Quinine Sulphate treatment for ICH!

Quinine phosphate treatment Day 6 Update:
No signs of re-infestation. All fishes eating, swimming, inquisitive. Clown Fairy Wrasse prefers to hide behind sponge filter as the Powder Blue Tang has gotten somewhat bossy in this little 55 gallon tank. I've got the twenty gallon ready in case the CF Wrasse becomes over-stressed by the PB Tang but so far, he pops out to eat and swim around every once in awhile. I'm considering extending the treatment time out to 10 days at least as they are tolerating it very well. Ammonia highest at 1.0 (fishes showing NO signs of stress from this - no breathing at the surphase or streaked fins) and I bring it down by a twenty gallon water change with 1/2 teaspoon quinine phosphate. pH is steady at 8.3 -8.4.
 
It takes 8 weeks for ick to die out in a display tank without fish. The fish will not need to be medicated in quarantine for that long. The 8 weeks is to make sure they aren't re-infected upon re-introduction.

The pharmacy recommended ammonia binders for this particular type of medication (I know they aren't recommended for other treatments). Even without these, ammonia may not climb that high as the OP said he wasn't going to feed during treatment.
 
It takes 8 weeks for ick to die out in a display tank without fish. The fish will not need to be medicated in quarantine for that long. The 8 weeks is to make sure they aren't re-infected upon re-introduction.

I am not sure about fish not needing treatment for eight or more weeks.

But I have never tried treating fish for just say four weeks and then wait another four doing nothing in QT. It is hard to do, unless you are committed to science.

Reason suggests that copper or hypo does not kill even waterborne ich instantaneously. Treating longer than one life cycle of ich seems prudent.
 
I don't have the luxury of having a fallow tank for 8 weeks - I would do it if I could. I'm leaving in a few weeks for holiday and so my fish "has to" either go back to the DT which will be fallow for five weeks OR my LFS offered to keep them for me. The problem with keeping them at the LFS is that they will be in a 30 gallon tank that is connected to his WHOLE system of more than 10,000 gallons and I'm afraid that they will be re-exposed to ich or other pathogens there. He treats systematically but I'm just a little worried. I'm thinking that if I put them back in the DT ten days prior to me leaving, I'll have some time to observe them, if they break out with ich again...move those rocks again and take them to the LFS as he had offered to treat them for me. Another thought is to get a larger tank like a ninety gallon, start seeding/cycling it with sponge filters from the three other tanks that I've got that have been running without ICH ever and put the fishes in a larger tank for when I'm gone so that my fish sitter doesn't have to do any water change but just feed them every 3 days or so. I guess I was so fixated on fending off the ich that I didn't think about this until just now. If I set up a ninety gallon, I will be able to keep my tank fallow for as long as I need, even three months...what an exciting thought.
 
If you do not leave your display fallow for an extended period, certainly much longer than the 10 day quinine treatment, it is a virtually certainty that all of your fish will get re-infected with ich. The recommended fallow period has some variation and is as little as 4 weeks and as long as 12. Anything less than 4 weeks will not work.
 
I don't have the luxury of having a fallow tank for 8 weeks - I would do it if I could. I'm leaving in a few weeks for holiday and so my fish "has to" either go back to the DT which will be fallow for five weeks OR my LFS offered to keep them for me. The problem with keeping them at the LFS is that they will be in a 30 gallon tank that is connected to his WHOLE system of more than 10,000 gallons and I'm afraid that they will be re-exposed to ich or other pathogens there. He treats systematically but I'm just a little worried. I'm thinking that if I put them back in the DT ten days prior to me leaving, I'll have some time to observe them, if they break out with ich again...move those rocks again and take them to the LFS as he had offered to treat them for me. Another thought is to get a larger tank like a ninety gallon, start seeding/cycling it with sponge filters from the three other tanks that I've got that have been running without ICH ever and put the fishes in a larger tank for when I'm gone so that my fish sitter doesn't have to do any water change but just feed them every 3 days or so. I guess I was so fixated on fending off the ich that I didn't think about this until just now. If I set up a ninety gallon, I will be able to keep my tank fallow for as long as I need, even three months...what an exciting thought.

Raise the temp in DT slowly to the low 80F's if you have not done so, unless you have species in DT that may be harmed by warmer temp.

This will hasten the life-cycle of ich.
 
Actually Marine Ich's life cycle is not really affected by temperature. Freshwater ich is affected by temp., which is where the confusion comes from.
 
Actually Marine Ich's life cycle is not really affected by temperature. Freshwater ich is affected by temp., which is where the confusion comes from.

