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rocmills

Battling Mouth Rot

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We have a large goldfish, about 5 years old and 5-6 inches in body, who seems to have a very bad case of mouth rot. Condition was first noticed on New Years Eve, and treatment was begun that same day. She was removed from the 70 gallon tank she shared with three others, and placed into a 10 gallon hospital tank. We treated with erythromyacin, removing charcoal from the filter first. We have also been feeding her antibiotic food.

For a while, it looked like the problem was getting worse - but then she started to improve and we bought a 20 gallon tank to isolate her in. The water is regularly treated for ammonia; partial water changes once a week, complete water change every weekend. She is given extra Stress Coat on a regular basis as well. I use a "dip stick" tester for nitrates, etc. and the results are always within the recommended levels - probably due to the water being changed so often.

We've been treating her for two months now, and one pet store guy said at her size and age that if I wanted to give her a fair, fighting chance I should give the treatment 3-4 months - so we are only halfway there.

I wonder if there is a better treatment. Would sulpha be better than erythromyacin? Tetracyclin perhaps? I put a bit of Pimafix in the water each evening, and the meds go in each morning. She eats and poops regularly and has no other external signs of disease or injury. She is a perfect white, so any bleeding or parasites would be easily seen. Her behavior seems normal for someone who was yanked out of her known home and stuck in isolation.

The problem is not getting worse, but it doesn't seem to be getting better. I managed to get some photos, would it be appropriate and acceptable to post a few if that would help?

I have two issues; how best to treat her being the first; how best to dispose of her should it become necessary to do so being the second.

Obviously, I'm not concerned about the money. She's just a comet, an overgrown feeder fish, but she's been with us a long time and I've already spent scads of money on her this far... I just want her to get better so she can go back in the big tank with her life buddies.

I'd appreciate any advice you have, and thank you for taking the time to help.

--Roc

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Hi roc ! Sorry about your big white common.

Usually the questions in the white box need to be answered before help. You have given us a lot of info but a little more is needed.

Having said that, to sum up, you have your fish isolated and have been treating with erythromycin for 2 months. That is a lot of antibiotics, especially if they are not the precise one needed. You say that the mouth rot initially improved but since has not made vast progress. There is no need to put down your fish, it may just be that you need to look at switching meds.

Antibiotics are highly specific and will only work on certain bacteria within their power zone. Truthfully many bacterial infections are acombination of bacteria and in this case where a fish has shown initial progres sthat has then slacked off it seems likely that a few opportunistic bacteria were killed off by the erythromycin but the main obligate bacteria still looms at large.

Erythromycin's curing range extends to a selection of gram postive bacteria. It will not touch gram negative bacteria. Mouth rot (tehre are many kinds) is sometimes caused by a gram pos bac but MOST often caused by a gram neg bac. This is why the columnaris mouth rot is often treated with an antibiotic cocktail of both erythromycin and minocycline (some gram neg).

However, and most important before any medication is to establish exactly what kind of mouth rot he has, symptoms can be telling of which bacteria group are at work.

More description is needed. Can you describe the mouth. Is he having trouble eating? Is there white stringy fluffy stuff inside or around the mouth? Is the roof of the mouth inside red???? Is there any swelling or lumps/pimples around the mouth? All these symptoms are key ones for different bacterial lines of attack.

Waiting on more details and WELCOME to kokos :exactly

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Trinket,

Thank you coming to my aid so quickly!

Yes, the fish (Lucy) has been isolated since January 1; and everything else you summed up seems correct.

Most recently, I did try switching her over to Triple Sulfa - but it obvious after the first couple of days that it was not helping and I switched her back to the erythromycin. As we are nearing the end of our current batch of meds, and I am planning on going to the store tomorrow anyway, now would be a perfect time to switch meds - if I knew what to switch to!

On to your questions about symptoms:

1) She has no trouble eating, whether from the surface of the water or off the bare bottom of the hospital tank.

2) White, stringy, fluffy stuff... not that I've noticed, exactly. I have seen what looked to me like strips dead skin come off her mouth around her lips.

3) Is the roof of her mouth red... that's difficult to answer as it is a difficult place to see.

4) Swelling and pimples around the mouth... again, difficult to answer, but for a different reason. Her entire lips (for lack of a better word) are swollen, red, and raw - like hamburger. There is an especially bad little hole in the middle of her lower lip, which could be described as a ghastly pimple.

