Stocking the Marine Fish Medicine Cabinet

[leebca]

STOCKING THE MARINE FISH MEDICINE CABINET


The question comes up sometimes from those who are thinking ahead or those who, having faced their first fish disease/ailment, now wonder what medicines they should have on hand. Aquarists often find they are stuck with only what their LFS has on the shelf. Even then, not all LFSs are open every day of the week. So the aquarist might find they can't help their fish as quickly as they would like, or as quickly and they should. Sometimes an immediate treatment is necessary.

For these reasons, it is worthwhile for aquarists who plan to keep an aquarium with fish in it to have some things on hand to cure typical fish ailments, diseases, or problems. Even if you have a reef aquarium with fish in it, you'll want some basics in your "Fish Medicine Cabinet." But if you have or plan on having a fish only (with or without live rock) aquarium, there are some musts to have on hand to make the hobby more enjoyable and to protect your emotional and financial investments.

Medicines have expiration dates. Be aware of them when you buy the medication. If you're getting them from your LFS and the expiration date is close, ask them to order fresh meds, or find fresher meds elsewhere.

You should be using a quarantine process to verify that all marine specimens you add to your display are disease free and not carrying any hitch hiking problem marine organisms.

There are three cases where you will want to treat your newly acquired fish even though you are sure the fish is healthy. You want to treat all Anemonefish for Brooklynella disease (and also get rid of other ciliated protozoan); you want to treat all tangs of the Genus Acanthurus for both Marine Ich and Marine Velvet; and you want to de-worm all fishes. The indicated special fishes carry specific diseases with them so often that it is best in my opinion to just go ahead and threat them. So many fishes of any kind carry intestinal worms that all newly acquired fish need to be de-wormed. So the Minimum Medicine Cabinet contains medications specifically for these cases.


MINIMUM MARINE FISH MEDICINE CABINET

Medicines and Chemicals
Cupramine (copper medicine)
Formalin (37% formaldehyde)
Methylene Blue (2.0 to 2.3% solution)
Sodium bicarbonate (Arm & Hammer food grade Baking Soda)
Praziquantel (or other de-wormer -- see below)
Maracyn Two for Saltwater Fishes
Beta Glucan (Beta 1,3-D glucan) [extracted from Baker’s yeast or saccharomyce cerevisiae]
Stabilized Vitamin C
Either Pro Tech Coat Marine or StressGuard

Equipment
Copper Test Kits (one Salifert or Seachem Copper test kit - unexpired!)
Refractometer
Air pump and diffuser (stone)
Dipping/Bath bowls and colanders



Cupramine is one of the best copper treatment medications. This is about the only time you will find me recommending a single product. It is so gentle it can be used on the most sensitive of fishes and is effective even in half concentrations. This treats both Marine Ich (Cryptocaryon irritans) and Marine Velvet (Amyloodinium ocellatum). This will be used to treat all incoming tangs of the Genus Acanthurus. This will be used on any fish indicating it may have a case of Marine Velvet.

Formalin (the gas formaldehyde in solution at 37% concentration) is used to give formalin baths/dips. This is the best treatment for Brooklynella disease. All newly acquired Anemonefish will be treated with this chemical for Brooklynella. Some good guidelines can be found here, for administering a Formalin dip/bath treatment:
Formaldehyde: Friend or Foe - Treating Saltwater Fish Diseases

Methylene Blue and Sodium Bicarbonate will be used in the freshwater dip process. It's used for all newly acquired fishes and for fishes needing this treatment.

The Praziquantel is to be used to for all newly acquired fishes. It is a de-worming chemical the aquarist adds to the food. (See below for more info and for alternatives to using pure Praziquantel).

Maracyn Two is for both surface and internal (systemic) bacterial infections, curing many different (common) bacterial caused problems in marine fishes. Since this is an antibiotic, only stock a little of this or, if your LFS has it and they are open 6 or 7 days a week, let them stock it.

Beta glucan is found at your human health food store. It boosts your fish's immune system during illness and disease.

