Disease Identification and treatment

[Mitratus]

I added two multibar angelfish (Paracentropyge multifasciata) into my quarantine tank (which also currently houses a pair of ruby red dragonets; one of is eating mysis, the other accepts pellets) five days ago and at that time they were both eating mysis.

Four days ago I noticed that both of the angels were scratching on rocks, though one scratched more often than the other, and that one of them had white stringy feces. This lead me to begin treatment with prazipro (praziquantel) since multibar angelfish often come in with flukes (which may explain the scratching) and since it may deal with the white feces. This scratching lead to the larger of the two angels to develop a lesion near its dorsal spines:

Two days after beginning treatment, the smaller angel almost completely stopped scratching (only a couple times per day) while the larger one scratches more frequently (about once every 1-2 hours). However, the smaller angel lost its appetite while the larger one began eating less.

One day later (yesterday), I noticed a milky haze on the side of the larger angel:

Also, the larger angel also seems to have lost its appetite for mysis. It should be noted that both angels still occasionally pick at the live rock in the quarantine tank.

As of today, neither angel is accepting mysis. I have not seen anymore white feces (though I may have simply missed them) and both angels are quite active and alert. Both angels scratch very infrequently, and when they scratch, it is only the gill cover.

It should be mentioned that the larger angel has some white/off-white dots on its caudal and pectoral fins (no spots on the body). I believe that these may be ich or lymphocystis. The smaller angel does not have these. I unfortunately do not have pictures of this as they are difficult to capture.

I am wondering what the milky haze may be (seems to resemble Brooklynella from browsing images online, though I am inexperienced with diagnosing diseases) and whether the lesion appears to have any infection. Also, what would be the most likely cause of the loss in appetite of both angels? Lastly, what would be my best course of action? My current thoughts are a freshwater dip with methylene blue for both angels to perhaps provide relief of the gills and prevent infection of the lesion or simply a dip in methylene blue. I am also considering chloroquine phosphate treatment, however I am not sure whether it would be a good idea to mix treatments with prazipro.

It should be noted that all above images are of the larger angel and that the dragonets have not experienced appetite depression.
EDIT: The quarantine tank has been up for 6 months now though without livestock until 2 weeks ago when the dragonets were added.
SG: 1.026 measured using a refractometer
Temperature: 26°C (78.8°F)

 

[HumbleFish]

I would do a second dose of Prazi (5-6 days after the first), and then start CP treatment. Try to do at least a 25% before the second dose of Prazi, and then again before beginning CP. I would also advise removing the rocks before starting CP.

It's possible you are also dealing with a secondary infection from either flukes and/or ich. I wouldn't use antibiotics unless you outright have to, as that will just further suppress their appetite. But if you have to, alprazo has confirmed that you can safely use Furan-2 in conjunction with CP (see link below).

http://www.reefcentral.com/forums/showthread.php?t=2397496

 

[Mitratus]

I would do a second dose of Prazi (5-6 days after the first), and then start CP treatment. Try to do at least a 25% before the second dose of Prazi, and then again before beginning CP. I would also advise removing the rocks before starting CP.

It's possible you are also dealing with a secondary infection from either flukes and/or ich. I wouldn't use antibiotics unless you outright have to, as that will just further suppress their appetite. But if you have to, alprazo has confirmed that you can safely use Furan-2 in conjunction with CP (see link below).

http://www.reefcentral.com/forums/showthread.php?t=2397496

Thank you for the response.

I performed ~33% water change and began a second round of Prazi today. Prior to this I once again attempted feeding mysis shrimp which resulted in the smaller angel eating a couple pieces, however the larger angel continues to refuse eating.

Thanks for the reminder about removing the rocks prior to beginning chloroquine phosphate.

Would it be possible to administer Furan-2 via a bath? If so, will it be as effective as using it in the quarantine tank?

 

[HumbleFish]

Would it be possible to administer Furan-2 via a bath? If so, will it be as effective as using it in the quarantine tank?

The fish wouldn't be in the bath solution long enough to do much good; IMO.

Some people soak antibiotics in the fish's food, so it is ingested orally. But I am dubious about the effectiveness of that as well.

 

[Mitratus]

The fish wouldn't be in the bath solution long enough to do much good; IMO.

Some people soak antibiotics in the fish's food, so it is ingested orally. But I am dubious about the effectiveness of that as well.

Sounds like treating the tank is the best course of action.

Providing an update:
The larger angelfish was breathing more heavily than usual and was scratching its gill cover quite frequently (~once every 20 minutes) this morning so I performed a freshwater dip. I had to abort the process after 2 minutes since it was becoming excessively stressed (darting around the container). I did not notice anything significant drop off but the angel has ceased scratching for the present time and is breathing a bit slower. An airstone was also added to the tank to increase oxygen content of the water and aid in respiration.

 

[snorvich]

Sounds like treating the tank is the best course of action.

Providing an update:
The larger angelfish was breathing more heavily than usual and was scratching its gill cover quite frequently (~once every 20 minutes) this morning so I performed a freshwater dip. I had to abort the process after 2 minutes since it was becoming excessively stressed (darting around the container). I did not notice anything significant drop off but the angel has ceased scratching for the present time and is breathing a bit slower. An airstone was also added to the tank to increase oxygen content of the water and aid in respiration.

