Trying to save a Red Sea Regal

Rea17

New member
Hey everyone. My LFS had this Red Sea regal for probably 2 months before they gave it to me to treat. They ran it though CP and Prazi (supposedly), but it had a bacterial infection that went untreated until I got it home. He's a little larger than I'd like, 5-6"

At first, the fish was thin but eating (not very well) and had flared/red gills. I know ammonia burns can result in the gill tissue appearing bright red, but I suspected a bacterial infection and told the LFS to treat him. When they didn't, the infection spread into his mouth and his entire lower "lip" was eaten away, leaving his bottom row of teeth completely exposed. At this point I was able to take the fish and treat it. It reacted very well to a round of Furan-2 and perked up almost instantly, it ate constantly for 2 days. After that, it's appetite has been up and down, and at this point the only thing he likes are the 1mm NLS pellets, but he eats them fairly well several times a day off the floor of his QT tank.

My problems: the fish "appears" to have flukes, but nothing comes off in a FW dip and Prazi isn't helping. One of his pectoral fins has cloudy spots around the edges (very hard to see unless looking at him straight on), and he has a twitch. He doesn't flash.

His mouth isn't healing, at all. I'm considering running him through another round of antibiotics, something different this time, in case the infection isn't completely wiped out. I really think he'll eat better once he doesn't have that bothering him, but I'm not sure how to proceed on that front. Also, his flared gill seemed better after I ran him through the first Prazi treatment, but is still present.

He gained some weight, but is still thinner than I'd like. His appetite seems stable at this point, but feeding him is still tedious. If anyone has any ideas, I would really appreciate some input! Thanks
 

triggerfish55

New member
from my past experiences dealing with delicate tangs and other marine fish, its really all about feeding very well, obviously good water quality will also help it heal faster but food is the most important, make sure you are giving it as much variety and feeding it as much as it can eat multiple times a day.
what is the temperature in the QT tank?
have you tried feeding any fresh food? or just pellets and prepared items?
Also are there any structures for it to hide in the QT?
 

Rea17

New member
from my past experiences dealing with delicate tangs and other marine fish, its really all about feeding very well, obviously good water quality will also help it heal faster but food is the most important, make sure you are giving it as much variety and feeding it as much as it can eat multiple times a day.
what is the temperature in the QT tank?
have you tried feeding any fresh food? or just pellets and prepared items?
Also are there any structures for it to hide in the QT?

Sorry, regal angel not regal tang, should have specified.

Temp is a steady 78F. I'm offering fresh food as well as nori but he has no interest. He will inspect clam and mussel on the half shell but doesn't peck, probably because of the severe irritation his mouth is causing. He has PVC hiding places.
 

Reefsi

New member
Are the cloudy spots look as if you could "scratch" them off? What do they look like? Are they puffy?
 

Rea17

New member
They are just cloudy areas, they look like flukes :p I haven't gotten to the point of attempting manual removal to confirm what they are, but I'm close at this point. Definitely not lympho or anything.
 

Reefsi

New member
The only thing I can think of that is red and could seem to be eating away at a fish would be Uronema Marinum. The cloudy spots on the fin, are they on the edge or centrally located?
 

Reefsi

New member
I'm trying to think of what will leave reddening anywhere on a fish, that leaves Vibrio, Uronema, Ammonia Burns, and bacterial infection. Have you considered another meds?
 

HumbleFish

Dr. Fish
Premium Member
I would try erythromycin or kanamycin or even NGP (if you have it). As I'm sure you know; like with people, individual fish respond differently to various medications.

The twitching could just be phantom symptoms. I've had that happen post-treatment with certain fish. Usually following a heavy infestation or treatment was delayed. However, I would start from scratch with this fish, and prophylactically treat for ich & flukes once the infection has cleared.
 

Reefsi

New member
My AT(which you have been assisting me greatly on) has some cloudy spots on his pectoral fin as well, as why I suspected flukes. I FW dipped him and he is undergoing Prazi at the moment and they are still there. Extremely feint as you described but if I look hard enough I see them. I have honestly read for countless hours on fish diseases in the last week and have yet to come up with a viable answer for it.
 

Rea17

New member
I would try erythromycin or kanamycin or even NGP (if you have it). As I'm sure you know; like with people, individual fish respond differently to various medications.

