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Old 05-30-2013, 02:10 PM   #1 
akhan
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Very unique, difficult to solve, complicated condition with my precious Betta. HELP!

I've had JB, a crowntail male betta fish, now for around 1 year. He's in a 1.5 gal filtered and aerated tank normally, and sometimes I might put him in a smaller treatment tank that holds probably a liter. If in the small tank, I'll rinse it out and give him a one hundred percent water change every two days, and do a partial water change, almost 75% everyday to get the uneaten food and the feces out. If in the big tank, I'll do partial water changes everyday, usually between 25% and 50%. I'll rinse out the tank and do a one hundred percent water change every week or every two weeks. His water conditions are all great and normal, as the vet said. I feed him betta buffet flakes (3 or 4 small ones) and as many pellets as he'll eat once each morning. Sometimes I'll give him a treat of bloodworms, mysis, or daphnia. I've been trying to figure out a solution to the problem or condition he's had since this past September, and I would appreciate any insight since he means so much to me. I want him to be in the best condition he can be, and I've listened to so much advice and taken so much advice, and sometimes it can get quite overwhelming. The worst is when people say or think why are you doing so much for a fish? It's so unappreciative of such a beautiful and intelligent animal, that I've truly formed a strong attachment too. I think every creature's life should be given the sort of importance we'd want. It's important to me to try all I can that is within my means of arranging to make him better; it's what I endeavor to always do, and I think you all might be able to understand and perhaps appreciate that.

I started to notice his tail and fin tips getting shorter in the summer. Sometimes his tail tips would bend and I was told that's pretty normal with crowntails. Sometime in September, I noticed a nodule like bump, same color as his tail, forming near the base of his tail. Around maybe October or November he started losing large chunks of tail tissue and the bump grew and began to have a white growth over it that reduced itself and became larger from time to time. I took him with me on a long car trip in November, and after that the opposite side had a black smudge (opposite the side with the white growth). Over time the tail tissue in that region began to disintegrate and shorten and shorten no matter what treatments were provided. This progressed until he was left with a fork-like tail of two stubs, pretty much black. One stub receded all the way down, and but he still has the other stub. He just recently got a big, clean hole in his dorsal fin, and it may have a bit of a small black outer lining. We just recently had him with us on a 4 hours drive so the stress or movement may have caused it, or something else. I just noticed it yesterday and it looks slightly smaller today so maybe it's healing?

When I first noticed the nodule, I tried many different options. I treated with bettafix conservatively. I bought a medication from a fish store named polyguard, using advice from someone there. I tried that but it didn't help. I also tried aquarium salt, and I didn't find that to be of help either. After the tail tissue chunks began to fall out and the white growth appeared, it made me really frustrated in finding a solution so I found an exotic vet specialist who would see fish. I wanted him to be diagnosed and treated right away before more tissue wasted away. A previous fin snip showed Ambiphyra a parasite, and later cytology revealed gram-positive cocci bacteria. The lesion had minimal response to formalin, metronidazole, Panacur, Sulfatrim, amoxicillin, and Baytril. The Ambiphyra resolved after metronidazole. The tail continued to erode after resolution of Ambiphyra. The only other option the vet suggested then was to do a biopsy and send it to a histopath specialist. The report said the following:

All of the submitted tissue consists of sheets of macrophages and melanomacrophages with numerous small elongate gold refractive crystals present, many of which appear to be within the macrophages. The crystals resemble oxalates. There is no microscopic evidence of infection. The cause for the accumulation of crystalline material is uncertain. Is it possible that some crystalline foreign material became embedded in the skin of the fish at this site, stimulating a granulomatous inflammatory response that has continued to enlarge? Examining the environment of this fish is recommended. Oxalate crystals, in particular, can be found in some plants, and if there are live plants in the tank, this may be a source for the material. Unfortunately because there is so much crystalline material within this lesion, the lesion may continue to persist and enlarge unless the entire lesion is removed surgically.

There were live plants in his tank some months ago but those were thrown out. I was unfortunately cleaning his tank with soap in the past so I don't know if residue from that may have been the source of the crystals. I also used attison's betta spa which is brown/golden, has a lot of different ingredients but I don't know if this would be the source.

The only methods of treatment my vet was able to provide from the report was removal of all the tissue with the crystalline material, which is something we are unable to do with my fish; the reasons being because he is so small and also because he has lost basically all tail tissue except for that one stub. So my vet has told me that's an implausible solution. The only other option Dr. Hannon could suggest were anti-inflammatories. But that was also something he advised against since there are many dangerous side effects that could result from short term or long term use of anti-inflammatory products on a fish. And he has no idea what amount would be appropriate to administer to obtain a particular blood concentration, so he's ruled this out as well as a plausible solution or treatment. Is there anything else you can suggest treatment-wise, other than what I have already mentioned? Is there anyway to help him grow back his lost tail tissue?

