Ich and treatment in our tanks! You too can be Ich free!

xyzpdq0121 · Mar 26, 2007

After being inspired by Todd's rant to make more "useful" threads on here, I have decided to take a step in the right direction and write about a subject that is near and dear to my heart, Ich. Lets face the facts folks, Ich is a problem that most every hobbyist faces at some point or another. New to the hobby or old to the hobby, it really does not matter, we all have to deal with it. Not that I am judging any tank that I see, or am thinking that I am better then any one person, but I have seen about 30 member tanks and about 25 of them have had Ich. Not a good ratio for our fish. Even worst, I have seen almost all the major LFS tanks in the area, I would say all but 3 had Ich that I could see. Maybe I am alone in this thinking, but I think our fish deserve better. I think we pour THOUSANDS of dollars into this hobby but throw up our arms about Ich like it is fighting a loosing battle. I have heard members say "Oh my fish will just learn to live with it." "I keep it at bay as long as my fish do not get stressed." I have not spent as much on my kid as I have on my tank in the last few months but if he gets cancer, I am not going to take the attitude of "He will fight it on his own!" 


The point of this thread is going to be to discuss what has worked and what has not worked in the fight against Ich. It will highlight some of the things EVERYONE should be doing to prevent an outbreak in your tank. It will offer advice on what to do if you find yourself with the dreaded Ich one hot summer morning, and more importantly, what not to do. I know not everyone is going to agree with what I have to say. I know some people are going to say that I am over reacting, to them, I can say that I will over react while I look over my Ich-free tank.

Some of what is posted here is original, some is "borrowed" from other posts and sites across the web. I will try to site where I can (and when I remember) but if I forget a post or site and you find it, please let me know and I will correct it ASAP if someone feels like I have stolen ideas and writings. 


BTW: This thread is dedicated to all the fish I have killed while finding out what has worked and what has not. They gave their life's so that others could live, and for that they will never be forgotten! A moment of silence please..........

Ok on to the nuts and bolts....

xyzpdq0121 · Mar 26, 2007

What is Ich?

Ok so what is Ich anyways?!? The ugly little causative parasite of Marine Ich is the ciliated protozoan (single celled animal), Cryptocaryon irritans (even the name sounds bad!). The parasite has a rather simple life cycle, and has several different phases during its life cycle when it is especially vulnerable. The parasite, in its free swimming phase, locates a suitable host (i.e.; your fishes!), and burrows into the hostâ€™s skin, gills, and fins, where it feeds on the fluids contained within the hostâ€™s body. For protection, the parasites form a thin cyst over themselves. The cysts, which look a lot like grains of salt, are usually the aquaristâ€™s first signal that the fish has contracted the disease. The encysted parasites, called trophonts, remain attached to their fish host for approximately 7 days until the protozoan reaches maturity. Next, the protozoan leaves the host and enters the water column as single cell, known as a tomont. The tomont (or cyst) can swim for up to 18 hours before it attaches to a suitable substrate, such as sand, rock, or the aquarium itself. Then, the cells within the cysts divide, and form up to 200 "daughter" parasites, or tomites. This process, which takes anywhere from 4 to 28 days, results in a new generation of free swimming protozoan called theronts. The theronts must then locate and inhabit a suitable host to complete their life cycle within several hours, or they will die. It is during this free swimming phase that the Cryptocaryon parasite is most vulnerable, and this is the part of the life cycle when Marine Ich can be eradicated with a relatively high degree of success. Amongst the most myth-ridden subjects of marine aquarium keeping, "marine ich" must be near the top. Some folks (in print no less) have stated that the cause of this disease is bacterial, viral... directly environmental! All is false, What is true is that the parasite is introduced into the system to effect fish at different times and rates. Environment does not CAUSE Ich. If I go to the beach and smear Crisco on my butt and lay out in the sun it is going to get really burned. The Crisco did not cause the sun burn, the sun did. The Crisco just helped it along. Same things applies to Ich. A stressed out fish is going to show more signs of Ich and get it worse then a non-stressed fish. Does that mean that ALL fish have to be stressed to get Ich? Not in my observations. Does Ich raise the stress level of the fish? You bet your top lip it does!


So, How do my fish get Ich and why can't my fish live with Ich?

Ok call me a tree hugger, call me what you will... Lets think like a fish real fast. One day I am swimming along in the ocean, minding my own business and all the sudden I am knocked out with cyanide. I Wake up in a box with a bunch of other half alive fish. Within a few hours I am on a plane bound for sunny California. No I do not get to do the Movie Star tour. I get thrown into a tank (lucky for me because my bag was getting nasty with all sorts of rank stuff). I am still having a hard time breathing because of the cyanide. I am sorted and bagged again while I am sent off to Atlanta. I arrive in a LFS store known as Pet Co. ( I pick on them because of the horrors I have seen in their tanks!!!) There are a few fish dead in the tank next door and another Yellow Tang that is looking like he has pimples all over him. Bingo, within a few hours, his bugs are in my gills. I am pretty weak from the trip and I just do not have the energy to fight them off. A few days later, a guy pays hard earned money for me and brings me home to live in his beautiful 180Gal tank. It is not the ocean but it will do! Little does he know, he plops me in and the stuff living on me has a new place to breed. Bingo, lets tell our local reefer what he has won Johnny! A lifetime supply of Ich!!! So that is one way you can get it. Another? of since you asked! Remember how they told you in reefing 101 not to mix water from another's tank in with yours! Yep this is one reason why. Another? Darn you guys are a tough crowd. I will admit this way is unlikely but it HAS happened to me so I will share it. How about those corals and inverts that you just plop in your tanks. You think theronts and tomonts can not live on or inside the shell of your new hermits? You would be wrong, they can and do. 

Ok so why fight Ich, why not let my fish just learn to live with it. Ok, let me take you to Haiti, give you an parasite to "live with" in your intestines and see how comfortable you are with it. BTW, I am going to shove you in a small box just for added comfort! We should strive for the best system for our "pets". I swear some peoples thought is, "If they die I will just get another fish." (Which will get Ich too because your system has it now and will meet the same fate somewhere down the road). I am going to try to leave my personal feeling out of this but believe me, I do not think people that think this way should own a tank! I will just say, your fish should not HAVE TO live with this parasite and it is your duty as a reefer to support the needs of the fish you have decided to keep.

xyzpdq0121 · Mar 26, 2007

I heard Ich is in EVERY system and will ALWAYS be in my system!

Welcome to the land of Myth and legend. No one has PROVED that Ich in in every system. I BELIEVE it is not in mine. I have taken MANY slides to the microscope and have not found it in my system any more. Could I be wrong? Sure I will admit to that but I think that many people smarter then me feel the same way and I will stick by that opinion. Listen, Ich is not just a random thing, it is an parasite, and with all parasites, if it does not have a host then it will not live. In theory, this means if you did a tank cycle without fish for 4-6 weeks, then your tank started Ich free. This also means that you introduced it at some time. So if you take away the host, the parasite dies and no more Ich. Until someone can prove me other wise, this "Always in the system" myth will remain just that, a myth in my eyes!


Ok, Ok, You have made your point! How do I not get Ich?!?

Well, Question for the ARC group. How many people in the group have set up a QT tank?!? Ya not too many! (and your excuse is not because you got me to pawn your fish off to and do it for you! You know who you are!

) I have never met another member that has shown me their tank, sump, fuge and then QT set up! I only know one person that has told me that they were setting up a QT tank when they got their last batch of fish, and I do not know if that was the truth or if this member was just saying this because he was afraid that I would not give him his fish without it! Other then that, I do not know of ONE other QT/Hospital tank in the club other then my own! (I am sure there is one but I have never seen it!) Why is this?!? It costs less then one of the fish you put in your tanks! You would keep more fish alive in the long run with it! You would save yourself WEEKS of work and heart ach if you would have one! EVERY book you have read that was published in the past 10 years has told you that you NEED one! So why don't you have one?!? Ya, I am talking to you, WHY DON'T YOU HAVE ONE?!? Having one is they ONLY way not to get Ich in your display tank! That is it, that is the cure all! Easy end of thread.... Well not quite. 