I am (hopefully) a photo, just taken a few days ago, of her mouth.

When I say it got worse then got better... at one point it, the decay/wound, had spread to within a quarter inch of her eye, then that part healed up and it remains isolated to the lips area.

Thank you again for answering my post!

--Roc

100_3985.jpg

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I see. Well this looks like a very advanced case of columnaris type mouth rot. Poor Lucy.I am wondering if you might not be better to switch track and try a "diinfectant" type cure rather than antibiotics given the hardy and normal beahavior of your fish and the fact that she is large (easier to treat with disinfectant like meds). Something like PP for example. Do you have any pottasium permanganate? There are several choices of disinfectant type treatments. I would also consider a once only swipe of HP, hydrogen peroxide on the mouth itself. Have you ever done something like that? It is a topical treatment that kills bacteria dead immediately but they may return and it isn't something you can keep repeating endlessly so a water treatment would be needed too.

I just don't think antibiotics are going to get this. Disinfectant type treatments can be harsh on small fish or fish who are displaying abnormal behavioral symptoms but they are an excellent choice for hardy fish that seem to be managing but displaying bad bacterial sores/problems.

She's a pretty fish. Does she have red albino eyes? Please don't consider euthanizing. I have seen cases this bad recover well.

Edit: roc, Im signing out now. Wanted to add the link to PP treatment for you. This explains how + all precautions including lights off. I really think this will be the best and fastest way to cure your fish.

Edited by Trinket

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Trinket,

Once again, I thank you for coming to my aid!

We are off to the pet stores now in search of PP treatment.

I have never applied any type of medication directly to a fish, so I am unclear how I would dab some hydrogen peroxide on Lucy's lips... but I am willing to give it a try. Perhaps if one person holds her in the net while I come at her with the peroxide soaked cotton ball.

As for her coloring.... when we got her and the three others, they were tiny 12 cent feeder fish meant to keep an older, larger goldfish company when he got depressed after the death of his tank mate. Fred has since passed of dropsy, but Lucy and the other three have thrived for several years now, getting bigger and bigger and causing us to buy at least three new tanks as they grew. When we got Lucy, she was a standard red and white fishie... but a couple of years ago she seemed to lose all the red overnight! She is a perfect pearl white all over, but she has some gold outlining her eyes. Our black and gold is now a white and gold, but the other two have kept their juvenile coloring all these years. Three of the four, including Lucy, have long, beautiful fins and tails - the other has stubby fins and tails and looks like an overgrown countyfair goldfish.

Should I continue the antibiotic food with the PP treatment?

--Roc

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Trinket,

I have now a rather large bottle of Permoxyn, in a 3.85% solution.

Some questions:

1. How do I proceed with the Permoxyn, as the link you provided seems to speak mostly of how to handle the concentrated granules/powder?

There are directions on the bottle for "as a dip for disease treatment" - should I just follow those directions and perform the 30 minute dip? How often should this 30 minute dip be performed? Since the dip will take place in another container, not the hospital tank, is there anything I should or shouldn't do to the tank water itself?

To refresh, I have Stress Coat, Pimafix, Tetracycline, Triple Sulfa, Erythromycin and aquarium salt all readily available (along with standard water treatment chemicals).

2. How do swipe with the peroxide? Seriously. I can soak a cotton ball and get Lucy in a net... then what? Dab the wet cotton ball against the afflicted area? Once, twice? How long do I let her thrash in the net before I put her back in the water?

2a. Should the peroxide wipe take place before or after the PP dip? I would think before as it mentions that peroxide is one of things that will cancel out PP if I understand what I am reading correctly.

Lucy is schedule to get a complete water change today or tomorrow anyway, so now would be the perfect time to perform these treatments.

--Roc

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Hello rocmills -

Trinket will be back on quite soon and will be able to direct the Permoxyn treatment for you, but until she gets back I thought I'd just mention the HP swab.

If it is possible to grasp her and lift her just above the water line for a short moment, I would do this rather than net her; it will be less stressful. The thing to do is to soak a Q-tip in the HP and have it ready to swab as you lift her to the waterline - if you can get two pairs of hands, so much the better - one to hold, the other to swab. I think a soaked cotton ball would hold too much HP and risk running it into the gills and eyes - this must be avoided.

I'll leave the rest to Trinket as I haven't use Permoxyn myself.

Fingers crossed for you.

