Aquarium, Aquatics Information, resources, articles, pond Aquarium Ich: Ichthyophthirius multifilis and Cryptocaryon irritans treatment, identification, and life cycle.
• Overview • Diagnosis
• Life Cycle • How it kills
• Prevention • Treatment
• Marine Ich (Cryptocaryon); treatment/prevention
     
 
By Carl Strohmeyer

Ich, also called white spot disease, is one of the most common protozoan infections affecting aquarium and pond fishes. The scientific name for freshwater ich is “Ichthyophthirius multifilis. The marine protozoan causing ich is Cryptocaryon irritans (for more information about Cryptocaryon, please scroll towards the bottom of this article). Both organisms cause whitish spots, called “cysts”, to appear on the bodies and fins of the infested fishes.

Ich on fins As common as this disease is there is also a lot of misunderstanding and often down right misinformation (please read more about this later). Stress is correctly recognized as a major factor in ich infestation outbreaks, however causes of this stress are not always recognized.

Here are a few causes of stress that makes it easier for an ich infestation to take hold (first commonly known stressors):
*Sudden drops in temperature
*Stress caused by transfer of a fish from one tank to another.
*Stress from other fish chasing or bothering another.
*Stress from high ammonia/nitrites

Equally important stressors that are often forgotten:
*Stress from improper electrolytes (resulting in poor osmoregulation in fish); this is a very important stressor that is easily corrected but often forgotten. For more please see these links:
How to maintain a Proper KH/GH, why calcium and electrolytes are important.
Proper Osmotic Function/Electrolytes
*Stress from poor immunity caused by poor diet and poor Redox.




DIAGNOSIS:
The usual way of diagnosing ich is by close observation of the infected fishes. The presence of small, (.5 to 1.0 mm) white dots (kind of like salt) scattered about on the fishes' skin. This is most easily observed around the tail or fins (especially if the fins normally clear). You can check this out by removing one of the spots and observing it under a microscope. Ich has a small micronucleus and a prominent crescent-shaped macronucleus.

Early Symptoms of ich, clamped fins Fish behavior: The fish will often hide in corners near the top of the aquarium to get oxygen. Sometimes bobbing up and down with their head above the service again trying to get extra oxygen as ich infestations often start in the gills and this robs the fish of the ability to properly respirate. Fins are often held down and are clamped as well.
Darting and scratching is also sometimes exhibited (although this is more a symptom of velvet in Fresh water or oodinium infestations in salt water). As the he infestation progresses, the fish become more listless, loose color, and often develop secondary fungal and/or bacterial infections.

LIFE CYCLE:
ichthyophthirius, Ich, tomitesIch is most often introduced into the aquarium or pond by adding new fishes or aquatic plants. Tomites which have only recently attached themselves to the host will not be readily visible. It is good aquarium and pond keeping practice to isolate any new fishes for at least four days under close observation. For tropical fishes, maintain a temperature of around 75° F (24° C). Check carefully for the presence of any tell-tale white spots appearing on the skin of the fishes and treat them accordingly. If no white spots are observed on tropical fishes within four days at this temperature, they can be moved from isolation. Remember, fishes maintained at cooler water temperatures (such as pond fishes) will require longer isolation times.
The visible stages of Ich are carried out within the host fishes' skin. The first stages are called trophozoites and are highly resistant to drug therapy. Trophozoites mature into trophonts and leave the host, falling to the bottom of the aquarium or pond. These mature trophonts release from 200 to 1,000 tomtits. These tomites move about looking for a host, which they must find within 2 to 3 days at 75° F (24° C) or they will die. Cooler temperatures will lengthen this time. IT IS THIS FREE SWIMMING STAGE that is most vulnerable to treatment. It is important to note that these intermediate stages may also attach themselves to plants and be accidentally introduced into an aquarium or pond along with the new plants. Once the tomite attaches to the host, it matures and the cycle begins anew. The parasite forms a nodule under the skin or gill epithelium of the fish host. It constantly turns and moves under the skin, feeding on destroyed cells and body fluids. It continues to feed on the cells until it matures, causing damage to the skin tissue. This leads to osmotic stress, resulting in secondary bacterial or fungal infections.

