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Metroplex treatment duration for Hexamita?

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  • Metroplex treatment duration for Hexamita?


    1. I would like to ask you what is the proper treatment duration against Hexamita when treating with Metroplex incorporated in the food?
    The affected fish(emaciation, not being able to swallow/eat and spit out, string clear/white poo) became better fast and within 3 days was eating healthy amounts, and has already gained lots of weight and got nice coloration again by day 10 of treatment. Is there any point in continuing the medication or should the fish be clean now?

    There was also Ick present at the same time and it's now 3-4 days since I last saw a spot. I keep the temperature at 30C and its day 10 now. I did see my Green Terror scratch once today but that's all. 2. Does that mean there are still parasites in the tank trying to infect the fish? Shall I continue the therapy or stop it? I want Ick and Hexamita eradicated from the tank, but don't want to over medicate.

    I have a pleco in the tank as well, but this one never ate prepared foods and doesn't want to claim his share. As a result, I doubt if he ever ate any of the medicated food. It never showed Ick nor Hexamita symptoms. He grazes the whole tank(2m long, 831L) for algae and biofilm, so he does eat satisfactorily. 3. Is this fish sufficiently exposed to the medication or a potential problem in eradicating the parasites? I am trying offering fruits and veggies in small pieces with metroplex and focus dusted on them according the the directions dosage for food. 4. Is the pleco getting enough medicine or how can I medicate his food of fresh fruits and vegetables? I wouldn't like to dose the tank the moment the other cichlids and catfish are getting enough medication through their food.

    Tank is 831L, sump filtration
    Sand, Woods, rocks and live plants

    pH 6.8-7.2
    NO3 < 12.5ppm
    Water changes every week

    Andinoacara rivulatus
    Archocentrus multispinosus
    Herichthys carpintis
    Hypsophrys nicaraguens
    Thorichthys meeki
    Platydoras armatulus
    Pterygoplichthys joselimaianus

    Thank you very much in advance!

    Best regards,

  • #2
    Re: Metroplex treatment duration for Hexamita?

    It's now day 14 and I am stopping the metronidazole treatment. It's now more than 5days(7-9 I think) since I last saw a sign of Ick. I sometimes see very small clear poo areas but appear different from the typical appearance of poo from Hexamita infected fish. I saw the fish pass out a dead worm every now and then, so praziquantel is in order at some point, but since day 11, I saw columnaris on my Green Terror's dorsal fin, affecting a single ray. On day 12 I got Kanaplex and have even adding it to the food once per day. Kanaplex in the morning, Metroplex in the afternoon feed. I also lowered the temperature to 29 on day 13 and 28 on day 14. Today, day 14, I fed Kanamycin in the morning and at night, at full dose both times as the infection subsides after the kanamycin feed but gets a bit worse by next morning, probably as the drug wears off.

    Should I divide the dose mentioned on the package to two feeds or should I put full dose at both feeds? Is it normal that the infection doesn't go away after 24h+ of medication? I realize this is an aggressive bacteria which thankfully has been under some control so far. I am stopping the metronidazole now though(should I continue it? Supposedly it doesn't do much against Columnaris and the infection gets worse by morning even after a metronidazole feed) and can feed kanamycin more times per day, up to 3 if that is safe and will allow eradication of the bacteria/infection without risking any toxicity on the fish. How many times per day should I feed and at what dosage?

    If things are not getting better tomorrow, I think that adding nitrofurazone is warranted to help the fish fight the infection. Is this a safe medication or should I stick with just kanamycin alone? Will it work at curing columnaris without letting the infection proceed at disfiguring or damaging internally the fish?

    Thank you very much in advance!


    • #3
      Re: Metroplex treatment duration for Hexamita?

      For ease of feeding, you can actually combine the KanapLex and MetroPlex into one medicated food blend to be fed only once a day. To do this use 1 scoop KanaPlex, 1 scoop MetroPlex and 2 scoops of the Focus for every tablespoon of food. You will only need to feed this once daily.

