Tang still flashing after 30+ days of QT

[LeftyReefer]

I purchased a little scopas tang from the LFS a while back. He appeared healthy at the lfs, but I planned on QT'ing him anyway. When I first got him home and in the QT, I noticed he was scratching his snout on the PVC elbows. I figured this was ICH (it's a tang!) so I started him with Copper Power right away. I dosed the QT tank to 1.75 ppm (hanna checker) the first day, then ramped it up to 2.5 the following day. Within a day or two in copper, all his scratching stopped completely.
he continued to eat like a pig and seemed to be doing fine during the entire copper treatment. I thought all was going great and I had high hopes for this fish making it back to health. fast forward, and 30 days was up and I dosed the QT tank with GC (2 packets into a 20g QT tank) at which point the tang started scratching his face and flashing like crazy.. head shaking, sudden darting across the tank, more shaking his head, rubbing the PVC again, lost color as he went really pale... I figured this was flukes. waited a couple days and then redosed (2) more packets of GC to the 20g QT tank.

The label on the General Cure says to dose 1 packet per 10 gal, then wait 48 hours and redose and do a water change. I waited 3 days, not 2 and then redosed. My QT tank is a 20 long, filled to only 18 gallons or so. I use 2 full packets of GC per dose. Online, I see many people say 5-7 days between doses.... which is not what the label says. The label says 48 hours.

I did my first dose of GC on the evening of 9/1. The second dose was on the evening of 9/4. Today is 9/7 and he's still shaking his head, rubbing on PVC, and seems to be swimming into the bubbles created by the air stone a lot... now I'm worried i messed up this prazi treatment.

I've never once seen a single spot on him, and he's been through 30 days of copper at 2.5ppm. I'm still suspecting this is flukes and not ICH, but two treatments hasn't seem to fix it yet.

Saying that, I found the marine parasite calendar page and it says for my tank temp and salinity that my second dose should be 6-7 days after the first dose. Which would be today or tomorrow. I've already dosed the tank with the second dose after only 3 days.... which was probably much too soon. am I OK doing a 3rd dose again, now that it's in this day 6-7 window that the marine parasite calendar page says is the right time to retreat?

I've been using GC, but can grab some prazi-pro from the LFS if it works better.
after doing a couple searches on flukes here at R2R, I see lots of mentions of prazi resistant flukes. ugh.

Any suggestions? Am I safe to do a third dose of GC in such short time? it would be the 3rd dose in 6 days.... although I guess I could wait one more day and do the dose on day 8, which would be 7 days after the first dose. If this is a prazi-resistant strain of flukes, then what are my options? hyposalinity for another 30 days +? Any other meds I should be trying?

 

[MnFish1]

I purchased a little scopas tang from the LFS a while back. He appeared healthy at the lfs, but I planned on QT'ing him anyway. When I first got him home and in the QT, I noticed he was scratching his snout on the PVC elbows. I figured this was ICH (it's a tang!) so I started him with Copper Power right away. I dosed the QT tank to 1.75 ppm (hanna checker) the first day, then ramped it up to 2.5 the following day. Within a day or two in copper, all his scratching stopped completely.
he continued to eat like a pig and seemed to be doing fine during the entire copper treatment. I thought all was going great and I had high hopes for this fish making it back to health. fast forward, and 30 days was up and I dosed the QT tank with GC (2 packets into a 20g QT tank) at which point the tang started scratching his face and flashing like crazy.. head shaking, sudden darting across the tank, more shaking his head, rubbing the PVC again, lost color as he went really pale... I figured this was flukes. waited a couple days and then redosed (2) more packets of GC to the 20g QT tank.

The label on the General Cure says to dose 1 packet per 10 gal, then wait 48 hours and redose and do a water change. I waited 3 days, not 2 and then redosed. My QT tank is a 20 long, filled to only 18 gallons or so. I use 2 full packets of GC per dose. Online, I see many people say 5-7 days between doses.... which is not what the label says. The label says 48 hours.