I also want to try to better understand how this happened- so can you let me know if my theories make sense? The crystalline material became embedded in the tail tissue, creating lesions and activating his immune system. His immune system (as well as secondary infections from bacteria or parasites) caused the necrosis of the tail tissue. His immune system launched an attack on that crystalline embedded region, causing that tissue to die away. The white growth was actually the WBC involved in the immune attack in that tail base region. So the necrosis and dissipation of the tail and white growth were all results of an immune response to the embedded crystalline material?

The only advice Dr. Hannon could provide was to administer an antibiotic to my fish's water one week out of the month just as a prophylactic to prevent any further infections to his current tail lesions. If there is any better advice or treatment suggestions you can provide that could be more of a solution to the problem of crystals embedded in his tissue, I would greatly appreciate it.

Recently he developed a large clean hole in his dorsal fin- maybe from the stress of a long car trip with me? How can I help him heal from that. Unfortunately today he jumped out when I was cleaning his tank and he landed all the way on the floor- it tore his hole a little larger, and I was so worried about any damage he may have faced from the fall but he seems to be active and swimming and acting normally thank goodness. Any suggestions on ways to help him heal and recover from what he's been going through? I've posted here in the past and haven't received much advice or solely criticisms instead of help, so I hope you can understand I'm trying to make my fishy all better and it would mean so much to me to have your support. Thank you!
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Old 05-30-2013, 03:14 PM   #2 
LittleBlueFishlets
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Hi Akhan,

Well, you've definitely tried to determine the cause of this!

I've just contacted two people: Sakura8 and Percyfyshshelley. They may be able to give you some advice.
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Old 05-30-2013, 04:02 PM   #3 
NorthernLights
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Treating this is way out of my league but I wanted to tell you how happy it makes me to see someone trying so hard for their fish. Fish are living creatures; they have a central nervous system, they feel pain, stress, etc. It's really heartwarming to see someone who cares so much!
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Old 05-30-2013, 05:29 PM   #4 
Sakura8
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Hi akhan, LittleBlue asked me to take a look at this thread. Wow. I'm really touched that you've gone to such lengths to care for your fish. Amazing. :) I'm sorry you have not received much help or received criticism in the past. That's not good. I'm glad you have come back to the site.

That said, I'm definitely no veterinarian so I'm not sure if I can be of much help but I'll give you my thoughts, for whatever they're worth.

Your theory definitely makes sense. When fish are attacked by foreign objects like parasites etc, their first reaction is to create excess slime coat to dislodge it. If that fails, the immune system will most likely treat that object as a potential disease and attack it. As long as his immune system stays strong and is not compromised, his body will probably continue to try and fight off its perceived disease. The important part is to keep that immune system as strong as possible.

My first thought is possibly trying to clean the lesion using formalin as a direct application. You could possibly try applying potassium permanganate directly as well but this has a possibility of burning the tissue. I know it can be applied to the eye in cases of cloudy eye.

I'm not sure I would add an antibiotic every month as I feel that's a good way to cause bacteria to build up a resistance. If you did want to try an antibiotic just once, I'd recommend erythromycin or tetracycline as they are both gram positive antibiotics. You may also consider trying Seachem Kanaplex (kanamycin) as well, as it is a broad spectrum antibiotic that has not yet been abused to the point where it's no longer effective.

If you want to try and prevent any further infections, rather than an antibiotic, giving a methylene blue bath once a month may be just as effective and not as potentially harmful. Meth blue is a good disease preventative; any time you see a betta in a cup of blue water, that water has been treated with meth blue. Adding Kordon Fish Protector or Stress Coat while using meth blue wil also cause the polymers to adhere more to the skin so they can attack bacteria and other potential pathogens. Beware: this stuff stains like crazy!

Just offhand, it seems unlikely that his tail will ever grow back completely because it sounds like the tissue has taken a lot of damage and scar tissue alone may prevent regrowth. But as long as we can keep that lesion clean and infection free, that's what matters.

Again, I'm not sure what help I can offer but I will certainly give my support and my best wishes to you and your little guy. :)
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Old 05-30-2013, 08:39 PM   #5 
LittleBlueFishlets
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Quote:
So the necrosis and dissipation of the tail and white growth were all results of an immune response to the embedded crystalline material?
Yes, this is likely the case. Oxalate crystals do cause tissue necrosis.

Have you investigated fungi? Aspergillus is a fungus that causes the formation of oxalate crystals. There are several aquatic species of it.

From an article about Aspergillus within the lungs:

"The presence of calcium oxalate crystals in respiratory tract specimens is another important diagnostic clue to the possibility of Aspergillus lung infection....

Oxalic acid has long been known to be a fermentation by-product of Aspergillus fungi, and the precipitation of calcium oxalate crystals in alkaline tissue environments infected by the fungus is a recognized phenomenon. The crystals are themselves potent agents of tissue destruction, causing extensive necrosis....