Life is biochemistry. Chemical reactions always increase in rate with temp.

Life of animals that do not regulate temp will always be hastened by increase in temp, I tend to think.
 
Actually Marine Ich's life cycle is not really affected by temperature. Freshwater ich is affected by temp., which is where the confusion comes from.


I read that also....But not sure where.....

What I do....

12 weeks fallow
4 weeks in copper
 
My tank will be fallow for two weeks tomorrow. I've just recounted the weeks and it will be 6 weeks when I return the fishes back to the DT. I think RBU's 12 weeks is a beautiful thing, then you are more than 100% sure that there is not a single molecule of ich around. In my situation with me being gone, they fishes will most likely do better back in the 225 DT. It is amazing how quickly marine life reproduces - I've never seen so many copepods in that tank, and not to mention the size of those creatures!

The part about marine ich not affected by temperature...is found in
leebca's Marine Ich - Myths and Facts
http://www.reefsanctuary.com/forums/fish-diseases-treatments/23132-marine-ich-myths-facts.html
I think I've read it other places too but can't find it this moment.
 
Raise the temp in DT slowly to the low 80F's if you have not done so, unless you have species in DT that may be harmed by warmer temp.

This will hasten the life-cycle of ich.

I've had the temperature in the DT at 80 for weeks now, even before I took the fishes out. I might increase it a little higher still.

Update on day 8 of Quinine Phosphate treatment:
No observable ich on fishes but I admit that the decreased water parameters got my Clown Fairy Wrasse and Lubbock's Wrasse behaving a little strange - increased breathing rate and very shy.
So, today was the day that I was supposed to do a 25% water change and put carbon in the HT, but since I decided to try to go a little longer, stretching treatment out for another 3 days, I went ahead and did a 30 gallon water change. It is amazing how fishes respond to better water quality! I redosed 3/4 teaspoon of QP dissolved in solution first before adding to HT.
The little Atlantic Blue Tang's dorsal fins are a bit tattered - I think it might be from where he and the Flame Angel were chasing each other. I will keep watch on this. No other fishes are showing any fin damage. They are still eating well pellets, frozen mysis, brine, and brown algae.
I'll keep you all updated!
 
Hi Claudio,
I am currently treating all my fishes in a 55 gallon hospital tank with Quinine Sulphate and leaving my tank fallow for 6 weeks before re-introduction of my remaining fishes (PBT, Atlantic Blue Tang, Flame Angel, Clown Fairy Wrasse, Lubbock's Wrasse, and Cleaner Wrasse). You are one of the few people at RC who treats with QS! I'm glad that you are here because I've been posting on the "fish disease" side and have received some, how do I say... Anyways, what I wanted to ask you is:
1. How do YOU do your quarantine and for how long?
I was thinking of replacing my Kole tang upon re-introduction back to the DT and I'm planning that out but not sure if I should treat during quarantine or wait to see disease.
2. In your experience, how do you dose your QS and for how long do you treat? How long do you treat in QT?
I'm doing the 1/4 teaspoon per 10 gallon, water changes almost daily to rid ammonia as I did not have a seeded HT, and I'm planning on going for a full 10 days. I'm contemplating going for 14 but that may be over kill.
3. I already have a PBT and ABT, plan on adding KT, what do you think about an Achilles Tang in addition? Or am I pushing it too far? It's a 225 gallon reef tank.
Thanks!

Hi Blennielove,

I just finished reading this thread, I am sorry for your ich outbreak. Looking at the fish pictures it look like a very bad case of ich.

I understand your fish are in the 55g Hospital. They are getting better as far as ich is concerned, however the QT tank has not cycled yet. You should be at day 5 of the treatment.

The main problem you are facing at this point is water quality. Water from the DT at this point is not an option to you but you could have used it to fill the QT tank since your fish already have ich. This may have helped cycling the QT quicker rather than starting from freshly made water and clean filters.

Quinine Sulphate does not affect at all the nitrifying bacteria that will start growing on the filters so hopefully soon your ammonia will start going down.

You are doing right as far as the dosing regimen that unfortunately is dictated by the need of performing daily water changes. Dosing every 3 days with a 25% water changes works very well on a cycled tank. In your case you have to do water changes to keep your water quality reasonable but you have to redose quinine daily. If you change 30% of the water I would add instead of 1/3 of the full dose (that should have been 5.5 * 1/4 tsp) 1/2 of full dose in order to compensate for the quinidine from is natural decay.
I would treat for 10 days.

I would keep your DT fallow for as long as you can. Also I would not reintroduce the fish just before you leave. If there is still ich and they get reinfected while you are gone it is a problem.

