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Treating hole in the head

5683 Views 22 Replies 4 Participants Last post by  Blue angel
I have an angelfish developing what looks like hole in the head. Some tankmates have white stringy poo. I have hex-out which I've never used and can't find info on. It mentions it can damage biological filtration and I'm scared to use it. I suspect the fish could have hexmitia which is why I picked up a med with metro in it. Has anyone used hex-out? Any problems with your tank after using it? Also if there are better suggestion for a med I'll grab it today. I want to start a treatment soon so the fish recover. Some fish have lost their appetite over the past week the angelfish started showing symptoms two days ago. This is a 55gallon, moderatly planted tank. Also went through a three day power outage and had aerobic conditions due to a lily bulb that got buried and rotted. Finally don't have fart bubbles coming out of the gravel. Please help.
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should be a big help to understanding things here in this link

good luck with your fish
I looked at the link. Are you talking about the image of the fish? My angel has what looks like a flat blister. It's not leaking but it's like a clear pit/hole on one side of his face. I've had him since October and he was full grown when I got him. This looks like HITH.
Hole in the head is caused by poor water quality and can never be fixed and there is no real cure for it you can only help to improve/reduce it.

Keep the water quality at it's best and vary the diet from time to time, live food for example now and again will help keep fish in good condition along with good water quality.
Metronidazole and heat is the best known treatment with Cichlids.
Angels can easily tolerate temps into the 90's.
I raised the temperature to 96°F and kept it there for 14 day's while feeding medicated flake. Treating the water with metro kills the bio so food is a much better option.
Several things are lumped into HTH and while poor diet and bad water conditions may stress fish flagellate protozoans and bacteria are whats treated.
I challenge conditions or diet triggering the two I dealt with but that's another debate.

AngelsPlus sells medicated food of good quality.
Thanks for the advise. I picked up a lot of different things that I've heard appeal to fish with poor appetite. Freeze dried: Blood worm, brine shrimp, and a package of mixed shrimp. Also picked up a flake that's veggie concentrated since somewhere I read veggie based food can move internal parasites from the intestines.
The food I normally use are: tropical flakes and a salmon based flake, shrimp pellets, carnivore pellets, and algea wafers.
I don't want to over feed, so should I rotate the various foods daily? My normal feeding is morning and night. 2 feedings a day mixed flakes, 2 carnivore pellets 2 algae wafers and 5-7 shrimp pellets. Feeding angels, cories, bumblebee catfish, bristlenose, discus.
Should I try to medicate as well? I also picked up API general cure which also has metro. Either or neither?
You are going to have to self educate and understand what is involved and decide which course of treatment you can best follow.
Steve's site AngelsPlus is owned by someone with over 30yrs breeding experience and he has many articles on his site explaining what and why.
The link I provided is to an angelfish breeder site and that thread is helping / guiding a new member to information dealing with HTH conditions that appeared right after receiving new fish. My post in that thread links to another thread and information from yet another long time handler and breeder of quality angels. Rather than relying on my limited experiences with it to guide you into folly reading for yourself would be a much better option in my opinion is why I posted the link. Proper treatment requires understanding what is involved.

again wishing you luck with the fish.
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I'm still working through the links. I actually enjoy reading up on fish, learned about HITH before I ever had it in my tank. I'm trying to consider all aspects. Water quality is always my first move when anything goes wrong. Doing an extra change tonight before I decide to medicate. I do weekly changes 30-50% and this puts me right in the middle of that schedule.
I'm having a hard time finding reviews/experiences with hex-out specifically. I found a lot of people praising API general cure. I don't usually medicate unless there is a need.
I'm curious will items or inhabitants in the tank be able to spread HITH? Or is it just nutrition and water quality based?
Yes I have rescue fish with HITH and they are 100% better now.
When I got them


All I did was kept them in a hospital tank. Feed them well kept the water extra clean 50% wc 2 times a week. I got some fish vitimines that I added to the water. clean water and good food these uarus are plant eatting fish so I made sure they got greens. Keeping fish away from stress and in clean water can be enough to fix it.