Pro Tech Coat Marine or StressGuard is kept on hand to repair or replace the fish's mucous coating from net damage, injury, or disease damage.

The refractometer is needed for a proper hyposalinity treatment for just the disease Marine Ich. Hyposalinity only works to cure Marine Ich. It does not cure Marine Velvet.

The air pump and diffuser is necessary for the proper formalin dip process.

The bowls & colander are for the freshwater dip process and are further explained in the Freshwater Dip reference.


EXTENDED MARINE FISH MEDICINE CABINET

Extended Medicines and Chemicals
In addition to all the above, add these for a much more comprehensive cabinet:
Fluke Tabs
Maracyn One for Saltwater Fishes
Nitrofurazone (in the product, Furan-2 for Saltwater fish) or the product Spectrogram
Metronidazole
Clove Oil

Extended Equipment
The equipment from the Minimum list plus:
Portable Hand-held pH meter (that gives readings in less than 0.05 pH units)
Portable Thermometer (digital that gives readings in at least 0.2 degrees F units)

Fluke Tabs are as the name implies - for treatment of flukes. It contains organophosphates which thank goodness many surface parasites can't take at all, yet doesn't bother our marine fishes!

Maracyn One for Saltwater Fish is another antibiotic that kills the 'less likely' bacteria that Maracyn Two doesn't kill. Stock if your LFS doesn't carry it or is closed more than 2 days a week.

Nitrofurazone is an antibiotic that is very tough on surface bacteria. It is found in the two named products. Stock if your LFS doesn't carry it or is closed more than 2 days a week.

Metronidazole treats dinoflagellate infections. It's a special kind of intestinal parasite which comes in more fish than we'd like to see. Found in products like Hex-A-Mit.

The Clove Oil is obtained from almost any vitamin store or health food shop. It is used to put fish down.

The pH meter and digital thermometer are used for the Fresh Water dip process referenced above. If you're serious about your Fish Medicine Cabinet, then you should be using slightly more sophisticated equipment such as these two items. Hanna makes a reliable portable hand held pH meter. Shop around for what's available.



You don't have to buy the specific products given as examples. Any fish medication for saltwater fish containing a large quantity of the chemical/antibiotic is fine.

Directions usually come with the medication. The formalin treatment I recommend is given in the above reference.

Most of these medications can be found at your LFS, or your LFS can perhaps order them for you, or you can find them through Internet sources (especially Reef Sanctuary sponsors!). The Beta Glucan is obtained at the (human) health food stores.

Praziquantel may be hard to find. But it is available on-line along with other medications at: National Fish Pharmaceuticals, Fishyfarmacy. It is also available on-line from PondRX. Unfortunately, the quantity of Praziquantel you need to order as a minimum order may be more than you’ll need in the next few years. It is administered at 23mg per pound of fish, in their normal food. The dose is repeated in 6 days.

There is a commercially prepared anti-parasitic pellet food available. It is made by Jungle. The product name is: Anti-Parasite Medicated Fish Food. The active ingredients in this food are levamisole (a stimulant for the fish immune system), Metronidazole, and Praziquantel. This particular formula will kill a much broader spectrum of intestinal organisms.

Also, the product Gel-Tek Ultra Cure PX can be used instead of Praziquantel. Another de-wormer alternative is the product Pipezine. The aquarist is looking for a treatment that the fish will swallow (not a water treatment like Pipezine). However, if the fish isn't eating, the water treatment is necessary.

Buy quantities depending upon the size of your QT, the number of fishes you will likely be putting through the QT process and the total number of fishes you plan to keep. OR. . .You can just buy enough to get the treatment started so that you don't have to wait while more meds come in. Make sure you replace medications that go out of date/expire.

Despite all the nice chemicals we have at our disposal, a world of good can come about by doing daily large water changes when there appears to be something wrong with your fish. Water quality (especially pH) for fishes is very important along with providing the proper nutrients.