      For columnaris, your best bet is to continue dosing with KanaPlex and you can dose with this once daily (in a medicated food mix) for up to 14 days before taking a break from this medication. We do not recommend mixing medications, and would suggest that you only use one treatment at a time. After 14 days, if symptoms still persist, you can switch treatments to continue treatment.

      I hope this helps, good luck with the treatment!


      • #4
        Re: Metroplex treatment duration for Hexamita?

        Thank you very much for your reply, I appreciate it!

        I quit Metroplex yesterday as I reached 14 days of medication which from what I found so far is adequate for Ick and Hexamita. Is this correct or should I continue it?

        Unfortunately, when I fed Kanaplex once a day for about 2 days, I found that it inhibited the disease the next several hours but then the disease was taking over again and the damage increasing by the time I was to feed it again. I tried feeding it every 12h yesterday and I am seeing sustained results, without worsening in between the feeds. Should I continue feeding it this way at full dose(meaning half a measure to half a tablespoon frozen bloodworms and dry pellets) or should I divide this dose between the feedings? Or is this risking toxicity to my fish?
        Should I switch back to once per day and expect some worsening in between till a certain number of days? I think that with an aggressive bacterial disease like this, I should eliminate all symptoms ASAP and accept no worsening between the treatments, only incremental disease elimination till no symptoms are seen, and then continue 4-5 more days. Is this correct? Antibiotics are generally dosed every 12h and for a minimum of 7-9 days in human and animals in general, but I am sure you have the appropriate studies for the fish which may differ in their response to the other vertebrate animals, so I am awaiting your advise on how to best use it in my case to effect a cure without risking the long term health of my fish

        Thank you very much in advance!


        • #5
          Re: Metroplex treatment duration for Hexamita?

          Unfortunately I continued getting new patches(some white/grey, others black) on the fish, even though some of them were healing after the medicated feed each time. I realized there was concurrent Aeromonas infection but this was handled very well by the medicated feed, leaving mostly the external infections to spread relatively superficially. I also see black bushy strands, somewhat like black beard algae, growing on woods and plants in the tank but they are soft and fleshy like bacterial culture, not algae.
          Because columnaris was getting worse and I started to worry about how I will find them next morning(I don't want any sores to develop nor any disfiguring), I treated with nitrofurazone(in the water) as well and plan to continue the Kanaplex medicated feeds. I don't like the properties of nitrofurazone but it seems to be needed to effect a cure in my case and hopefully there won't be any lasting negative effects from the short term use(4days treatment dosing every day 85mg per 10g, with a 25%water change before the 3rd dose).

          Any advise would be much appreciated


          • #6
            Re: Metroplex treatment duration for Hexamita?

            If you are dealing with a rapidly progressive infection, then it is certainly possible to do a more aggressive treatment regimen. Just keep in mind that overuse or prolonged use of antibiotics, mixing medications, or extended treatment for multiple infections can be very stressful on fish. Anytime a fish is stressed, the immune response will be further weakened, making it more difficult to fight off the infection and making the fish susceptible to further infection or differing infections.

            Sometimes over-medicating can also lead to infectious agents which have become immune to a particular treatment. If you It sounds like you are at a crossroads with this infection, and that it may be a good time to switch treatments completely if the KanaPlex is no longer working.

            Making sure water quality is pristine and feeding a balanced nutrient rich diet will also be the best way to ensure that the fish has the best chance of survival with any medication.

            I hope this helps. Have a nice day!


            • #7
              Re: Metroplex treatment duration for Hexamita?

              Thank you very much for your reply!
              Thankfully it's not overly aggressive with the treatments so far but it's not getting eliminated yet either. There are no loses and all fish look reasonably well, but there are obvious infections of Aeromonas and columnaris, just not affecting their looks much if at all. The gills are in good condition and fish breathe fine as well, though some keep them more open than they should, so they do are mildly affected there too.