How to set up a QT tank:
The equipment involved for quarantine is ridiculously simple. You will need a small glass/acrylic tank with cover (from 10 – 40 gallons, depending upon the size/number of specimens that you are working with), outside power, canister, or sponge filter, and a reliable aquarium heater of sufficient wattage for the tank that you’re using. Other items include an accurate thermometer, a dedicated net (that will not be used in any other aquarium), siphon for water changes, and test kits for any therapeutic agents that you will be using, such as copper.

That’s about all you need! No rocks, gravel, or other substrate is used, as these materials can potentially bind with or absorb any medications you may be using. Inert materials such as PVC pipe sections may be used to create hiding places for your fishes.
Setting up is a very simple process. Several days before the arrival of your new animals, fill the aquarium with water from your main system. Introduce the filter, plug in the heater, and you’re ready to go. (Here’s a tip: If you keep your filter sponge or other quarantine tank filter media in your main system’s sump when the quarantine tank is not running, you will always have a filter that is fully colonized by beneficial bacteria at all times.)
Following a proper dip/bath procedure, which is in itself a simple procedure, introduce your fishes to the quarantine aquarium. I highly recommend refraining from running the tank lights, if present, for at least the first 24 hours to give the new fishes a chance to settle in after a rough journey. In fact, ambient room light is usually fine.

It’s a good idea to wait overnight before attempting to feed your new arrivals, as they are usually not inclined to eat right off the bat. Besides, cleanliness in the quarantine tank is of utmost importance. Any uneaten food should be promptly siphoned from the tank to avoid pollution.

The quarantine tank’s water chemical parameters (pH, etc.) and temperature should approximate these found in your main system. Some hobbyists like to run their quarantine tank at a lower specific gravity (as low as 1.010) to assist in eliminating parasites, but I like to keep the quarantine tank at a "normal" specific gravity (1.022 – 1.026). Since you are working with a smaller volume of water in most cases, it’s important to follow a diligent schedule of small water changes. Assuming that your main system is healthy, you can utilize water from the main tank to replace the water in your quarantine tank. Since it is the water that your new charges will eventually be living in, I can’t think of a better use for wastewater from your main system’s routine water changes (you are doing regular water changes, aren’t you?). The quarantine period should last 21 days. <Let me interject here to and say you should run it for 4-6 weeks at a minimum in my opinion! Better to be safe then sorry. Also the clock starts when you add your last fish to the QT, not your first. If you add a fish 2 weeks after the others, the clock starts over again!>

During the quarantine period, observe your fishes daily and be sure to keep a keen eye out for any potential infection. Obvious signs of illness, such as rapid respiration, open sores, fungus, etc. require recognition and quick action on the part of the aquarist. As you will find, the quarantine tank presents a perfect environment to treat fish diseases before they can spread to your main system. See elsewhere on the wetwebmedia site for information on the recognition, diagnosis, and treatment of various afflictions that can affect your fishes.

What do you do if your fishes do become ill during the quarantine period? Two things: First, take the appropriate actions to treat your fishes, and second, congratulate yourself on having the foresight to utilize quarantine procedures with your fishes! Unfortunate though it may be, you will receive the best possible lesson on why quarantine is so important.

Keep in mind that, should disease rear its ugly head during quarantine, you’ll need to reset the clock for another 21 days after you have successfully eradicated the ailment. There would be absolutely no point in rushing to add your newly cured fishes to your main system at that stage of the game. Patience is truly a virtue with quarantine, and it will, reward you and your fishes handsomely.

Should you acquire more new fishes while you are in the middle of the quarantine period (this never happens, right?), you have two options: either add the new fishes to the quarantine tank (after appropriate prophylactic dips/baths) and reset the calendar for 21 more days, OR you can set up a new quarantine tank! Either way, you have to stick to the 21-day rule. It’s that important.

In addition to being an invaluable aid in the prevention of disease in your main system, the quarantine tank provides a perfect environment for newly-received fishes to "toughen up" and rest after the long ordeal of capture, shipping, and handling. Your fish will be refreshed, well fed, and most important of all, healthy after a stay in your quarantine tank.
When the 21 days are up, and your new fishes have been introduced to their new home, you can break down and thoroughly clean the quarantine system. Be sure that none of the equipment from your quarantine tank comes in contact with your main system before it has been cleaned, particularly if you were utilizing copper or other therapeutic agents in the tank. Your sponge filter or other filter media may then be sterilized and placed back in the sump of your main system to re-colonize beneficial, ready for your next new arrivals.
Hopefully, you are now convinced of the value of the quarantine tank, and the piece of mind and other benefits it provides. Such a simple concept, yet an invaluable tool. The quarantine tank is used at all public aquariums as a first line of defense against the introduction of disease. Aquarists at public aquariums cannot afford the risk of infecting their entire population of fishes, neither should you. Quarantine should become an integral part of YOUR fish keeping procedures.

Thanks to Scott Fellman (http://javascript:DoCompose('ADDRd125bd6d-9f1f-428b-9f74-7f8340daa53d');">algaeguy01@hotmail.com</a>) for that article. Saved me a lot of typing! ;)

xyzpdq0121 · Mar 26, 2007

I am NOT going to QT my fish no matter what you say!

Ok, your choice not mine! But if you insist on another method, I will give you one that works better then nothing but is not fool proof. Kind of like a Kroger Bag condom on prom night, better then nothing to some but God only knows if it works. As you read before,a FW dip should be performed before QT. Well a dip should AT LEAST be performed before you skip QT! It is your first, and this case only, line of defense against the nasty stuff that lives on fish! How do you do a FW dip? Well I am glad you asked! It is REALLY easy for your fish, but stressful for you! Yes you read me right, I said FRESHWATER dip! The nasty crap that lives on your fish can not live in fresh water. "Is this safe for the fish?" In 99% of the cases, yes. There are some fish you can not dip, rays, sharks, and puffers being the most common. But they really do not get Ich so you are good there. There are MANY different things that people use for dips but the safest and most effective is Methylene Blue and freshwater. What? Disappointed? Hear me out, this stuff works! And it's very safe. Methylene blue and fresh water is useful for both marine fishes and many invertebrates, a help against ich, skin and gill flukes, funguses, velvet (Amyloodinium) and most other external parasitic and infectious diseases. It has several other added benefits. It's a good oxygenating dye, sort of like our blood's hemoglobin, aiding in keeping oxygen concentration high. It also is helpful in reducing light penetration, soothing frightened livestock. In fact, Methylene Blue converts methemoglobin to useful hemoglobin, reversing the ill-effects of nitrite and even cyanide exposure. These qualities are what make Methylene blue particularly useful as an "anti-fungal" for transporting stock and rearing eggs. Add to this the low cost, ready availability and lack of restriction on it's use and disposal and we have a winner! Score! (Fenner) Now the kicker... You can not find this stuff easily, I think I have seen it at one LFS but I can not remember where. Dr. Fosters has it for like $4.00 a bottle and one bottle will last you for ever. Buy two bottles because the stuff is really funny to put in the ARC president's coffee or coke at the next meeting. Won't harm him but he will pee green or blue for the next 12 hours or so! No it won't hurt him! (Sorry Tony!)

xyzpdq0121 · Mar 26, 2007

So these are the best instructions I have found for doing a FW dip with Methylene Blue:

THINGS YOU NEED

TWO identically sized plastic (non-clear) bowls such that (when equipped with the colander insert if you choose to use one) it is no less than 2 inches over the height of the fish and enough room for the fish to swim around in (or at least be able to easily turn around in).

