Nifurpirinol & Copper

Christoph · Jul 1, 2017

Dear all,

anybody knows if the antibiotic Nifurpirinol (Sera Bactopur direkt, one of the only fish ABs we can get here) can be combined with Cupramine?

Seems i have a nasty bacterial infection going aswell

Thanks a lot!
Christoph

Maritimer · Jul 1, 2017

While the antibiotics we use here in the U.S. _can_ generally be combined with copper, I have no experience with that particular one. @Humblefish might know the answer, as he's researched a truly remarkable amount about this sort of thing.

Generally a good idea to increase aeration in the QT when using antibiotics, especially in combination with other medications, as oxygen levels can drop pretty sharply.

~Bruce

aykwm · Jul 1, 2017

I discussed this recently with @Humblefish , there is an old article that mentioned that they used nifurpirinol along with copper to cure velvet with success. Nifurpirinol and Nitrofurazone (furan-2 active ingredient) are derivatives of each other and people mixed furan-2 before without issues.
Ill leave it for @Humblefish to confirm it, but I believe you should be fine doing so.

Humblefish · Jul 1, 2017

^^ Agree; Nifurpirinol & Nitrofurazone are very similar, and both can be safely combined with copper.

Christoph · Jul 2, 2017

Thanks everyone! Great advice here in R2R, its greatly appreciated!

The P. hepatus is swimming since yesterday in 0.2 ppm Nifurpirinol in addition to ~0.4 ppm Cupramine. Appetite is still very good, but the skin looks worse today. How long would it take to see results from the Nifiurpirinol?

Ive also ordered some Kanaplex from the US, it should arrive within the next days. Is it safe/wise to dose it additionally?

Symptoms are very pale skin, looks a bit like dust covering, but unlike velvet. Hard to describe, and unfortunately impossible to fotograph. Fish is in therapeutic cupramine since June 17th.

Is it also possible im seing skin irritation because of the copper treatment?

Thanks everyone!

All the best,
Christoph

Humblefish · Jul 2, 2017

Christoph said:
The P. hepatus is swimming since yesterday in 0.2 ppm Nifurpirinol in addition to ~0.4 ppm Cupramine. Appetite is still very good, but the skin looks worse today. How long would it take to see results from the Nifiurpirinol?

Sometimes within a few days, but often up to 10 days. Antibiotics are notoriously slow acting with fish.

Christoph said:
Ive also ordered some Kanaplex from the US, it should arrive within the next days. Is it safe/wise to dose it additionally?

Yes, kanamycin can be safely combined with nifurpirinol.

Christoph said:
Is it also possible im seing skin irritation because of the copper treatment?

Yes, very possible.

Christoph · Jul 2, 2017

Hi Humble,

thanks again for the speedy reply! What would you suggest to find out if its copper side-effects or bacterial?

I could set up a sterile 10 gal container with just the antibiotics, and move the fish over. Meanwhile i could empty the QT and let it air dry for 48 hours. After that i could restart the QT with a seeded spomge from the (desease free) DT. Is this adviseable, or just adds too much stress to the fish?

Best,
Christoph

aykwm · Jul 2, 2017

Since you already started copper treatment I don't suggest you stop it and try it again, at the end of the day copper is poison and you want the least amount of time for the fish to spend it in copper. You can post a picture of the irritation to better judge if its bacterial or copper irritation, but I think what you are doing now is just fine, hopefully it will clear up soon. Usually if its heavy infestation it might be gone but the fish needs some time to heal up and repair the damaged tissues, thats why keep observing it and check if there are improvements or not.

Humblefish · Jul 2, 2017

^^ Agree; please post photos of the P. hepatus so we can ascertain the condition.

Christoph · Jul 20, 2017

Hello Everyone,

id just like to give an update on this issue. Problem was the hippo tang that developed fading colors, loss of appetite and rapid breathing while in QT on cupramine.

What i did was to dose Nifurpirinol into the QT, but the symptoms didnt improve very much. So i figured that it might be copper adverse effects. Since Copper was already up at therapeutic level for over 2 weeks i did a careful tank transfer into a sterile QT and dosed Kanaplex for 6 days. The fish improved a lot. Also appetite came back. Still it wasnt sure if the condition was copper induced or bacterial or both.

The fish went back into the main QT (unmedicated) after the QT has been drying completely for 24 hours plus. Within a few days the hippo tang developed again loss of color and also a "bump" on his head.

Now dosing metronidazole since 4 days: Appetite and color seems to be back 100% but the bump on the head is still very concerning. What would you say: Lympho? Or maybe something like a Tumor?

What would you recommend? Shpuld i add Kanaplex again in addition to the metronidazole? My plan would be to keep dosing metronidazole for at least full 10 days.

