View Full Version : Important, must read, HITH

11-30-2006, 02:04 AM
Let me know what you guys think. Ask any questions if you get them.

Hole in the Head:

Hole in the head (HITH), also called head and lateral line erosion depending on the symptoms displayed, is very tricky and not as understood as it should be in my opinion. It is one of the most complex conditions commonly encountered in the aquarium hobby. Whereas most diseases are straightforward (if your fish looks salted, it has ick) and have commonly accepted treatments (for most with ick: use Quick Cure or the like, raise temp, add salt, etc.), HITH is one of the most controversial conditions as far as cause and treatment go. I had been lucky enough to rarely encounter it in my years of fishkeeping, but recently have had a few cases of it threaten a handful of my fish. In order to attempt a treatment on this condition, I started researching as much as I could. During this research I came across many sources and almost all of them had completely different approaches and subscribed to many different lines of thought. From what I have gathered HITH goes something like this:

A protozoan parasite, Hexamita spp., is present in many fish, especially cichlids. Under adverse conditions (low water quality, poor diet, etc.) the fish is under stress, and the Hexamita gets a stronger hold on the animal than usual, allowing it to spread and take over. The observable signs of Hexamita are in the form of Hole in the Head (HITH) or Head and Lateral Line Erosion (HLLE). The holes are eroded tissue away and center around the lateral line system, especially the many pores on the face. Different species will display it in different ways, some only having pits on the face, others having the erosion all along the length of the lateral line system. There are also different forms of the appearance of the holes themselves. The holes can be narrow but deep and may include a stringy discharge from the middle, other times the hole may de shallow but very wide. This article focuses on HITH in freshwater fishes. Prevention is always the best treatment.

For prevention:

A high quality diet including Hikari Cichlid Bio-gold+ is important. I mention Hikari Cichlid Bio-gold+ specifically because it is the only fish food on the market that contains live beneficial bacteria. These beneficial digestive bacteria actually out-compete the Hexamita for its niche in the digestive system. In addition, Hikari Cichlid Bio-gold+ is a very high quality food, helping to prevent the poor diet issue. I would also highly encourage feeding New Life Spectrum (NLS). It is expensive, but worth it. Between the NLS and the Hikari food you should have no issues with diet. Important for the diet are foods that include an assortment of trace/micro nutrients. They should list off a lot of weird sounding names in the ingredients, many times including what the nutrient is with a common name. For example: D-activated animal sterol (vitamin D).

The other half of prevention is water quality. This requires massive filtration and big frequent water changes. In general whatever a filter claims it can handle "up to", cut that in half and that is about what it can actually handle. However, this is only for moderately stocked community type tanks in my opinion, so cichlid and other high waste tanks will need even more filtration. My 14-15" jaguar cichlid is in a 75 with a Fluval 405 ("up to" 100 gallons), and two Whisper 60s ("up to" 60 gallons each). Water changes on big cichlid tanks need to be big and frequent. I keep all my tanks on this routine with a 75% water change every week. This will not harm your biological filtration at all, and it will only have benefits. If you are concerned about this water change schedule, please ask me about it and I can provide an article on water changes. This water change schedule will keep nitrates, phosphates, dissolved organic compounds, and many other harmful substances to a minimum, allowing for less stress on the fish and much higher water quality.

Another likely contributor to HITH/HLLE is a lack of trace elements in the water. This can be considered as part of diet, but needs its own mentioning. Trace elements are important for any animal and without them you can end up with an assortment of problems. It is believed that in this case it works similarly to diet. If there are not enough trace elements then the body doesn’t function quite properly, leading to stress on the organism and its organ systems. This allows the Hexamita to get a start. There are a number of ways to help prevent and treat this issue. First is to do the large frequent water changes. This brings in a lot of trace elements into the tank. The second is to use available additives if appropriate for your fish. For example: If you have a Central American cichlid, use a 'salt' or trace element supplement made for Central American cichlids. And lastly it is important to keep the trace elements in the system. This means no carbon in the filters. The carbon doesn't care if you consider the chemical to be good or bad, it will remove it. I have stopped using carbon and so far there is no discoloration, odor, or other ill effects (I believe due to the large frequent water changes).