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Pixiefish,

Thank you!

I had already come to doubt the cotton ball method since I read that one didn't want to get peroxide inside the mouth... considering it is her lips that are being treated, I realized that a soaking cotton ball might be too much. Hubby is going to help me, and our plan is to have one person hold her while the other wields the q-tip.

Is the peroxide treatment something I can do right away, or should it wait until she has freshly cleaned water in her tank? (the water in there now is several days old and going cloudy)

My current plan, awaiting input from Trinket, is to perform the dip described on the bottle - letting the 30 minute soak occur while I am emptying and cleaning the hospital tank. I will move on to treating the tank itself once I am certain I have the proper instructions.

Thank you again for the help, Pixiefish, it is so nice to have finally found a place where people don't say "Why all the fuss? It's only a goldfish!" Sheesh.

--Roc

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Thanks Pixie!

Roc, hold on a few minutes -I have just expalined HP to another poster, hold on I am going to paste the detailed advice in here :)

It's for the tail. Mouth is a little different but I'll add about that, at the end of this.

______________________________________

How to HP a tail fin

Here's how I have done it. Get everything ready first. Pour some HP in to a small container of some sort -just enough to wet a paintbrush- and have this close and ready to apply: a new soft paintbrush,or you can use several earbuds clinched with an elastic band, something new/clean like this. Remove the fish to a LOW if possible clear container but any clean plastic or glass one will do as a quick temporary home. Filled with tank water to just a few inches or so deeper than the fish. Lay a towel on the floor (for splash) and place the container on the floor on the towel. Working on the floor means if the fish should wriggle a lot he won't fall far.

If you can be quick you don't need to sedate the fish. Especially the tail is easiest. Lift the fish out of the water in a way that stresses him least. If you can get just the tail out without a big wriggle and jump- great, if not, hold the fish with wet hands, so that he is just under the surface in your left hand (if you are right handed) allow the ends of the tail to leave the water and quickly apply the brush laden with hp. Wipe it downwards from the top of the tail to the bottom of the tail so most of the liquid goes on the ends. Don't let any get in the fishes gills or eyes (other end so not usually a problem with fin coating). Put him back in the container and then quickly return him to his home where he will be in salt and able to de-stress. Any drips/spills will be left in the container.

Some people dab the fins dry and add an antibiotic ointment like biobandage to seal. But you can use the HP on its own to good effect. It will have killed all the bacteria on contact.

__________________________________________________

_

For the mouth, you will be able to, as Pixie says, just lift the fish to the surface of the water to swipe the HP. The fishes mouth will automatically open so you need to be very careful not to get HP/iodine in it. Get a clip light fixed so you can see well. Have your hubby pass the QTip and carfully disinfect with dabs rather than swipe, just as you would a small wound on yourself. Make sure NO HP dribbles in the gills or eyes. A tiny drip in the mouth will not kill the fish but of course is best avoided.

If you feel you cannot do this, never mind. The PP dip as directed on the bottle will also do the same job. It was really to help matters before the PP arrived. Since you have the PP and if you can do that soon (and then place the fish back in clean low 0.1% salted water) this will be enough perhaps. If not, you could do the HP later on....after the dip...

Do you know how to salt? There is a link in my sig to explain it if not. Otherwise you look to be on track for Lucy's healing :)

Keep us posted!

Edited by Trinket

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Trinket,

Just read your HP post in that other thread; so if you read this in time, there is no need to repost for that question.

--Roc

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Trinket,

If there is no need to do the peroxide trick, I'd rather not so as to save Lucy the stress (though all four of our goldfish seem to enjoy being petted).

I will do as I stated in previous post, then; wait until I do the complete water change in the morning and allow her to sit in the dip bucket while I clean the hospital tank.

Oh, and is the dip to replace the direct-tank treatment? How often should the dip be repeated?

I have probably been under-salting, as putting salt into a freshwater tank has always seemed somehow wrong to me. I read the directions in the link you gave me and will salt the clean tank accordingly before I put Lucy back in.

Should the rest of the meds and treatments I have go back on the shelf, or should I continue with the antibiotic powders? Should I keep feeding her the antibiotic food or let her go back to her crisps? I think the medicated food is what originally halted the progression of decay when she started getting worse last month - so if it doesn't conflict with the Permoxyn, I'd like to keep giving it to her.

Again, I cannot thank you enough for taking the time and trouble to help with our little crisis.

