My puffer is breathing healthy with ich! Help!

[DoggoThePuffer]

hello! Emergency! My dogface puffer 5 inches big has ich! The water quality is gold!! Everything is at zero and PH is at 8.4!! Please, help!

 

[Big G]

Welcome to R2R!
The treatment methods with the least risk to puffers are "Tank Transfer Method" or "CP". I have treated puffers with chelated copper (recommending Copper Power these days), but you have to go very slowly (twice as long 7-8 days) in ramping up the level and watch for a fish that is very sensitive. Do not use ionic copper like Seachems Cupramine on puffers.
Treatments below are from Humblefish's treatment advisory:

Tank Transfer Method: Treats Ich (Cryptocaryon irritans) only.

How To Treat - Tank transfer (TTM) is probably one of the most underused and underappreciated resources in our hobby. To properly execute TTM you need two tanks (or buckets), with dedicated equipment for each tank (not to be shared between the two). I personally use 2 of the 10 gallon tanks to do TTM, each with its own heater, thermometer, air stone, airline tubing and PVC elbows for hiding places. This is how TTM is implemented:

• Day 1 - Fish is placed in initial QT.
• Day 4 - Roughly 72 hours later transfer the fish to new tank. The time of day you do the transfer is unimportant, but never exceed 72 hours from the last transfer. The temperature and SG of the new tank should match the old one perfectly, so you can just catch & release (no acclimation). Transfer as little water as possible with the fish.
• Day 7 - Repeat.
• Day 10 - Repeat.
• Day 13 - Repeat and done (fish should now be ich free).

After transferring, immediately sanitize the “old tank” and all equipment using bleach or vinegar. Rinse well. Let air dry thoroughly before next use. The air drying is the sterilization process when using vinegar, or detoxification process when using bleach.

Simply put, this process works because you are literally outrunning the parasite’s known life cycle. If a fish is infected with ich, trophonts will leave the fish at some point during the TTM process, and the encysted stage doesn’t have enough time to release theronts (i.e. free swimmers that re-infect the fish) before the fish exits the tank. Ammonia isn’t much of a concern with TTM, because every 3 days the fish is placed in a new tank with new water; or you always have the option of using ammonia reducers, such as Amquel or Prime, in conjunction with TTM since there is no risk of negative interaction because no medications are present. However, you do have the option of dosing Prazipro (if you need to deworm) at the onset of “Day 4” and “Day 10”; transfers 2 & 4 respectively. Just remember if you do this that you can’t use any ammonia reducers while Prazi is present in the water.

One of the cons to tank transfer is the amount/cost of saltwater needed to do it. For example, using my 2-10 gallons I go through 50 gallons of saltwater before the TTM process is complete. However, a thrifty hobbyist can use water stored from a recent display tank water change to implement TTM. Obviously, this only works if you are 100% confident that your display tank is disease free and don’t siphon anything off the bottom. ;-) The other problem with TTM is netting the fish every 3 days. That concern can be somewhat alleviated by using a plastic colander in lieu of a net to catch the fish (square ones work better than round ones):



Chloroquine phosphate: Treats Ich (Cryptocaryon irritans), Marine Velvet disease (Amyloodinium), Brooklynella hostilis & Uronema marinum.

How To Treat - Chloroquine phosphate (CP) is a “new drug” that actually was widely used to control external protozoa in saltwater aquariums back in the 70s & 80s. It was even used in some aquarium medications sold at LFS. Nowadays CP requires a prescription to purchase legitimately, making it more difficult to obtain. Fast forward to today and thanks to the power of the Internet, CP has come roaring back! The biggest obstacle to overcome is obtaining pharmaceutical grade 99% pure CP. I cannot stress the importance of this enough. Do not buy it from some guy on eBay or even an online vendor. The only way to be sure you are getting 99% pure CP is to get your vet to write you a prescription that can then be filled at a local pharmacy.

CP is a “one and done” medication, meaning you dose once and that’s it. There are no test kits for CP, so it’s important that you dose accurately using a digital scale. Also, don’t forget to dose any replacement water (from water changes, but not top off) with CP. The dosage rates are as follows:

• Prophylactic treatment is 40 mg per gallon.
• Active infections (visible symptoms present) is 60mg/gal.
• For Uronema marinum and really bad infestations, you can dose up to 80mg/gal.

