Hexamitosis, or hole disease: symptoms, how to treat, prevention

Aquarium fish kept in freshwater or saltwater may be affected by a concerning condition called hexamitosis, sometimes known as "hole-in-the-head" disease. Hexamita is the name of the protozoan parasite that causes this illness. It gets its name from the distinctive symptoms it causes, which include the fish’s obvious pits or lesions all over its face and head. It’s essential to recognize these symptoms early on in order to treat the illness effectively and stop it from spreading throughout your aquarium.

Hexamitosis symptoms can be extremely upsetting. Fish that have this illness frequently exhibit a variety of symptoms, such as deteriorating fins, appetite loss, and general physical decline. Small, circular depressions may start to form around the fish’s head, especially in the vicinity of its eyes and gills. Timely intervention is crucial because, in severe cases, these lesions have the potential to deepen and cause more serious health issues.

Hexamitosis treatment is a multi-step process. Improving the general quality of the water in your tank is usually the first step, since bad circumstances can make the issue worse. Protozoan infection-specific medications can be useful, and there are other options as well, such as medicated foods and water treatments. Keeping the environment clean and thinking about putting sick fish in quarantine are also crucial to stopping the disease’s spread.

The key to preventing hexamitosis is to keep your aquarium clean and to frequently check on the health of your fish. To help prevent this illness, make sure your fish are not under stress and that their habitat is clean. Maintaining a stable tank environment and reducing the risk of infections requires regular water changes and adequate filtration.

Hexamitosis in fish – what kind of disease is this?

This intestinal and gall bladder illness in aquarium fish is caused by parasites. The disease is easily recognized visually by holes, ulcers, and furrows of varying sizes. In fact, this is the reason why hexamitosis is also known as hole disease.

An intestinal parasite with a unicellular structure called a flagellate is the source of the disease in an aquarium. The flagellate’s body has an external structure that resembles a droplet, with a maximum size of no more than 12 micromillimeters. The parasite’s name is explained by the presence of a few flagella on its body. It’s important to keep in mind that this parasite can proliferate while dormant.

Kindly take note! The flagellate can be very dangerous for other aquarium occupants because it can exit the fish’s body with the byproducts of their vital activity.

Aquarium fish that suffer from hexamitosis, also referred to as hole disease, have visible symptoms and may even suffer harm if left untreated. This post will discuss the symptoms of hexamitosis, including lesions and behavioral abnormalities, and offer helpful guidance on how to properly care for fish that have the infection. We’ll also go over important precautions to take in order to maintain the health of your aquarium and lower the chance of contracting this illness. You can guarantee that your aquatic pets have a higher quality of life by comprehending and applying this knowledge.

Which fish are susceptible to the disease?

Salmon fish are typically affected by hexamitosis. Their head and sides have affected skin. However, the illness is most dangerous to:

• labyrinth fish;
• cichlids;
• lapius;
• gourami.

Regarding other fish species, the only way for them to get infected is through invasive methods. Thus, until a certain point, they are merely the parasite’s carriers; the illness itself doesn’t show up until the right circumstances are established in a shared aquarium.

Hexomitosis carriers include:

Additionally, the following may also fall prey to the flagellate, albeit to a lesser degree:

Kindly take note! The development of holes and ulcers in the head region of these fish can also serve as an indicator of when the disease first started.

Causes of the disease

The majority of aquarists believe that failure to follow the fundamental guidelines for maintaining the aquarium and its inhabitants can result in hexamitosis in aquarium fish. Specifically, we might be discussing:

• the use of spoiled or low-quality food;
• about avitaminosis , lack of minerals in fish, which provokes a weakening of the immune system;
• about excessive or, conversely, insufficient feeding.

Numerous studies, however, have demonstrated that while the aforementioned causes are undoubtedly significant, they are merely incidental; they do not actually cause hexamitosis; rather, they are its catalyst.

Thus, dirt, water, poor-quality food, and vegetation can all enter an aquarium with pathogens. The parasite then waits for the right circumstances to arise before disclosing its existence. The disease itself is then triggered as the flagellate starts to actively divide. The outcome of the active phase is distinctive in that it is visible to the unaided eye. Fish that are infected could die if you do not begin treating them right away.

Note: It is believed by some scientists that virtually all aquarium fish carry the disease’s pathogens. Fry, especially in young fish.

The fact that fish that recover from hexamitosis are immune for life is intriguing. which shows that the body successfully produced the required antibodies and that the treatment was administered as intended. Remember that the illness affects healthy fish as well! Hexamitosis-causing pathogens produce cysts that leak out with excrement and have the potential to start a true epidemic in the reservoir.

Symptoms of hexamitosis

It is nearly impossible to diagnose the illness in its early stages, which makes it very difficult to begin treatment on time. The fish’s darkened natural color, abrupt weight loss (even with regular feeding), or loneliness are the only non-direct indicators. In order for the therapy given later to be effective, you must check your pet as soon as possible for the onset of hexamitosis if these symptoms are present.

It’s also a good idea to become acquainted with the primary signs of the illness in a typical aquarium.

