Hexamita is caused by intestinal flagellated protozoa and attacks the digestive system and the lower intestines of infected fish. The symptoms of this disease are often confused with those of hole in the head diseases as these two diseases usually are present at the same time in a fish. They are however two separate diseases that each needs to be treated. Some fish species are especially prune to Hexamita such as large cichlids and especially Oscar and discus fish.
The first sign of Hexamita is usually that the faeces become whitish and slimy. During this stage of the development of the disease the fish can still appear to be healthy and eat as usual. As the disease progress the numbers of symptoms will increase and you can often start to see symptoms of hole in the head disease as well. The symptoms of more progressed Hexamita includes the fish becoming darker or even black, the fish start swimming backwards, the head sinks in (becomes thin), weight loss and the fish starting to hide in small corners with its head facing downwards. Hexamita does as earlier mentioned attack the digestive system and can therefore cause nutrient deficiencies in the infected fish. Nutrient deficiency is one of the reasons behind hole in the head disease.
Since the disease is internal it is necessary to medicate internally. The easiest way to do this is to mix 1% metronidazole in fish food (25g food for one 250mg metronidazole) and feed it to the fish. Feeding sparsely before feeding the medicated food can help guarantee that the fish eats the medicated food. It is also recommended to medicate the water as well by adding 12 mg metronidazole per litre aquarium water to make the treatment more effective. Repeat the water treatment every other day until you have treated the water three times.
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