ONE cover for the above bowls that is ‘open’ or has holes in it, like a plastic latticed cover or flat colander.

Methylene Blue (a solution sold for fish medication that is about 2.0 to 2.2% Methylene Blue)

Sodium Bicarbonate (Food Grade Arm & Hammer Baking Soda) to adjust pH up

Vinegar (pure without additives) to adjust pH down BUT avoid the use of this -- don't overshoot pH and prefer to dump the bath and start over rather than adding vinegar to the bath

Timer (stove, microwave, portable timer, watch, etc.)

Net(s) (preferably, use a colander (see below) to transfer and dip fish to avoid injury from a net)

Long plastic kitchen spoon (either solid or with holes) for mixing the bath

pH tester

Temperature tester

OPTIONAL THINGS YOU MAY WANT

A third plastic bowl (non-clear) exactly like the two from THINGS YOU NEED

Plastic Colander (that fits snugly into the above required plastic bowls; the fish will be inside this and it still needs to give the fish the 2" minimum water over the fish and swimming around room)

pH meter (Hanna handheld or similar model that measures to 0.05 pH units (or better) reliably)

Thermometer (easily portable digital that reads to 0.2 degrees F reliably)

xyzpdq0121 · Mar 26, 2007

DIP PREPARATIONS

Prepare equipment:

There must be no sharp edges to the colander and plastic bowls (use fine sand paper then Emery Cloth to remove sharp edges)
There must be no labels or glue left from removed labels, on the equipment and tools.
Clean everything and rinse well with RO/DI or distilled water. (NOTE: Especially if you use a dishwasher for your household, you must rinse in hot tap water to remove any residue, then thoroughly rinse again in RO/DI).
Although it isn’t necessary, if you haven’t recently calibrated the pH meter (if you’ll be using one) I suggest doing that before this process.

Prepare the freshwater bath:

1. Use RO/DI water or distilled water for the bath water. Measure how much water you are using in gallons or liters.
2. Adjust bath water to about 3F above the temperature of the quarantine tank water (some cooling will occur). Stir with spoon.
3. Using Sodium Bicarbonate in small increments, adjust bath water to a pH just about 0.10 pH units below the pH of the quarantine tank water. Stir with spoon.
4. Add drops of Methylene Blue to the bath water as follows: 2 or 3 drops per liter of water; 9 drops (0.4 ml) per gallon of water. (NOTE: dispense drops holding the dropping bottle or dropper exactly vertical (not at an angle).)
5. Stir bath with spoon. 
6. Finish adjusting the pH to match that of the quarantine tank water pH while stirring the bath.
NOTE: It is not impossible for the QT water to change pH in a short time. Be sure to verify that the bath pH still matches the pH of the QT water JUST BEFORE the fish is to enter the bath. Adjust pH just prior to use, if necessary.
7. Check temperature. If it is up to 2F above the quarantine tank water, that will be okay. If the bath water temperature is lower than the quarantine tank water, it must be raised. A lower bath water temperature than the quarantine tank water, is not acceptable. (You can use a microwave to heat a small portion of the bath water, then mix with the whole bath to raise the bath water temperature).
*8. 

Prepare rinse bath:

Fill one of the bowls with quarantine tank water to use as a rinse, just before you need it (see DIP PROCESS)

----------------

So you have two (or three if using the colander method) identical sized bowls;

1 with the freshwater bath water in it, properly adjusted for pH and temperature
1 empty (to be filled when needed with quarantine water for the rinse off)
1 empty with the colander inside of it (if you're using nets, these two pieces aren't needed)

The colander will fit snugly into each of the three identical bowls

xyzpdq0121 · Mar 26, 2007

DIP PROCESS

Process directions are given as if you are using the colander suggested equipment. 

1. Acclimate the fish in its bag, to the quarantine tank water according to: http://www.reefland.com/forum/marine-fish-care-health-disease-treatment/19094-acclimation-i-know.html#post137198">It Was Acclimation, I know. . .</a>
2. After this acclimation and while fish is still in its transport bag: Gently pour the fish and water into the empty bowl with the colander insert in it. Cover the colander. (Now the fish is inside the plastic colander, which is inside the bowl, which now contains the bag water).
3. Lift the covered colander and let the water drain away out of the colander (and away from the fish). Hold for two seconds.
4. Insert covered colander into bowl with freshwater bath in it, and sink it.
5. Set timer for 5 minutes and start the timer.
6. For the first 5 minutes watch how the fish is doing through the lid or by peaking under the lid. Tangs often pretend to be dead. Don’t be fooled! If the fish is in legitimate danger, stop the bath and proceed to number 9.
7. After 5 minutes, check the fish again and start the timer again (for another 5 minutes).
8. Repeat 7. until the fish has been in the bath for 30 minutes or until the fish is in legitimate danger (see below: Signs of a fish in trouble).
9. Fill the still empty dry (third) bowl with quarantine tank water.
10 When time has come to stop the bath, raise the covered colander out of the bath, sink it into the rinse container of quarantine tank water to rinse off excess bath water. Pause just a few seconds.
11. Raise colander and sink it slowly into the quarantine tank so that the fish can quietly swim out.

Look closely at the freshwater bath water in the container. Do you see anything that came off the fish? It is maybe hard to see through the blue (so pour some off (decant it); dilute it with distilled water), but spend some time and look closely to see if anything came off. Look for anything the size and shape of a sesame seed (fluke); look for tiny specs the size of powdered sugar (Marine Velvet ([I]Amyloodinium ocellatum)). This will help you with a diagnosis, should the fish end up being sick, infected or ?

[B]TIME IN THE BATH[/B]

A freshwater bath experience is more stressful to the novice aquarist that it is to the fish. [IMG]http://www.reefland.com/forum/images/smilies/biggrin.gif" alt="" /> Most fishes can handle an hour in this bath, but 30 minutes is plenty. With experience you can tell the difference between a fish faking stress and one that is really in trouble. Hard to explain in writing, but I’ll try. 

Signs of a fish in trouble. Often tangs (and a few other fishes) sink to the bottom of the bath and ‘play dead’ laying on their side. It is okay to prod it gently with a clean plastic rod or the long spoon handle, with no sharp edges. If it flops about or swims or swims then falls over ‘dead’ again, it is okay. Once some time goes by the tang will probably swim around. You’re mostly interested in how it’s breathing. Watch the gills.

Some fish will go into their defensive mode by erecting all spines, changing colors, changing patterns, or any combo of these. [IMG]http://www.reefland.com/forum/images/smilies/looney.gif" alt="" /> What the aquarist wants to do is don’t read too much into such antics, but to look closely at the fish to see how it is breathing. Rapid or normal breathing is okay for the first few minutes, but the methylene blue should calm the fish down shortly after the first few minutes (see below). If the fish is breathing very fast or not at all, with any one or more of those 'defensive' signs, the bath should stop.

xyzpdq0121 · Mar 26, 2007

OTHER DIP BACKGROUND INFO

Without getting technical, the methylene blue helps calm the fish and provides the fish an easier time to breath. At the same time, the methylene blue will actually make life difficult for some external and gill parasites. It has a very nice dual use in this process so take advantage of it. DON’T overdose the bath water with methylene blue. More is not better!

I found you can find/buy inexpensive colanders and bowls from your 99 cent store, K-Mart, Wal-Mart, etc. You want a plastic colander that fits tightly into the bowls and gives the fish the most swimming/moving around room inside the colander. You can even buy such plastic containers from suppliers of aqua culture products through the Internet. Alternatively you can use nets, but as we all know, nets can harm the fish (and by the time you get the fish, the fish is totally afraid of nets!). Buy the bowl sizes that are right for the size fishes you will be dipping.

If you use nets rather than the colander method, then you don’t need one of those bowls and the colander. You’ll make the transfers using the net to move the fish from bath to rinse to QT.

