Ich - possible new treatment protocol. The Naka protocol.

[el papai]

Hi everybody.

Recently I have had a leak in my tank. So I had to move my yellow tang to a nano temporarily. All was well and the YT was happy and eating like a cow. But after two weeks in the nano, the terrible white spots appeared. And after a while, my occelaris also developed the white dots. After a little research, I discovered that it was ich, a diseased that is caused by cryptocaryon irritansa ciliate protozoa. Well, being a surgeon, I have some knowledge about etiopathogenic agents and decided to do a treatment on my heavily stocked reef.

The treatment is simple:
150mg of levamisol per 10 gallons of the tank volume.
500mg of secnidazole per 10 gallons of the tank volume.

Let me explain: many reefers applied the levamisol treatment with succes, but also, many have failed in eradicating this disease. Well, the levamisol is very useful against helmints, but not protozoa, but it is also a good immunomodulator. As for the secnidazole, it is great against protozoa, so I decided to try both of them together to have a synergetic action.

So far, after two days, those are my results:
-No more white dots in any of the fish;
-No more fish scratching at the sand;
-The yellow tang evacuated worms (yes, I can see them hanging from exactly where you are thinking);
-I have zoanthids, green star polyps, gonioporas, montiporas, trumpets, duncans, hammers, frogs and al, except one GSP are doing well;
-The anemone isn't doing so well. But I must say it didn't look well the day before the treatment. By the way, it is a rose BTA;

-i didn't take out cabon;
-i didn't stop my skimmer;
-I didn't do any water changes;
-All my parameters are ok;

I must say this treatment is not still tested enough to be reommended. Also, we need more samples and experiences to validate the findings. Also, the environment wasn't controlled and the variables weren't considered. This is more like a case report. So my friends, use this protocol at your own risk.

Best regards,

 

[mbingha]

Subscribed... wishing this the best of luck, but there have been all to many of these threads to fail.

 

[el papai]

Thank you very much, Mbingha.
I'm not sure if it is the treatment that worked, because it was not a controlled environment. Maybe the ich would be healed if I didn't add anything. Who knows. If anybody else tests this protocol, please, be sure to post here.

I hope this treatment works because we are, in theory, trying to attack the protozoa in two fronts: the levamisol, theoretically, will positively immunomodulate the fish organism (increasing the defensive response from the fish's organism) whereas the secnidazole will act directly in the parasite. I'm just not sure if the dose is enough or what are the long term implications.

Best regards,

 

[GroktheCube]

Interesting.

Subscribing.

Keep an eye on the corals, I think the biggest concern would be how the treatment would affect their zooxanthellae. They (Symbiodinium) are in a different phylum, but even so.

If you have luck, I may try looking for something I want to add anyway that has ich, and use this instead of TTM in QT, and leave a coral in there with it to see what happens. I'd need to leave it in there for a few months to be able to draw a remotely reliable conclusion, but it might be worth it.

 

[mbingha]

The treatment is simple:
150mg of levamisol per 10 gallons of the tank volume.
500mg of secnidazole per 10 gallons of the tank volume.

Out of curiosity, where would one get these medications, and can anyone obtain them?

 

[Deinonych]

Tagging along. Also interested to understand the long-term effect on zooxanthellae, if any, as well as how the treatment affects Cryptocaryon (and which stages).

 

[el papai]

Interesting.

Subscribing.

Keep an eye on the corals, I think the biggest concern would be how the treatment would affect their zooxanthellae. They (Symbiodinium) are in a different phylum, but even so.

If you have luck, I may try looking for something I want to add anyway that has ich, and use this instead of TTM in QT, and leave a coral in there with it to see what happens. I'd need to leave it in there for a few months to be able to draw a remotely reliable conclusion, but it might be worth it.

Thank you for your inputs. In fact you concerns are well place. The protozoa and the zooxanthellae are both unicellular, so secnidazole could somehow damage it. I really don't have a clue. I'm totally ignorant about zooxanthellae, so I hope someone comes here to help us.

mbingha,
You probably need prescription for secnidazole. It is almost the same as metronidazole, the practical main difference is that the first need only one dose while the latter needs continuous applications to be effective.

Deinonych,
Thank you for your input. I've read somewhere that Cryptocaryon Irritans can live up to six months in a reef in a latent stage. So, I will only be able to claim long term success after this time.

Also, I would like help form all of you. First, what would you consider short term success and long term success? Second, we need more people with ich to test this treatment.

I think it is still pretty risky to use this protocol in the reef. But, it looks to me that the fishes haven't even felt the treatment, so using this protocol in QT would be relatively safe, I guess. Another thing I must say is that all my fishes with Ich were eating well before the treatment. I don't know what would happen with a weaker fish that hasn't been eating for days.

