View Full Version : QT'd new addition but still got Ich, talked to vet and got a drug please advice.
Paalk
05/19/2016, 02:50 AM
So, I got it anyway don't know how but I did. Long story short, after I did everything right(I thought) I still got Ich in my DT.
The tank is a new 500 g tank set up early this year, I used dry rock and TTM to make sure this new tank stayed disease free. I failed!
Anyway last night I noticed several of my fish had white spots on them in spite of my efforts. So I called a veterinarian who specialize in fish medicine for the Salmon industry here in Norway and she wrote a prescription for this drug: Plaquenil 200mg. Hydroxycloroquin. sulf. and told me to dose 5-10mg of the drug to every liter of tank water.
In regards to this I have a couple of questions for you, is this drug the same you call Chloroquine Phosphate? I asked the vet if this was safe to dose into the tank without removing any of the inverts and her answer was that she would have moved the corals but shrimps, snails and starfish could probably stay. Probably don't cut it for me so I ask you guys too. Can I move corals then dose in the display?
The vet claimed that this drug probably did not do any damage to the bio filter except that I might experience an ammonia spike due to algae die off after dosing. So according to her I should be able to use this drug directly in the DT after removing all corals.
After reading about CP here and other places I see that a lot of what she said is similar to some people's beliefs. What do you guys think, should I remove the corals and try this drug?
Please advice.
Dmorty217
05/19/2016, 06:59 AM
Its one of the 3 forms of Chloroquine you can buy. Remove corals, snails, basically anything that isn't a shrimp or hermit (exoskeleton). I would guess that it will kill starfish too.
Paalk
05/19/2016, 08:28 AM
Thank you for your input Dmorty. I have no way of finding all my starfish in the tank, this is a pretty large tank and I got a approx. 10-15 starfish which are hidden everywhere under the massive rock formations. You say you guess it will kill them, do you or anybody know for sure the effect it has on starfish? I wouldn't want to kill anything if I can avoid it.
Paalk
05/19/2016, 08:36 AM
Anybody know for sure what this do to the bio filter? Is the vet right in assuming that it won't affect it?
ThRoewer
05/19/2016, 10:46 AM
There is no need for rush if it is ich. I would take the time to hunt down all sea stars before starting treatment.
ThRoewer
05/19/2016, 10:50 AM
BTW, do you have any pipefish or seahorses in that tank? To those CP is reportedly deadly.
Dmorty217
05/19/2016, 11:08 AM
BTW, do you have any pipefish or seahorses in that tank? To those CP is reportedly deadly.
+1 and wrasse too. It won't affect the biological filtration. If you're unable to find all the starfish I would closely monitor the ammonia levels in the tank
Paalk
05/19/2016, 01:36 PM
Ok, thank you guys so much for your input. I'll try to find the sea stars before I treat the tank. I do not have pipe fish or sea horses but I do have a Leopard Wrasse, are they sensitive to CP too?
Paalk
05/19/2016, 04:55 PM
One question Dmorty, you said the CP I have is one of three. In this thread: http://www.reefcentral.com/forums/showthread.php?t=2136214&page=11
They say it is two different drugs that require different treatment regimens, what is your opinion on that?
krullshards
05/19/2016, 05:18 PM
One question Dmorty, you said the CP I have is one of three. In this thread: http://www.reefcentral.com/forums/showthread.php?t=2136214&page=11
They say it is two different drugs that require different treatment regimens, what is your opinion on that?
Those guys may be talking about Quinine, but I think Dmorty guided you right here.. Take a look at the following link and this bit within it:
[chloroquine base 150 mg is equivalent to chloroquine sulfate 200 mg or Chloroquine phosphate 250 mg]
http://apps.who.int/medicinedocs/en/d/Jh2922e/2.5.1.html
Used in humans to treat Malaria it seems.