How Ich Kills:

The general thought as to how ich kills fish is the epithelium (the top layer of the gill cells) reacts to an Ich invasion by growing thicker, the result of this is a restriction of the oxygen flow from the water to the blood in the gills. The lamellae (respiratory folds of the gills) also become deformed, reducing the proper transfer of oxygen. The shear numbers of Ich trophozoites covering the gills also causes a mechanical blockage of successful oxygen transfer. These conditions combine to stress the fish by hindering respiration. The epithelial layer of the gill may also separate and cause loss of electrolytes, nutrients and fluids from the fish, making it difficult for the infected fish to regulate the water concentration in its body. Bacteria and fungus may also invade the fish more easily while it is stressed from the Ich infection.

PREVENTION:

As in many parasite caused fish diseases the fish may need to be stressed due to changes in environment, poor water conditions, stress from other fish to be susceptible to the parasite (this is not to say a perfectly healthy fish cannot get ich, only that often a foothold in a stressed fish is the starting point). Also, the parasites must be present in the aquatic environment (ich is not air borne). It is not unusual for an aquarium population to have a low level of ich infestation present but not be showing any signs of the disease. Then, once a new fish is placed into the system or a weak/stressed fish becomes the start point for an ich infestation gets a foot hold in the aquarium. Fish can sometimes carry the parasite and not actually be diseased. These carriers can shed the parasite into a new aquarium into which it is placed. If the fish in the new aquarium have never been exposed to the parasite, and they become stressed, they can develop the disease.
Put another way, with healthy fish, they can usually produce enough mucous to prevent the ich tomites form getting started on the fish, but once these tomites get a foot hold on a stressed fish, even the healthy fish get overwhelmed.

The health aquatic environment can play a major role in susceptibility to the ich parasites. High ammonia and nitrites severely stress a fish. Also long term nitrates above 50 ppm in freshwater or 30 ppm in saltwater can weaken the immune system in fish. Calcium is also often forgotten as an essential to fish health (including soft water fish such as Discus). Without calcium fish cannot carry out many osmotic functions and are more susceptible to disease, including ich infestations. In fact I have found much quicker response to treatment when adequate calcium is present in freshwater aquariums.
For more information about Calcium and KH, please see this article: CALCIUM, MAGNESIUM, GH & KH IN AQUARIUMS

A healthy, cycled aquarium (0 ammonia/nitrites; low nitrates) with a steady temperature and a GH above 100 ppm is less likely to develop ich, or when it does, a healthy aquarium will have a less serious and more easily treatable infestation.

Before you begin any treatment, make sure your water parameters are correct, otherwise this may just worsen the situation and make treatments ineffective and/or poisonous:
*Ammonia- 0
*Nitrites- 0
*kH- 80 ppm or higher (depending on fish, marine much higher)
*GH – 100 ppm or higher for important electrolytes necessary during times of stress, especially an ich infestation

If you are having problems with ammonia, Prime is an excellent product for de-toxification of ammonia and nitrites. Prime only changes the electron number in ammonia (NH4 to NH3) making ammonia less toxic, but ammonia will still show in ammonia tests.

Changing 20% of your water before treatments is also helpful in an effective treatment.

TREATMENT:

SeaChem ParaguardThere are many ways to treat ich infestations in freshwater, less in saltwater, but not all treatments are equal or can be used for all types of fish or all aquatic environments. I will discuss the options I prefer to use in my maintenance business or in my personal aquariums first.

