Baby Fahaka Puffer Internal Parasite Identification - Can See Worms In Belly

[Tbo]

First of all I apologize for another help/advice post, but I cannot for the life of me treat this or even find anything that seems to fit. So Im throwing myself at the mercy of the collective brain for help... Maybe the puffer king, the nermbasador himself, can bestow his wisdom upon me. 

Would anyone be able to help identify the internal parasites in this baby Fahaka puffer so I can best treat him, and possibly have a recommendation for treatment? You can almost make out little worm squiglies but I can’t tell. 

He’s in a quarantine tank with cycled filter and gets a water change twice a week, once 20% just to vacuum the bottom and another 30-50% after the meds.  So far one round of the med trio and then another round of Maracyn and ParaCleanse with little improvement. No visible worms expelled. Oh around 7, water fairly hard, ammonia/nitrites/nitrates 0 because of the frequent water changes (I avoid WCs during meds), temp around 77. 

I can only get him to eat live brine shrimp, where he plumps up a little but is deflated again the next morning and cannot put weight on. Feeding a few brine shrimp 3 times a day now just to get him to eat a few shrimp a day. He follows and looks at other food but then shys away. 

I’ve tried everything I can get my hands on, garlic dipped or not. Also tried soaking his food in vitachem just to see if I can maybe get some vitamins in him but he won’t eat anything but brine. Frozen: Mysis shrimp krill blood worms and brine shrimp; Live: Daphnia and brine shrimp; xtreme nano. Live brine and maybe 1 daphnia on occasion is all he takes. 

Stool is little reddish brown balls in a string like loose beads. Can’t seem to find info or examples of this anywhere. 

Doesn’t seem too lethargic considering his emaciated condition. I’ve got Levamisole HCL being delivered tomorrow (11/4) and will be treating with that followed by a little epsom salt in the water, water change, and another round follow up.

Trying to see if someone can point me in the right direction to try to cater the treatment. Hate to just keep throwing meds at him. 
 

Please help 😞..

Video of underside of the belly.

 

Thanks in advance! 

Edited November 5, 2020 by Tbo
Flow

[Cory]

The main struggle here is getting weight back on this puffer. I'd try some cooked cocktail shrimp that you can buy at the store, as well as keeping some small ramshorn/pond snails in there all the time once the levamisole treatment is finished. I'd also try some freeze dried krill as it's one that is used to try and get fish to eat. 

The feces sounds like internal parasites.  Unfortunately with the puffer so emaciated , it can be hard to treat and keep the puffer eating.

 

If levamisole doesn't work, you could try tetra lifeguard, i believe this is the same med that jungle used to make, it was used with 1/4 quarter tablet soaking food. The biggest struggle will be getting the puffer to eat, the parasites being secondary currently. 

[Tbo]

Thank you for the reply Cory! So I’ve actually got some raw shrimp marinating in vitachem for my other meat eaters, I’ll try cooking some and seeing if he’s interested. He is only 1” though so I’ll have to mince it. Question though, why cooked? I’ve got a brine shrimp and daphnia culture for him which has kept him alive this long, so I’m hoping the levamisole will perk up his appetite and get him to eat more. I’ve got ramshorn and bladder snails growing out I can add for him after the treatment. I havnt tried freeze dried foods but I’ll grab some krill tomorrow. I read that levamisole is supposed to help fish perk up a bit so I’ve got my fingers crossed. I’ll take a look at the tetra lifeguard if the levamisole doesn’t work. 

thanks again! 

Edited November 5, 2020 by Tbo
Raw shrimp isn’t cocktail shrimp till it’s cooked and served cold.

[Tbo]

Follow up question: 

There’s seems to be a wide range of doses discussed for levamisole HCL. Is there one you could recommend? Thanks again