Of greatest diagnostic value is the observation of both oxalate crystals and typical fungal elements in a single specimen."
Source: Birefringent Crystals in a Pulmonary Specimen

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One study investigated 360 freshwater fish that had health issues. When the health issues were caused by molds, Aspergillus accounted for 43.0% of the cases!
Source: The Assessment Of Mycotic Settlement Of Freshwater Fishes In Egypt

Another study found that 19 out of 24 black moors (a type of goldfish) were infected with fungal infections. Of these, Aspergillus spp. were the most prevalent fungi found in 14 fishes (58.3% infection).... "The high prevalence of Aspergillus in black moor corresponds to the contaminated aquarium water with this fungus. Maintenance of water quality and feeding in pet shops needs attention to prevent fungal infection."
Source: Some Fungal Pathogens of an Ornamental Fish, Black Moor (Carassius Auratus L.)

Last edited by LittleBlueFishlets; 05-30-2013 at 08:58 PM.
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Old 05-31-2013, 09:37 PM   #6 
percyfyshshelley
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Akhan, wow, JB is sure lucky to have a caretaker like you. I really commend you for all the lengths you've gone to for him!
Gosh, I wish I could add something to help. I'm a vet, but not a fish vet, adm I rely on this forum for fish advice.
Having said that, the theory of the I flam story respon to a foreign material (crystals) makes perch sense to me. If JB were a mammal, I would definately try antiinflammatories, but your vet seems to think that may do more harm than good with a fish. Steroids would be something else I. It consider with a mammal, but I don't think that would work with a fish. Plus, steroids suppress the immune system, which is good and bad. They decrease the oversctive inflammatory response but also increa the chance of infection.
Sakura had some really good suggestions. I, too, would worry about using antibiotics as "pulse" therapy. This is done sometimes but there is controversy about how useful it is.
Does anyone know of any natural, fish-safe antiinflammatories?
Good luck to you. I wish there were some way to get the lesion off of JB.
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Old 05-31-2013, 10:17 PM   #7 
Sakura8
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It's not an anti-inflammatory but another possibility of treatment is usnea.
http://www.americanaquariumproducts....on4.html#usnea

It has supposedly proven to be effective against gram positive bacteria, even mycobacteria, so it could do something against the cocci bacteria that he's dealing with now.
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Old 06-01-2013, 12:48 AM   #8 
LittleBlueFishlets
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I found mention of two anti-inflammatory medications that were used after surgery, along with the dosages of each:
  • Ketoprofen (single injection given after surgery, dosage of 2 mg/kg bodyweight IM)
  • Carboprofen (single injection given after surgery, dosage of 2-4 mg/kg bodyweight IM)
Source: Fundamentals of Ornamental Fish Health, edited by Helen E. Roberts (pages 164 and 191).

(You can access the reference by clicking the link above, then clicking "Search inside this book" (link is on the left side of the screen, just under the image of the book.)

Last edited by LittleBlueFishlets; 06-01-2013 at 12:50 AM.
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Old 06-02-2013, 01:47 PM   #9 
akhan
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I want to say I am so moved and so humbled to see your responses. Your appreciation, your encouragement, support, and everything, it all means so much to me. It's so frustrating to have watched the condition of his beautiful tail disintegrate and to not have a clear solution or path of treatment or action. And the fact that I now have some biopsy results and some idea about what's going on, in addition to your amazing and thoroughly-researched advice, it makes me feel worlds apart from where I was with him before. I don't think a simple thank you is enough!

I've added formalin as a bath, per vet instructions, that was the first treatment I ever gave him for the parasites he had found- that was back in October. I have administered quite a few antibiotics, but those suggestions are helpful. I actually bought kanaplex and was thinking about using it because before the biopsy I actually thought he had mycobacteria since his condition had been so hard to treat. The biopsy had proved otherwise, but for treating future infections I'm glad I have it on hand now. The biopsy was weird in that it was showing as of now there was no proof of infection from any sort of pathogens- no bacteria, no parasites, no anything. Just the oxalate crystals. The methylene blue was a good suggestion as a prophylactic- I think it's in polyguard so I could use that if I need to? I definitely agree about the fact that I don't like the pulse treatment because it could cause bacteria to gain resistance.

The aspergillus research was extremely interesting. I had no idea the fungus can produce oxalate crystals, and it could have likely been a source. In the biopsy or the fin snips from the past, the vet or the histopath specialist never mentioned seeing any fungi structures or spores, but the fact that it could have been in the tank environment or could have led to the presence of the crystals is still a possibility. Really interesting theory.

I had read about that and had been really interested in usnea. How would I purchase it and do you think it would be safe, how much would I administer and how often, and in which form?

The vet had suggested those anti-inflammatory injections but again advised against it because he said the effects of those would only last 1 or 2 days, based on my fish's metabolism, and then they would need to be re-administered again, which seems like a lot of stress. I would have definitely liked to look into this more, but I'm worried about hurting him. :(

Please continue to provide your support and advice. I can't express how much it means to me! He's doing well now, his hole on his dorsal fin all about healed up and he's active and eating normally. He really does mean so much to me, and I'm amazed everyday by him. Let me know what you all think on everything I mentioned, and thank you so much for caring the way you all do about bettas! I'm going to attach a picture of JB from a year ago and one from now that shows the tail damage. I love my little guy <3
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Old 06-02-2013, 02:30 PM   #10 
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