The time you need to keep the DT fallow is very debatable. You know the life cycle of the parassite as you read it in the book, 5-6 weeks should be enough, however in a natural environment things always happen differently than in the lab. The average hatching time for the tomont (cyst phase) is reported at 3 to 28 days however this time can vary up to 72 days. No strictly speaking "dormant" phase exists, so at some point the tomonts have to hatch. Because this variable incubation time I would keep the DT fallow for as long as you can, at least 8 weeks, 10 if you can. You went through a lot of aggravation removing the rocks, catching and treating the fish that you probably don't want to go through this again.

Once you QT cycle you can use eggcrate to partition the tank and separate the fish in 2-3 groups so they don't fight.

As far as quarantining new fish this is what I do:

Prior to getting fish I place the filter pads of the QT in my sump so that water flows through them for about a week. I then use water from the DT to fill the QT. I drip acclimate the new fish to the DT water and then place in the QT for 3-4 days without any treatment, however if the fish show signs of ich I start treatment immediately.

Once the fish are acclimated and eating, even without signs of ich I treat them anyway. It is safe to assume that at the LFS they have been exposed to cryptocaryon. If their immune system is strong enough they will not show ich but probably are carriers and I like to kill the parassite alltogether if I can.

At this point i treat with quinine at 1/4 tsp x 10g, 25-30% water change after 3 days and then redose at full strength. I do this 3 times. Total of 9 days. As you have notice as you start quinine the ich spots disappear quickly and leave behind small pits. I believe (however I have never done any study on fish skin scraping to prove that) that quinine works differently from copper as it is systemically absorbed by the fish, build medication concentration in the fish tissue and kill the parassite attached to the fish itself. So it is effective on different phases of the parassite and not just on the free swimming trophont phase as copper does. This is why it is not necessary to treat for an extended period of time. I then do water changes and if the fish are fine without signs of disease at 15 days i dip them in FW with Methylene Blue and then introduce them on the DT.

From this point on you have to be prepared to quarantine everything you are going to place in the DT that has been in water. How long do you quarantine non fish animals is hard to say. There may be tomonts in the water or on the coral or maybe not. If I see a hippo tang or PBT swimming in the coral system at the LFS (and I have seen that) I would QT corals coming from that system longer. If the fish in the system are say mandarin dragonets that almost never get ich I would do a shorter period of time. This reasoning is convenient but flawed. If you assume that there is ich on the coral holding system, (and perhaps you should) the only 100% sure thing to do would be to keep those corals in a fallow system for the same time you are keeping your Dt fallow. This is where fishless frag tank not connected to your DT comes very handy.
 
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Thank You Claudio!!!

You don't know how much I appreciate your input!!!

I think I might be loosing my Lubbock's Wrasse as he has been decreasing his food intake and is less active in the hospital tank. I took him out of the HT and put him in one of my 6 gallon "leather/chaeto farm" where he can be alone and in a more "normal" environment. I'm don't think he still has ich, he never really showed much, I think what is hurting him is the water quality in the HT. Hopefully this will give him a chance of living through this as that tank has been up for more than a year and is very stable.


I did a 15 gallon water change tonight. Will dose at 1/3 the normal, which means I'll add just 1/4 teaspon of QS. I'm glad that you pointed out the "pits" that were in the pictures - those showed up around day 2 of treatment, the by day 3 or 4 were cleared up. I will stop treatment with 10 days. That will be tomorrow. I will do a 50% water change and put the carbon filters in on Sunday. I can probably take some chunks of my sponges from my three other tanks and use them to seed the HT - or maybe I shouldn't just in case ich is lingering there...Oh no that's a frightening thought! Those three tanks been running for at least a year and a half, I did have an ich outbreat that cleared with daily water changes. Maybe I should just leave the HT filters alone, it should be seeding now.

The largest tank SHOULD in theory be the "easiest" but, YIKES, did I mess up bad!

All I can think about is "SLOW DOWN!"
 
I have been on vacation since i last posted but it appears you have done well in your treatment.The only thing i would not do is rush putting the fish back in dt or at least keep them out as long as possible.I would recomend 11 weeks if you can do it but at a minimum 8 or 9.I agree with jjstecchino and he has a nice qt regime and a good one to follow.Once you get to the point where you no longer have medication in the tank run carbon and should get easier with less water changes since your tank will be handling alot of the bioload bye itself. -Kieth
 
Welcome back Keith! Hope you had a good vacation!