Best,
Christoph

aykwm · Jul 20, 2017

I thought it might be copper sensitivity, but you mentioned that the tank has been dried and now contains no meds. So my other theory is biofilm. Sometimes drying tank is not enough and you need to sterilize it with other measures like bleach, vinegar, chlorine, etc. how long has it been since you setup the qt, if qt stayed few months biofilm might develop which will be to a certain degree resistant to antibiotics so other means should be utilized. For now, since the fish was happy in the other tank i recommend you take it back to the tank and observe it there. Copper sometimes need less than 30 days, but its safer 30 days, so you can check if no symptoms develop it will be safe to add to dt. Probably observe it for 2 or 3 weeks before adding it to dt.

Best of luck

Christoph · Jul 20, 2017

Hi akwym,

thanks for your reply. But I dont really understand where youre aiming at. What would you suspect is the diagnosis here?

The other tank was unfortunately just a rubbermaid container to temporarily hold the fish, while the main QT was cleaned and dried. Symptoms basically returned a few days after stopping the Kanamycine dosage, so there was no Meds in there, if there were any biofilm there would have been nothing to degrade

Now metronidazole seems also to be working nicely in improving the fishs condition, but the fish shows still some heavy breathing (its day 4 into treatment) - which is maybe not so untypical, since this hippo seems to be stressed always, especially when food is present. Anyway, the hippo eats like crazy, so i hope he is on a way to recovery.

My main question is this "bump" on the left forehead. This is unfortunately somethink new. I noticed it about 6 days ago. Might be a consequence of a physical injury, Lympho, something else or an oncologic problem. Anyone here on Reef2Reef seen something like this before?

Would you move on with Metronidazole or add other antibiotics as well?

Best,
Christoph

Maritimer · Jul 20, 2017

I think that what Aykwm is asking is whether you sterilized the QT (using vinegar or bleach, perhaps) before draining and drying, or whether you only drained and dried the tank. There can be a "biofilm" on wet surfaces that can have adverse effects on both fish and meds.

The tang's rapid breathing and twitching have me concerned, as well as that odd brown lump on his head. @melypr1985, @Humblefish - any thoughts?

~Bruce

4FordFamily · Jul 20, 2017

The head looks more like an abscess to me

Christoph · Jul 20, 2017

Hi Bruce,

thanks! Nope, was not sterilized, only let dry.

Looking forwards to Merediths and Humbles opinion here. Our hippo tang "Tipsy" has been with us for quite along time and is very personable, its our top priority to save him.

Best,
Christoph

ngoodermuth · Jul 20, 2017

Bacterial infections can be stubborn and very difficult to treat, and I suspect that is what you might be dealing with here. I dealt with something similar recently, and unfortunately despite my efforts I eventually lost the fish.

If you have acriflavine, a 90-minute bath could be helpful.

You can dose all three of your medications- Kanaplex, metroplex, and the nifurpirinol; for at least 10 days, doing a 25% water change every 48 hours before re-dosing. Add an airline if you can, as using multiple medications will suck oxygen from the water.

Ten days would be the minimum, but if he is still symptomatic you could go for 12-14.

The problem with bacterial infections in fish, is that antibiotics don't actually cure them. The idea is to knock it back hard enough that the fishes immune system can finish it off. Feeding is going to be important, make sure he is getting nutritious foods- preferably soaked in vitamins or selcon.

Good luck, and keep us posted!

Christoph · Jul 20, 2017

4FordFamily said:
The head looks more like an abscess to me

I also dont have the feeling its lympho. Regarding an abscess, additional antibiotics might be worth a try?

Best,
Christoph

4FordFamily · Jul 20, 2017

Christoph said:
I also dont have the feeling its lympho. Regarding an abscess, additional antibiotics might be worth a try?

Best,
Christoph

Perhaps-- if it's not infected and red I am not sure how well it'll help.

Christoph · Jul 20, 2017

ngoodermuth said:
Bacterial infections can be stubborn and very difficult to treat, and I suspect that is what you might be dealing with here. I dealt with something similar recently, and unfortunately despite my efforts I eventually lost the fish.

If you have acriflavine, a 90-minute bath could be helpful.

You can dose all three of your medications- Kanaplex, metroplex, and the nifurpirinol; for at least 10 days, doing a 25% water change every 48 hours before re-dosing. Add an airline if you can, as using multiple medications will suck oxygen from the water.

Ten days would be the minimum, but if he is still symptomatic you could go for 12-14.

The problem with bacterial infections in fish, is that antibiotics don't actually cure them. The idea is to knock it back hard enough that the fishes immune system can finish it off. Feeding is going to be important, make sure he is getting nutritious foods- preferably soaked in vitamins or selcon.

Good luck, and keep us posted!

Thanks for your support! I followed your QT threat very closely. Great you have made it through fairly well!

Tipsy is feeding very well, and im giving him multiple feedings a day. I will wait also for melpyrs and Humbles opinion, but id guess everything is pointing towards another round of kanamycine.

Thanks again!
Christoph