Bladder Disease - Is it time to Euthanize? But I don't want to!

[Jan Cavalieri]

My powder blue dwarf gourami has had this for 4-5 weeks now. First and second time it was a distinct tilt and inability to swim straight, this time it's hanging vertically, with the head at the top. I can snap her out of it for a few minutes by repositioning her. She cab even straighten herself out when she wants to swim. With each occurrence she eventually goes back to swimming normally until it takes over again. She has been isolated in a 5 gallon tank during this time. I see no poop anywhere. She never fights me. In fact she even wags her butt and fins at me when she sees me - which I always interpret as a sign that she's glad to see me when my other fish do it.

As far as I can tell she has not eaten a real meal in 4-5 weeks. She was terribly thin, now somewhat bloated,but she'll likely get thin again. She just refuses to eat - which means she doesn't ever eat the blanched peas that I've peeled for her. (actutally none of my fish will eat peas - isn't that strange?).

I've treated with General Cure. No change. Currently on the third round of Furan-2 (a broad spectrum antibiotic). No notable change other than she's still alive.

Have twice added Epsom salts (medical grade) (about 2 teaspoons each time in a 5 gal tank). I DO think it helps but I've dosed the tank twice and do a 25% water change after every 2 doses of Furan-2 - so every 3 days - but I'm sure there is plenty of salt in the tank. Do I dare dose salt again?

Here is what I DO feed her: I mash the peeled peas into lots of water until the water is very green. I add about 1 teaspoon Miralax. I added a little garlic extract (that is what really caught her interest). I used a small syringe (no needle) to force feed her the mixture. First time I tried it with the garlic she willingly opened her mouth - now not so much. Problem is she's not really getting the fiber from the peas at all just the flavor. I continue to offer her flaked food and blood worms and during about week 3 she ate some twice in a row. The next day it all came back up completely undigested. So I am assuming she still cannot process food. She still rejects all that is offered daily.

Most often after a "feeding" of pea "soup" she goes to the top of the tank and a big airbubble comes out. Not sure if that's a puke of what I just fed her or just her regular breathing (she's a labrynith fish like a betta). Starting to think she swallowed too much air during feeding just puked up the air.

I noticed her issue to begin with because she stopped going up for air ALL the time, every time I watched her for nearly 2 weeks - very abnormal - in fact I thought it was believed that Gourami's (not Betta's) MUST go up for air periodically, yet here she was, alive, but not breathing normally and not eating at all.

So going into her 5th or 6th week I wonder how can this fish be alive? No way is she getting enough nutrition off of pea soup. Is she suffering? She seems pretty lively not at all depressed. The only time I get a serious pain response out of her is if I press on her lower sides where I presume most of her intestines are. Trying to see if there is a hard mass in there or what is going on - she just about jumps out of the tank when I press there so I don't try that any longer. Other than that she just lets me handle her and hold her upright until she re-stabilizes herself. I keep thinking if I could just get her to EAT the DAMN PEAS she would have been well a long time ago.

I'm not even sure if what she has is bladder disease now anyway - most of those cases resolve fairly quickly don't they? (for better or for worse)? If it's a blockage of her intestines I'm guessing her intestines may have died by now.

Do I go ahead and euthanize her? (I'm not sure I'm ready to do this)
Do I stop all supportive care such as the pea soup, laxitive and antibiotic
Do I go ahead and add more Epsom Salts - if so how much?
Was adding Miralax crazy? I just wanted some way to get a bunch of fiber in her when she will only consume watery substances. Any better ideas

One limitation I am VERY VERY sick with one of the work cases of bronchitis I've ever had so I can't run to the store and buy anything - I can get it from Amazon in 2 days typically.)

Is it time to give up and let her go? I do have clove oil so I'm prepared to euthanize when necessary.

 

[Jan Cavalieri]

Can anybody offer any advice? Are my post too long that they just get ignored? I'm sure a number of you have had a problem with swim bladder disease just no advice to give?

