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  1. Default HITH - Metronidazole - What is the dosage rate when treating both food and water?

    0 Not allowed!
    For hole-in-the-head disease, what is the dosage rate when treating BOTH food and water at the same time? In my search results, different sites are giving different numbers. What is the most reasonable/accurate dosage, to wipe out the pathogen without harming fish or breeding superbugs?

    For dosing schedule:
    - Add an amount to food that would put "A" mg of metronidazole into each kg of fish in each feeding, for "B" feedings per day, for "C" days
    - Add an amount to tank that would put "P" mg of metronidazole into each L of water every "Q" days for a total of "R" doses

    Values, source:
    A=25, B=(?), C=(?), P=12, Q=2, R=3
    A=25, B=(?), C=1~3, P=6.6~25, Q=1~2, R=3
    A=50, B=(?), C=5, P=5, Q=2, R=3

    Quote Originally Posted by BIO-Linist View Post
    -This is HITH again isn't it? Battled it 4 years ago (see original thread here: ), the scars never completely healed and looks like they're spreading again.
    I'd blame injury and stress from the move which allowed the pathogens an opportunity.

    Parameters as last tested:
    NH3/4+: 0 (9/9/13)
    NO2-: 0 (9/9/13)
    NO3-: 15ppm (9/9/13) (Usual max is 20ppm just before weekly water change of 5025%)
    pH: 8.0 (9/9/13)
    GH: 4d (9/9/13)
    KH: 3d (9/9/13)
    Temp: 86F (9/10/13)

    Other potential targets of the blame game include:
    - Bright lights at night (see thread:
    - High temperature (temp stays around 86-7F by itself with NO heater), causes include: waste heat from pumps, tank and sump are covered, tank and sump made of acrylic (higher insulator than glass), windows closed most of the time, tropical climate, no air conditioning.

  2. #2


    0 Not allowed!
    Just took a look at the link for aquaticcommunity and I think you mistyped. It's 25 mg per 2.5 g of food (1%).

    I'll try to feed them instead. Did you get any medicated food from AngelPlus? Metro can be costly in water since it has a half life of 6-7 hours, so we'll say 8. So, when treating in the water, sometimes people would retreat in 8 hours interval. Since this isn't such a severe case, I'd say prepare the food for it (25 mg is fine for food preparation). Is it still eating and passing faeces correctly?

    Are you running carbon in your filter by any chance?
    Think with logic and rationality more than emotion. Act with moderation and consideration. Contemplate ideals and realistic goals and weigh out possibilities and options. Temper not with personal delusions or false hope but learn to accept and move on.

  3. #3


    0 Not allowed!
    Also, what do you feed your fish? We want to make sure the food meet all of its vitamin requirements.
    Think with logic and rationality more than emotion. Act with moderation and consideration. Contemplate ideals and realistic goals and weigh out possibilities and options. Temper not with personal delusions or false hope but learn to accept and move on.

  4. Default

    0 Not allowed!

    Oops, assuming the fish eats 1% body weight that would be 100mg/kg. Sorry about that, I was looking at the Wet Web article at the same time.

    I plan to take measurements in 3 dimensions in order to estimate her weight from volume. Fish must be same density as water it lives in.

    The reason I want to treat the water also is I've read the parasites still in the water can reinfect the fish, so it's best to hit them both inside and out.
    Where did 8 hours come from? Most of what I've read said dose 1x/day, and I don't remember where but somebody said that the half life was measured in warm blooded animals???

    I didn't get the medicated food because they only have flakes which need to be eaten in 10 seconds else the medication would dissolve into the water.

    I feed once a day.
    She gets 1 Hikari Algae Wafer. Also TetraMin flakes, though these are meant for the yoyo loach she will usually intercept 2-3 flakes.

    Today I observed green poop, breaks up quickly into little chunks. I don't know what is normal.

    Yes I run carbon. Tank is downwind of bathroom.
    Of course carbon would be removed before medicating water.

  5. #5


    0 Not allowed!
    Every element have a half-life as all atoms eventually decay. Metro is active for about 6-7 hours so people treat metro for 3 times a day for effectiveness and especially on more resistant strains at a higher dose in water. Green faeces is fine, you don't want to see stringy white or translucent faeces. The reason I don't want you to treat the water yet is because it's still passing normal faeces.

    Just keep up with the water changes, nutritious food fortified with vitamins. I also ditch the carbon. IMO, you don't really need carbon at all unless you are removing medicine or other unwanted chemicals.
    Think with logic and rationality more than emotion. Act with moderation and consideration. Contemplate ideals and realistic goals and weigh out possibilities and options. Temper not with personal delusions or false hope but learn to accept and move on.

  6. Default

    0 Not allowed!
    I understand half life, that's the time it takes for half of something to decay. So if you start with, for example, 20mg/L and the half life is 8 hours, after 8 hours there would be 10mg/L left, then after 16 hours 5mg/L and so on.

    What concerns me is, the half-life quoted in the Pharmacokinetic Data for metronidazole (6-7 hours) is meant for humans and similar. It gets metabolized in the liver. So I suspect in aquarium water the half-life could be different (potentially wildly different).

    4 years ago, I treated the water with 3 doses of API General Cure (6.6mg/L) timed approximately 48 hours apart, w/c before each dose and apparently it didn't eradicate the parasite.

    So it's important to me that it gets done right this time.