1. Deterioration of appetite. In a more acute form, the fish may completely refuse to eat food.
2. Destruction, falling off of fins.
3. Picky eating. For example, the fish may grab food and then spit it out.
4. Enlarged anus.
5. Deep erosions on the lateral zones. These erosions go to the skin of the head.
6. White mucous discharge. The disease affects the intestines, due to which its cells are rejected and often excreted in large quantities from the body.
7. Bloating of the abdomen. This symptom is observed mainly in cichlids. Usually, due to the disease, the shape of the abdomen and back changes.

Kindly take note! Furthermore, the disease also causes changes in the aquarium inhabitants’ external coloring.

Not all of the symptoms listed are typically present when hexamitosis is present. White discharge can occasionally even be a sign of enteritis or poisoning. But you also shouldn’t ignore what you’ve observed. The diseased fish should ideally be kept in a different aquarium so they can be examined. This will prevent disruption of the general tank’s ecological microclimate and improve the efficacy of metronidazole treatment.

Video – Signs of hexamitosis in a Malawi fish

Treatment of hexamitosis in aquarium fish

There are numerous options available today to treat this disease in fish. However, you must take into account the specific factor that served as the disease’s catalyst when selecting one of them. Researchers have demonstrated that nearly all cases of hexamitosis are associated with a viral infection; as a result, the most severe outcomes may result from hastily administering metronidazole treatment.

As a sort of quarantine, first transfer the diseased fish from the main aquarium to a different one. This will allow you to prevent the illness from spreading throughout the entire tank. Next, raise the breeding tank’s water temperature; 34 to 35°C are the ideal ranges.

Crucial! Most parasites may perish from such a severe jump. However, you must proceed with caution: before beginning the procedure, make sure you are familiar with the physiological traits of the sick fish, as not all of them will be suited for warm water. For instance, treating cichlids with this approach will not work.

Treating the illness with metronidazole is an additional strategy to eradicate it. This antiprotozoal medication’s efficacy has been demonstrated time and again. It also becomes evident why so many aquarists prefer metronidazole because the ingredients in it have no negative environmental effects.

Both a regular aquarium and a quarantine aquarium can use the medication. Remember, though, that the drug’s maximum allowable dose is 250 mg/35 l. In this scenario, water should be changed frequently (roughly 25% of the total volume on the first day, and 15% on the second and third). The metronidazole treatment should last for three days. It is preferable to stop the treatment if there is no discernible improvement.

Be aware that it will take a week for metronidazole to start showing effects. Furthermore, it is advised to do therapeutic baths after a week in order to be proactive.

You can use other medications in addition to metronidazole; fortunately, pet stores carry them. However, make sure to speak with the seller before purchasing any products and find out if the treatment will negatively impact the aquarium’s current microclimate.

The goods that are most in demand are:

• Tetra Medica HexaEx;
• Ichthyovit Kormaktiv;
• ZMF Hexa-ex.

We also point out that an integrated approach is the only way to treat hexamitosis with the greatest possible impact.

As previously mentioned, some fish can only be carriers of the pathogen; as such, treating them with a single medication is not recommended. However, this is where you need to exercise caution. Expert aquarists suggest mixing branded and pharmaceutical preparations together. For instance, combining 50 mg of "furazolidone" with 1 g of "kanamycin" in 15 liters of water at the same time. For seven days, add daily, replacing a quarter of the total water volume on a regular basis.

Crucial! If you use "Ciprofloxacin," make sure to follow the recommended dosage of 500 mg for every 50 liters. Together with it, we advise using ZMF HEXA-ex (be sure to read the instructions on how to dilute the drug).

After receiving treatment, fish may occasionally exhibit toxicosis symptoms. If so, use half the medication dosage and quickly replace at least 50% of the aquarium’s water. This also holds true for pharmaceutical and branded preparations.

Take preventive action in the general aquarium (within 4 days) after the quarantined fish return to avoid potential relapses.

Video – How to treat hexamitosis?

Hexamitosis (Hole Disease)	Treatment & Prevention
Symptoms: White stringy feces, loss of appetite, small holes on the head, weight loss, lethargy.	Treatment: Increase water temperature, use metronidazole, maintain good water

For aquarium enthusiasts, hexamitosis, also known as hole disease, can be a difficult condition to manage. It’s critical to identify the symptoms as soon as possible, such as unusual behavior, obvious sores, or weight loss. The degree to which the illness is treated and controlled can vary significantly depending on this early detection.

Hexamitosis is usually treated with a mix of medicated treatments and tank environment modifications. Your fish’s immune system will be strengthened and they will be more resistant to illness if you maintain high water quality and feed them a healthy diet. To guarantee the best chance of recovery, it’s also critical to carefully adhere to treatment guidelines.

The secret to keeping your aquarium fish healthy is prevention. A balanced diet, proper hygiene habits, and routine maintenance can greatly lower the chance of developing hexamitosis. A healthy aquatic environment can be preserved by keeping a close eye on your fish and acting quickly to treat any symptoms of illness.

You can prevent hexamitosis and other related problems in your aquarium by being watchful and proactive. Your fish will appreciate all of your efforts to keep them happy and healthy in their underwater habitat.

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