I used some medicated food too just for a little bit. I doing think it helped much. Metro powder is good to use wih blood worms. I would Soak the worms in the metro then feed.
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My temp is 82 and my thermometer goes to 86. Would 85 do anything or should I pick up a better thermometer? And go for the higher temp?
I appreciate any and all suggestions and I know I can be long winded. I hope I dont come off as anything but grateful for help.
I finished the links and read a few similar posts.
So I'm giving myself an hour to psyc myself up and trying to be positive. My plan is to bump my temp gradually to the max my thermometer will give me a reading. ( maybe pick up a new one and raise the temp higher over the next day) water changes every other day(unless that's excessive) and api general cure with the hopes of whatever recycle happens the water changes help. I couldn't find medicated flakes but considered crushing or dissolving the meds and mixing with food for a more aggressive approach. I don't know if that would be good or risky. *got the idea from winning a battle against camalanus worms, (long story first month the tank was running when I set up last year) if I can beat that I'm hoping this will be painless. Knock on pressed wood fish tank.
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Bull **** it can be fixed fish can make a full recovery. My uarus when I got them were almost a year old now they are 2 years old and have NEVER had HitH since I nursed them to health.

Hole in the head is caused by poor water quality and can never be fixed and there is no real cure for it you can only help to improve/reduce it.

Keep the water quality at it's best and vary the diet from time to time, live food for example now and again will help keep fish in good condition along with good water quality.
AngelsPlus med page link
use a traditional oral human thermometer easy access and cheap
Will any of my equipment be contaminated? I was planning on setting up a new tank(totally different group of fish) and was going to fill it with the syphon that attaches to the sink(same one that I've been using for the 55)
Anyone know if API general cure is safe for Amano shrimp and flounder(yet another tank I may treat to be safe since I removed my Platys from the 55 a while ago)
Huzzah! I have a ton of regular thermometers(joys of toddler keeping) never even crossed my mind. Done and done. Note-it will become fish only so don't worry about it getting reused for people. ;)
Do you have photos of the fish? If it looks anything like my Uarus clean water and a hospital tank is all you need. What are the other tank mates? Are any fish picking on him? Stress will not help.
I'm not sure how to add pictures. Can I do it from my phone? If you can tell me how to post them I'll get some in the morning. Lights are already off and I don't want to surprise him. He's been the dominant fish since I got him although the largest discus is claiming his favorite places in the tank. The discus are the newest members of the tank (one five inch and one four inch) they have been in there for two weeks. They didn't get quarantined due to their size so I might be paying for it now. They are also cleaning flat surfaces and chasing off the other angels. If they are planning on spawning I'm going to have one heck of a fish give away party!
The hole looks similar to the kidney shaped hole on one of the fish, but it's got a clear layer over it. Like the last layer of skin before it melts away. I went for the general cure, tried the better food, small samples of each thing I picked up like a fish buffet. I have to wait on the water change. My daughter insisted on sleeping in mommy/daddy's bed so thats next. My last wc was three days ago and all test came back right amm 0 nitrite 0 nitrate test needs replaced so pet store trip tomorrow, ph 7 gh kh med hard. Fingers crossed.
Yup sounds like you have a very stressful tank. when ever cichlids spawn they putnlots of stress on take mates. What size is it? Stress will make HITH worst that's why I say get a hospital tank. I never found HITH to be contagious unless the water quality was poor then many fish will get it. But besides the Uarus I posted photos of I rescued a Geo That had the start of HITH from a pet store all he needed was go get out of the over crowded tank and into some good clean water with propper food. With the Uarus was a buffalo head cichlids that I still have and has made a full recovery.

My buffalo head cichlids rescued with the Uarus from the same tank was in really bad shape.
when I got him he looked a little worst then this. These fish was rescued off Craigslist.

I took this photo a few months ago. She tail will never be the same.

To up load photos:
Open up a photo bucket account and upload photos to that then cut and paste the image link here. I have a photo bucket App for my iPhone so it really easy.

Do have a 10 gal tank to set up as a hospital tank?

You say your nitrates are at 0 ? How old is the tank? Your tank should have some nitrates. Do the water test right before you are going to do the WC not right after. then see what it says.
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Well Snowflake you are the first person I know of that has cured HITH, I have never had any fish with it personally but from everything I have heard and seen ( mainly big Oscar's ) I was of the opinion it could not be cured.

I stand corrected.
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