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Discussion Starter #1
For a few months now my largest angel has been exhibiting what looks like ulcers on her face. They have been symmetrical in size and location on each side of the head like they were nostril openings or something along those lines so I haven’t been concerned. Recently she has been losing patches of scales and the ulcerations seems to be opening up more. Other than the outward appearance she has been acting completely normal, eating daily, and even breeding a few time. I can’t be sure when I first noticed the lesions but a guess would be 4-6 months ago so if this is some kind of illness it is progressing incredibly slow. My best guess is some kind of hole in the head disease but seems unlikely due to how long she’s been like this and that none of the other fish are exhibiting symptoms.



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The spots on the head do look like hole in head disease but the ones on the body I'm not sure.

Can you post your water test results for ammonia, nitrite, nitrate, pH, KH and GH?

Water change frequency and percentage changed?

Are you running CO2? What if any are you dosing for fertilizers?
 

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Discussion Starter #4 (Edited by Moderator)
I forgot to put water parameters.
90 gallon planted.
2 adult angels 4 sub-adults
2 pearl gourami and and an opaline.
4 pleco from 2-3 inches
5 Siamese algae eaters
1 black ghost knife 10”
Temp-78
Ph-6.8
Gh-4
Kh-6/7
Ammonia-0
Nitrite-0
Nitrates- I try to keep under 20


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The spots on the head do look like hole in head disease but the ones on the body I'm not sure.

Can you post your water test results for ammonia, nitrite, nitrate, pH, KH and GH?

Water change frequency and percentage changed?

Are you running CO2? What if any are you dosing for fertilizers?

I’m doing 25% water change every Monday.
Yes there is co2 and I don’t have a fertilizer regiment I just use the bare minimum here and there when I notice the plants stunting


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That is caused from Hexamita (aka Hole in the Head). A healthy fish can fend this off for a long time but they will eventually succumb if not treated. Treat with metronidazole as recommended in last post.
 

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Discussion Starter #7
Thank you for the insight everyone. I ordered seachem metroplex and focus and will be mixing it in their food. I will update with any developments.


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Update: it’s been 2 weeks since beginning of medication with metroplex/focus mixed with bloodworms (only thing she will eat with the medication) and the ulcerations on her head seem to have gotten slightly worse or at least they haven’t improved. I’m starting to wonder if maybe this isn’t hole in the head or if it is why isn’t the medication working?


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If the metronidazole itself is not correcting the issue, this means there is a secondary bacterial issue also going on. This is common. Many times with internal parasite conditions, the fishes immune system will be lowered and they will get a secondary bacterial infection from the parasite itself. I would recommend treating with kanamycin (active ingredient in Seachem Kanaplex).
Kanamycin will take care of any internal bacterial infection as well as the external secondary bacteria from ulcers brought on by the Hexamita.
 
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