The most important thing you can provide your fishes is the proper nutrition. I would like to end this post giving the reader a change of thought on medication. Think of medications not as curing agents, but as agents to help the fish cure itself. Most medications just 'mess with' the pathogen enough to give the fish a chance to heal itself. That takes energy reserves of the fish, stored fats, and proper foods. If the reader can think in these terms, then it should be clear that the proper nutrition is one of the best 'cures' of an ill fish!

Good luck!

[Woodstock]

A reading assignment for myself! Thanks again Leebca! My fishes thank you too

[PEMfish]

.

[framerguy]

Bookmarked and printed for the notebook! Thanks Leebca!!

[ScottT1980]

Very comprehensive list, impressive.

Is metronizazole a trade name for metronidazole (flagyl)? Just have never seen it called that, but am not all that familiar with the various trade names in the hobby.

I tend to like the idea behind the jungle dewormer. The levamisole will take out all your nematodes, the metronidazole hits the protozoa, and the praziquantel will get your cestodes (tapeworms) and flukes. A large majority of our wild caught fish will have subclinical infections with intestinal parasites. It may never present itself as a problem, but if you see chronic wasting of your fish with an adequate diet, then it is any easy thing to try.

Again, great list leebca!

[leebca]

Scott,

Thanks for the catch. It was a typo that my spell checker changed the word to throughout the post. I think I caught them all.

The Jungle product would seem to be the best, but some have told me they can't get their fish to eat it, even if disguised. It's the three-punch the aquarist wants, though.

[Frankie]

Awesome stuff Leebca! (funny that, your name is my kids password to her laptop side. Her name is Lee and her friends is rebecca! )
I book marked this for emergency's!

[Woodstock]

Lee, you mention two deworms, praziquantel and metronidazole for deworming fish. Do you recommend using panacur also?

[cracker]

All very good info. Other than the Cupramine will any of the other medications mentioned make a tank unfit for a future reef ? I wanted to set up the 55 as a QT but don't want to taint it with unsafe meds/chemicals. I assume it's best to obtain a tank that will be both qt & hospital ready. A 55 would be nice for fish during QT, but can it be too large? Meaning the extra meds required & upkeep might be impractical costwise. Thanks ,

[kathywithbirds]

agents to help the fish cure itself

Yes, yes!!! Are you an osteopathic doc by any chance?

Great info Lee, I have just gotten to the point where a fish has a bit of ick and I'm QT-ing and treating and wondering what should be "on hand" for my fishies.

Have you any opinion on Lifeguard? Seems well received by the few I've heard of who've used it, but more of a "help" than a "cure."

[leebca]

All I know of Pancur is that its original intent was for the intestinal track of land animals. I don't know about its use for fishes.

[leebca]

cracker,

Other than copper, none of the other meds should cling or be left over after a thorough cleaning of the equipment.

Size the QT to the fish. Part of the value of the QT is in fact its limited space. A small tank makes such parasites and diseases like Marine Ich multiply quickly and show themselves quickly to the hobbyist.

[ScottT1980]

Originally Posted by Woodstock

Lee, you mention two deworms, praziquantel and metronidazole for deworming fish. Do you recommend using panacur also?

Fenbendazole (Panacur) is a very affective dewormer in animals. It has efficacy against some tapes, some flukes, and virtually nematodes. I haven't seen any preparations for fish, but I am sure they are out there.

Personally (although leebca may have a different opinion), I think it would be ok. However, if you are just using a shotgun approach with the hopes of killing all potential intestinal parasite, you may miss some tapes and protozoa (I don't know what the most common species are in fish).

Of course, I primarily have a mammalian perspective and things could be completely different in fish.

[leebca]

kathy,


Lifeguard contains a chlorinated chemical used as a disinfectant. It has not been shown to cure fish of Marine Ich 100% of the time in actual marine fish. As a broad spectrum disinfectant, diluted out so as to not adversely affect marine life, it has its limitations.

Like some other products and UV, it may inhibit the bloom of some parasites, but not wipe them out.

[leebca]

I don't disagree with Scott. I just don't know. I know the two that are commonly used, that they work, and how to use them.