    I don't watch the poops that much, but I've seen what looks like a clear stringy poop stuck to the filter pad. But I'm not sure where it came from or how long it's been there. According to this
    ,it may be possible to "have regular looking feces while still having the slimy white feces"

    By "nutritious food fortified with vitamins" do you mean I should keep using Hikari or switch to something else? I do keep the main bag in the freezer inside another bag, only taking enough for 2 weeks or so at a time. Letting it come to room temperature before opening the outer and inner bags.

    I am running carbon to remove chemicals, such as plasticizers used in airline tubing. Also as mentioned before the tank is downwind of a bathroom.

    For dosing food, I'm thinking of mixing up a stock solution (or slurry if it doesn't completely dissolve). Then suck some of it into a needle/syringe and use that to measure out a dose onto the concave side of each algae wafer, let it soak in, then put in freezer. Sound like a good plan?

    Finally, I've taken measurements and calculated weight to be 1.3lb or 0.59kg (based on approximating the body as 26 elliptical cylinders and ignoring the fins).

    Thanks very much for your help.
    Last edited by BIO-Linist; 09-15-2013 at 09:00 AM.

  7. #7


    0 Not allowed!
    Again, imho, I don't really like to treat the water just yet unless there are very clear signs that the fish has hex. If it is still eating fine and regularly passing dark colored faeces, it is not a problem. Sometimes fishes will pass clear faeces from time to time depending on what you feed them.

    I think HITH is another ball game....

    Try reading this for a discussion on metro.

    Onto the food, what kind of Hikari brand food are you feeding? Are you supplementing it with any kind of vitamins?

    In my personal experience with HITH (mild case in a blue tang that was in a friend's tank and he gave it to me), I didn't use metro in the water. For cautionary steps, I followed the regular QT procedures. The food I fed were all enriched with liquid vitamins. After a month of a well balanced diet and excellent water conditions, the wounds cleared up.

    If you are dead-set on treating the water however, I'm sure that link I provided also discussed on the water treatment as well. The high temperature will aid you, but do turn off the light during treatment.

    Do you thoroughly clean the carbon package before putting it into the filter? Make sure you see no carbon dust floating around.

    Mixing the solution into frozen food, letting it soak, and throwing it in the freezer is fine until you need to feed.
    Think with logic and rationality more than emotion. Act with moderation and consideration. Contemplate ideals and realistic goals and weigh out possibilities and options. Temper not with personal delusions or false hope but learn to accept and move on.

  8. Default

    0 Not allowed!
    Oh yeah the tilapia's name is Tiger and I'm quite sure she's female. The yoyo loach doesn't have a name and I don't know its sex.

    I've read some of that thread, there are indeed some success stories, also failures (along with an overdose which killed somebody's discus).
    Also the following are articles that I read and feel are more authoritative:

    Basically my takeaway from these is HITH treatment needs to be approached from all angles, just targeting one aspect without addressing the others may produce an improvement but a true cure would only be achieved using a combined approach.

    This is the main food, Hikari Algae Wafers:
    The other food is TetraMin Tropical Flakes, the amount she gets is tiny compared to the algae wafers. I deliberately feed her first so she's busy chewing the algae wafer.

  9. Default

    0 Not allowed!
    Carbon: Yes I rinsed the carbon thoroughly. Which reminds me, it's almost time for the first carbon change anyway (6 weeks), might as as well take it out and begin treatment.

    But first I still need to do some calculations to obtain the density of the metro powder (for mass to volume conversion - I don't have a milligram scale) and decide on dosages.

  10. Default

    0 Not allowed!
    Sorry I was too busy last week, didn't have time to calculate and start treatment. Did increase frequency of water changes to 2-3 times a week instead of 1x/week.

    Several things I ordered a while ago have arrived, including microscope and scale (0.01 gram precision).

    Saturday I was able to examine a fresh fecal sample. To the naked eye it was dark greenish brown, held itself together somewhat (didn't break up like the poop observed on 9.14.13).
    Under the microscope, 40x objective, it looked like an angry beehive, there were swarms of little bugs rapidly swimming around. Rapidly swimming bugs = flagellates right?

    This is the planned dosage schedule:

    In food:
    35 mg/kg body weight
    x 2 feedings/day x 10 days x 0.59 kg = 413 mg
    The calculated amount of metronidazole per algae wafer is 21mg/wafer.
    Normal feeding is 1 wafer/day, upping to 2 to help clear out the digestive tract. Is this a good idea?

    In water:
    10 mg/L
    x 1 dose/day x 10 days x 742 L = 74,200 mg

    Tonight I have finally prepared the medicated food, but it looks like way too much. There is a layer of metro powder stuck to the surface.

    Should I prepare another batch at a lower dosage, and if so what? (the rest of my algae wafers are double bagged & frozen, need many hours to thaw out before I can open the bags)

    One more thing: unfortunately, it seems fin rot has started, Tiger's pectoral fins which normally have pointy tips look like the tips have burnt off. Rounded off black edge.
    I'm thinking if this doesn't improve after metronidazole treatment I'll have to start a different antibiotic :(
    Same kind of fin rot killed all the fish in my old 20 gallon (all of them died one by one, tore down the tank and never set it up again) several years ago.

    More bad news: got important commitments tomorrow, gotta get out by 8am and won't be home til 7-8pm.

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