ThRoewer
05/20/2016, 03:15 AM
I just started CP (Ick-Shield Powder) treatment on the QT with my 3. BSJ and 8 barnacle blennies. The last 4 blennies must have brought ich in - all have some white spots and the BSJ started to scratch, get slimy skin and cloudy fins. If it was just for the blennies I may have waited, but with BSJ I'm rather proactive.
In this case I picked CP due to it's anti-inflammatory properties. Let's see if it helps.
Ick-Shield Powder is 1,4-Pentanediamine, N4-(7-chloro-4-quinolinyl)-N1,N1-diethyl (http://www.chemspider.com/Chemical-Structure.2618.html) = Chloroquine diphosphate salt.
Hydroxychloroquine sulfate (http://www.chemspider.com/Chemical-Structure.12410.html?rid=43b4bd9f-9d11-4bac-9306-1ac4360da56c) is 2-[{4-[(7-Chloro-4-quinolinyl)amino]pentyl}(ethyl)amino]ethanol sulfate (1:1), a different form of Chloroquine. Plaquenil is a trade name for this form.
No idea how it is different in efficiency and dosage, but I would follow the vet's directions.
Dmorty217
05/20/2016, 06:36 AM
One question Dmorty, you said the CP I have is one of three. In this thread: http://www.reefcentral.com/forums/showthread.php?t=2136214&page=11
They say it is two different drugs that require different treatment regimens, what is your opinion on that?
I have only used Chloroquine Phosphate and not the other two so I can't speak to proper doses for them. I would follow what your vet recommended for dosage and if for some reason it isn't working, try to increase the dosage. As far as the Leopard goes, I would take it out and Tank Transfer it or run in copper for 30+ days. I personally don't use copper or advocate it for treatment of any disease but there are plenty who use it successfully
Paalk
05/21/2016, 07:09 AM
Thanks guys for all your input. So at midnight Thursday Oslo time I dosed 5mg/l in the tank after everything living that I could find was removed except for the fish.
Today I see less spots and the fish looks to be more "up and going". Don't know if this is just the life cycle of Ich or if it is the meds kicking in. I would have thought that even more of the spots was gone but I don't know. Anyway I am inclined to dose another 5mg/l which was the max dosage recommended by the vet today, but I am not sure if I should stay a little longer on this dosage. What do you guys think? I read a lot of different opinions on dosage on RC so I am a little confused. Should I dose another 5 or wait another day or two?
Dmorty217
05/21/2016, 08:46 AM
If everyone is still eating I would dose the recommended amount. With chloroquine phosphate I dose 50-60mg/gallon or 12-15mg/L which is on the high side but I haven't had any fish react negatively yet.
Paalk
05/24/2016, 08:46 AM
Dmorty, still out there? I got another one for you. I am at day 5 now and still no improvement in the tank. Fish are sprinkled with spots but are eating like mad still. I did what you told me and increased to 10mg/l with Hydroxychloroquin. sulf. Krullshards mentioned that 150mg of Chloroquine Base is equivalent to Hydroxychloroquin. sulf. 200mg/l. Does that mean that I have to dose more of my Hydroxychloroquin. sulf to make it work?
If anyone can advice me here I would love to hear from you as I have quiet a lot of prized individuals of fish that I do not want to loose. You'll never get their personality back:sad2: I would hate to see them go.
As a foot note I even found snails alive and all the shrimps. Some starfish I couldn't get out is still alive and even some small ricordea I missed is alive though a little retracted.
Does this mean something, to low dose? Please advice guys.
Thanks
Dmorty217
05/24/2016, 09:13 AM
IF snails are still alive then the dose isn't high enough... The spots will fall off the fish within the first 3 days and not reappear when the correct dosage is in the tank. Sounds like maybe you have to dose 25% more of what you have to equal the same dose as CP??
ThRoewer
05/24/2016, 10:31 AM
Should CP not work even after a week at the higher dose I would give hyposalinity a try. If that also doesn't show results within a week, I would start looking at the possibility that it might be something other than ich. Best would probably be to take one fish with clear symptoms to the vet for a biopsy.