For freshwater a Malachite Green/ Formalin combination has generally been the most effective for moderate to severe infestations. “Quick Cure” is good product with this combination of medications (Malachite Green/ Formalin). While a newer product “Sea Chem ParaGuard” is slightly safer and more and more tests showing to be an effective treatment with little side effects when used properly.
Malachite Green by itself as in “Nox Ich” is also effective in moderate infestations. Other treatments of note are copper sulfate and Quinine Sulfate or Hydrochloride. For scale-less or delicate fish use Malachite Green at half dose. The safest treatment for scale-less fish is Quinine Hydrochloride, but this is less effective than other treatments, although it can be combined with half strength Malachite Green for more effectiveness.
It should be noted that sodium chloride (salt) can be combined with all this recommended treatment at a rate of 1 teaspoon per gallon for may fish and 1 tablespoon per 5 gallons for more sensitive fish such as Catfish, Tetras, Clown Loaches. This will help most all medications be more effective in part by adding electrolytes. For further information about the use and safety of salt in freshwater aquariums, please see this article: “Salt in Freshwater Aquariums”.

Catfish with Ich With sensitive fish (such as Clown Loaches) it is imperative that you are careful with most ich treatments. Malachite Green is more dangerous to these fish, however if used in a buffered form such as ParaGuard or Medicated Wonder Shells it is less toxic. You may also use Triple Sulfa at the same time to further buffer the MG (I and many of my colleagues have used this method considerably for Clown Loaches, Elephant Nose, ect. with good results). Another VERY important aspect that is often forgotten is that Malachite Green is much more toxic at lower pH (especially on the acid side of the pH algorithm). Calcium is VERY important to buffer this as well (calcium also improves osmoregulation, see this article: “Calcium, GH, KH, & Electrolytes” ).
Malachite Green is generally safe (long as it is zinc free) for shrimp, crabs, & snails. Be careful with Copper, and prolonged exposure to Methylene Blue. Please see this article for more in depth medication information: "Aquarium Medications and Treatments; How they work"

For severe infections (especially with sensitive fish such as Clown Loaches) I would recommend a bath in Methylene Blue for as many fish as I could capture (especially the really sick ones that tend die quicker from ich such as Clown Loaches again). This bath will also help with the main reason ich kills (at least in my opinion), depletion of oxygen from damage to the gills (methylene blue is a hemoglobin transfer agent). To prepare this bath I use 1 teaspoon 2.303% solution per 5 gallons (double dose) in a bath of aquarium water from the tank the fish you wish to treat came from, I usually use about a ½ gallon of water, however you may use less. I also recommend about one teaspoon of salt (Sodium Chloride) per gallon of dip water to aid further in aiding the fish via production of more mucous, and yes Clown Loaches CAN tolerate some salt, just not a lot Please reference this article for research proving this: “Salt in Freshwater Aquariums”)
Measurement of the Methylene Blue does not need to be precise as this bath should be used for about 30 minutes (although do NOT overdose). Make sure you keep the water in a warm area, as in a cold room the water temperature can drop rapidly which would stress the fish. Do NOT pour this water back into your display aquarium when finished. This can be performed twice per day.
After this bath I would also suggest a 3 minute dip for most dire of fish in a salt solution of about 1.012 specific gravity, this will rupture some of the some of the Trophozoites on the fish.

For mild to moderate infestations I also use “Medicated Wonder Shells” as these products have Malachite Green (lower levels safe for most delicate fish), Acriflavin, and small amounts of methylene blue (not enough to affect bio filtration) and copper. What is best about these “Medicated Wonder Shells” is that they also add electrolytes, calcium and maintain a proper KH, which is very important for treatment with Malachite Green as this medication is more toxic at lower pH and KH (Best used at a pH of 7.2 or higher and a kH of 80 ppm or higher). These great for use in tanks with poor or no filtration such as many betta tanks.

One more treatment option is a hospital tank with a Sponge Filter and no gravel. Methylene Blue works well here, but so do ALL of the above treatments as well.

Another method that can work is salt and heat (FW). 1-3 teaspoons of salt is added per gallon of tank water added SLOWLY over 1-2 days (while watching fish' reaction) and the temperature is adjusted to 84-86 F. I have tested many methods over the years and used to use this method more under the flawed assumption that is safer and even more effective, it is neither. Salt is safe for most fish, but some fish such as catfish, elephant nose, and more cannot tolerate much salt (Clown Loaches are also sensitive, so I would be careful and not go past 2 teaspoons per gallon). This method can take so long that the fish die of the ich infestation (I have affected a cure with salt, but is generally less effective, and research bears this out). That said a tablespoon of salt per 5 gallons (20 liters) is useful for electrolytes in the aquarium and in turn aids the fish in slime coat generation. This aids in the prevention of freshwater ich and aids in the treatment of ich infestations even when used with chemical treatments. But for serious ich infestations, salt by itself is generally not enough.
You also need to careful of the heat part of this method as dissolved oxygen greatly DECREASES at temperatures about 80 F (27 C), many fish are sensitive to this, especially fish from more salty or alkaline waters. You need to maintain a dissolved oxygen level between 5-7 ppm, under 3 ppm can be dangerous, especially with an ich infestation.

