2014-4-13

So per Kenny and my experience will dose MetroPlex (70% Metronidazole) at at least 500mg/10gal BID to TID for 7 days before I try Dimetridazole which I received today.

Dosed 2.6gm of 70% Metro tonight.  Will need to dose BID vs TID.  So that would be 750mg/10gal q 12 hours.  Also added a little MgSO4 bc no aquarium salt here to ease tx with antibiotic.

pH still maintained at 4.0 which has clearly helped more than anything.  They are eating but not well.

 Set up the Mike Senske tank.  Will do dry start method to decrease demand and improve early plant growth.

CC

Carey,

http://www.drsfostersmith.com/product/prod_display.cfm?pcatid=4753

Metro is best administered at 92F +/- so initially raise the tank temp to be around that range, and dose 500mg per 10g(Metro from the above link is at 250mg strength so use 2 tablets per 10g) and re-dose every 8-12 hours with a full single dose, with a 50% daily WC for a total of 5-7 days. Upon finishing the Metro treatment I would keep the tank temp elevated at around 90F for another week just to maintain their metabolic rate higher for a little longer.

Btw you should pre-dissolve the Metro tablets/powder(calculate how many Metro you'll need to use for your tank size beforehand if using tablets) with hot water in a small container and shake them well, prior to pouring them in to your main tank.

Sincerely,

Kenny Cheung
Kenny's Discus
Tel: (650) 290-1283
E-mail: kennysdiscus@gmail.com
Monthly shipment listing: http://goo.gl/IIGMwk
Facebook page (Click "Like" to follow us): https://www.facebook.com/kennysdiscus 

Sent from my iPhone

On Apr 10, 2015, at 2:33 PM, <ccottle@earthlink.net> <ccottle@earthlink.net> wrote:

Kenny,

I hope you are well.

I've bought fish from you several times and they are beautiful.  Unfortunately my fish have a chronic wasting disease caused by cryptobia.  This has been confirmed by necropsy of 3 fish and microscopic stool analysis showing the organisms.  Unfortunately, the vets I've consulted know of no cure.  I've ordered dimetridazole as recommended by one of the vets.  Given your experience I wonder if you know of something else to suggest.  If this doesn't work I will lose all these fish...I have 8 with 3 showing signs of the infection and one confirmed with it from analyzing the stool.

Thanks,
Carey Cottle MD

-----Forwarded Message-----
From: "Baumgartner, Wes"
Sent: Apr 8, 2015 9:04 PM
To: Carey Cottle Jr MD
Subject: RE: CONFIRMED CRYPTOBIOSIS RE: new stool sample of corral colored thin discus (Cottle)

Carey,

I haven’t received any information from Roy Yanong in florida. At this point I’d say to try either of the methods advocated by florida and see if either works.  I’ll send an email to PTK Woo in Canada-he’s the expert on vaccines in cryptobia.

From: Carey Cottle Jr MD [mailto:ccottle@earthlink.net]
Sent: Wednesday, April 08, 2015 6:35 PM
To: Baumgartner, Wes; Dr. Sam Young
Subject: CONFIRMED CRYPTOBIOSIS RE: new stool sample of corral colored thin discus (Cottle)

Wes and Sam,

I have examined a stool sample from an affected fish and under 400X clearly seen numerous cryptobia.  This YouTube video helped my certainty about what I’m seeing.

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=7&cad=rja&uact=8&ved=0CE0QtwIwBg&url=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DWucYjMth6gI&ei=DbglVcHiDomCsAW-54HQBA&usg=AFQjCNGxbejRsVaej10gcQkJrgcouyMMKw&sig2=OgUx_w66FvZzztZ41bV7hw

The fish have started eating again in the QT at pH 4.0.  But it does not look like this organism is affected.  Please offer me something, even experimental to try on this organism.  I’ve been using metronidazole again, but I have used it before without cure. Univ of Fla suggest this:

Experiments run at the Tropical Aquaculture Laboratory suggest that these two treatment regimens may decrease the infection load: a) a bath treatment with dimetridazole (80 mg/L for 24 hrs, followed by a 80-100% water change, repeated daily for 3 days); or b) a bath treatment with 2-amino-5-nitrothiazol (10 mg/L for 24 hrs, followed by a 80-100% water change, repeated daily for 3 days).

http://edis.ifas.ufl.edu/vm077

Sam, Can you help me get one of these to try?

