Troubles with Popeye continue

[Reefer1978]

One of my angels continues to struggle with popeye, with the following symptoms: both eyes, have it, left larger than right, fully clear, he's struggling to swim as one eye is pretty large.

Currently he's getting dose 3 of erythromycin. I performed eye surgery mid last week, which helped a lot, but it started growing again and is back to the original size. I have read adding erythromycin behind the eye and then sucking it out, but I am struggling to figure out how to do it (fresh SW, RODI mixed with erythromycin, etc). I also tried epsom salt, with no effect.

Any other thoughts?

 

[vetteguy53081]

One of my angels continues to struggle with popeye, with the following symptoms: both eyes, have it, left larger than right, fully clear, he's struggling to swim as one eye is pretty large.

Currently he's getting dose 3 of erythromycin. I performed eye surgery mid last week, which helped a lot, but it started growing again and is back to the original size. I have read adding erythromycin behind the eye and then sucking it out, but I am struggling to figure out how to do it (fresh SW, RODI mixed with erythromycin, etc). I also tried epsom salt, with no effect.

Any other thoughts?

Eye surgery can allow air and bacteria within area. Maracyn works well with eye issues

 

[Reefer1978]

Eye surgery can allow air and bacteria within area. Maracyn works well with eye issues

He had it before the surgery, and I am pretty certain it's already bacteria based. Isn't Maracyn also erythromycin which she's already on?

 

[MnFish1]

Umm. The 'eye surgery' may have lowered the pressure in the eye temporarily - but also can introduce other pathogens (as said above). Eye surgery - I would not think is ethical to do - unless you're trained to do it (yes even in a fish). I would not recommend the erythromycin behind the eye - since I don't know the protocol. and it could be doing as much damage as good.

I would continue the erythromycin.

 

[MnFish1]

He had it before the surgery, and I am pretty certain it's already bacteria based. Isn't Maracyn also erythromycin which she's already on?

Yes - maracyn is erythromycin phosphate. don't believe that are any recommendations for intraocular administration. it is a very irritating drug

 

[Reefer1978]

I believe @Paul B specifically advocated for "surgery" and I took every precaution possible.

 

[MnFish1]

I believe @Paul B specifically advocated for "surgery" and I took every precaution possible.

Sorry I was making more a general comment.

 

[Reefer1978]

Yes - maracyn is erythromycin phosphate. don't believe that are any recommendations for intraocular administration. it is a very irritating drug

That's my concern also, but how does it get "in there" behind the eye to work?

 

[Reefer1978]

Sorry I was making more a general comment.

Please don't apologize, I am here to learn and all my questions are genuine.

 

[vetteguy53081]

He had it before the surgery, and I am pretty certain it's already bacteria based. Isn't Maracyn also erythromycin which she's already on?

Yes

 

[KrisReef]

That's my concern also, but how does it get "in there" behind the eye to work?

If the concentration in the water is correct the medication should be taken up across the gills, into the blood stream or by osmosis across the eye itself. I am not certain which route is active, but the dosing of antibiotics, if done properly should provide the eyes relief without an injection.

Follow the labeling instructions for use. Hope the fish recovers.

 

[Jay Hemdal Verified Community Expert]

One of my angels continues to struggle with popeye, with the following symptoms: both eyes, have it, left larger than right, fully clear, he's struggling to swim as one eye is pretty large.

Currently he's getting dose 3 of erythromycin. I performed eye surgery mid last week, which helped a lot, but it started growing again and is back to the original size. I have read adding erythromycin behind the eye and then sucking it out, but I am struggling to figure out how to do it (fresh SW, RODI mixed with erythromycin, etc). I also tried epsom salt, with no effect.

Any other thoughts?

Can you post a picture? I’d like to get some sense of the severity of the issue. I’ve tried bubble reduction surgery hundreds of times, the bubbles almost always return. Here is an article on fish eye health:

Aquarium Fish: The ‘Eyes’ Have it: A Review of Eye Health in Aquarium Fishes

Aquarists need to inspect their fish closely every day, for signs of impending health problems. It is much easier to resolve a problem when it first starts, than to attempt a drastic emergency treatment when the fish is close to dying.

reefs.com

It won’t give you a cure, but has some important background info in it.

Jay

 

[Reefer1978]

Can you post a picture? I’d like to get some sense of the severity of the issue. I’ve tried bubble reduction surgery hundreds of times, the bubbles almost always return. Here is an article on fish eye health:

Aquarium Fish: The ‘Eyes’ Have it: A Review of Eye Health in Aquarium Fishes

Aquarists need to inspect their fish closely every day, for signs of impending health problems. It is much easier to resolve a problem when it first starts, than to attempt a drastic emergency treatment when the fish is close to dying.

reefs.com

It won’t give you a cure, but has some important background info in it.