SUMMARY

If you perform this process on all acquired fishes, you can save yourself a lot of grief of having to cure sick fishes, or even just give an acquired sick fish a good chance to fight off its affliction.

In the case of anemone fish: After they are in the QT they need to begin a treatment for Brooklynella. The freshwater dip will not clear them of Brooklynella. ALL ANEMONE FISH need to be treated for Brooklynella. It’s too common of a disease for these fishes not to do this treatment.

Similarly, after the fish is in the QT, all tangs of the Acanthurus genus should be treated with Cupramine copper treatment to rid them of both Marine Ich (Cryptocaryon irritans) and Marine Velvet (Amyloodinium ocellatum. These fish are so often infected with one, the other or both that treatment should be considered part of the QT process. I like the use of hyposalinity, but hyposalinity doesn’t kill Marine Velvet. Copper kills both these parasites
Special thanks to Lee over at http://www.reefland.com/">www.Reefland.com</a> for this awesome dip procedure that saved me a lot of typing time.

xyzpdq0121 · Mar 26, 2007

Ok, so you told me how not to get it, but I have it, now what!
Ok, this is not the end of the world, you will need to take ALL your fish out of the main tank and get them into your QT tank. BEFORE they go into your QT tank, they need to do a freshwater dip. Believe me, the dip is more to limit the infestation and help the fish ASAP by getting the crap off them! While your fish are in QT, you are going to jack up the temp in your display tank and let it run without fish for AT LEAST 4 weeks! Your temp should be around 84 degrees or as constant to that as you can keep it. Believe me, your corals will be ok. To tell you the truth, they are going to love the warmer temp and do better then you can imagine. What jacking up the temperature does is speed up the life cycle of the Ick that was left behind in the display tank. I say you need to do this for AT LEAST 4 weeks. I recommend 6-8 to most people to be on the safe side. Yes, there has been research done by Noga in the 80's that suggested that Ich can live "incased" for up to 3 months in a tank. But this was at normal temperatures and not likely in most cases. So you want to be really safe, do 3 months, you want to be 99% sure, do 6-8 week at a higher temperature. That is as low as I can cut down the "fallow" period for you. Listen, running your tank without fish is not such a bad thing. For one your corals will love you for it. Second, your pods will explode all around the tank because there is nothing to eat them. Your fish will have a buffet to look forward to when they get out of QT. Third, You get to upgrade areas of your tank you could not easily do before because of your fish. Forth, Well I can't think of one at 3:00am but I know there is a forth good reason for letting your tank run fallow. So people Dip after QT, I do not all the time but I have before. It will not hurt anything to do this dip to be on the safest side of safe!

xyzpdq0121 · Mar 26, 2007

What treatments work and more importantly, which don't?
Ok I am going to admit, I am going to steal this from Steven Pro and Bob Fenner here. There is just too much for me to type and they have said it better then I could ever:
Probable Cures Include:
In a "bare" treatment tank: Copper compounds (chelated or free cupric ion) WITH matching daily or more often testing... Formalin dipping and moving to non-infested systems... Formalin and Malachite... Lowering spg., elevating temperature... Need to remove some types of chemical filtrants, turn off UV, skimmer/s. Allow the main tank to go fallow for a month. 
Even serious bottom vacuuming, water changes may effect cure. 
Oh, and yes... many fish groups are sensitive to irritating chemical treatments.
NOT Recommended: There is NO such thing as effective AND "reef-safe" medication. NONE.
RXP... X for experimental?
"Kick-Ich", kicks nothing
Garlic, best applied to pizza, not a cure. Melafix, not a fix.
"Vital", Reef DNA... Not! Probiotic Marine Formula, No-Ich, Hydroplex, Marine, Immune Plus, and Marine-Max... "chemical free!"
Can't be filtered or UV'd out
Re: Cleaner Organisms:
Shrimp, Wrasses...
Will help, won't cure.
Organicure... contains... Formalin
Magnets? You're joking.

Treatment Option 1 - Copper:
Copper is a highly effective medication against Cryptocaryon irritans when dosed and maintained in the proper concentration. The references I found varied in their recommended dosage:
Andrews et al, 1988: 0.15-0.30 mg/l
Bassleer, 1996: 0.25-0.30 mg/l
Gratzek et al, 1992: 0.115-0.18 mg/l
Noga, 2000: 0.15-0.20 mg/l
Untergasser, 1989: 0.15-0.20 mg/l*
*(recommends to be used with Methylene Blue)

I am going to abbreviate my advice and simply suggest to: "Always follow the directions of the manufacturer of whichever brand of copper medication you employ, and always use a test kit to verify the dosages." Copper has a narrow range of effectiveness and levels must be monitored at least daily.
Copper has several disadvantages in treating Ich. First, at too low a dosage, it is ineffective. Secondly, at too high a dosage, it could kill all your fish. Daily, or better yet twice daily, testing is required to maintain an appropriate and consistent level of copper. Even when within the appropriate ranges, some fish cannot tolerate copper. Some of the fish more sensitive to copper are lionfish, pufferfish, mandarins, blennies, and any other scaleless fish. Copper is also a known immunosuppressive, making fish more susceptible to secondary infections. Invertebrates are extremely sensitive to copper and cannot be housed in a tank undergoing this treatment. Lastly, copper cannot be used in the presence of any calcareous media. Live rock, sand, crushed coral, and dead coral skeletons will all adsorb copper, rendering it useless a treatment.
Copper specifically targets the infectious, free-swimming theront stage of this disease, as being buried deep in the skin of the host protects the trophonts; the cyst walls of the tomonts are similarly impervious (Colorni & Burgess, 1997). Knowing this and the life cycle of Cryptocaryon irritans, monitoring and dosing as needed in the evening right before the lights go out is going to be the most effective method. This should ensure optimal treatment concentrations at the most beneficial time.
Copper is probably the most popular method of treating Cryptocaryon irritans, but is not my first choice. It is far too labor intensive for me to recommend to the general public, has a large risk of overdose, lowers the fish's resistance to other diseases, and can cause serious damage to the kidney, liver, and beneficial intestinal flora of the fish being treated. Damage to intestinal flora is what many hobbyists point to as a possible contributing cause for Head and Lateral Line Erosion (HLLE), although there is currently no definitive cause of HLLE. 
<Used only at a last resort if Hyposalinity does not work!>

xyzpdq0121 · Mar 26, 2007

Treatment Option 2 - Formalin:
Formalin can be administered one of two ways; either in short dips with saltwater or used continually in a hospital tank. The dosage for the continuous use is 1 ml of the 37% stock solution for every 25 gallons of quarantine tank water (Bassleer, 1996). I prefer the formalin dip to continuous use because formalin is a fairly toxic compound. Also, with no commercially available test kits to monitor the concentration, it would be difficult to dose an entire tank and account for evaporation, absorption, etc.

To prepare the dip, I take 5 gallons of tank water and add to it 3.75 ml of 37% formalin. I also aerate the water vigorously to ensure there is maximum dissolved oxygen. The dip should last 30 to 60 minutes. As when using any medication, it is best to monitor the fish's reaction and be prepared to act if it appears in distress. When the dip is complete, net the fish, place it back into the hospital tank, and discard the dip water. This protocol should be repeated every other day for two weeks.

I would like to remind readers of a few precautions regarding the use of formalin. First, it is a carcinogen. Formalin is an aqueous solution of carcinogenic formaldehyde gas, so gloves should be worn and the area should be well ventilated when using it. Secondly, formalin should not be used if fish have open sores, wounds, or lesions. It is likely to cause tissue damage to these open wounds. And lastly, formalin can rob the water of dissolved oxygen. That is why proper aeration is so crucial. For that reason, do not use formalin if the water temperature is 82*F or higher (Noga, 2000 and Michael, 2002).