Any help is appreciated.

Carey

              

From: Baumgartner, Wes [mailto:baumgartner@cvm.msstate.edu]
Sent: Wednesday, April 1, 2015 4:25 PM
To: Carey G Cottle Jr MD
Subject: RE: new stool sample of corral colored thin discus (Cottle)

Carey,

You raise an interesting question. I don’t know if the cryptobia can survive the low pH, nor am I sure of the pH of a discus stomach. If the cryptobia are relatively symbiotic in the discus stomach, then I tend to doubt that acid treatment  would affect flagellates in an acid stomach. However, if diseased individuals have abnormally high gastric pH, then acid treatments (with swallowing) may affect flagellate numbers in the stomach, possibly relieving the infection temporarily.

Also, you’re right that the acid treatment may be doing something unrelated to the cryptobia. I found moderate numbers of dermocystidium in the gills, which normally don’t cause too much of a problem. Acid baths may reduce these parasites, leading to improved fish behavior.

I’ll look in to cryptobia in stool samples as a diagnostic method.

From: Carey G Cottle Jr MD [mailto:ccottle@earthlink.net]
Sent: Friday, March 27, 2015 11:29 PM
To: Baumgartner, Wes
Cc: uncommoncreaturesmvs@gmail.com; 'Carey Cottle Jr MD'
Subject: FW: new stool sample of corral colored thin discus (Cottle)

Wes, 

I wonder if we can take advantage of one of the features of discus….they tolerate a low pH of 4.0.  Do cryptobia tolerate pH 4.0? 

Here’s the background.  I took the 3 discus that showed poor or limited eating and QT them for 3-4 days and lowered the pH to 4.0.  The discus that was euthanized, and which you received, responded initially.  He began eating all foods again for 2-3 days (after not eating for over a week) before he suddenly died.  The other fish also responded to the low pH treatment and have started eating all foods again.  I had seen an article that said mycobacteria did not survive at pH below 4.0 and I knew discus could so that’s what gave me the idea to try it.  BC of a trip I had upcoming I had to return them to the main tank on Tues of this last week.  My main tank is maintained between 6.2 and 6.8 depending on the time of day. In the QT tank at pH 4.0 the nitrifying bacteria also die and ammonia levels build up too high without daily 80% water changes.  I wasn’t going to be there to make the daily water changes necessary for maintaining a pH 4.0 tank therefore I had to return the fish to the main tank. 

I wonder if Cyrptobia don’t tolerate low pH could we do an experiment using low pH to try curing the discus from this menace.  If you think adding metronidazole may help as well we could do a combination.  It was really remarkable seeing all the fish regain their appetite using the low pH.  This of course could have been a coincidence.  Humans secret acid in their GI tract and yet occasionally pathogens survive.  Maybe discus GI pathogens also tolerate low pH.

For your info.  My main tank is a planted discus tank 90 gallons in size.  It is maintained at 82F for the discus.  I do 40% water changes weekly without fail.  I use local tap water every other week alternating with RO water for the changes.  The tank is connected to a computer where I monitor temp, pH, ORP (oxidation reduction potential) continuously. 

Can Cryptobia be diagnosed by microscopy of stool?  I have a Nikon microscope and am interested in learning to better recognize pathogens in discus stool samples.  If you have any suggestions on aids to help with microscopic identification of pathogens I would appreciate it.  I have seen flagellates but wasn’t sure what was pathogenic and what wasn’t.  Of course stool samples must be analyzed immediately upon collection.  If I learn to recognize the pathogens then Dr. Young can treat the fish correctly.