As you can see, there is quite a bit of wiggle room between the minimum & maximum dosage. Practically speaking, 40mg/gal will treat all external protozoa issues… it’s just that the higher dosages may get the job done a little faster. Treatment lasts 30 consecutive days, and no carbon, UV, etc. may be used during this time (although it can be used later when you wish to remove the medication from the water). A little quirk about CP is that it is light sensitive, so you cannot use a light on the aquarium while treating. However, this does not mean your fish have to remain in total darkness; ambient lighting (say, from a window across the room) is fine. CP is NOT reef safe. In addition to killing your corals, it is a very strong algaecide.

Pros - Gentle on most fish (DO NOT USE with wrasses), a “one and done” medication that treats most external protozoa. CP is the closest thing there is to a “wonder drug” in our hobby.

Cons/Side Effects - Expensive, hard to get (requires a prescription), light sensitive; some evidence of appetite suppression with certain species (especially wrasses.) Attempts to feed CP laced food are usually not successful due to its bad metallic taste.



Copper: Treats Ich (Cryptocaryon irritans), Marine Velvet disease (Amyloodinium); possibly Uronema marinum

How To Treat - First, it is important to know what kind of copper you are using. Cupramine is fully charged (ionic) copper, and has a therapeutic range of 0.35-0.5 mg/L or ppm. You would use a Seachem or Salifert copper test kit for Cupramine, as those are capable of reading copper in the low range. Coppersafe, on the other hand, is chelated copper. It has a much higher therapeutic range of 1.5-2.0 mg/L or ppm. As such, you need a “total copper test kit” such as API’s to measure Coppersafe. Currently only recommending Copper Power as a "chelated copper", there have been some problems with the strength of dosage with Coppersafe lately.

Standard copper treatment lasts 30 consecutive days. The reason it takes so long is copper only targets the “free swimming stage” (the same holds true for allchemical treatments & hypo). While 7-14 days is the “norm” to reach this stage, certain strains of ich have prolonged life cycles. Indeed, even 30 days may not be long enough in some rare cases. This is why it is so important to observe after treatment ends, to ensure symptoms do not return.

Therapeutic copper levels must be maintained at all times during the 30 days, so testing often is important. If the level drops even slightly out of range, then the 30 day clock starts all over again. One reason your copper level may drop unexpectedly is if you are treating in a tank with rock and substrate; those should not be used in the presence of copper due to absorption. Conversely, if you exceed the therapeutic range you risk killing the fish.

Copper is a poison, pure and simple. It only works because most fish are able to withstand being in it longer than the parasites. Knowing this, it is wise to raise your copper level very slowly (over 3-5 days) instead of the usual 24-48 hours recommended on the labels. Doing so increases your odds of successfully treating a “copper sensitive” fish. Remove copper after 30 days by running activated carbon.

 

[DoggoThePuffer]

Welcome to R2R!
The treatment methods with the least risk to puffers are "Tank Transfer Method" or "CP". I have treated puffers with chelated copper (recommending Copper Power these days), but you have to go very slowly (twice as long 7-8 days) in ramping up the level and watch for a fish that is very sensitive. Do not use ionic copper like Seachems Cupramine on puffers.
Treatments below are from Humblefish's treatment advisory:

Tank Transfer Method: Treats Ich (Cryptocaryon irritans) only.

How To Treat - Tank transfer (TTM) is probably one of the most underused and underappreciated resources in our hobby. To properly execute TTM you need two tanks (or buckets), with dedicated equipment for each tank (not to be shared between the two). I personally use 2 of the 10 gallon tanks to do TTM, each with its own heater, thermometer, air stone, airline tubing and PVC elbows for hiding places. This is how TTM is implemented:

• Day 1 - Fish is placed in initial QT.
• Day 4 - Roughly 72 hours later transfer the fish to new tank. The time of day you do the transfer is unimportant, but never exceed 72 hours from the last transfer. The temperature and SG of the new tank should match the old one perfectly, so you can just catch & release (no acclimation). Transfer as little water as possible with the fish.
• Day 7 - Repeat.
• Day 10 - Repeat.
• Day 13 - Repeat and done (fish should now be ich free).

