HITH - Hole in the Head Disease

This disease is arguably one of the most common ailments that Oscars develop. Hole in the head disease strikes fear into any Oscar owner because it can be fatal for Oscars if not treated properly. The disease itself can cause horrible lesions and holes on your Oscars head and body. This alone makes hole in the head disease particularly nasty.

Hole in the Head Disease is relatively easy to diagnose. In its very early stages you may notice one or two small holes appearing on the fish's head. Often the holes are very symmetrical, almost as if somebody has stuck a dart into the Oscars skin. If left these holes will gradually get bigger and grow in number. Holes and lesions may spread to the mouth area, around the gills and eyes. In severe cases the lateral line may start eroding. Once the condition becomes very bad, you may notice stringy mucus trailing from the wounds, people often mistake these for worms. The fish may well go off its food and develop a hollow bellied appearance.

Hole in the Head Disease is curable, but more importantly it is perfectly preventable. Regular tank maintenance, i.e. water changes, removing solid debris from the tank and filtration system will help keep the water in good condition. Good water conditions are the key to preventing the Hole in the Head Disease in Oscar Fish. You mustn't let your ammonia and nitrite exceed 0 ppm for any length of time. It is inevitable that you may get ammonia and nitrite spikes from time to time, as long as these small hicks ups are not a common occurrence and do not lost a long time, your fish shouldn't suffer any long-standing damage. However, prolonged exposure to these toxins could cause serious harm to your fish and trigger Hole in the Head Disease.

If your fish does develop Hole in the Head Disease then act quickly by first carrying out a water test. If your fish has got this disease then the chances are it is your water conditions that are causing the problem, it is extremely uncommon for fish to develop this disease for no reason. If you discover that you have indeed got poor water conditions then you must act accordingly by carrying out a large water change to remove as much of the toxin as possible. You may also be wise to get a product called "Prime". This product not only removes chlorine, but also detoxifies ammonia and nitrite. Cap you will still get a reading of ammonia and nitrite when you carry out a water test, but it will not be a toxic form. Carry out water changes until your ammonia and/or nitrite are back to zero and stay like that.

Nitrate is a byproduct of ammonia and nitrite. Whereas it is no where near as toxic as ammonia or nitrite, it must be kept as low as possible. Very high levels of nitrate will cause stress to your fish which in turn can bring on disease and illness such as Hole in the Head Disease. We do not recommend letting your nitrate exceed 40 ppm. Regular water changes will help keep nitrate levels low.

Early stages of Hole in the Head Disease can be cured by simply increasing your tank maintenance and water changes, making sure that there are no toxins present, and your nitrate is always low. Severe cases of hole in the head disease may need intervention from medication. One of the most recognized treatments for Hole in the Head is a medication called Metronidazole. Metronidazole comes in tablets and powder form, and is also part of the ingredients of some medication.

Treating using Metronidazole

On advice from the Fish Helpline with regards to the diagnosis of hexamita, I contacted my local vet to obtain the necessary medication, metronidazole. After consultation, this was prescribed in tablet form 200mg per tablet. The ratio of medication to food was calculated by the vet at 1-1/4 tablets to 100grams of food. I weighed out 100 grams of dried pellets food and then crushed this using a mortar and pestle to fine powder. I then crushed the 1/1/4 tablets and mixed thoroughly with the crushed food. To bind the food back together so that I could feed the fish I used gelatin, as advised by the vet. The gelatin was obtained from local supermarket. I mixed the gelatin into hot water as per instructions given on the packet using approximately half the sachet per 100gms of fish food - this was a bit hit and miss until I found the correct consistency to bind the food. The gelatin was added to the crushed food and mixed thoroughly until all the liquid was absorbed, and the consistency was like firm paste. This was then rolled by hand into large pellets approximately 15mm in diameter. These pellets were then cut using a sharp knife into smaller segments (the size of normal food) 6mm. I found it easier to do this than try to make small pellets initially. The pellets were then allowed to set for approximately 30mins or until cold. Tthe food was then fed individually to each fish. The food should be fed at 1% of fishes body weight daily for 7 days to all fish, however this I found was very impractical. Please note that once the food has been broken down and reconstituted with gelatin it does not float."

This information was obtained from http://www.koidoctor.co.uk

With kind permission from my client Mr. N I Rice.

If you are in the UK then there is a product called Octozin. This medication comes in tablet form and you treat your tank over a number of days. I can't really give you any kind of guarantee that this medication will work, but it's always worth trying.

A Healthy Diet

I think it goes without saying that a healthy diet is very important when you keep the Oscar fish. Feeding your fish on a poor diet is thought to contribute to hole in the head disease. The best advice I can give you is to not give your fish goldfish that you have purchased from the fish store, these often contain parasites and disease which will not do your Oscar any good whatsoever. If you really want to give your fish live food then always quarantine the feeder fish for enough time so as to determine that they are healthy. Having said this, I don't believe that feeder fish contain that many good nutrients anyway so I would actually advise feeding other types of food which contain a lot more goodness. Good quality pellets are always in my cupboard, Tetra Dorimin & Hikari are two types of pellets I would highly recommend. Also, blood worm is a good healthy food that any fish will gladly accept. A healthy live food supplement I would also highly recommend would be mealworms, garden worms, and crickets, all of these will contain nutrients that will be good for your fish.

Vitamins

Most good quality fish foods contain all of the vitamins that your fish require. However, it wouldn't hurt to give them a few extra vitamins whilst you are treating them. With some vitamins you can add a few drops to the aquarium water every day, or if you want to make sure that the fish are getting the vitamins, try soaking the food in some liquid vitamin. You can soak various foods such as blood worm, meal worms, pellets and probably even worms. How much difference extra vitamins will make is something I cannot answer, but it is certainly not going to do your fish any harm.

Unfortunately, due to the fact that many people do not keep Oscars in the correct environment, hole in the head disease is all too common and we often get people seeking help on the forums. Oscar Fish can get quite big, they produce lots of waste and create large amounts of ammonia. If you do not provide them with the correct living conditions, i.e. a large aquarium, a healthy diet and plenty of filtration, it is inevitable that you will be putting your fish at great risk from developing not only hole in the head disease, but many other disease and illnesses as well.

Sensory Pits, Don't Panic

I think it's worth mentioning an Oscars "sensory pits". Lots of people suddenly notice tiny little pinprick holes when they are observing their Oscar close up, or when they are looking at a photograph that has been taken using the flash.  They then start panicking  because they think their Oscar is developing hole in the head disease. Worry not, these are sensory pits and are totally normal, they should not be confused with hole in the head disease. The excellent photograph above provided by Rafel, one of our members  clearly shows lots of pinprick holes arranged in circles, these are the sensory pits.