I did my first dose of GC on the evening of 9/1. The second dose was on the evening of 9/4. Today is 9/7 and he's still shaking his head, rubbing on PVC, and seems to be swimming into the bubbles created by the air stone a lot... now I'm worried i messed up this prazi treatment.

I've never once seen a single spot on him, and he's been through 30 days of copper at 2.5ppm. I'm still suspecting this is flukes and not ICH, but two treatments hasn't seem to fix it yet.

Saying that, I found the marine parasite calendar page and it says for my tank temp and salinity that my second dose should be 6-7 days after the first dose. Which would be today or tomorrow. I've already dosed the tank with the second dose after only 3 days.... which was probably much too soon. am I OK doing a 3rd dose again, now that it's in this day 6-7 window that the marine parasite calendar page says is the right time to retreat?

I've been using GC, but can grab some prazi-pro from the LFS if it works better.
after doing a couple searches on flukes here at R2R, I see lots of mentions of prazi resistant flukes. ugh.

Any suggestions? Am I safe to do a third dose of GC in such short time? it would be the 3rd dose in 6 days.... although I guess I could wait one more day and do the dose on day 8, which would be 7 days after the first dose. If this is a prazi-resistant strain of flukes, then what are my options? hyposalinity for another 30 days +? Any other meds I should be trying?

1. Did you check the copper levels during the copper treatment (every so often)?
2. The fact that the fish started acting 'funny' from what you said - immediately after adding General cure, it sounds more like a reaction to the medication perhaps. Were these changes (the flashing, getting pale, etc) immediately after adding General cure?
3. You overdosed the general cure perhaps a little bit - by 10 percent. Was there still copper in the water?
4. According to the instructions - you are correct - you are supposed to add general cure on day 1 and then 48 hours later. Then 48 hours after that - add carbon and a 25 % water change.
5. Have you tried a freshwater drip - for flukes (I'm not recommending that - just asking).

To me the odd thing - the fish was doing fine in copper treatment (i.e. no symptoms of flukes) - I'm not sure why all the sudden they would show up immediately upon adding general cure. I'm sure the experts will weigh in

 

[LeftyReefer]

1. Did you check the copper levels during the copper treatment (every so often)?
2. The fact that the fish started acting 'funny' from what you said - immediately after adding General cure, it sounds more like a reaction to the medication perhaps. Were these changes (the flashing, getting pale, etc) immediately after adding General cure?
3. You overdosed the general cure perhaps a little bit - by 10 percent. Was there still copper in the water?
4. According to the instructions - you are correct - you are supposed to add general cure on day 1 and then 48 hours later. Then 48 hours after that - add carbon and a 25 % water change.
5. Have you tried a freshwater drip - for flukes (I'm not recommending that - just asking).

To me the odd thing - the fish was doing fine in copper treatment (i.e. no symptoms of flukes) - I'm not sure why all the sudden they would show up immediately upon adding general cure. I'm sure the experts will weigh in

1. Yes, I have a hanna checker and always kept it at 2.5ppm. I would dose water change water before adding it to the tank, so the tank never dropped under 2.5ppm copper for the entire 30 days.

2. Yes, it was shortly after adding the GC. I assume the prazi in the GC was affecting the flukes, causing irritation. I assumed it would get better within a day or two, but after a week, the tang is still showing signs of fluke irritaion.... mostly head shaking and rubbing its head on PVC. but I guess it could just be irritated from the damage left by the flukes and not actually the flukes themselves still.

3. Yes, there was still some residual copper left in the tank. I did a 50% water change after 30 days and then started the GC treatment.

5. I have not done a FW dip. It will only show 1 kind of fluke and I was going to treat for flukes regardless, so I just started the treatment and didn't bother doing a dip. Maybe I need to do this.

 

[LeftyReefer]

The tang is still head shaking, but does appear a little better than yesterday.. not shaking as often or darting around as often. seems a bit calmer, hopefully getting better now.