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Dmorty217
05/24/2016, 11:52 AM
Should CP not work even after a week at the higher dose I would give hyposalinity a try. If that also doesn't show results within a week, I would start looking at the possibility that it might be something other than ich. Best would probably be to take one fish with clear symptoms to the vet for a biopsy.
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+1 hypo and CP work well together too if you wanted to do them both
Paalk
05/24/2016, 12:11 PM
Ok, thanks a lot! So I will add another 5mg/l or should I try 10mg/l? Maybe I should drop salinity at the same time. How low do you recommend, I read a lot of different opinions regarding that topic. Some people say 1.008 other say 1.017 etc.
Dmorty217
05/24/2016, 01:30 PM
Actual hypo is 1.010 but I would aim for 1.009 since keeping the salinity stable at that is what's paramount. If salinity rises .001 the 30 day clock starts over at day 1. I would only increase the dosage 5mg/L at most, I'm not familiar with the drug you're using so I don't feel comfortable telling you to dose more honestly. Although if you dose too much the fish will start acting differently (hiding, not eating, listing to one side,ect) and you should do a water change immediately to lower the concentration.
Paalk
05/24/2016, 02:54 PM
Thanks Dmorty, I dosed another 5mg/l now. I'll check the fish tomorrow morning for strange behavior. Hope it's not too much meds😁
If I choose to do hypo at the same time, is it really that critical to stay at 1.009? Won't the drugs pick up the slack if salinity should rise?
ThRoewer
05/24/2016, 03:24 PM
Actually 1.011 should still be effective, but you want to stay below to be on the safe side due to measurement inaccuracies and evaporation.
You also want not to go lower than 1.008 to not get into the danger zone for the fish.
1.009 is a good value.
Once set correctly it should be fairly easy to maintain as evaporation has a much lower impact on salinity changes than at normal ocean salinity.
The lower salinity is not only to kill the parasite, but also to help the fish to preserve energy and cope better with the infection. If done just to make life easier for the fish you can stay above the therapeutic maximum level of 1.011. I usually go with 1.016 as this level doesn't require a slow salinity ramp up.
Dmorty217
05/24/2016, 03:40 PM
+1^ Don't go below 1.008 . Nogas' 2nd edition book says 10mg chloroquine diphosphate per liter every 5 days for 4 treatments
Paalk
05/26/2016, 11:14 AM
Guys, I really need your advice. I just don't get this. I have upped the dose now to 15mg/l and the fish is still getting worse. Some of them are sprinkled with spots some white and some black. One of my tangs are having some kind of sores on it's body too. And my cardinals are suffering from something which seems like a combination or fin rot, pop eye and what not. I am at a loss here, should I take the Hydroxychloroquin sulph. out and try some antibiotics(Flagyl)? Please advice, I am afraid that they are all going if I don't do something soon. I lost a clown today and one of my Pyjama Cardinals looks like he is soon going.
Paalk
05/26/2016, 02:23 PM
Update: Three of my Pajama died, that makes 4 fish including the clown only today :worried. I also have among others a large Naso Vlamingii he is my prized possession as I play with him and have a really special connection with the guy, he is 14-15" long so he is a pretty big fish and tame as my dogs😊 He is starting to breath rapidly and starting to develop a red line at the bottom of the fin on the back + a red sore behind his right gill where the pectoral fin starts(I think it's called pectoral fin). I am sorry if my English is sub par but Vikings don't speak English as their native tongue😳 I do not want to loose this guy I have had him for years and love him, please advice. I don't want to loose any fish! I am at the verge of treating the whole tank with Metronidazole as there was a guy up here in the north who told me that would end all my problems. Except he said it could kill all beneficial bacteria too, so I had to stock up with a lot of Seachem ammonia stop and an alarm? But.....I don't want to do that unless you seasoned guys could ease my mind a little regarding that and say go or not go.