              I have only used kanamycin 5days now, so I do have some more I can use it. It seems to work but only partly, not fully. Would dosing in the water be more effective than feeding it? I would think not, but then again there are the external patches of these bacteria on the skin(and the internal Aeromonas too though). From what I read, feeding it is the more effective administration way and I chose that.
              I added nitrofurazone as a complementary treatment, not to replace kanamycin but to take care of the external patches of bacteria and to increase the efficacy of kanamycin. Is this correct or not? The fish seemed to like it initially, getting somewhat more confortable. Maybe they feel a surface antiseptic action? I don't know but the bacterial patches are still there, though declinining somewhat. Still in the first 24h of treatment, second dose goes in tonight.
              If this combination treatment doesn't work due to resistance or something(I have never used those medicine before in my tanks and haven't overused them now either, I try to follow the proper antibiotic use rules applying for human medicine as well), what medicine could I switch to? I haven't really found anything else mentioned as more effective than this combination treatment for these bacteria, and even this is not described as a fool proof/definite cure, but one that works in the majority of cases. Just to keep it mind as so far I don't see another option that is more effective than the one I am using. Read a few things about ciprofloxacin, etc but not much experience with it around for fish.

              I am keeping good water quality and the fish are few for my 200g aquarium. Now on diet, I am feeding bloodworms too often due to needing to offer medicated food and frozen being proposed as s good way to offer the medication in the food. I mix in some pellets as well and let them soak the medicated bloodworm melt water, but the bloodworms gave been a staple lately, which I don't think is balanced. I try to mix in spirulina wafers as well for some greens and feed fruits as well for the pleco, which the catfish devour as well. Should I switch to dry pellet food and dilute the medication in a tiny bit of water and soak the dry food in it or continue as I am doing?
              I understand and believe what you said about prolonged therapy bringing the immune system down. In this case it was warranted though with hexamita and Ick and now columnaris and Aeromonas. Is there something different I could do? None of these infections can be left for treating later without losing the fish unfortunately.

              I am bringing the temperature down a degree each day till I hit 24.5C. Is this good or better leave the temperature as is, at 26.5? I started with 30C which I had kept for the Ick treatment period to speed the results and shorten parasite lifecycle and medication time. This also speeds the bacteria though, so I have been lowering it slowly to not stress the fish but slow down the bacteria some.

              Have a great day too! Sorry for the many questions


              • #8
                Re: Metroplex treatment duration for Hexamita?

                Since KanaPlex functions the same whether you are feeding or dosing the system, then one method is not necessarily more effective than another. You can treat for 2 full rounds when using KanaPlex ( a total of 14 days). After this you will need to cease treatment for 1 week before resuming treatment.

                I honestly can not comment on the possibility of or application of using nitrofurazone as this would not be our medication.

                If you want to switch out from KanapLex I would recommend that you use MetroPlex or SulfaPlex as you continue treatment although typically KanaPlex will be most effective against the infections you have mentioned.

                I would just recommend to feed the medicated frozen for blend once a day and then to feed a well rounded flake or pelleted food (unmedicated) for a second feeding each day as you are fighting off the illness.

                As for temperature, I would suggest to lower it slightly and to do so slowly as you have mentioned as this can help to inhibit the spread of the bacteria.

                It sounds like you are doing everything you can and have some good knowledge in tools to put to use to fight off the infection. I hope that you will be successful in eradicating the bacteria. Please let us know if you have additional questions as you push forward with the treatments!


                • #9
                  Re: Metroplex treatment duration for Hexamita?

                  I am closing 14 days of Kanaplex this Friday, so i will do a 25% water change and add carbon then.
                  I finished treatment with nitrofurazone this Sunday and it helped some but did not clear the problem along with feeding with Kanaplex(The fish showed discomfort with the last nitrofurazone dose which brought the medicine levels close to toxic levels, so i lowered it till fish stopped showing any major discomfort). So i switched from feeding Kanaplex to treating with it in the water from Saturday night as its supposed to have a synergistic action with nitrofurazone. I did a 25% water change on Sunday to lower the nitrofurazone concentration, replacing the Kanaplex quantity i removed, but left nitrofurazone at a concentration of ~4-5mg/l(toxicity starts at 8mg/l). I am continuing the Kanaplex treatment in the water and the columnar seems to be clearing finally! Its the first time the infection is only going backwards! I am attributing the biggest effect on the Kanaplex treatment in the water, with some help from nitrofurazone. I think that the Kanaplex feed was effective at keeping the fish healthy inside but was not enough to help with surface infection nor lower the pathogen count in the tank, which covered the wood with strands. I think that systemic and surface antiseptic function was needed to effect a cure to this pretty hardy infection. The lower temperature i have the last couple of days helps some as well(23C). I am hoping all symptoms clear within the next couple of days and i can cease medications for good on Friday.
                  Last edited by Kostas; 11-24-2015, 02:13.