Treatment Option 3 - Copper & Formalin:
It is possible and sometimes preferable, like in the case of heavy infestations of Cryptocaryon irritans and Amyloodinium sp., to use copper in conjunction with Formalin in a quarantine/hospital tank. The same warnings about sensitive fish still apply. If a fish is sensitive to either copper or Formalin, they are not safely exposed to the combined protocol. At this point, it is "cure or kill." You will either cure your fish or kill it from poisoning. It is the most aggressive and dangerous treatment described in this article.


Treatment Option 4 - Hyposalinity:
Low salinity has been demonstrated to be an effective treatment against Cryptocaryon irritans (Noga, 2000). A salt level of 16 ppt or approximately 1.009-1.010 specific gravity at 78-80*F for 14 days was reported to kill the parasite. I have never experienced problems when placing fish into a hyposalinity treatment, but have routinely witnessed fish showing obvious signs of distress when brought back to normal salinity levels too quickly. For that reason, I try to limit the specific gravity increase 0.001-0.002 points per day.
One of the alleged benefits of this treatment is the resulting conservation of energy for the affected fish. Reef fish have to constantly drink saltwater and excrete the salt to maintain the proper osmotic balance. Lowering the salinity of the surrounding environment eases this energy demand on the sick fish, thereby allowing them to expend more energy towards fighting the infection (Kollman, 1998 and Bartelme, 2001). On the contrary, keeping fish in low salinity means that they don't "flush" their kidneys sufficiently. After long-term exposure, this can cause kidney failure and kill the fish (Shimek, pers. comm..)
The drawbacks to this treatment are the same as for many of the treatment options discussed above. Invertebrates and certain fish will not be able to tolerate it, so you should not apply a hyposalinity treatment in a display tank. Sharks and rays are two fish groups that do not tolerate this procedure. I would also not recommend this approach in the presence of live rock or live sand. The hyposalinity treatment will likely kill the worms, crustaceans, mollusks, and other life in and on the substrate, causing a severe drop in overall water quality. 

I have another word of caution when using this treatment. I would strongly suggest the use of a refractometer or perhaps a salinity monitor. Swing arm style box hydrometers are notoriously inaccurate. The glass, floating style hydrometers are better, but easily broken. An accurate measure of the salinity could mean the difference between being inside the effective treatment range or being too high and ineffective or too low and jeopardizing your fish.

Even given its few drawbacks, hyposalinity is a great method of curing infected fish of ich in a proper hospital tank. Of the treatment options discussed this far, in my opinion, it is by far the safest. While none of these options is appropriate for use in a display tank, and all have their drawbacks, weighing the pros and cons of each leads me to recommend hyposalinity above the others.

xyzpdq0121 · Mar 26, 2007

Treatment Option 5 - Daily Water Changes:
John Walsh related this method in a presentation given to the Pittsburgh Marine Aquarium Society, Inc. It is safe and effective for all marine fish (Colorni, 1985) and is my preferred first course of action.Fish are put into a quarantine/hospital tank and then everyday for two weeks the tank is completely cleaned and a 50% water change is performed. While the size of this water change may concern some aquarists who are not accustomed to water changes of this magnitude, as long as you are careful about matching the temperature and salinity, you should not experience any problems. This method helps to remove the tomites, tomonts, and theronts from the tank and lessens the chance of reinfection. The fish should remain in quarantine for an additional month to ensure the treatment has worked and to allow them time to gain strength.

This method is best used as a preventative when a fish is first acquired. It is also useful for mild infestations or when other more aggressive treatments cannot be used due to species sensitivity. The best thing about this kind of treatment is it is safe for all fishes and invertebrates. One of the other benefits is the daily water changes should help you maintain optimum water quality and therefore should stimulate the fish's immune system to combat any secondary bacterial infections that might be attacking the vulnerable areas where the Cryptocaryon irritans parasites have burrowed into the skin. This is in contrast to copper or Formalin, which are both immunosuppressive, and may actually promote secondary infection. 

Variations of this method (and the likely source for the original idea for the treatment) have been suggested and used successfully by Colorni (Colorni, 1987 and Colorni & Burgess, 1997). They involve moving the infected fish between two tanks with the tanks being cleaned and dried in between uses or removing a sand substrate and replacing with new sand every three days. I don't like the idea of handling a sick fish that much using the tank transfer method. While fishnets are designed to be soft and supple, it can still be dragged across the fish's eye. I have found the more you have to manipulate a fish, the more likely it is to contract a secondary bacterial infection like pop-eye or cloudy eyes. The substrate removal method is interesting. The sand is supposed to be an ideal media for attracting the encysting parasites. Removing the sand every three days removes the tomonts with it. Utilizing aragonite sand for this purpose is expensive (unless you happen to live somewhere that Southdown sand is readily available) and very messy. Silica sand is widely available, cheap, and will create slightly less cloudy water, but it is still not as clean and easy as the water change method. I have found the water change protocol to be just as effective and considerably more practical than either of Colorni's methods.

xyzpdq0121 · Mar 26, 2007

Treatment Option 6: Freshwater Dips
Freshwater dips are a highly effective form of treatment against a wide variety of parasites, although their use against Cryptocaryon irritans has been questioned (Colorni, 1985). I am including them here because I still choose to employ them, as I believe they have at least some effect against Ich and because they have been proven effective against Amyloodinium, Turbellarian Worms (the so-called Black Ich), some Flukes (Noga, 2000), and Uronema (Kollman, 2003). For these reasons, freshwater dips are still part of my standard operating procedure when receiving fish.

For some reason, many hobbyists are extremely reluctant and nervous about freshwater dipping their fish, yet show little concern about using toxins, poisons, and carcinogens, such as Copper or Formalin, for treatment. It is my contention that any fish that does not survive a properly conducted freshwater dip would not have lived regardless of treatment. I have dipped hundreds, perhaps thousands of fish, and have yet to kill a fish with a freshwater dip. I define this by the fish dying either in the dip bucket or within hours of the freshwater treatment. If a fish dies a day or two later, while one may claim it was the result of the dip, it is more likely that the disease was too far along and the fish too damaged to survive.

To prepare a proper freshwater dip, take either dechlorinated tap water or demineralized water (RO or DI), aerate for an hour to maximize dissolved oxygen, heat to match the temperature of the dip water to that of the tank water, and then add buffering compounds to match the freshwater pH to your saltwater pH. The aeration should continue throughout the dip. It is crucial to match temperature and pH and to maximize dissolved oxygen. Most people that experience problems with freshwater dipping have made an error in these critical parameters.

The recommended duration of the dip varies from author to author because different species of marine fish tolerate freshwater to different degrees. Generally speaking, any dip less than two minutes is useless. Many fish will easily tolerate five, ten, even fifteen minutes or more. The least tolerant fish are wrasses, lionfish, pufferfish, drumfish, hi-hats, jackknives, firefish and many of the scaleless fish as a rule (Calfo, pers. comm.). I also choose not to dip lionfish, foxfaces, or any other venomous fishes because I don't want a flying torpedo of spines to come shooting out of a dip bucket at me. A lionfish has stung me before, and it is not an experience I ever wish to relive.

Please only dip one fish in each bucket. If you must dip several fish, it is best to make up several smaller freshwater dips versus one large bucket, and always discard all dip water. I also would like to warn you about dipping fish that excrete toxins. There are several fish that give off toxins with their protective slime coat. Mandarins, boxfish, and the Six-line Grouper are a few. When in freshwater, they will naturally excrete more protective slime. There is a possibility that in the confines of a dip bucket, these fish could poison themselves or others, so be careful.

The best advice I can give you is to observe your fish closely. Some fish will swim around like nothing is happening. Others will go straight to the bottom and lie there. Definitive signs of trouble are manifested by the fish jumping out of the dip bucket and spitting water.

