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Posted By: Kristin <Smiley2501@aol.com>
Date: Friday, 14 February 2003, at 1:56 p.m.

I just wanted to make sure you get this post. I wasn't sure how you have you messages set up, so I thought I would post the same message again for you just in case. : )

Hole In The head Disease (HITH)
The main symptom of this disease is the small pits, mainly on the head, which give the disease its name. These are usually whitish in colour, and there may be yellowish mucus trailing from them. The fish may also stop feeding and become hollow bellied.

The disease affects mainly cichlids, particularly oscars and discus, but can also affect gouramies.

The disease is linked with a protozoan parasite, Hexamita (sometimes known as Octomitus). This may often be present at low levels in fish, but the acute infection does not occur unless factors like poor water quality or poor diet have an influence. Therefore, Hexamita alone may not be the primary cause, and good water quality and a varied diet should prevent this disease occuring.

Details Of Infection

Spironucles sp. and Hexamita sp. are the parasites to blame for this disease. It is thought that they are passed on by being taken in by food where the parasite multiplies in the intestine and spreads via the bloodstream. Out breaks are more prolific in crowed aquariums.


Specific anti parasitic medication is available to treat Hole-in-the-head also known as Hexamita. Your veterinary surgeon can also prescribe a medication which is taken with food to tackle the parasite. The chosen medication of Jack Wattley (famed discus breeder) is Mentronidazole, trade name "Flagyl". He suggests one treatment a day for four days.

It is important to perform a large 30-40% water change before treatment and if possible raise the temperature to 92F. It is advisable to remove plants as they will wither at such temperatures.

Early treatment is important as the holes that the parasite create often leave the fish open to a secondary infection.

Possible cures
The fish can be treated by isolating to a separate tank and adding either Dimetridazole (5 mg/litre) or Metronidazole (7 mg/litre). In some countries (including the UK), these are only likely to be available via veterinary prescription. The treatment will probably need to be repeated a few days apart, with a 20-30% water change between each treatment. Medicated food is useful for treatment, but this can be problematic if the fish is not feeding. Direct injection near the affected area is likely to prove very effective, but should only be attempted by an appropriately qualified person. In the UK, Waterlife Octozin may also be used for HITH disease


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