--Roc

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Its important to complete antibiotic courses. It sounded to me that the erythromycin was well completed, did you add any other antibiotics to the water? Yes you can continue with the med food course and should but only for the prescribed course.

After that you will need to focus on vitamin C in case there are hexamita involved here. These parasite/bacteria will gorge on the decaying mouth making holes and increasing vit C really helps control them because they live in the intestines where good gut flora help keep their numbers at safe levels. Unfortunately antibiotics deplete good gut flora radically so after use of antibiotics we have hexamita coming through externally and these secondary issues.

You cannot feed any other food except the antibiotic food (which one do you have ...Medikoi?) or the fish especially a large fish like this will not get enough of the dose inside. As soon as the course is finished try peas, brocolli, orange etc to try and increase vit C. intake.

Yes the dip will replace the tank treatment. If you do a FULL water change this will be fine I think. The main thing is to kill whats on teh fish, and then focus on her re-building her immunity (in good water) to fight any stragglers.

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Trinket,

Technically, I am between "courses" of antibiotic powder treatment. Was considering starting in with tetracycline as it seems to be good for general open wounds, which Lucy definitely has.

Should I go ahead and start the tc or just go with the dip and the clean, salted water?

What about the Pimafix? Should I bother?

Assuming that Lucy doesn't show improvement in a few days, do I repeat the dip? How often, how many times, etc.?

I have instructed my husband to stop giving her crisps and only feed the medicated food... I'm not at home right now, or I would tell you the name of medicated food... but I do know they are tiny pellets with e'mycin. We have fed an entire small bottle of this food so far, and just started a new bottle this morning. At what point should we introduce peas, etc. to the diet? And should the veggies be in addition to the medicated food, or instead of the medicated food?

--Roc

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Trinket,

Technically, I am between "courses" of antibiotic powder treatment. Was considering starting in with tetracycline as it seems to be good for general open wounds, which Lucy definitely has.

Does Lucy have any other open wounds apart from the mouth problems we can see so well in the pic?

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Should I go ahead and start the tc or just go with the dip and the clean, salted water?

What about the Pimafix? Should I bother?

Assuming that Lucy doesn't show improvement in a few days, do I repeat the dip? How often, how many times, etc.?

I have instructed my husband to stop giving her crisps and only feed the medicated food... I'm not at home right now, or I would tell you the name of medicated food... but I do know they are tiny pellets with e'mycin. We have fed an entire small bottle of this food so far, and just started a new bottle this morning. At what point should we introduce peas, etc. to the diet? And should the veggies be in addition to the medicated food, or instead of the medicated food?

--Roc

If its just the mouth problems I would do the PP dip once (you can repeat once with a recovery interval of a few days between). I would not add pimafix its for very minor scrapes and is oily which can build up in the water. Salt is better right now. 0.2%.

Don't add any more antibiotics for now. If you add too many things its impossible to see which treatment is working and you need to know this so that you can choose the best next step most appropriately. I don't know which brand medicated food you have there. That would be good to know.

It sounds like a lot of medicated food. Usually one month is max. If the antibiotics are correctly assigned they should work long before that.

The veggies can be fed alongside the regular crisps when the med course is finished.

Any more Qs fire away!

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The medicated food is "Anti-bacterial medicated fish food for internal and external bacterial infections" by Jungle. It was recommended by a guy at the pet store.

No, Lucy does not have any other wounds, sores, or signs of illness except for what you see in the photo of her mouth.

Am about to do the dip and water change. Will treat the new water with standard water treatment chems, add the .2 salt, filter with no carbon... or can the carbon be added back now that we are not putting meds in the water?

Will stop feeding the medicated food and return her to crisps and some veggies starting today if you think that is best for the time being. We just finished a jar of the medicated food, and she has been on it for a while... so we'll see what happens with just regular food and the veggies.

--Roc

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The dip went well. At first, Lucy just floated there and I worried she was in some sort of shock, but after watching her for a couple of minutes, she started to move around the bucket and seemed fine so I put a towel over the bucket and moved on to cleaning the hospital tank and doing a complete water change. Used standard water conditioner on the new water, .2% salt, and some Stress Coat. Let Lucy soak in the dip for the recommended 30 minutes then placed her back in tank with filter and air stone.