I plan to give it treatment #3 tomorrow, which would be 7 days after the 1st dose, which is what the parasite treatment calendar recommends. I figure prazi and metro are pretty safe and well tolerated. the package even mentions two rounds of 2 doses, might be needed, so I plan to do 4 doses total to be sure.

 

[DaddyFish]

If two rounds of GC have not cured the problem. I would go back to copper, or do 35-days of hyposalinity, or TTM if you have the resources available, all under the assumption that the fish has Ich and hasn't yet shown external signs of the parasite. Ich begins in the gills, long before anything becomes externally visible.

 

[LeftyReefer]

If two rounds of GC have not cured the problem. I would go back to copper, or do 35-days of hyposalinity, or TTM if you have the resources available, all under the assumption that the fish has Ich and hasn't yet shown external signs of the parasite. Ich begins in the gills, long before anything becomes externally visible.

The fish actually spent 37 days in Copper, before starting the GC. I stated 30 days in the OP, but it was actually 37 days in copper. I'm going to give it another dose of GC today, which would be the properly timed 2nd dose, then wait a couple days before doing a water change and then reevaluate. Jay said he recommends 3 rounds of Prazi, spaced 7-10 days apart... I did 2 rounds spaced 3 days apart, which doesn't appear to be anywhere near sufficient... based on their life cycle, so I'm not going to give up on the Prazi working just yet. I still think this fish has flukes, which copper won't do anything for.... so I'm going to stick with the Prazi treatment, but spaced out correctly.

 

[MnFish1]

The fish actually spent 37 days in Copper, before starting the GC. I stated 30 days in the OP, but it was actually 37 days in copper. I'm going to give it another dose of GC today, which would be the properly timed 2nd dose, then wait a couple days before doing a water change and then reevaluate. Jay said he recommends 3 rounds of Prazi, spaced 7-10 days apart... I did 2 rounds spaced 3 days apart, which doesn't appear to be anywhere near sufficient... based on their life cycle, so I'm not going to give up on the Prazi working just yet. I still think this fish has flukes, which copper won't do anything for.... so I'm going to stick with the Prazi treatment, but spaced out correctly.

I'm curious. If its improving, why not just wait and watch it? You may be causing more problems than you're solving. For example - could your symptoms be due to copper? "During toxicity, in addition to general signs of distress (e.g., increased respiration), fish may display darkening and behavioral abnormalities: lethargy, incoordination, problems with posture and balance, and, eventually, death"

Maybe @Jay Hemdal can weigh in

 

[LeftyReefer]

Because at this point, I'm pretty convinced it is flukes. The fish is exhibiting classic fluke symptoms... rabid breathing, head shaking, rubbing only its face/snout, sudden darting like it's being bitten, etc..

And based on flukes life cycle, you have to get the flukes to detach from the fish and you also have to allow enough time for any eggs to hatch and then also die off, which is why you should wait 7-10 days between doses.... I only waited 3 days, so if I don't dose prazi again after 7 days, the eggs could hatch and then reattach to the fish again, starting this all over again.

I think I need to do another dose today, which would be 7 days after the first dose. and then possibly do another dose in another 7 days....

I saw in another thread where Jay recommended 3 doses, spaced 7-10 days apart. At this point, I'm just going to act as if I never did the 2nd dose after 3 days, since that was incorrectly timed. I'm doing another dose today, which is 7 days after the first dose, and I will consider this my 2nd dose now. I will do a water change in a few days, before doing a third dose, if necessary.

 

[Goaway]

I will do a water change in a few days, before doing a third dose, if necessary.

You will want to do a large water change to remove bacteria (20-30%), as it loves to devour prazi and will quickly before the meds can work.

 

[Jay Hemdal]

Because at this point, I'm pretty convinced it is flukes. The fish is exhibiting classic fluke symptoms... rabid breathing, head shaking, rubbing only its face/snout, sudden darting like it's being bitten, etc..

And based on flukes life cycle, you have to get the flukes to detach from the fish and you also have to allow enough time for any eggs to hatch and then also die off, which is why you should wait 7-10 days between doses.... I only waited 3 days, so if I don't dose prazi again after 7 days, the eggs could hatch and then reattach to the fish again, starting this all over again.