After transferring, immediately sanitize the “old tank” and all equipment using bleach or vinegar. Rinse well. Let air dry thoroughly before next use. The air drying is the sterilization process when using vinegar, or detoxification process when using bleach.

Simply put, this process works because you are literally outrunning the parasite’s known life cycle. If a fish is infected with ich, trophonts will leave the fish at some point during the TTM process, and the encysted stage doesn’t have enough time to release theronts (i.e. free swimmers that re-infect the fish) before the fish exits the tank. Ammonia isn’t much of a concern with TTM, because every 3 days the fish is placed in a new tank with new water; or you always have the option of using ammonia reducers, such as Amquel or Prime, in conjunction with TTM since there is no risk of negative interaction because no medications are present. However, you do have the option of dosing Prazipro (if you need to deworm) at the onset of “Day 4” and “Day 10”; transfers 2 & 4 respectively. Just remember if you do this that you can’t use any ammonia reducers while Prazi is present in the water.

One of the cons to tank transfer is the amount/cost of saltwater needed to do it. For example, using my 2-10 gallons I go through 50 gallons of saltwater before the TTM process is complete. However, a thrifty hobbyist can use water stored from a recent display tank water change to implement TTM. Obviously, this only works if you are 100% confident that your display tank is disease free and don’t siphon anything off the bottom. ;-) The other problem with TTM is netting the fish every 3 days. That concern can be somewhat alleviated by using a plastic colander in lieu of a net to catch the fish (square ones work better than round ones):



Chloroquine phosphate: Treats Ich (Cryptocaryon irritans), Marine Velvet disease (Amyloodinium), Brooklynella hostilis & Uronema marinum.

How To Treat - Chloroquine phosphate (CP) is a “new drug” that actually was widely used to control external protozoa in saltwater aquariums back in the 70s & 80s. It was even used in some aquarium medications sold at LFS. Nowadays CP requires a prescription to purchase legitimately, making it more difficult to obtain. Fast forward to today and thanks to the power of the Internet, CP has come roaring back! The biggest obstacle to overcome is obtaining pharmaceutical grade 99% pure CP. I cannot stress the importance of this enough. Do not buy it from some guy on eBay or even an online vendor. The only way to be sure you are getting 99% pure CP is to get your vet to write you a prescription that can then be filled at a local pharmacy.

CP is a “one and done” medication, meaning you dose once and that’s it. There are no test kits for CP, so it’s important that you dose accurately using a digital scale. Also, don’t forget to dose any replacement water (from water changes, but not top off) with CP. The dosage rates are as follows:

• Prophylactic treatment is 40 mg per gallon.
• Active infections (visible symptoms present) is 60mg/gal.
• For Uronema marinum and really bad infestations, you can dose up to 80mg/gal.

As you can see, there is quite a bit of wiggle room between the minimum & maximum dosage. Practically speaking, 40mg/gal will treat all external protozoa issues… it’s just that the higher dosages may get the job done a little faster. Treatment lasts 30 consecutive days, and no carbon, UV, etc. may be used during this time (although it can be used later when you wish to remove the medication from the water). A little quirk about CP is that it is light sensitive, so you cannot use a light on the aquarium while treating. However, this does not mean your fish have to remain in total darkness; ambient lighting (say, from a window across the room) is fine. CP is NOT reef safe. In addition to killing your corals, it is a very strong algaecide.

Pros - Gentle on most fish (DO NOT USE with wrasses), a “one and done” medication that treats most external protozoa. CP is the closest thing there is to a “wonder drug” in our hobby.

Cons/Side Effects - Expensive, hard to get (requires a prescription), light sensitive; some evidence of appetite suppression with certain species (especially wrasses.) Attempts to feed CP laced food are usually not successful due to its bad metallic taste.