Yesterday she ate small amounts of food - I don't know if she kept it down but she did release some very large bubbles which fixed the swim bladder. Now that she's eating I'd offer small amounts of peeled peas again except they don't float and she is the type of fish that only eats what is on top of the water. She won't eat from a spoon (tried that)

 

[Kritastrophe]

If it has been going on for 4 to 5 weeks and she hasn’t passed or deteriorated I would think she might be able to live a viable life. She has to be eating something to still be alive that long. If she does stop eating completely, is wasting away, or getting sucked into the filter intake I would personally consider euthanizing because quality of life would be an issue. How old is she?

 

[Naughts]

the lack of replies is probably because it's a moral minefield and it's too personal for someone else to say you should or shouldn't do it- you're the only one who can assess the level of suffering and you have to be comfortable with either course of action, to euthanize or not.

 

[Jan Cavalieri]

"Moral Minefield" - love that term, it's what I feel when I mention on here that I've used PHup or PHdown (GASP)

It's an internal moral minefield for me because she seems to be trying so hard - so I think the decision made is that she is wanting to go on - so I'll let her. I can't count how many humans I've watched die and with a few exceptions, most just gave up and died - the rest were forced (by taking them off life support etc). It was much easier to watch when they just gave up on their own. Even if that sound's cruel, it was actually a more peaceful death.

I've had her since May of this year, she was nearly of adult size when I got her. I don't know what she's eating because she can only eat what I feed her since she's in a tank by herself. I guess there is a remote possibility that she could be eating the leftovers that don't get suctioned out but given that I've never seen her be a bottom feeder and she doesn't seem to be physically adept enough to even maneuver her body to the ground I don't think she's getting food for herself. After I feed her she goes up to the top and lets out a huge air bubble, early on that bubble contained every piece of food I had given her for days now it just appears to be water.

Is the Miralax a totally stupid idea? I mean I was trying to think of something that could be dissolved in water and yet stimulate her intestines - of course it works on humans but either it doesn't work on fish or her intestines are physically closed off and dead so nothing can get through.

Her appetite interest has picked up dramatically in the last two days but she still only eats about 2 bites of food and I try to get the garlic flavored/pea soup/miralax mixture down her as well. I think it's probably the watery mixture she's burping up.

At the same time - her swim bladder disorder comes and goes even in the same day - the worst - standing on her head trying to swim to more commonly swimming with a slight tilt. I'd show video but for the most part she doesn't move at all unless I nudge her or force her to change positions. I can pick her up and manipulate her body however I want as long as I do it without pushing in on her sides - which she reacts violently to.

Did a 25% water change today per the antibiotic instructions. Since she is improving I guess I will continue with another round of antibiotics.

Fish are even better than birds at not showing pain or illness - I suspect reptiles are the same way. If it wasn't for the weird swimming behavior she'd still be in her regular tank slowly starving to death - I have way to many fish to make sure all of them eat a full diet. I would never have noticed her, she's got an identical "twin" and I can't tell them apart.

Oh and what does everybody think about the fact that she sat near the bottom of the tank without coming up for air for nearly two weeks before I realized her swim bladder wasn't working AND SHE DIDN'T DIE. The last article I read was a debate about whether or not betta's and gouramis MUST come up for air periodically or die. Their conclusion after great observation was that betta's only do it when they are short on air but Gourami MUST do it or die. She didn't die - even now she doesn't change position for hours in the water without getting any air and she doesn't die. So my conclusion is that Gourami's do not HAVE to come up for air to survive. When I force her to come up for air she won't even always take a breath but often she will. There is a filter and two air stones in her little 5 gallon home along with plants. Water is likely very well oxygenated.

 

[Jan Cavalieri]

She's back to refusing all food, but the swim bladder issue hasn't returned. How is this fish still alive? I am amazed at her will to live. Wish I had a little x-ray machine and could see what's going on in her intestines - if they have died off in sections I would likely decide to euthanize her since she can't recover from that but if it's still just a blockage I will continue with pea soup and miralax. Anybody have any experience giving laxatives to fish? Are there any specifically made for fish - she's been fed so much Miralax by now I would think it would have worked if it ever is going to.