I think I need to do another dose today, which would be 7 days after the first dose. and then possibly do another dose in another 7 days....

I saw in another thread where Jay recommended 3 doses, spaced 7-10 days apart. At this point, I'm just going to act as if I never did the 2nd dose after 3 days, since that was incorrectly timed. I'm doing another dose today, which is 7 days after the first dose, and I will consider this my 2nd dose now. I will do a water change in a few days, before doing a third dose, if necessary.

One issue is that GC is a mix of praziquantel and metronidazole. It is the metro that is the wild card here in terms of redosing. The timing I mentioned is for Prazipro or praziquantel powder.
Jay

 

[Reef AquaCult]

I have the same issues with my convict tang currently. Full copper 2.5 over 30 days, multiple rounds GC. Went to DT and kept scratching. Did 30 days 1.008 hypo. Still scratching. Dosed prazi to DT, still scratching. Never any spots. I’ve read that once fish have flukes it can take weeks or months for them to stop scratching even if the parasites are gone. I’m hoping this is the case. Maybe it’s just continued irritation.

 

[LeftyReefer]

One issue is that GC is a mix of praziquantel and metronidazole. It is the metro that is the wild card here in terms of redosing. The timing I mentioned is for Prazipro or praziquantel powder.
Jay

Correct me if I'm wrong, but Metro doesn't really absorb much via the fish's skin does it? I thought metro really needed to be ingested by the fish.... so I'm thinking that dosing metro (via GC) to the water column doesn't pose much overdose risk to the fish. Seachem actually recommends dosing metro every 48 hours, for up to 3 weeks, when dosing it to the water column, so I'm not too worried about the repeated Metro via repeated GC treatments, every 7 days.

I chose GC over PraziPro just to avoid any bacterial blooms, but maybe I need to switch to PraziPro anyway. Everyone else seems to have good luck with it.

 

[LeftyReefer]

I have the same issues with my convict tang currently. Full copper 2.5 over 30 days, multiple rounds GC. Went to DT and kept scratching. Did 30 days 1.008 hypo. Still scratching. Dosed prazi to DT, still scratching. Never any spots. I’ve read that once fish have flukes it can take weeks or months for them to stop scratching even if the parasites are gone. I’m hoping this is the case. Maybe it’s just continued irritation.

Interesting.

I wonder if some baths in RRR (acriflavine and aminoacridine) or similar baths might help the fluke wounds heal faster.

 

[Jay Hemdal]

Correct me if I'm wrong, but Metro doesn't really absorb much via the fish's skin does it? I thought metro really needed to be ingested by the fish.... so I'm thinking that dosing metro (via GC) to the water column doesn't pose much overdose risk to the fish. Seachem actually recommends dosing metro every 48 hours, for up to 3 weeks, when dosing it to the water column, so I'm not too worried about the repeated Metro via repeated GC treatments, every 7 days.

I chose GC over PraziPro just to avoid any bacterial blooms, but maybe I need to switch to PraziPro anyway. Everyone else seems to have good luck with it.

Marine fish drink water pretty consistently in order to maintain osmotic balance. The thought is that if the metro dose is correct, the fish ingest a proper dose that way. I’ve never tried to work on the math though as I don’t know how much water a fish drinks in a day.
Jay

 

[MnFish1]

Marine fish drink water pretty consistently in order to maintain osmotic balance. The thought is that if the metro dose is correct, the fish ingest a proper dose that way. I’ve never tried to work on the math though as I don’t know how much water a fish drinks in a day.
Jay

I would think with every breath - there would be equilibration between the water and the gills - I don t know if a concentration effect occurs - just my guess

 

[Jay Hemdal]

I would think with every breath - there would be equilibration between the water and the gills - I don t know if a concentration effect occurs - just my guess

My understanding is that marine fish lose water through their skin and gills and then drink seawater to gain back water (presumably their kidneys remove the excess salt).