Copper: Treats Ich (Cryptocaryon irritans), Marine Velvet disease (Amyloodinium); possibly Uronema marinum

How To Treat - First, it is important to know what kind of copper you are using. Cupramine is fully charged (ionic) copper, and has a therapeutic range of 0.35-0.5 mg/L or ppm. You would use a Seachem or Salifert copper test kit for Cupramine, as those are capable of reading copper in the low range. Coppersafe, on the other hand, is chelated copper. It has a much higher therapeutic range of 1.5-2.0 mg/L or ppm. As such, you need a “total copper test kit” such as API’s to measure Coppersafe. Currently only recommending Copper Power as a "chelated copper", there have been some problems with the strength of dosage with Coppersafe lately.

Standard copper treatment lasts 30 consecutive days. The reason it takes so long is copper only targets the “free swimming stage” (the same holds true for allchemical treatments & hypo). While 7-14 days is the “norm” to reach this stage, certain strains of ich have prolonged life cycles. Indeed, even 30 days may not be long enough in some rare cases. This is why it is so important to observe after treatment ends, to ensure symptoms do not return.

Therapeutic copper levels must be maintained at all times during the 30 days, so testing often is important. If the level drops even slightly out of range, then the 30 day clock starts all over again. One reason your copper level may drop unexpectedly is if you are treating in a tank with rock and substrate; those should not be used in the presence of copper due to absorption. Conversely, if you exceed the therapeutic range you risk killing the fish.

Copper is a poison, pure and simple. It only works because most fish are able to withstand being in it longer than the parasites. Knowing this, it is wise to raise your copper level very slowly (over 3-5 days) instead of the usual 24-48 hours recommended on the labels. Doing so increases your odds of successfully treating a “copper sensitive” fish. Remove copper after 30 days by running activated carbon.

Thank you so much! But I can’t do copper since I do have inverts and corals! (I have been studying for 1 month, the puffer has no interest in the corals. I also am using Ich-X and I’m broke, so I can’t do fancy things however, I think he got ick by me introducing a saddle puffer, cleaner wrasse, box puffer and a watchman goby. He got ich after I put them in. The wrasse and box puffer have sadly died. But my parents will pay ANYTHING to save my dogface’s life! He is like a dog to me! If I lose him, I would be done with my saltwater tank. He is my favorite fish in the wold!

 

[Big G]

Here's some a link with lots of info on Ich management vs. Ich Eradication. Hope this helps a bit.
https://www.reef2reef.com/threads/ich-eradication-vs-ich-management.188775/#post-2171424

Are you sure it's Ich not Velvet? Velvet is rampant in the industry these days. Can you post a picture for us to help?

 

[DoggoThePuffer]

Here's some a link with lots of info on Ich management vs. Ich Eradication. Hope this helps a bit.
https://www.reef2reef.com/threads/ich-eradication-vs-ich-management.188775/#post-2171424

Are you sure it's Ich not Velvet? Velvet is rampant in the industry these days. Can you post a picture for us to help?

Sure! I’ll try to get one this morning! And thank you again!

 

[DoggoThePuffer]

Here's some a link with lots of info on Ich management vs. Ich Eradication. Hope this helps a bit.
https://www.reef2reef.com/threads/ich-eradication-vs-ich-management.188775/#post-2171424

Are you sure it's Ich not Velvet? Velvet is rampant in the industry these days. Can you post a picture for us to help?

Here u go! 2 dif shots.

 

[Big G]

Sorry can’t see much from the pictures.

 

[Paul B]

Looks like Picasso painting

 

[DoggoThePuffer]

Sorry can’t see much from the pictures.

Here’s a better pick of what it looks like! Sorry for the last one,

 

[Big G]

Really hard to see white spots on a fish of that texture and color. If it's velvet there would be too many spots to count.
Here's a link you might want to keep. It's a pictorial by Meredith of common fish diseases.
https://www.reef2reef.com/threads/fish-disease-index-pictorial-guide.285708/#post-3473098

 

[DoggoThePuffer]

Really hard to see white spots on a fish of that texture and color. If it's velvet there would be too many spots to count.
Here's a link you might want to keep. It's a pictorial by Meredith of common fish diseases.
https://www.reef2reef.com/threads/fish-disease-index-pictorial-guide.285708/#post-3473098

My puffer has ich sadly, he has been battling it for the past 4 days. I added 4 fish in at the same time and I think it stressed him. But it has Ich. The pics I provide make it hard to see but I know he has ich. It looked like the 3rd fish on the ich picture part of that link.