There is an alternative to standard freshwater dips that should also be mentioned. Some individuals prefer to use freshwater with methylene blue in the dip (Fenner, pers. comm.- more information http://www.wetwebmedia.com/dips_baths.htm">here</a>). Methylene blue is an anti-microbial dye. It is effective against a wide range of microbes such as bacteria, fungus, yeast, etc. This combination works well to rid the animal of external parasites and provides some protection against secondary infections. As I stated in part one of this series, I almost always use daily water changes. These daily cleanings tend to spur the fishes' own immune system to combat any secondary infections by helping to maintain optimum water quality, so I have not felt the need for using Methylene blue, but it is a worthwhile option to consider.
I wanted to add a footnote on the effectiveness, or lack thereof, for freshwater dips against [I]Cryptocaryon irritans. The question of whether they work or not stems from one study, Colorni 1985. In that study, Colorni watched as trophonts and their host, the Gilt-Head Sea Bream, [I]Sparus aurata, were given freshwater dips. After the dips, which lasted up to 18 hours, were administered the trophonts were still there in their same positions. These same trophonts later dropped off the fish and reproduced successfully. My first comment is, I am unsure if any of the common ornamentals we see in the trade could withstand an 18-hour freshwater dip! Secondly, Gilt-Head Sea Bream, [I]Sparus aurata, are found in marine, brackish, and even freshwater [IMG]http://www.fishbase.org/Summary/SpeciesSummary.cfm?ID=1164&genusname=Sparus&speciesname=auratus">environments</a>. I am concerned that whatever protection these fish have that allows them to withstand such osmotic shock could also unintentionally protect the parasite. Please take my musing with a grain of salt. Better yet, make that a whole 50-gallon bag. I am not a doctor, nor am I schooled in fish pathology. This was merely something that struck me in my reading, so I wanted to mention it. In fact, it has aroused such curiousity that I am currently working on developing a protocol for testing freshwater dips against [I]Cryptocaryon irritans in a common marine ornamental species. I will keep you posted.

With all that I have discussed concerning freshwater dips my position on its use may seem a bit murky. Just to clarify, I do employ and advocate the use of freshwater dips when first receiving fish. I believe all fish that can be dipped should be administered this treatment prior to placement into a proper quarantine tank. This is done in an effort to minimize all possible parasitic infections. I do not, however, recommend freshwater dips as a cure for [I]Cryptocaryon irritans. In my opinion, the repeated handling and osmotic shock of repeated dips are far too stressful to warrant its usage when other proven, but less aggressive treatments are available such as hyposalinity or daily water changes. Lastly, assuming freshwater dips can kill the embedded trophonts on a fish, once they are returned to the infected aquarium, they are just going to contract this pathogen again. So, I recommend using them and using them once only upon receiving the fish to minimize all possible parasitic infections.

xyzpdq0121 · Mar 26, 2007

Treatment Option 7: Quinine Based Drugs
Quinine Hydrochloride and Chloroquine Diphosphate are two medications commonly available, although the later is usually indicated for the treatment of Marine Velvet/Amyloodinium. Several of the references report these Quinine-based drugs as having mixed results, and I agree (Bassleer, 1996, Gratzek et al, 1988 and http://www.wetwebmedia.com/ichartmar.htm">Fenner</a>). I have used a commercial preparation of Quinine Hydrochloride and Malachite Green on several occasions when treating a display aquarium. In all instances, the infestation subsided, but with a few mortalities. In my opinion, I would have experienced fewer deaths with the removal of the all the fish to a separate quarantine/hospital tank.
I can say that the Quinine Hydrochloride and Malachite Green preparation is fairly invertebrate safe. Although I have never used it in a full-blown reef tank, I have used it in the presence of motile invertebrates (various shrimps and crabs), liverock, and livesand (along with the various hitchhikers; amphipods, copepods, small feather dusters, sponges, chitons, etc.) with little to no discernable adverse reactions. The only effect I witnessed was Sun Polyps ([I]Protopalythoa grandis) turned green, although this was likely due to the Malachite Green. They did survive though, resumed their normal coloration, and have since multiplied, as did all of the little liverock hitchhikers.

I need to point out a few serious precautions regarding the use of Malachite Green. First, it is a respiratory poison, teratogen (an agent that can cause malformations of an embryo or fetus), and a suspected carcinogen. For these reasons, it is illegal to use on food fish in the United Sates, although it is still used on ornamental fish for treating eggs for mold and fungal infections. Also, Malachite Green is thought to accumulate in tissue after repeated treatments (Noga, 2000). Lastly, the original preparations of Malachite Green from the 50's were made from the mineral Malachite (Dr. Shimek, pers. comm.), which contains high levels of [IMG]http://webmineral.com/data/Malachite.shtml">copper</a>. Although the compound Malachite Green does not contain [IMG]http://omlc.ogi.edu/spectra/PhotochemCAD/html/malachiteGreen.html">copper</a>, it is possible some aquarium preparations may contain traces of copper and could be very toxic to invertebrates (Dr. Shimek, pers. comm.). 


Treatment Option 8: 5-Nitroimidazoles
There is another class of products on the market that are alleged to be a reef-safe, alternative, anti-parasitic medication for [I]Cryptocaryon irritans. The active ingredient of this category of treatments is 5-Nitroimidazoles. I have only used this type of product a few times, but never in a reef tank, so I cannot speak to those claims. I found these to be moderately successful against [I]Cryptocaryon, although it required twice as many applications as the manufacturer stated on the instructions to affect a complete cure. My biggest complaint is how expensive it was, in particular accounting for the amount and time needed to affect a full cure. Anyone who wishes to try one of these products should perform a search on several of the online message boards to get additional feedback prior to purchasing. Based on my own experience alone, I cannot recommend them.


Treatment Option 9: U.V. Sterilization
Ultraviolet sterilizers work by damaging most anything in the water column that passes through them. Their effectiveness is dependent on the wattage of the unit, the flow rate through the unit, the age of the lamp, the volume of the water being treated, the cleanliness of the sleeve, the clarity of the water, and the decorations (potential hiding spots for tomonts) in the aquarium (Moe, 1989). Colorni & Burgess (1997) discuss the use of UV. They extrapolate from a previous study done on freshwater Ich, [I]Ichthyophthirius multifiliis, and UV (If you are so interested, the original article is Gratzek, Gilbert, Lohr, Shotts, and Brown's 1983 piece "Ultraviolet light control of [I]Ichthyophthirius multifiliis in a closed fish culture recirculation system." It can be found in the Journal of Fish Diseases volume 6 pages 145-153). In the study, they showed UV could prevent the spread of [I]Ichthyophthirius multifiliis when used on a central system, but could not affect a cure within an individual aquarium. Colorni and Burgess believe the same would hold true with [I]Cryptocaryon irritans. I would concur with them as my own personal/professional experience has demonstrated the same. I have found UV's to be very effective in bare bottom tanks, primarily in retail and wholesale operations. In display aquaria, the volume of the tank, the substrate and rockwork, the flow rate of the UV, and the wattage all work against its effectiveness. In commercial operations, many times, employees wipe down bare bottom tanks daily to maintain a clean appearance for customers. This has the added benefit of knocking loose the cyst stage of the parasite. The bare bottom, minimal decoration, high flow rates, and massive UV units on these systems ensure that most all the cysts and theronts pass through the sterilizer and are neutralized.
Please note that while I have drawn a comparison between freshwater and saltwater Ich, there is no taxonomic relationship. They may appear superficially similar to aquarists and they do in fact share some common features such as life cycle, mode of reproduction, and dispersal mechanism, but they are different and distinct organisms. This is a case of convergent evolution; when different organisms evolve to have a similar appearance because they occupy similar niches. There is a very nice example illustrating this phenomenon located at this [IMG]http://www.waypoint1.aone.net.au/converge.htm">website</a>.

xyzpdq0121 · Mar 26, 2007

Treatment Option 10: Ozone
The use of ozone is somewhat similar to the use of ultraviolet sterilizers in that you are attempting to kill the pathogen by killing everything that passes through a reaction chamber. In this case, the reaction chamber is usually a protein skimmer, although there are some dedicated ozone reactors on the market and instructions on the Internet for DIY units. Ozone does not have as many of the variables affecting its performance as UV's do. On the contrary, if water clarity is an issue, ozone will help to improve overall water quality while at the same time, work towards neutralizing parasites.