For my article about calcium and electrolytes which has more information about how salt works, please see this article:
How to maintain a Proper KH, why calcium and electrolytes are important.

The other false assumption by armchair aquarists is the dangers of ich medications such as malachite green. Yes this is a poison and can be more poisonous to scale-less fish, but many of these persons do not recognize the importance kH and pH play in the treatment and toxicity of ich medications such malachite green (usually the kH was too low and the medication gets blamed for poor water parameters). At a kH below 80 ppm, you have too low a calcium level to buffer the pH and the malachite green itself that is why the Medicated Wonder Shells are especially useful for delicate fish. More should be read about the role kH & Calcium plays even in soft water fish in my article: How to maintain a Proper KH, why calcium and electrolytes are important.
For more information about chemical ich treatments; their strengths and weaknesses as well as debunking of some more myths, please read this article: Aquarium Treatments; Parasite and chemical treatments

I will also note to the many different treatments currently available; many are similar Malachite Green/Formalin combinations, however not all are equal. One often recommended product is Rid Ich, which is very safe however in the MANY tests of this products it usually fails in moderate to severe infections so unless your fish are strong, the water conditions are good, the disease is mild or you have very sensitive fish such as Ghost Knives, I would not recommend this product.

Here are a few truths and myths about FW ich (ick) treatments:
* Chemical treatments will destroy biological nitrifying bacteria- Myth & Truth. Malachite Green, Formalin and Copper sulfate DO NOT harm nitrifying bacteria. Methylene blue can harm nitrifying bacteria in full doses.

* Salt is a natural treatment- Myth and Truth.
Salt is sodium chloride (NaCl) a chemical treatment with such side effects on freshwater fish loss of internal chemical balance and dehydration. Some will call Sodium chloride natural, but by that definition, so is NH3 (ammonia). Usnic Acid and Pepper are natural organic treatments.
Please understand I am not knocking salt, just some reasoning behind the use. In fact it is an important electrolyte that is useful any time most fish are stressed by disease.

* Malachite Green is extremely toxic- Myth & Truth.
Older versions of Malachite Green that contain zinc are definitely more toxic, especially for scale-less fish, but the newer zinc free formulas found in most ich medications today are 97% zinc free and are only more poisonous to scale-less fish in high dosages (and Triple sulfa buffers this mild effect even more). Unfortunately many posers as aquatic experts have not done their homework here.
For more about Malachite Green (including so-called carcinogenic properties), please see this article: “Aquarium and Pond Medications; Chemical treatments including Malachite Green”

For information about FRESHWATER VELVET (Piscinoodinium pillulare), As well as Costia (Ichtyobodo) follow this link (this article is from Aquarium Answers)
Velvet in aquariumsCostia in aquariumsFRESHWATER VELVET - Piscinoodinium pillulare; COSTIA -My full article about freshwater velvet and treatments, as well as Costia









FOR SALTWATER CRYPTOCARYON;

marine ich, cryptocaryon, saltwater information
Malachite Green is relatively safe for saltwater fish and some invertebrates such as crabs and even some anemones, but definitely NOT for cephalopods. Malachite Green is not as effective a treatment as it is in freshwater applications for ich infestations. You can find Malachite Green in this treatment: “Quick Cure”. Another slightly safer Malachite Green based product that also will no alter pH is: “Sea Chem ParaGuard”. There is a marine version of the “Medicated Wonder Shells” which only contains Malachite Green, this product is mildly to moderately effective for marine ich (Cryptocaryon) depending on conditions and other remedies such as dips also being employed.

