OK got the angelfish photo!
Your confirmation that the small white spots on this fish look more like salt or sugar sized granules sprinkled on the fish indicate that the fish indedd does have Ich — and you should consider proceeding as per suggestions I outlined in my previous post. The odd-shaped wound near the dorsal fin is definitely not HITH (Hole-In-The Head) disease. Without yet any info coming forth as to whether the area of undetermined origin behind the eye is raised or indented, it’s hard to say exactly what that is (in one post, you mentioned it was an area of missing scales). If this (missing scales) turns out to be the cause for this blemish, this should heal up in short time as well, and may have been incurred at the same time as the larger wound.
I would like to add that while many Cichlids are prone to contracting externally manifested HITH disease, I can’t say I’ve ever seen an Angelfish contract this malady in my lifetime. More noted for getting HITH (external) are Discus and a number of particular species related to what was once known broadly as the Cichlasoma Clade — which would include its close relations, Oscar’s and Uaru’s. Its just possible that I may have been fortunate in not ever seeing HITH in Angelfish, but if they do contract it, I’d have to say its rare. Angels will, however, contract internal parasite disease (Hexamita), which early on was thought to be associated with HITH diease, but further studies of any connection between the two have dispursed this theory.
At this time, and with the descriptions noted here as best as can be seen, I see no reason for treating this fish for HITH, and no reason to continue searching for medications for treating HITH, including Metronidazole — which, if you live within the confines of the United States (or have access to the LFS’s), can be readily obtained if needed. SeaChem’s Metronidazole (powdered) is just that, as is primarily also Jungle Laboratory’s Internal Parasite Guard, Jungle Lab’s Hole-in-the-Head Guard, Thomas Laboratory’s Fish-Zole, Aquatrol’s Metrozol, Aquarium Pharmaceutical’s General Cure, Hikari’s Metro+ and the Jungle Lab’s Parasite Clear Tank Buddies. Jungle Labs also offers a medicated food, Anti-Parasite Medicated Fish Food, with Metronidazole as the main medication as the active ingredient. These medications do not seem necessary in your case, however.
The next step? Expect to treat for Ich, posibly via the heat treatment as already outlined. Continue to keep an eye on these injuries — NOTE — HITH DOES NOT APPEAR OVERNIGHT; the mark behind the eye, contiguously occurring in time with the mark beneath the dorsal and noticed very suddenly this past Monday, on December 22nd IS NOT HITH. HITH does not spontaneouly appear! Ray
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