plus the 1000s of aquariums Carl kept showed the difference between tanks with and without the minerals. There was less disease and less death.

Here's a couple videos that show what I'm talking about.

www.youtube.com/watch?v=--qBgwco4a0

www.youtube.com/watch?v=fSmJ2wFKrwk

[devonjohnsgard]

Here's another video that looks at it from a different direction that shows it again. UV sterilizers work similarly.

www.youtube.com/watch?v=gEXHnrawZZk