                  • #10
                    Re: Metroplex treatment duration for Hexamita?

                    Glad to hear you are seeing improvement. Hopefully a full recovery is just around the corner. Thanks for keeping us updated on your progress.


                    • #11
                      Re: Metroplex treatment duration for Hexamita?

                      Thank you! The treatment with Kanaplex in the water worked and the fish are columnaris free since Thursday and the tank medication free since Friday night, right at 14days of Kanaplex usage. I should had searched harder and found the quantities needed for in water use of Kanaplex right from the start and I think it would have effected a cure. Maybe nitrofurazone was needed for its synergistic effect against this difficult infection, or maybe not.


                      • #12
                        Re: Metroplex treatment duration for Hexamita?

                        Glad to hear it worked for you!


                        • #13
                          Re: Metroplex treatment duration for Hexamita?

                          It seems my problems are not over yet to sit back and enjoy. I have reasons to suspect fish TB on my Platydoras costatus as the bumps on their bellies have not gone away, except on one of them following the Kanamycin treatment. The bumps are increasing in number and getting bigger. Kanamycin is suggested as a one full month treatment against this disease in order to be effective. Can you confirm this? Is KanaPlex safe to use for a full month and able to cure the disease with the dosage suggested on the package or is a different dosing method suggested? I guess i need to add it in the water and not just feed due to the resilience and ability of the bacteria to survive in the aquarium and re-infect after the end of treatment. Is this right?
                          Will the bumps eventually go away with this treatment or will they remain even after the disease is cured?

                          Thank you very much in advance


                          • #14
                            Re: Metroplex treatment duration for Hexamita?

                            I could not be sure what they have and kept searching for the cause before proceeding with any treatment. From what i found, Mycobacterium was not the most likely cause. From my searches, i found that it could be of sporozoan/myxozoan origin, fungal(Ichthyophonous) or Mycobacterium. BUT, i also found that Hexamita can cause granulomas when they get out of the gastrointestinal tract and into the organs. I don't know what it really was and could not conclude.

                            But at the same time, one of my very young cichlids started showing Hexamita symptoms, so i began metronidazole treatment. After just 1 feeding with metronidazole, the bellies of the Platydoras were half size and closer to normal again! Then columnaris made a reappearance right away on light fin and body injuries of a cichlid and on the eye of a Platydoras and on 2 more cichlids, overnight...So i began simultaneous treatment with Kanamycin in the water. Now, 3 days later, the bellies are very close to normal and columnaris seems to be fading away.

                            What treatment length should i use for Hexamita and what for columnaris? I don't want to over-medicate unnecessarily as it can't be good for the fishes but i also want these completely cured. Any tips on making sure these 2 pathogens do not recur? The water conditions are not deteriorating at any time point to cause them. As for stress, a minimal stress is always present in cichlid tanks from occasional aggression.
                            Current tank temperature is 23C, i have kept it that low since the previous columnaris infection and have been reluctant to raise it in fear of causing it to recur. Was this maybe a stressor?
                            Last edited by Kostas; 12-10-2015, 02:42.


                            • #15
                              Re: Metroplex treatment duration for Hexamita?

                              Tomorrow is the day I am adding the third dose of Kanaplex. If I need to continue treatment for a further 1-2doses, how do I proceed after the third dose? 25% water change before the 4th dose or something else?

                              Thank you very much in advance