Please guys advice, I am getting desperate here I've had most of these fish for almost 10 years and 7 of them are prized specimens of different tangs plus plus. I re-dosed Hydroxychloroquin sulph today with 5mg/l and put in lot of air stones in the sump plus a lot of other measures to increase O2 which I hope will ease their breathing. I have also lowered the salinity down to 1.018 for the time being and plan to lower it even more tomorrow.
Am I at the right track?
Sorry if my post is a little messed up but I am really messed up too, I feel so helpless seeing the fish struggle like this. It really BREAKS my heart.
This is painful learning, for ten years I haven't seen any disease in my DT then I did the most stupid move of all.....Introduced a Moorish Idol which had lived in a buddy's tank for two years with no problems. I thought that was quarantine enough but obviously I was painfully wrong. I hate myself for this move. Maybe I should go back to Malawi Cichlids and admit defeat hehe
illumnae
05/27/2016, 07:28 AM
+1^ Don't go below 1.008 . Nogas' 2nd edition book says 10mg chloroquine diphosphate per liter every 5 days for 4 treatments
Does this mean chloroquine diphosphate degrades and needs to be redosed every 5 days? I always thought it was dose and forget
illumnae
05/27/2016, 07:32 AM
Update: Three of my Pajama died, that makes 4 fish including the clown only today :worried. I also have among others a large Naso Vlamingii he is my prized possession as I play with him and have a really special connection with the guy, he is 14-15" long so he is a pretty big fish and tame as my dogs😊 He is starting to breath rapidly and starting to develop a red line at the bottom of the fin on the back + a red sore behind his right gill where the pectoral fin starts(I think it's called pectoral fin). I am sorry if my English is sub par but Vikings don't speak English as their native tongue😳 I do not want to loose this guy I have had him for years and love him, please advice. I don't want to loose any fish! I am at the verge of treating the whole tank with Metronidazole as there was a guy up here in the north who told me that would end all my problems. Except he said it could kill all beneficial bacteria too, so I had to stock up with a lot of Seachem ammonia stop and an alarm? But.....I don't want to do that unless you seasoned guys could ease my mind a little regarding that and say go or not go.
Please guys advice, I am getting desperate here I've had most of these fish for almost 10 years and 7 of them are prized specimens of different tangs plus plus. I re-dosed Hydroxychloroquin sulph today with 5mg/l and put in lot of air stones in the sump plus a lot of other measures to increase O2 which I hope will ease their breathing. I have also lowered the salinity down to 1.018 for the time being and plan to lower it even more tomorrow.
Am I at the right track?
Sorry if my post is a little messed up but I am really messed up too, I feel so helpless seeing the fish struggle like this. It really BREAKS my heart.
This is painful learning, for ten years I haven't seen any disease in my DT then I did the most stupid move of all.....Introduced a Moorish Idol which had lived in a buddy's tank for two years with no problems. I thought that was quarantine enough but obviously I was painfully wrong. I hate myself for this move. Maybe I should go back to Malawi Cichlids and admit defeat hehe
Your Tang's symptoms sound like septicaemia, bacterial blood poisoning. I'd suggest removing him and putting him through a course of antibiotics. Oxytetracycline, Furan 2 and Dr G antibacterial food have worked for me on separate occasions
ThRoewer
05/27/2016, 10:29 AM
I just had a similar experience with a BSJ and a bunch of barnacle blennies. I tried CP (Ick-Shield), but they only got worse and the BSJ died. I have some serious doubts that CP is an effective enough treatment against ich, especially if the fish are already weakened by other factors.
For the blennies I have now switched to hyposalinity - if it is ich it should work.
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Deinonych
05/27/2016, 10:35 AM
I have some serious doubts that CP is an effective enough treatment against ich, especially if the fish are already weakened by other factors.
I agree, especially when there are much more effective treatments against ich (namely, TTM).
ThRoewer
05/27/2016, 12:08 PM
I agree, especially when there are much more effective treatments against ich (namely, TTM).
While TTM is a great preventative method for new fish and also suitable to treat single or small groups of fish, it is completely unsuited to treat large numbers of fish. He has 50 fish to treat!