Flukes would be visible. Ich would be basically unaffected by a fresh water dip. Velvet would have symptoms ameliorated.

 

[Mitratus]

After some lengthy observation, I have noticed that the spots on the fins of the larger angel are gone and that the smaller angel appears free of all problems troubling the larger one (however appetite is still suppressed). The larger angel is also breathing more calmly, though its pelvic fins appear clamped.

Flukes would be visible. Ich would be basically unaffected by a fresh water dip. Velvet would have symptoms ameliorated.

Since it appears that amyloodinium ocellatum is likely to be present, would it be advisable to begin chloroquine phosphate treatment one day early (i.e. 4 days after the beginning of the second round of Prazi rather than 5 days after)?

Also, what dosage and duration of chloroquine phosphate would you advise? My current thoughts are 20 mg/L for 28 days but I am not sure if the angels will tolerate it.

 

[Mitratus]

After some lengthy observation, I have noticed that the spots on the fins of the larger angel are gone and that the smaller angel appears free of all problems troubling the larger one (however appetite is still suppressed). The larger angel is also breathing more calmly, though its pelvic fins appear clamped.

I would just like to update that the fins are no longer clamped; behaviour is back to how it was before (generally active) though the angel (still) has no appetite.

 

[Deinonych]

Also, what dosage and duration of chloroquine phosphate would you advise? My current thoughts are 20 mg/L for 28 days but I am not sure if the angels will tolerate it.

10mg/L (40mg/gal) is the recommended dosage for both cryptocaryon and amyloodinium. 4 weeks should be sufficient.

 

[Mitratus]

Yesterday evening both angels were breathing very rapidly and lying on their sides inside their respective pvc pipes. A ~4.5 minute freshwater dip was performed for both angels, during which they were both relatively calm. Upon reintroduction into the quarantine tank, they swam around for a few moments, then went back to lying in their pipes (though they were not breathing as rapidly as before). Both angels would swim a couple inches and reposition themselves regularly.

I decided to begin chloroquine phosphate treatment (Note that it had been just over 4.5 days since the second round of Prazi was started); a ~40% water change was performed, the live rock was removed, and a dosage of ~13 mg/L was added. Afterwards I went to sleep.

Upon waking this morning, I found that the larger angel had died along with the female ruby red dragonet. The female dragonet's head appeared to be covered in a grey haze. The smaller angel was lying on the bottom of the tank, motionless except for its gill plate (breathing). The smaller angels body was rigid and it did not respond to stimulus (i.e. did not respond to gentle touches). The male dragonet was breathing more quickly than usual and was not very active. About an hour later the smaller angel expired, with the male dragonet following about an hour later.

The water in the quarantine tank is currently cloudy which may potentially be attributed to non-medicinal ingredients in the chloroquine phosphate powder. It should be noted that ammonia is at safe levels according to a Seachem Ammonia Alert badge. The live rock is in a bucket with an airstone and it will remain there for 6-8 weeks to ensure that any parasites are dead.

I am unsure as to what was the cause of death of the dragonets. I am thinking that perhaps the chloroquine phosphate was expired; it was purchased back in September of last year and stored according to instructions (there was no expiry date printed). Does anyone have any thoughts on this?

 

[tylersarah]

Sorry to read this. One thought, o2 levels? Adequate circulation and air stone?

 

[Mitratus]

Sorry to read this. One thought, o2 levels? Adequate circulation and air stone?

The set up with regards to the airstone and circulation is as follows:

A Tetra Whisper 10-30 was used to supply the air stone and was set so that ~3/4 of air output was heading into the tank while the other 1/4 was supplied to the bucket with live rock.

The first component of the circulation was provided by a Tunze nanostream 6045 positioned on one side of the tank, ~14 cm off of the bottom of the tank, and angled ~30° above the horizontal (such that it agitated the surface). The powerhead was set to its second slowest speed using the mechanical flow control; thus it moved at least 1500 L/h (as this corresponds to the lowest setting on the powerhead). The second component of circulation was provided by an Aquaclear 50 filter, with no flow restriction, positioned on the opposite end of the tank.

It is possibility that oxygen levels were lowered however I currently do not have any means of monitoring it. I will probably purchase a Salifert oxygen test kit to provide some insight into this; thank you for bringing this possibility to my attention.

An idea I am considering (which may tie into oxygen levels) is that perhaps one of the non-medicinal ingredients (which I found out to be dibasic calcium phosphate, lactose, magnesium stearate, microcrystalline cellulose, povidone, and pregelatinized starch) and/or die off from select organisms (e.g. algae) triggered a bacterial bloom that adversely affected the fish directly or indirectly (as would be the case if oxygen was depleted).

It is unfortunate that all of the fish were lost (especially since they were all feeding on prepared foods in some form at a certain point in time); I feel my best course of action now is to learn from this experience and prevent similar events from occurring in the future. Thank you for the help.

Feel free to add any more comments.