# Marine Aquariums > Seahorses & Pipefish >  Internal gas bubble disease

## Gary R

This condition manifests as a bloating or swelling of the pouch in the male, which in turn, prevents normal locomotion.  The horse will float to the surface and become stuck there, unless he is a very strong swimmer, in which case he may be able to overcome the bouyancy problem for a while. 

The major problem with this condition is the weakening of the fish during the symptomatic phase.  As the horse struggles to overcome the bouyancy problem, he will become weaker and weaker, potentially to the point of not being able to eat, and thus may starve to death.  Another problem is that the fish may get caught in bad areas such as filtration intakes/returns or against heaters, without being able to free himself.


*Pouch Evacuation for Male Seahorses*

Evacuating the brood pouch of a male seahorse may be necessary from time to time if a male's pouch accumulates excessive gas in the pouch. At first, this may seem like a frightening thought, but its really very simple to do, even with the squirmiest of guys. Just remember, seahorses are smart and he'll probably sulk and shy away for a few days. That's okay.
*Equipment you'll need*

shallow container with tank waterblunt tipped bobby pin, soft plastic pipette, or iv catheter sleeve with needle removedmoral supportFirst, you'll need to grasp the male firmly underwater. Some people prefer to do this in a shallow container with tank water, but once you're proficient at it, you can do this in the tank. If you do it in a separate container, make sure there is enough water to fully cover the seahorse from back to tip of snout with your hand holding him. He shouldn't be exposed to air during the procedure.
To hold the male, position him so he is laying across the palm of your hand. I prefer having it so the male's upper body rests between my index and middle fingers, as it aids in manipulating the pouch. You'll want to get him to wrap his tail around your pinky or ring finger or he'll use it to grab his head, snout, etc. to block you from getting to his pouch. He may struggle for a bit, but keep him immobilized without squeezing too tight, and he'll calm down. Eventually. Some males take longer than others to relax.

Once he's still, you'll want to begin applying pressure to his pouch. First try without using any tools to open the pouch. You'll want to apply pressure from the front at the base of the pouch and work your way up. Do this in sort of a rolling fashion, keeping the area you previously applied pressure to down and working your way up. Sort of like a tube toothpaste. Its hard to describe the exact pressure needed, its not too hard but not too gently either. Do what feels comfortable to you, and remember, you can always try again if you don't apply enough pressure the first time you do it. One common mistake is the use of rubbing as the term "pouch massage" is often used to describe thus procedure. The pouch is soft skin so intensive rubbing can lead to skin damage and infection. Instead, you want to apply pressure in a more direct pushing fashion. You may also need to gently squeeze the sides of the pouch to direct the air towards the opening, using the free hand to squeeze while using you holding hands thumb to push.
If all goes well, the bubbles will start to come out of the pouch opening. This is why I prefer doing the procedure in tank; you can tip Mr. seahorse so his pouch opening is the highest point, thus allowing the air to leave.
If it does not come out on its own, you may need to tease the pouch open. This is where it gets tricky, especially if you do it alone. But, as I can attest, it can be done on your own with patience and dedication. However, if you can find a non-squeemish friend to help the first few times, it might be a good idea.
Again, hold the seahorse the same way in your palm. Now you'll need to force the air near the opening of the pouch similar to before to make the pouch opening more taut. You can do this with the thumb of your holding hand. Now, hold the insertion tool, (blunt bobby pin, pipette, or catheter) between your thumb and index finger of the free hand and work at pushing the sides of the opening away. He will be holding it tight, so it may take a little while of gently working at it to get him to relax enough to let it open. You may not be able to see the opening as the pouch folds around itself here. Keep working gentle, careful to not actually insert into the pouch while doing this procedure. You will know when its open when the stream of bubbles comes out. Hold open and with the fingers you're putting pressure on the pouch with, keep working your way up until the air is all out.
In a small number of males, even teasing the pouch open will not work to get the air out. In those cases, you will have to use an iv catheter sleeve to insert completely into the pouch to release the air. Follow the above procedure to enter the pouch, and then slide in at an angle so the catheter is parallel to the body/tail. It may require gently wiggling in all areas inside the pouch to find the bubble. I have done this on a couple of my males, and while it has not noticeably caused problems, neither have bred since than so its not known whether or not this causes complications with infertility. It seems unlikely but it is something to keep in mind before attempting.

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## mac2kw

Absolutely amazing.

and really good advice, don't think i could try it though bit heavy handed me.

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## Dave wow

nice bit of info there your tank is in stock by the way.

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