Hole in the head

[Steve]

I believe I have a fish (ruby red) suffering from HITH. At first I thought some of the catfish had spiked him on his head, but after isolating him in a breeder net it seemed to keep getting worst for a couple days so I am pretty sure it is hole in the head disease.

I started treating the whole tank yesterday with Metro and today the affected fish seems for sure no worse, and perhaps even a little better which is good. Couple questions though if anyone can offer advice or have had to treat this before.

1- How long and how much should treat with the Metro? I find conflicting things  online. I started yesterday with 200mg per 10g.

2- How in the world did this fish get HITH?? Because this is my main 55g show tank which is overfiltered with a pair of Rena XP3 & XP4 canisters on it, I do water changes every 8 days so water pram's are about as good as you could want, I vary the diet with pellets, wafers, and skinned peas once per week. So I'm having trouble understanding how he could have this. And it's only the one fish infected, which I have had for about a year now.

[linuxrulesusa]

I'm not saying it can't be HITH, but that's more common with SA and CA cichlids, e.g. Oscars.

A pic would help in ID'ing the specific issue.

Beyond that, your water change and filtration sounds great.  Have you added anything/changed anything recently?  Measured your water parameters?

Sorry, I can't help on the Metro dosage.

[Steve]

That's kind'a why I was surprised as well. I'll snap a pic of him in a bit. Nothing has changed for the past 3 months or so now. Parms are all normal -

Amon -0
Nitri-0
Nitrate-20'ish
Ph- about 7.3

[Steve]

Couple pics
.
.

[Ron]

Looks more like an abrasion than hole-in-the-head from what I've seen. Is there any abrasive rockwork in the tank?

[Steve]

I thought that as well at first, but it was just a small hole/scuff at first when I put him in the breeder net, then over two days it turned into about four times the original size, all while he was in the breeder net so nothing he could have done in the net that would have made it worse.

You can't tell from the side angle pics (He wouldn't hold still so I could get a straight on shoot) but from a direct front view you can actually see some pretty decent holes/pot mark that are deep enough to cause concern

[Ron]

It's been a while since I've shopped meds at the LFS, but the cause of hole in the head is a parasite, so that would be the first course of action I suppose. The damage also creates concern about a secondary infection, either bacterial or fungal. If you find something to treat both, that's great, otherwise I'd probably focus on a fungal medication as well.

I haven't dealt with this myself, so that's about the best I can offer.

[merritt]

Hole in the head disease is actually a parasitical bacteria. Although i've never encountered this disease i know that its due to poor water. I also know that its treated with Melafix and aquarium salt. I use this bath for war wounds and it does work. Its worth a try before using any strong meds. For secondary infection theres Pimafix or Kanaplex

[Steve]

That's what really has me stumped because I read that it is usually water quality related, but this tank is always in tip top condition water quality wise, my OCD see's to that So it seems really odd. I've been dosing it with right between the two suggestions I read in articles online with Metro for two days now and I "think" he seems to be improving some. Definitely not getting worse at least.

I'll tryin get a better pic of him straight on when I can so maybe you guys can tell a bit more of if it is HITH or something else.

[Steve]

I'm happy to say he is pretty much all better now. His color on his head is pretty much back, he's eating well and active and only sign that anything was wrong is a small pinhole on his head. Other than that he's in good shape now. Thank goodness for Metro.

[Ron]

Good to hear. 

[Steve]

I don't believe this. I noticed this morning that now my Pheno is getting a hole. The ruby red is doing really well now, even his color where the hole was is coming back and you can't hardly even tell he had issues. Now the pheno is showing a hole though and I'm starting to lose my mind trying to figure out why???

Everything I read says HITH is due to high Nitrates/poor water quality. This tank is my main show tank/pride & joy and I do 50%-75% water changes in it every 7-10 days, it has live plants, and is overfiltered with a pair of Rena xp3 and xp4 canister filters. So there is no way WC can be the issue. I did just test Nitrates and right now it is about a tad over 40ppm I would say by the color chart. It's been about 5 days since the last WC so I think one of the filters is due for a good rinsing which I will do tomorrow, but still I doubt 40-50ppm nitrates for a short time frame are cause for this?

I started treating again with metro today, and actually doing a double edged attack by treating metro as well as Pimafix.

Anyone got any suggestion/thoughts that would help figure this out at all?

[lilscoots]

If that happened overnight, I'd say you have an aggressor in the tank.  Both of those look like an injury to me.

[Steve]

I really don't think that to be the case to be honest. One reason being I did notice for about 2 days before the Pheno showed any signs of the hole that he was shaking his head oddly every once in awhile. Plus in the case of the ruby red when he started getting a hole, I isolated him and it continued to get worse and new holes appeared even when he was completely alone and no other fish with him.

[Steve]

Not looking good tonight. His color is getting washed out and he's starting to swim oddly and bump into things. Doubting if he will make it through the night but I isolated him in hopes he does.