For treatment:

If HITH/HLLE is already present, go by the guidelines previously described and treat with metronidazole. This medication kills the Hexamita. Hikari (under the label name 'Aquarium Solutions') now has Metro+. It is a new medication that you can use to soak food in, treat the whole tank, or use as a dip. It contains metronidazole. Metronidazole is believed to be the only effective medication on Hexamita. Jungle’s Hole-N-Head Guard also includes metronidazole. Follow the directions on the label.

11-30-2006, 03:41 AM
This is very informative. Thank you for bringing this to our attention.

11-30-2006, 03:43 AM
Anything to help everyone take better care of their fish.

11-30-2006, 04:02 AM
Yes, a very informative article...but it does raise the question for me after reading this one and the one you wrote on the large water changes. I have heard you say you feed the hikari and such you recommend, so I know that, I have read you do 50-75% water changes.....in short, all of what you recommended to keep a healthy tank and avoid issues, you do. According to the HITH article....

"A protozoan parasite, Hexamita spp., is present in many fish, especially cichlids. Under adverse conditions (low water quality, poor diet, etc.) the fish is under stress, and the Hexamita gets a stronger hold on the animal than usual, allowing it to spread and take over."

thus, one would have to figure as long as you keep excellent water quality, feed a high quality diet, the fish are not stressed and should not be susceptible to HITH but you stated....

"I had been lucky enough to rarely encounter it in my years of fishkeeping, but recently have had a few cases of it threaten a handful of my fish."

Did you find some other reason for your fish to have been threatened by this disease that terrorizes the cichlids? Or is it just one of those unexplainable "flukes" of nature that you ended up having to deal with it even though you have been doing all of the recommended things with great success and feel that your tanks are doing much better than previously? Please don't feel like I am attacking you or trying to negate what you have said....hubby is the main cichlid keeper in my house, so I leave that stuff to him, just trying to answer the little guy in my head that is saying "how did this happen to him if he is doing everything as recommended?". It is frustrating for fishkeepers to do everything we hear is right, and still deal with issues. I have faced this trying to keep clown loaches, and still don't have success....one is still alive, but all have made it at least a few months around here....never long term :(

11-30-2006, 12:59 PM
That is the headache I went through. "He never got live, I do the water changes, he's got a good diet, etc." The only thing is I always used carbon. I don;t knwo how much I blame that, but it may have contributed to it. The other thing is that this is not a set number of all the causes. This is what I came up with after talking with everyone I could on the subject. There may be more reasons. I didn't always feed just Hikari Bio-Gold+ and NLS. HITH is a very complex condition and I think we still have a ways to go. This just seems to be about the most we have gotten to so far.

On a side note, African cichlids seem to have almost no appearance of the condition. The reasons are unknown, but I have never had anyone come on to a forum or anything saying their africans had it, same goes for people coming into my work. However in the books I read it did make it sound possible, but it is extremely rare. However this does not mean to not follow the good care desribed here, it will still help them thrive and avoid other issues.

11-30-2006, 02:02 PM
That must have been very frustrating for you dealing with the HITH....luckily we haven't had any issues with the oscars since getting rid of the texas cichlid. They have scrapped with each other at various times in their lives and we think it was a "who is going to be the boss" when they were hitting different levels of maturing because most of the time they are great buddies. I hope your HITH issues have been resolved and thank you for taking the time to research and share your findings with us. Might want to see about having William put that in as an article for reference so that it is always available without having to search it up off the forum.

Lady Hobbs
11-30-2006, 04:59 PM
I've been reading Quick Cure has been pretty effective in treating HIIH. Sure hope something good is found soon as it can be a pain to cure.

12-01-2006, 02:06 AM
I don't see how Quick Cure would be of much help. There are so many things out there that seem to be unfounded or coincidental. I am currently treating my jaguar cichlid with the Metro+, and will soon do the same with my Synodontis eupterus and sun cat that are also inflicted.