I still stand by my advice to take one sick fish to the vet for a more definitive microscopic identification of the pathogen(s). With this many fish on the line I would stop the guessing game and blind trials and take a more definitive route, especially since you have already a vet to go to.
Paalk
05/30/2016, 05:45 PM
So guys a smal update and a question. I have lost 17 fish now, very sad. But, the good thing is we have a confirmed diagnosis( from vet) it is Oodinium. I have spent the last twelve hours removing fish from my DT in order to treat with copper. I did a freshwater bath 10 min for each individual and from there I moved them into a temporary holding tank. Some of my tangs are looking better now after 24 hours of copper dosing. But here is my question, I think that my Vlamingii and Desardjini have a bacterial infection too as Illumnae mentioned in an earlier post, can I treat with antibiotics at the same time as I'm treating with Cupramine? Please advice.
ThRoewer
05/31/2016, 01:58 PM
If it is Amyloodinium ocellatum I'm kind of surprised that the Chloroquine didn't show any effect.
Copper should generally not interfere with antibiotics, though a careful observation of the fish is recommended to see if they show any abnormal behavior that may indicate an adverse reaction.
Paalk
06/01/2016, 05:27 AM
ThRoewer, I am surprised myself as it has worked in the past. Deaths have risen to 25 as I type, and I am very sad about it. Some of these specimens have been with me for over 10 years. My Vlamingii has been with me for 12 and he doesn't look so good now with his body covered in "rusty" patches. I DON'T want to loose him. Is there anything else I could do? He stopped eating after I put him in the HT with Cupramine too, in fact nobody is eating. I am willing to to just about anything in my power regardless of cost to solve this, so if there are ANY suggestions out there I am all ears.
I picked out two more Yellow tangs and a Scopas today and my PBT doesn't look good either.
How long time should I expect in order to see any improvement from the Cupramine? They have been in there since monday. I measured copper yesterday with Seachem's kit and it read 0,3 which was fine according to Seachem's support.
Sorry if I seem kind of desperate, but I am.....very stressed out about this. I had 50 fish in this tank and now we are down to 25 in 4 days.
Please, please anybody who has any advice throw them out here :reading:
tassod
06/01/2016, 09:43 AM
You may want to look at this thread, perhaps it may help.
http://www.reefcentral.com/forums/showthread.php?t=2551894
I'm real sorry about your situation and i understand how you feel as i have been through this myself. I have never tried what this link suggest to do myself but perhaps you could with the assistance of your vet. I hope for the best for you and please keep us up to date.
ThRoewer
06/01/2016, 04:34 PM
If you can get the medications and supplies listed in alprazo's thread I would definitely give that method a shot.
I would also lower the salinity as described in alprazo's thread as that will help the fish saving energy and increase the amount of dissolved oxygen in the water.
Not sure if it helps much, but here is a study on treating Amyloodinium:
Chemical control of Amyloodinium ocellatum (Brown 1931) (Dinoflagellida) infections: In vitro tests and treatment trials with infected fishes (http://www.sciencedirect.com/science/article/pii/0044848684901339)
"Copper sulfate, in concentrations up to 10 ppm, did not interrupt division. However, concentrations as low as 0.5 ppm were lethal to sporulating tomonts and dinospores."
Meaning: cysts will be unharmed by copper doses lethal to fish. Only the free stages can be killed. Fortunately the cyst stage of A. ocellatum is short and not as variable as C. irritans.
"Effective eradication of A. ocellatum infection from Sparus aurata larvae and post-larvae in the hatchery was accomplished by continuous application of 0.75 ppm copper sulfate for up to 2 week"
Important to know is also that there are quite a few different Amyloodinium strains (if not species) that have different levels of tolerance towards copper. Some can handle up to 1.5 ppm, which is already lethal for most fish.
I would go up in the Cupramine dose to at least 0.5 ppm.