When I first put her back in the tank, she seemed to be gasping a bit... gills flaring out much wider than usual. Again, this behavior stopped after a couple of minutes. Fed crisps which she eat heartily. Will pick up some peas, broc and an orange when I go grocery shopping this evening. What is the recommended "dosage" for feeding these? How many peas? How much broc? A single slice of orange? All at once, alternating, with or without regular food?

I guess now it's a waiting game... I will observe for at least three days before taking further action.

Testing of the water produces the following results:

General Hardness: 180

Carbonate Hardness: 180

pH: 8

Nitrite: 0

Nitrate: 40-80 (i would say color is closer to 40)

Will purchase amonia test strips and neutralizer in the next couple of days.

--Roc

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My tank thread reminded me that I have a drop test kit which includes ammonia... our general tank tests at 0 for ammonia, our tap water tests at .25 for ammonia... have not yet tested the hospital tank.

Oh, and I did the photobucket thing; edited and uploaded 30 pix of our fishies. Where is the appropriate place to post photos? (not all 30, obviously)

-Roc

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Can't seem to make the edit function work...

Hospital tank test out a 0 (zero) for ammonia.

Will test daily for the next week to see how the levels change all around.

--Roc

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How does Lucy's mouth look now roc? You can paste a link in a post by dragging the IMG link from photobucket.com or photo host site.

Or you can start a new thread in goldfish photos forum.

Water looks good in the tank. Keep the ammonia and nitrites at zero so she can heal up. Veggies can be clipped in on plastic suction clips and left about a day for her to nibble on. Orange and acidic things should be moved as soon as she loses interest but lettuce, brocolli, cucumber you can leave in usually longer without upsetting water readings.

brocolli- just a small florret piece zapped for 30 secs in the microwave to soften, an inch or so in size. One slice of orange. A chunk of cucumber. 2 skinned soft boiled peas etc. Try one of these a day, plus her regular crisps at a different time, and you'll soon find her favorite :)

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Trinket,

Hard to tell if there is any difference in Lucy's mouth yet. It isn't worse, which is a good thing... and I think maybe I am seeing the fishie equivalent of scabbing around the lips; tiny bits of dead, white flesh falling off. She's moving around the tank more, but I don't know if I should interpret that as a good thing or a bad thing.

She did not take to the broccoli or orange bits at all and I removed them from the tank this evening. What worries me is that I don't see obvious signs that she has gone back to eating... I knew she was eating before because there were plenty of poopies in the water. Today only one bit of poopie.

Did a 1/3 water change this evening, added some ammonia detox and extra Stress Coat just for good measure.

I'm thinking another PP dip tomorrow, and then the tetracycline on Thursday... I know the PP is supposed to kill whatever little nasties may be infecting her, but there is still the open wounds on the lips that I worry about and I think the tetracycline is supposed to help with open wounds.

And I made a thread for myself in the pictures section, probably got a bit carried away with all the photos.... ;-)

--Roc

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Okay well that sounds like a plan. Tetracyline is the antibiotic recommended for many columnaris stran mouth infections. I don't think I would subject her to another PP dip in fact. I would get going with the tetracyline soon if you have it.

Remember with antibiotic meds -and this is every important and critical to their success- Do not under dose and do not over dose.

The two big rules with those. Sorry she didn't like the foods. What about extra peas then..she eats those I'm sure.

More pics? I'll have to go check your photo gallery thread :D !!

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The grocery store didn't have any fresh peas... would frozen or canned be acceptable?

Lucy got her first tetracycline dose this morning, am following the instructions on the package. I only use API meds.

I am worried, though. She got her PP dip on Sunday, and while she was in the dip I emptied, cleaned, and refilled her tank (and if you think it was easy to do all that in under 30 minutes, you are mistaken!)... what worries me is that it is now Wednesday and I see no signs of poop in the tank and much more uneaten food at the bottom of the tank. If there are still no poops by morning, I will offer some of the medicated food again as she seemed to like that. I know it isn't good to mix meds... how long can she go without eating?

--Roc

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So sorry about your fish, Lucy. I do hope she gets better! It sounds like quite an ordeal you're going through.

I can answer one question - I use frozen peas and my fish love them more than any other vegetable - cooked and with the outer skin removed, as it says on this site.

All the best of luck with her.

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Lucy still isn't eating. She's more lethargic with the occasional mad burst of activity that looks like someone scared her for a second or something. I'm getting more and more worried. Don't know what to do or try next.

--Roc

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