The other big difference between ozone and UV treatments is there is a higher probability that the use of ozone can affect a cure in a single aquarium. Wilkie and Gordon (1969) reported that they were able to prevent the infestation of fish placed into an infected aquarium for 21 days with the use of ozone. Unfortunately, due to the prolonged life cycle of Cryptocaryon irritans, I cannot say that this is definitive proof, but it does show some promise. It was not until more recently that the biology and life cycle of Cryptocaryon irritans was better understood, so much of the older data on this disease is now deemed inconclusive.

The major drawback to the use of ozone is the potential to overdose and kill everything in the system. Ozone must be administered using a monitor/controller unit. Also, the effluent of the water and air should be run through activated carbon to ensure that any residual ozone is neutralized (Moe, 1989).


Treatment Option 11: Biological Controls
While probably not able to affect a cure in a full-blown infestation, the use of cleaner shrimp may help with a mild problem. I wish to express my dismay when seeing cleaner wrasses, Labroides species, offered for sale. The vast majority of these are doomed to waste away as they are obligate feeders of marine ectoparasites (Fenner, 2003). There are many other effective cleaners available with a much better survival rate. Please leave these fish in the ocean where they can live long, happy lives and help maintain the health of the other reef fish.

The other argument against the use of Labroides wrasses is, being a fish, they are just as susceptible to infection as the fish they are "treating." In a closed, contaminated system, the cleaner wrasse will, in time, become infected too. As a result, it will eat less and become useless for combating Cryptocaryon. This same argument also rules out the use of other cleaner fish such as the various Gobiosoma species. While these make excellent aquarium residents, they are not an effective cure for parasitic diseases of fish. The cleaner shrimp, on the other hand, are not susceptible to Cryptocaryon and could therefore help to bring about a cure, while not being a complete cure in and of themselves.
One last note on Labroides wrasses, contrary to popular opinion, they do not consume Cryptocaryon parasites. They have demonstrated a strong preference for gnathid isopods, which make up between 77 and 85% of their natural diet (Grutter, 1997 & http://www.int-res.com/abstracts/meps/v197/p241-246.html">2000</a>). The remaining prey items are composed of scales, parasitic copepods, and non-parasitic copepods. So, regardless of whatever conscientious objections one may or may not have regarding their availability in the marine aquarium trade, they are not going to help in the battle against Ich. Also, since [I]Cryptocaryon irritans is known to be rare in the wild (Bunkley-Williams & Williams, 1994), it would follow that it is unlikely that Ich makes up any significant portion of any cleaner organism's diet. This, coupled with how deep the trophonts embed, throws into question the effectiveness of any cleaner against [I]Cryptocaryon irritans.


Treatment Option 12: Medicated Foods
Tetra previously made a medicated food, Anti-Protozoan Medicated Flakes, which was reported to be effective against [I]Cryptocaryon. The active ingredient was Metronidazole, also known as Flagyl. This was a good option when it was impossible to remove the fish to a separate quarantine/hospital tank because this food was safe for use in the display tank. The only downside was whether the fish could be coaxed to eat it at all and whether they could eat enough of it. Although the Tetra Medicated Food is now discontinued, Metronidazole is available, so it is possible to obtain it and mix it into the fish's favorite food and, with luck, to elicit a feeding response.

The medicated foods are a good option for use as a preventative, for mild infestations, or when used in conjunction with one of the other less effective treatments, such as biological controls, UV, ozone, and garlic. All of these methods could be employed together in a display tank when removal is not chosen, although this is not the most effective solution, in my experience. I have always had better luck going through the trouble of removing all the fish for separate treatment or better yet, quarantining all new livestock and avoiding infection in the first place.

There is one possible drawback to this treatment that was brought to my attention. Feeding something like Metronidazole, or potentially even garlic (discussed below), could have deleterious affects to the beneficial microflora of a fish's intestine, much like the side effects to Copper exposure (Dr. Charles Moon, aka moonpod, pers. comm.). Additionally, any medication with significant antibiotic properties will act upon the bacterial populations living in the system, and will foster the development of drug resistant bacteria (Dr. Ron Shimek, pers. comm.).

xyzpdq0121 · Mar 26, 2007

Treatment Option 13: Garlic
Garlic is another of the alternative treatments for Cryptocaryon to be touted lately. I have read of many people reporting using it "successfully" as a preventative. The difficult part in assessing these reports is whether the fish would have developed Cryptocaryon in the first place. And, when someone claims it to be a "cure," how can they definitively rule out natural, acquired immunity or even confusion over Cryptocaryon's life cycle.
At the very least, garlic does have some proven anti-bacterial, anti-fungal, anti-parasitic, and antiviral properties (Bartelme, 2003 and and http://www.reefs.org/library/article/h_cortes-jorge.html">Cortes-Jorge</a>, 2001). I included it here because this treatment has shown enough promise to warrant further scientific evaluation. Unfortunately for us, all the real money in this industry is directed to commercial food fish, not our ornamentals. With other effective and inexpensive treatments available, I don't know if grant money will ever be directed into finding out if this alternative treatment conclusively works. Perhaps we could convince the fine marketing people at Mrs. Gordon's that they should try a pre-flavored version of their famous fish sticks by feeding the fish garlic. I can just hear the ad now, "A hint of garlic in every bite."
My biggest problem with the use of garlic is the mythology that has developed regarding it. This all began quite simply and innocently. Kelly Jedlicki was studying the use of garlic as an intestinal dewormer. For those who don't know who Kelly is, she is affectionately referred to as the "Puffer Queen" as they are her favorite fishes and oftentimes are brought into the trade polluted with various worms. As I said, she was examining the effectiveness of garlic against nematodes and cestodes on impacted puffers when she noticed a general decrease in [I]Cryptocaryon irritans incidence. Later on, she proposed feeding garlic to fish as a [B]preventative[/B] for [I]Cryptocaryon irritans. From there the legend of garlic has spread. Feeding garlic to fish is now an accepted cure for Marine Ich by some individuals. Furthermore, I have read of people merely hanging cloves of garlic in their tank in an effort to ward off the parasites, like some sort of bad vampire movie. And lastly, I have recently heard of a surprising number of hobbyists who soak their corals' food in garlic in an effort to combat possible pathogens when target feeding them. It goes to show that garlic has become an all-purpose wonder drug in some peoples' eyes based on little more than anecdotal observations.


Treatment Option 14: Ginger
First garlic, now ginger. Is anyone else starting to get hungry? Either I am going to whip up a plate of Roasted Garlic Fettuccini Alfredo or mix up some Wasabi and get busy rolling some Sushi Maki.