Thank you for your expertise, interest, and concern.

Carey Cottle

From: Baumgartner, Wes [mailto:baumgartner@cvm.msstate.edu]
Sent: Tuesday, March 24, 2015 1:34 PM
To: Carey Cottle Jr MD
Subject: RE: new stool sample of corral colored thin discus (Cottle)

Carey,

I’ve reviewed the histology slides of your discus and I’ve found several microscopic stomach granulomas that lack acid fast organisms. A wasting syndrome in discus fish associated with stomach granulomas has been reported in association with cryptobia iubilans, a flagellate of the intestinal tract. I think this is probably what’s been going on. I saw no convincing evidence of mycobacteriosis. I spoke with Sam and I’ve got a sample of spleen in ethanol that we can run PCR for mycobacteria on. However, without granulomas in any tissue but the stomach, I doubt we’d find any evidence for mycobacteria.

I’ve attached a report of cryptobia in discus that you will find interesting. The syndrome in your tank is remarkably similar. Treatment is difficult.

Additionally, there is abundant iron in the liver, which I associate with high red cell turnover. It is uncommon in fish and of uncertain significance, though can be associated with pollution in wild fish populations.

I’ll send a report by next week to Sam. This is an interesting condition in discus, the mechanism and cause of which is not entirely certain. I’ll mention this to the fish parasitologist in the department and see if there is interest in studying this disease.

Many thanks for the great case.

Regards,

From: Carey Cottle Jr MD [mailto:ccottle@earthlink.net]
Sent: Tuesday, February 24, 2015 5:47 PM
To: Baumgartner, Wes
Cc: Dr. Sam Young
Subject: RE: new stool sample of corral colored thin discus (Cottle)

Thank you so much, Wes!  I am anxious to learn from your expertise.  I will forward this to Sam Young DVM.  He is happy to participate as well. 

My loss will be rewarded by the advancement of knowledge for the significant Discus loving community.  “Discus wasting disease” is a common syndrome from which my  fish suffer.  No doubt, this syndrome can have multiple causes, but a definitive diagnosis in any case would be helpful.

Be safe in the ice,

Carey

From: Baumgartner, Wes [mailto:baumgartner@cvm.msstate.edu]
Sent: Tuesday, February 24, 2015 5:52 PM
To: Carey Cottle Jr MD
Subject: RE: new stool sample of corral colored thin discus (Cottle)

Carey,

I will be out of the office tomorrow due to icy weather here in Mississippi-I’ll try and contact Sam tomorrow or perhaps Thursday.

I spoke with a friend of mine at LSU- if the discus is euthanized and freshly examined, sterile samples of granulomatous material can be overnighted on ice to him for culture, PCR, and antimicrobial testing.

His address:

Louisiana Aquatic Animal Diagnostic Lab c/o John Hawke

1043 River Road

Baton Rouge LA 70803

Formalin fixed tissues, preferably the whole fish, can be sent to me at:

Wes Baumgartner

240 Wise Center Drive

Mississippi State, MS

39762

I’ll have a look at the reports and materials you’ve sent.

Best regards,

Wes

From: Carey Cottle Jr MD [mailto:ccottle@earthlink.net]
Sent: Tuesday, February 24, 2015 10:22 AM
To: Baumgartner, Wes
Subject: FW: new stool sample of corral colored thin discus (Cottle)

From: Carey Cottle Jr MD [mailto:ccottle@earthlink.net]
Sent: Thursday, December 11, 2014 7:09 PM
To: Dr. Sam Young (drsam@uncommoncreatures.com); ccottle@earthlink.net
Subject: new stool sample of corral colored thin discus

Sam,

There are couple of things to see in this stool sample. I don’t know what either are.

One is round large with apparent nucleus and spike protrusions.

The other is a rod-like organism with a distinct wall and which is motile.  The video shows that.

I checked the Noga textbook.  Didn’t see anything like these.  They may be benign.

Thanks again.

Carey