Since the feeding parasites are exposed to the tank water they should drop off quickly. If not, either the dose is not right or you got a copper tolerant strain.
Here a few more articles that may be helpful:
Getting Acquainted with Amyloodinium ocellatum (https://pubs.ext.vt.edu/600/600-200/600-200_pdf.pdf)
Amyloodinium ocellatum, an Important Parasite of Cultured Marine Fish (http://agrilife.org/fisheries/files/2013/09/SRAC-Publication-No.-4705-Amyloodinium-ocellatum-an-Important-Parasite-of-Cultured-Marine-Fish.pdf)
Mass mortality of hatchery-reared milkfish (Chanos chanos) and mangrove red snapper (Lutjanus argentimaculatus) caused by Amyloodinium ocellatum (Dinoflagellida) (https://www.researchgate.net/profile/Erlinda_Lacierda3/publication/248341028_Mass_mortality_of_hatchery-reared_milkfish_Chanos_chanos_and_mangrove_red_snapper_Lutjanus_argentimaculatus_caused_by_Amyloodin ium_ocellatum_Dinoflagellida/links/55651e4c08ae94e9572056f4.pdf)
Studies on Amyloodinium ocellatum (Dinoflagellata) in Mississippi Sound: natural and experimental hosts (http://aquila.usm.edu/cgi/viewcontent.cgi?article=1125&context=gcr&sei-redir=1&referer=http%3A%2F%2Fscholar.google.com%2Fscholar%3Fhl%3Den%26q%3Damyloodinium%2Bmissisippi%2Bsound% 26btnG%3D%26as_sdt%3D1%252C14%26as_sdtp%3D#search=%22amyloodinium%20missisippi%20sound%22)
Histone-like proteins from fish are lethal to the parasitic dinoflagellate Amyloodinium ocellatum (https://www.researchgate.net/profile/Uma_Silphaduang/publication/11874217_Histone-like_proteins_from_fish_are_lethal_to_the_parasitic_dinoflagellate_Amyloodinium_ocellatum/links/53d24da20cf220632f3c8b4b.pdf)
Host site of activity and cytological effects of histone-like proteins on the parasitic dinoflagellate Amyloodinium ocellatum (https://www.researchgate.net/profile/Uma_Silphaduang/publication/10930427_Host_site_of_activity_and_cytological_effects_of_histone-like_proteins_on_the_parasitic_dinoflagellate_Amyloodinium_ocellatum/links/53d24da20cf228d363e93148.pdf)
triggreef
06/03/2016, 08:47 PM
Guys, I really need your advice. I just don't get this. I have upped the dose now to 15mg/l and the fish is still getting worse.
Does this mean chloroquine diphosphate degrades and needs to be redosed every 5 days? I always thought it was dose and forget
Just to add in at this point a bit late... But the OP stated he's dosing in his display filled with a ton of live rock. I would venture that even CP will degrade in a display filled with LR. But I have no experience with CP so just throwing it out there.
Paalk
06/05/2016, 04:58 AM
So guys, here is a small update. First of all I would like to thank you for all help. I have followed most of the tips from alprazo's thread. It seems like I got some kind of control now, no more deaths the last 48 hours. I have lost 38 fish so far which is way to much.
So far my 12 year old friend the Vlamingii is still alive and so are my big Veliferum and a large Foxface, some cardinals, a chromis, one cleaner wrasse, salarias and a pair of fairy wrasse is still holding on.
I have now prepared another HT with fresh saltwater and matched all parameters so I am planning to move all fish over later today. My question is can I give the fish a Paraguard bath when I move them over? Will that help some? The reason I want to do that is that I can still see some red areas on my Vlamingii and redness at fin bases. I have been told that Paraguard have antiseptic properties and that it will give relief to secondary infections after copper treatment. Is there some truth to this? Should I do this bath between the two copper filled tanks? I am planning to keep the fish in Cupramine for another two weeks which will be a total of three weeks, that is unless I get other advice.
So guys, please advice what would you suggest I do?
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