Wow - I actually found some real data on this!

A “typical” marine teleost will drink on the order of 10–20% of their body weight per day, with the ability to drink up to 35–40% if the salinity is high. For an example, a fish weighing 500 g will consume around 100 mL of saltwater in a day.


Jay

 

[vtecintegra]

Up until recently I was dosing GC in QT for 14 continuous days. Flukes still got through to the DT. Had to dose Prazipro to the DT, and one fish was still scratching. Moving on to prazi powder in the future.

 

[LeftyReefer]

Update:

I've now given the Tang (3) treatments of GC, spaced 7 days apart, and an extra dose on day 4...
So I dosed GC to the QT tank on Day 1, Day, 4, Day 8, and Day 15. It is now day 16 and the Tang is still scratching and head shaking and breathing fast.

Not sure what else I can do besides putting him back into copper for another 30+ days? Maybe try cupramine instead of copper power this time?

He is the only fish in the QT tank now. Should I try hyposalinity instead of meds? FYI, I have never done hyposalinity before, so that would be something new for me (and him!)

Any other ideas?

meds I have on hand;
Copper Power
Cupramine
GC
metroplex
kanaplex
furan-2
ruby reef rally
kick ich
melafix
safety-stop dips. (methylene blue and formalin)
paraguard

I'm seriously thinking of just giving up on this fish. He's been in QT for over 2 months and he still has issues that don't seem to be going away or getting any better.
37 days of 2.5+ copper power
3 weeks of GC treatments, 7 days apart.
1 dose of melafix during GC treatment.
still darting, head shaking, and scratching his face, and breathing fast.

Not sure where to go from here. ugh.

On the bright side, all my corals seem to be thriving at the moment, and all other fish have been successfully returned to the DT and have remained clear. So it looks like my fallow period was sufficient. If only I could figure out the issues with this new fish!

 

[Jay Hemdal]

Update:

I've now given the Tang (3) treatments of GC, spaced 7 days apart, and an extra dose on day 4...
So I dosed GC to the QT tank on Day 1, Day, 4, Day 8, and Day 15. It is now day 16 and the Tang is still scratching and head shaking and breathing fast.

Not sure what else I can do besides putting him back into copper for another 30+ days? Maybe try cupramine instead of copper power this time?

He is the only fish in the QT tank now. Should I try hyposalinity instead of meds? FYI, I have never done hyposalinity before, so that would be something new for me (and him!)

Any other ideas?

meds I have on hand;
Copper Power
Cupramine
GC
metroplex
kanaplex
furan-2
ruby reef rally
kick ich
melafix
safety-stop dips. (methylene blue and formalin)
paraguard

I'm seriously thinking of just giving up on this fish. He's been in QT for over 2 months and he still has issues that don't seem to be going away or getting any better.
37 days of 2.5+ copper power
3 weeks of GC treatments, 7 days apart.
1 dose of melafix during GC treatment.
still darting, head shaking, and scratching his face, and breathing fast.

Not sure where to go from here. ugh.

On the bright side, all my corals seem to be thriving at the moment, and all other fish have been successfully returned to the DT and have remained clear. So it looks like my fallow period was sufficient. If only I could figure out the issues with this new fish!

Not sure where you should go with this. The symptoms seem to point to gill flukes, but the GC should have offered at least temporary relief. Other gill diseases can cause rapid breathing, but velvet kills rapidly and bacterial diseases are uncommon and don’t really cause scratching.
Hyposalinity, at 1/2 salinity is one option. In a treatment tank, drop the specific gravity to 1.012 over 48 hours, then hold the fish there for 35 days. Monitor the pH during that time. When returning to full salinity, go slower, take 5 days.
Jay

 

[threebuoys]

Food Allergy!

I'm not being serious.

But, you really seem to have done everything possible. Maybe the fish has poison ivy? Again not completely serious.

I know the rapid breathing is a big concern. I am following with great interest and hope you are successful at getting to the bottom of this.