Best regards,

 

[mbingha]

How would we go about testing this if we need a perception, unless there are enough MD's on the board with ich to test it? If it turns out to be a viable option maybe someone like seachem could market this to hobbyists.

 

[snorvich]

Ah, keep in mind the lifecycle of cryptocaryon irritans. That i, absence of white spots does not mean cured.

 

[el papai]

Update:
After a little more than one week, here are the results:
All the infected fish are fat and well. There are no white dots. Also, no more scratching.
All the corals are great, ALL of them.
Two hermit crabs out of ten, died. Since I was travelling, I'm not sure if it were the meds that killed them.
The anemone is ok.
All the parameters are great, so the biofilter bacteria didn't die.

So far, it is safe to assume this:
-this protocol is safe for zoanthids, hammers, GSPs, gonioporas, montiporas and trumpets.
-this protocol is safe for the fish;
-this protocol probably works for the acute phase of the disease, if promptly applied when signs and symptons appear;
-this protocol doesn't kill the beneficial bacteria;
-this protocol could kill some of your crab.

I'll keep you updated. So far, i'm pretty satisfied.

For the Tang Police: I already ordered a new tank for the YT.

Best regards,

 

[Deinonych]

Thanks for the update. How often do you dose the tank? Just once, or do these medications require redosing?

 

[FlyPenFly]

Super interesting, subscribing.

Thanks for your work.

 

[el papai]

Thank you for your support.
Yesterday, I did one more dose. And I discovered that this protocol is not safe for anemones. I have a rose BTA that is not doing very well. So, i'm pretty sure this treatment is not anemone safe.
Regards,

 

[SUPERSTOCKRACER]

Thank you for your support.
Yesterday, I did one more dose. And I discovered that this protocol is not safe for anemones. I have a rose BTA that is not doing very well. So, i'm pretty sure this treatment is not anemone safe.
Regards,

I wonder what the treatment would do to tridacna clams?

 

[snorvich]

I wonder what the treatment would do to tridacna clams?

Since they are filter feeders (in addition to the zooxanthellae (photosynthetic algae)), they may filter out the medication. What it does to them . . . ?

 

[el papai]

BAD UPDATE.

Thank you all for your interest. In fact in my science search I *#@$ it up. I decided to test double dose and add albendazole. In fact, with this, I'm pretty sure I killed all the latent ich but I also killed my biofilter.
I'm not sure if it was the double dose or the albendazole or both, but a day after the second treatment, I had a ammonia spike and suddenly the fish stopped swimming, staying in just one corner behind a rock. All my corals closed.
I did one 60% water change and another 50%. I also put my skimmer in max, filling the cup in just two hours. I also applied nite out II, stability and aquavitro alpha to stop my losses.
Well, after all that my zoanthids started to open after 4 days. GSPs are still closed and felt the most. Frogs didn't feel the treatment at all. Hammers and my BTA are almost dead. My montipora, apparently, didn't feel it. Palys are still closed.
The only good news I could find is that no corals nor anemone bleached, so I guess even after I #$%& up, the Zooxanthellae didn't die.

So, my conclusions thus far are that:
-this protocol, as first described, is safe for zoanthids, hammers, GSPs, gonioporas, montiporas and trumpets.
-this protocol, as first described, is safe for the fish;
-this protocol, as first described, probably works for the acute phase of the disease, if promptly applied when signs and symptons appear;
-this protocol, as first described, doesn't kill the beneficial bacteria;
-this protocol could kill some of your crab.
-Albendazole may be very dangerous to your reef;
-The double dose (for now) is very dangerous for your reef.

The next step is to identify if it was the double dose or the albendazole that caused my tank crash, but to do this I will have to have another ich outbreak. I'll see if I can find any ill fish at my lfs;

As for the clams, I wouldn't risk this protocol yet.

If I could give any advice until now, it would be this:
1. First try the most common treatment. If they don't promptly work, try this protocol, but I'm not sure if it would work after some time, since I applied it right after the first signs and symptons appeared;
2. Don't use this treatment in your reef yet as it hasn't been tested enough and I still can't assure its safety for corals and invertebrate;
3. If you have a quarantine tank, go for it (remembering #1), as the fish didn't feel it at all. My opinion is that if your fish dies, it would die anyway with or without this treatment;
4. Never double dose it and never add albendazole.

Hope this helps.
Best regards for all and thank you for following this thread.

 

[FlyPenFly]

Can prime be used to lock the ammonia while your filter ree stablished or would it interact with the drug?

As an alternative you can always use bio media, remove it from sump before dosing and keep it in some water. Put it back when drug has dispersed.