I will run carbon starting tomorrow. I'm hoping that in the next few weeks my filters in the HT will be able to handle the waste produced by the fishes. What my problem is that when I'm gone for the two weeks, the fishes are really on their own as my fish sitter will feed them every other day but that's it! NO water changes or anything for two weeks! I couldn't imagine. I think going back to the LFS is out as they will get re-exposed to pathogens there, BUT I guess I can alwasy QT for 4 weeks then...I have another trip planned in 6 weeks after that!
I guess "I" should be punished and NO VACATIONS FOR ME! :)

No signs of Ich on day 10 of QS treatment. No scratching, darting, flashing behaviors. Will do 15 gallons water change tonight with 1/4 teaspoon of QS.

Interesting observation of cleaner wrasse and tangs/angel interaction:
When everyone was sick with ich, the cleaner wrasse was very busy going from fish to fish, examining them and picking stuff off of them. The tangs and angel would form a line and take turn for this attention. This behavior has decreased by 99% since no signs of ich! The fishes do not look for the cleaner wrasse, nor does the cleaner wrasse "check out" the fishes! Maybe, this is my sign that they are doing very well and we are finished with ich, at least for now. Cross my fingers!
 
Welcome back Keith! Hope you had a good vacation!

I will run carbon starting tomorrow. I'm hoping that in the next few weeks my filters in the HT will be able to handle the waste produced by the fishes. What my problem is that when I'm gone for the two weeks, the fishes are really on their own as my fish sitter will feed them every other day but that's it! NO water changes or anything for two weeks! I couldn't imagine. I think going back to the LFS is out as they will get re-exposed to pathogens there, BUT I guess I can alwasy QT for 4 weeks then...I have another trip planned in 6 weeks after that!
I guess "I" should be punished and NO VACATIONS FOR ME! :)

No signs of Ich on day 10 of QS treatment. No scratching, darting, flashing behaviors. Will do 15 gallons water change tonight with 1/4 teaspoon of QS.

Interesting observation of cleaner wrasse and tangs/angel interaction:
When everyone was sick with ich, the cleaner wrasse was very busy going from fish to fish, examining them and picking stuff off of them. The tangs and angel would form a line and take turn for this attention. This behavior has decreased by 99% since no signs of ich! The fishes do not look for the cleaner wrasse, nor does the cleaner wrasse "check out" the fishes! Maybe, this is my sign that they are doing very well and we are finished with ich, at least for now. Cross my fingers!

Seems the ich fire has been put off. Now it is a matter of cycling the HT. Once the quinine is out, if you have some spare live rock on a coral only system this may help with water quality as well.

I would really strive for a minimum on 8 weeks, or better 10 weeks fallow period on the DT. You really do not want to do this all over again.
 
Oh, believe me, I never want this to happen again!

I will take some live rock from my little "coral farm" tank where I put that poor Lubbock's Wrasse last night and put that in the HT. I know I might be risking it a little but the Lubbock was in QS for 9 days. I'm glad to report that the little guy's still alive. He's eating the copepods in that tank. It was scary to see him literally upside down this morning, then I saw his little eyes moving around... I don't want any more deaths! This whole experience makes me afraid to add ANYTHING to my tanks!
 
Oh, believe me, I never want this to happen again!

I will take some live rock from my little "coral farm" tank where I put that poor Lubbock's Wrasse last night and put that in the HT. I know I might be risking it a little but the Lubbock was in QS for 9 days. I'm glad to report that the little guy's still alive. He's eating the copepods in that tank. It was scary to see him literally upside down this morning, then I saw his little eyes moving around... I don't want any more deaths! This whole experience makes me afraid to add ANYTHING to my tanks!

Dont be, just do it the right way
 
It's great you're sharing your experience with Quinine Sulfate but the best learning experiences from this thread are from the major bind you're in for not having an established biological filter for your QT tank from day one & introducing sick fish into the display.

Correct protocols of QT for new arrivals in an established QT system for 6 weeks would have avoided all this. It would have also avoided the bind you're in with having to put your fish back into a DT where the ich cycle has likely not run it's course

It's a high wire act trying to fight ammonia at the same time treating fish for a disease with chemicals that you can't measure.
 
It's great you're sharing your experience with Quinine Sulfate but the best learning experiences from this thread are from the major bind you're in for not having an established biological filter for your QT tank from day one & introducing sick fish into the display.

Correct protocols of QT for new arrivals in an established QT system for 6 weeks would have avoided all this. It would have also avoided the bind you're in with having to put your fish back into a DT where the ich cycle has likely not run it's course

It's a high wire act trying to fight ammonia at the same time treating fish for a disease with chemicals that you can't measure.


WOW that sounds really familiar......Some people just don't listen.....Guess some have to learn the hard way.
 
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