Ginger is the newest homeopathic treatment to be suggested. The main thread to this discussion is located [IMG]http://reefcentral.com/forums/showthread.php?s=&threadid=181818&perpage=25&highlight=ginger&pagenumber=1">here</a>, I waded through the entire thing. It was up to 11 pages and 258 individual posts when I read it. A good portion of the thread is devoted to an ongoing debate about whether this "experiment" was scientific and/or valid. It was neither. The next biggest group of replies debated which side of the previous debate was being rude in their replies. I would say there were some rude people who happened to be on both sides of the argument. Then there was a bunch of people posting nothing, just tagging along so they could get the email notifications. I hate to say it, but the vast majority of the replies were useless as far as determining whether or not ginger was effective at all.
I will attempt to sum up the essence of the thread to save you the time in reading it. Cratylus saw some Ich in his tank. He added ginger to his homemade frozen fish food. The Ich went away. There is no telling whether or not the ginger cured the infection or if natural immunity did. Then, Cratylus specifically purchased a Purple Tang that had a heavy infestation. He brought that fish home, placed it in a separate quarantine tank, fed it the same food, and the Ich went away again. Some people pointed to this experience as being proof. The problem is, moving a fish from an infected tank to a clean tank is a proven cure. It is one of the variations on the daily water change method that I mentioned in my first article on [I]Cryptocaryon irritans (Colorni, 1987). In that paper, Colorni describes moving an infected fish between two tanks. The tanks are cleaned and dried between uses, thereby ridding them of tomonts. He instructs to do this every three days for ten days. This is very similar to what happened with the Purple Tang. There should have been two more moves, but Cratylus got lucky with just the one.

I want to say explicitly that I do not fault Cratylus for attempting something new. There would be no new discoveries without someone trying to push the envelope. I only wish to put his experience in light with what is already known about the biology of [I]Cryptocaryon irritans and known methods or treatments.


Treatment Option 15: Pepper-Based Medications
We have yet another kitchen spice treatment, this time involving pepper. These medications claim to work by stimulating an increased mucus layer response from the fish. This in turn is alleged to be able to slough off the parasites and prevent reinfection. I was able to find only one article on this treatment option. There are several links to "articles" on this product at the Chem Marin website, but only one specifies that it was published in a magazine. Chem Marin's website utilizes frames, so I am unable to give you the exact link to the piece, but the main site is [IMG]http://www.chem-marin.com/index2.html">here</a>. Next click on "Reviews" at the bottom of the left side menu. Sandy Cohen's Review #2 from FAMA was the only publication I was able to find on these products. Both Chem Marin and Kent's pepper-based medication are discussed, but without documented, scientific studies, I am leery to recommend these products. There is also no bibliography given for Sandy's article. It would appear that it is just general impressions and background on these products, with no testing or literature referenced. Kent Marine offers a large list of "Considerations for use" about what is safe and what is not [IMG]http://www.kentmarine.com/html/rxp.html">here</a>. So if I have not dissuaded you, please review their precautions thoroughly before attempting this treatment.


Treatment Option 16: MelaFix
I have read several threads on various message boards suggesting the use of Aquarium Pharmaceuticals' MelaFix as a treatment for all manors of disease, including Marine Ich. It is important to note, however, that not even the manufacturer recommends this product for any parasite. As such, I certainly cannot recommend it as a treatment for [I]Cryptocaryon irritans.


Treatment Option 17: Mystery Solutions
Lastly, there are a couple of products on the market that do not list their ingredients. Sometimes they say something mysterious about being able to stimulate the immune system of the infected fish. I can only say, I won't use or recommend something unless I know specifically what it is, how it works, and preferably having some type of documentation showing its effectiveness.

xyzpdq0121 · Mar 26, 2007

*Treatment Option 18: Metronidazole <added by me, written by Fenner>
Amongst the newly discovered compounds that are "silver bullets" in ridding certain pet-fish diseases, Metronidazole, aka Flagyl is a shining star. With careful use it can quickly eradicate some of the deadly and debilitating protozoan complaints of freshwater and marine fishes. Particularly useful for hexamitosis (the causative organism in many cases of Head and Lateral Line (Neuromast) Erosion, or corrosive syndrome, and many gut infestations, Metronidazole does have a definite downside. It's prolonged or too-repeated use results in the death of stock from renal (kidney) failure. 

Scientific Designation:
1-(2-hydroxyethyl)-2-nitromidazole
Uses/Symptoms:
Principally for internal (lumen) protozoans and the flagellate commonly associated with HLLE (Hexamita, Octomita), though is promoted for use against other protozoans (Cryptocaryon, Ichthyophthirius, Ich). These last are better treated in other ways. Some groups of marine and freshwater fishes might/should be treated prophylactically... coming either directly from wild-environs or culture facilities known to harbor standing parasite fauna. Signs of neuromast destruction (HLLE) are open-pitting of the head and lateral line pores of fishes... Internal flagellate complaints manifest themselves in lethargic behavior, sitting on the bottom, bloating, slow, labored breathing, a lack of feeding...

Dosages/Regimens:
First off, know that Flagyl is only useful in the amounts that "get inside" your livestock... Though marine fishes drink "proverbially like fish", freshwater do not... and in any case, the only efficacious means of administering Metronidazole is through food. There is a further problem/issue of water solubility. In the process of mixing Metronidazole one must blend it well with water ahead of time... as this material is not very water soluble. Soaking frozen or live foods in 1% solutions for a few hours in a refrigerator is a very good idea. Actual dosages are best at about 0.25% Metronidazole fed at a daily rate of 1% of body weight. Feed just once usually, no more than thrice. 
For marines, long-term baths (a few hours) in more concentrated solutions may work... 5 mg of Metronidazole per liter (19 mg/gallon) administered daily for three treatments. Of course you must provide aeration during these baths. 
Some authors advocate tossing Metronidazole in the system water itself.... stated dosages range from 6.6 to 25 mg/l of 25-95 mg/gallon... either daily or every other day for three treatments total. 

Tolerances/Dangers:
As stated, not safe to use continuously or repeatedly.
Cloze:
A good deal of "anomalous" imported (from the Far East) livebearer and anabantoid losses, and mormyrid, polypterid losses from Africa exporters, and wild discus and angelfish from South America (from intestinal flagellates)... have been solved with a single dose or dip with Metronidazole... It is also the treatment of choice for "Hole in the Head" (and side) "Disease"... along with restorative measures to improve water quality and adequate nutrition. However, all should be warned and aware that Flagyl is toxic and accumulative in its toxicity. The author has seen quite a few valuable (expensive) nishikigoi (koi carp) killed by careless administration of this anti-protozoal. I do wish there was some compelling way to have the trade itself pre-emptively check, quarantine, and treat to avoid the transmission (on to consumers) of such easily defeated pathogens... sparing end-users the dangers of using such compounds, and avoidable losses. 
Again thanks to Steven Pro http://www.reefkeeping.com/issues/2003-08/sp/index.php">http://www.reefkeeping.com/issues/2003-08/sp/index.php</a>and Bob Fenner [IMG]http://www.wetwebmedia.com/metranidazole.htm">http://www.wetwebmedia.com/metranidazole.htm</a>for saving me ALOT of typing.



Ok, So I hope all this helps someone out there down the road. I will continue to offer advice on the subject but only to people who have read this thread and do not ask me questions like, "How do I get rid of Ich?!?" Best of luck in the fight against Ich. If anyone has anything to add, I am open to suggestions and input. Now that I have explained it all, there will now be a FEE for me to dip and QT any future fish of any member who I do not already own a ton of favors to. (You are safe there Cameron!) ;) 

If I can leave with one thought about all this it would be: Nothing in this hobby is cheap or can be done fast. To do things right you need to take the time and let nature take its course. If you try to rush, fool, outsmart nature, in the end you will usually end with a big mess on your hands. It is ALWAYS easier and cheaper to do it right the first time!

wolfie · Mar 26, 2007

Brandon Look like you put a lots of work into this.

I did not get a chance to read it all. Got to stop here "am NOT going to QT my fish no matter what you say!" because it is late. I am going to read the rest tomorrow.

look like some good ready there

FutureInterest · Mar 26, 2007

Gross Got!

I read it. It deserves a sticky somewhere... perhaps a new forum for ailments/treatments? Nice job man.

glxtrix · Mar 26, 2007

I second a sticky forum of ailments/treatments. Very nice write up Brandon, now lets just hope I stay ich free.

Ich and treatment in our tanks! You too can be Ich free!

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