I do have an exotic veterinary clinic where I would take my Parrot, but they treat reptiles and birds, I don't believe they have the set up to treat fish. (I watched a TV show once showing surgery on removing a tumor from a gold fish with anesthesia in the tank of water. A complete success) but this fish needs an x-ray - can you imagine how much that will cost for my dear little $10 fish (priceless actually) - since she can breathe air they actually probably could sedate her and take an x-ray and then get her back in the water before there was any risk (other than the sedation). Out of water she lies so still they might not even need sedation if they were fast enough. Just wishful thinking. They are VERY expensive.

 

[Jan Cavalieri]

Probably nobody cares since I didn't ever get a lot of replies (those that did are much appreciated). But I wanted to give you an update on my Powder Blue Gourami (still in the hospital tank). I soaked to death some tubiflex worms and she started eating again! No fish can resist these plus they tend to float on top of the water where she can get to it. I have to hold it in front of her little mouth (she lets me lightly restrain her) and she started eating small amounts of them. I'm feeding her 3 times a day - with no vomiting so far, no reoccurance of the swim bladder disease although she still swims at a slight tilt. I still don't see any evidence that she's pooping which concerns me a lot but I could just be missing it. Still administering antibiotics daily per the pkg instructions with a 25% water change every 3rd day (again, according to the antibiotic instruction). IF she ever progresses to where she'll eat on her own voluntarily I'll consider her cured and move her back to her home tank. This baby has been starving for weeks so it's so encouraging to see her eat. I just hope she can digest it and starts eating on her own.

 

[Aynia]

You are doing a great job! It is very apparent how much you love your fish and I really admire that

It doesn't sound like she's ready to give up the fight yet, just judge what you think her quality of life is and when she tells you she's ready, then she's ready. If I thought cats were bad at hiding their pain, they've got nothing on fish.

 

[BigBlue42]

I totally understand your situation. I had a blue acara that had the same symptoms. He sat at the bottom most of the time and he hardly ate. I tried all manner of treatments but nothing helped. He would sit back in a cave and every once in awhile come out. He had a hard time swimming. This went on for close to 4 months. I had the same struggle but I kept him alive because by outside appearances he looked fine . I would check on him each day until finally he came out and was swimming in circles, he looked stressed and very uncomfortable and I finally pulled the plug and euthanized him with clove oil.
So as one person stated before , it's really a matter of quality of life and is the fish only suffering silently and slowly. Hope all works out for you.

 

[Kritastrophe]

Glad your blue Gourami is eating. Lack of replies is probably due to the time of the year. Everyone’s entering into the busy holiday season so there are probably a lot of people absent from the forums to be with family etc. Happy Thanksgiving!

 

[Jan Cavalieri]

Happy Thanksgiving to you as well. I used to do big suppers and feed lots of relatives but now nearly all have died (including both my parents and my dear husband and nearly all my aunts and uncles) so my daughter and her husband spend the holidays with his parents. I'm ok with it - I cooked that meal for over 20 yrs and it's a huge stressful and expensive ordeal so I'm not sure I'll be sad being alone. Plus I don't eat turkey anyway! I still miss all our families special side dishes that I've eaten nearly every Thanksgiving since I've been alive.

Her swim bladder problem has returned, found her on her head this morning and her side this afternoon, but with some forced practice swimming (I gently coax her along) she straightened out. I still see no poop in the water. Her eating is good but still way to minimal to survive on given the number of weeks she refused to eat.

She keeps trying and so will I. We've gotten quite close - Instead of being scared of me I think we're buddies - I can handle her completely or she's too weak to fight me just as long as I don't startle her she does fine. I've just never heard of a fish surviving such an extended illness with such little food. She doesn't even look overly thin and she's not bloated either. Still keeping her on antibiotics with a water change every 3rd day (package instructions). I've given up on Miralax. I may try again to see if she'll eat some peas. I have that garlic sauce for them now.