Jay

 

[Reefer1978]

@Jay Hemdal pics posted. She received 4th Erythromycin dose yesterday. Treatment tank is 2.5, I am adding 550-600 mg of medication after a 25% WC daily, measured by 0.001g scale off of amazon (I know they are cheap and precision could off).

My concern is she's not getting better after 4 days, and not eating in over a week.

By the way I read your article already last week, great one, thank you!!

 

[Jay Hemdal Verified Community Expert]

@Jay Hemdal pics posted. She received 4th Erythromycin dose yesterday. Treatment tank is 2.5, I am adding 550-600 mg of medication after a 25% WC daily, measured by 0.001g scale off of amazon (I know they are cheap and precision could off).

My concern is she's not getting better after 4 days, and not eating in over a week.

By the way I read your article already last week, great one, thank you!!

Ugh - bilateral exophthalmia with visible bubbles has a REALLY poor prognosis. As you've found out, surgery hardly ever works. I wish I knew the mechanism as to how/why mechanical trauma causes gas formation. The two other possible causes are an acute supersaturation event, and bacterial gas production due to an infection (the Erythromycin will help with that).

 

[Reefer1978]

Ugh - bilateral exophthalmia with visible bubbles has a REALLY poor prognosis. As you've found out, surgery hardly ever works. I wish I knew the mechanism as to how/why mechanical trauma causes gas formation. The two other possible causes are an acute supersaturation event, and bacterial gas production due to an infection (the Erythromycin will help with that).

Thanks @Jay Hemdal. I was thinking it's bacterial, as oversaturation should be a one-time event, and after the surgery it came back, so something is forming the gas bubbles?

 

[MnFish1]

I would consider adding kanamycin. (i.e. using both together) - however, also realize that it's not totally unexpected that you may not see improvement yet (can often take longer). The antibiotic can be absorbed locally and through the gills and then systemically. I'm sorry - I don't recall - did you QT the fish/treat with prazipro? Some people recommend a FW dip - followed. by Prazipro - in case of flukes. To me it is a little odd to see bilateral injury - can you give a bit of information as to the buildup/detailed history of what happened?

PS - At least in humans - moxifloxicin and aminoglycosides (like kanamycin and neomycin) have good concentrations inside the eye.

 

[Reefer1978]

I would consider adding kanamycin. (i.e. using both together) - however, also realize that it's not totally unexpected that you may not see improvement yet (can often take longer). The antibiotic can be absorbed locally and through the gills and then systemically. I'm sorry - I don't recall - did you QT the fish/treat with prazipro? Some people recommend a FW dip - followed. by Prazipro - in case of flukes. To me it is a little odd to see bilateral injury - can you give a bit of information as to the buildup/detailed history of what happened?

PS - At least in humans - moxifloxicin and aminoglycosides (like kanamycin and neomycin) have good concentrations inside the eye.

Yes, all my fish are QTed, but, another animal was introduced with Flukes (QT - treated, but somehow still made it in). I am treating for Flukes, and this showed up within days, I didn't think both eyes would be hit in one day with a few flukes being introduced, but never know.

 

[MnFish1]

Yes, all my fish are QTed, but, another animal was introduced with Flukes (QT - treated, but somehow still made it in). I am treating for Flukes, and this showed up within days, I didn't think both eyes would be hit in one day with a few flukes being introduced, but never know.

Can you remind me - was this fish treated for flukes after the other one was introduced? And - which regimen did you use (I'm sorry if you mentioned already - and I think it was discussed already)

 

[Paul B]

I’ve tried bubble reduction surgery hundreds of times, the bubbles almost always return. Here is an article on fish eye health

Jay, you did it wrong and maybe you used that same needle on a horse before you used it on a fish.

You remove the bubble or fluid with the needle then inject a small amount of antibiotic behind the eye, then draw it out. I also have done it dozens of times and never killed or blinded a patient. Sometimes their insurance doesn't cover it so I have to do it for free but it always worked.

Sometimes, I agree it comes back and a second treatment is necessary just like when we go to a doctor, many times it doesn't work the first time.
But if we had Pop Eye they would first "fix" it by drawing out the fluid, then if necessary, medicate behind the eye.

Just using medication may cause the fish to lose the eye before the medication worked, if it ever works.