The twitching could just be phantom symptoms. I've had that happen post-treatment with certain fish. Usually following a heavy infestation or treatment was delayed. However, I would start from scratch with this fish, and prophylactically treat for ich & flukes once the infection has cleared.

This was what I was thinking... I was actually going to order some NGP for the sake of trying it. I didn't want to run Furan again because I don't think it would be as effective the second time around - but on that subject, I believe NGP uses the same antibiotic as Furan so maybe I'll start with kanamycin.
 

Rea17

New member
My AT(which you have been assisting me greatly on) has some cloudy spots on his pectoral fin as well, as why I suspected flukes. I FW dipped him and he is undergoing Prazi at the moment and they are still there. Extremely feint as you described but if I look hard enough I see them. I have honestly read for countless hours on fish diseases in the last week and have yet to come up with a viable answer for it.

Slight abrasions on fins can also appear this way. If your AT is flashing he could just be leaving scratches on his pectoral fins.
 

HumbleFish

Dr. Fish
Premium Member
I believe NGP uses the same antibiotic as Furan so maybe I'll start with kanamycin.

Well, they both use nitrofurazone as their "primary" antibiotic. But NGP uses sulfathiazole, while Furan uses furazolidone as the "secondary" antibiotic. NGP also contains methylene blue (and something else) as a healing agent.
 

triggerfish55

New member
since it is a red sea regal you can try to raise the temp up a little bit more to entice more enthusiastic feeding, ive seen this work with powder blue tangs which also originated from warmer waters.
 

cngreg

New member
Is this fish in good body condition? Is it still eating well? Fish that are on the brink I wouldn't try a formalin dip on but if it looks healthy consider quick cure dip (1 hour in a 5 gallon bucket with ample aeration). This works empirically to eliminate a variety of the ectoparasites like flukes/some protists which may be on the fins and in the gills). I like kanamycin (seachems kanaplex) as a dip as well because that class of drug is concentration dependant and bacteriocidal and only needs a short contact time if used as directed. Long term bath (like full time in a qt tank for 10 days). I like nitrofurazone at 10ppm. You could even do the formalin in that tank at bath dose and move the fish or run carbon if it starts to like agitated. The husbandry stuff is key but might not be enough in the face of an established infection/infestation. This fish may be too fragile to do a gill clip/ skin scrape then look at under microscope which would by ideal.
 

Rea17

New member
He's in decent condition aside from the open wound on his lower jaw. I'd rather not treat with formalin as long as that's there, but at this point it may be necessary. I've ordered some different antibiotics and NGP, if I don't see improvement I may move on to the formalin dips.

He has an interesting area on the caudal fin where the color is washed out. The area is long and thin, and has been slowly extending towards the end of the tail. There's a teeny red spot at the base of the area, I may do a fin scrape on that one. He hides every time I try to get a picture. I may pull him out to get some photos of his mouth and fins, and to do the scraping.
 

Rea17

New member
A little good news, the regal started to chow on mysis last night. Hopefully I'll get to expand his diet and get some weight on him now.

Also, I have a microscope camera on the way so I can share my findings on the scrapings. Thanks everyone who has chimed in!
 

ca1ore

Grizzled & Cynical
Ami, I am curious to see if a bacterially-eroded lip will actually regenerate/heal? I had this happen on a pyramid butterflyfish, and while it still survives to this day, the mouth has never looked quite right (has an 'underslung' look to the mouth that makes it look like it has an attitude).
 

Rea17

New member
Interesting, what did you treat with? The problem is, eating reopened the wound and I believe is slowing any healing that would take place. The wound looks white and after feeding sometimes parts of it are red, as if it caused bleeding. Kind of a vicious cycle at this point..
 

ca1ore

Grizzled & Cynical
I had been having a lot of trouble getting pyramids through QT. First group I got all succumbed to some kind of raging bacterial infection (my best guess); so when I tried again I used NGP right from the start. Three of the four came in with what looked like the beginnings of mouth infections; two cleared up quickly, with the third lingering for a week or two. It was that latter fish that ended up with a 'short' lower lip. Hasn't affected its ability to eat like a piggie though. Lip area went white, then fell off; never got red though.
 

Rea17

New member
Well here are a couple bad pictures of his mouth... my phone has a really hard time focusing on it. Anyway, you can see his lip/gums have eroded away and the teeth are exposed, and the redness throughout is irritation caused by eating. It was much worse when I got him, but I think it should be improving at this point, I've been working with him for about a month and a half.



 
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