Quinine Sulfate or Hydrochloride is also relatively safe for most fish, but not invertebrates. Metronidazole . can also be used for marine ich infestations and is safe for many invertebrates (NOT ALL! So use with caution), but again is a relatively effective ich (Cryptocaryon) treatment for mild infestations (better combined with dips and/or treatments such as Medicated Marine Wonder Shells or ParaGuard). I have achieved success using Metronidazole in established aquariums (when quarantine tanks were not an option) when all water parameters were optimal and usually combined with baths and dips as well.

The use of a quarantine tank is still the most effective and safe way to treat a Cryptocaryon infestation. I recommend using a seasoned “Sponge Filter that is kept somewhere in your main display tank, ready for use if the need arises or with a continuously running quarantine tank If kept in a main tank Sponge Filters will not raise nitrates if properly rinsed on regular basis.
In your quarantine tank, copper sulfate kept at 20-25 ppm (a Copper test kit is a MUST when copper is employed for Cryptocaryon treatment) is still the most effective way to treat in Cryptocaryon saltwater, but copper (especially chelated) can be hard to remove from your system once used and is deadly to invertebrates. I personally only recommend treating with copper in an isolation/quarantine tank. In the case of a reef tank or a FOWLR (fish only with live rock), I recommend removing all fish to a separate tank for treatment with copper, then leave the live rock and other inhabitants without fish for at least 3-4 weeks so as to allow the Cryptocaryon to die off as these parasites go thru their lifecycle.
Other excellent options in a quarantine tank include Sea Chem ParaGuard, Medicated Wonder Shells as well as many other similar products.

For saltwater fish, prevention is still the best cure, such as “UV Sterilization” (although UV Sterilization aids in Cryptocaryon prevention more by aiding in the maintenance of a healthy environment). Also a quarantine tank for new fish and a hospital tank for sick fish are also beneficial. If a hospital tank is available (bare tank with a sponge filter), a treatment with Methylene Blue and or copper is advisable.
Keeping your tank slightly on the hypo-salinity side at 1.019- 1.021 will also somewhat lessen the chance of Cryptocaryon and aid in treatment as well. However this is more effective for Oodinium prevention and treatment than with Cryptocaryon.
When Hypo-salinity is used for treatment, I have often brought the specific gravity as low as 1.015, but be careful using this method with anemones or coral present as these aquatic inhabitants do not do well with Hypo-salinity as most fish (also note that this is only mildly effective for Cryptocaryon and should be used in conjunction with other methods as by itself it is rarely effective). When returning salinity to normal this should be done slowly as this can be stressful to the fish.

A 5 minute freshwater dip is an effective means of eradicating Cryptocaryon (and more so with marine Oodinium) on fish. This can be used in conjunction with the above treatment methods.
In a dip, I adjust pH (so as reduce more osmotic stress than need be) and add Methylene Blue (at double in tank strength), I will use a specific gravity of 1.001 for the saltwater fish. This dip should be no less than 3 minutes and no more than 5 minutes to be effective. This is very effective in removing Cryptocaryon and oodinium directly from the fish (including gills). Do not be alarmed if the fish ‘lays down’ and acts dead, this is a common initial reaction and the fish will usually perk up a minute or two into the dip. How this works is that the cell membrane of the Cryptocaryon cyst cannot withstand the change in osmotic pressure as well as the fish and will burst, that is why the minimum three minutes is a must. It is important with this method to either treat the tank or remove the fish (place them in a separate aquarium) and allow the display tank to be without fish for at least three weeks for the Cryptocaryon to die off without a host. I often use this method when treating with Metronidazole.
A 30 minute bath is also a useful saltwater fish treatment for diseases such as Cryptocaryon (this is best used I conjunction with the other recommended treatments above as by itself is not likely to effect a full cure). I would make sure to adjust pH so that there is no pH shock.
For saltwater I would add Methylene Blue at double normal tank treatment strength the Dilute the saltwater to 1.015 (making sure your pH stays up by adding any buffers necessary before adding fish).




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