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FAQs about Environmental Disease of Tangs

FAQs on: Tang Disease 1, Tang Disease 2, Tang Disease 3, Tang Disease 4, Tang Disease 5, Tang Disease 6, Tang Disease 7, Tang Disease 8, Tang Health 9, Tang Disease 10, Tang Disease 11, Tang Disease 12, Tang Disease 13, &
FAQs on Tang Disease by Category: Diagnosis, Nutritional, Social, Trauma, Pathogenic (plus see below), Genetic, Treatments
FAQs by Tang Disease by Pathogen: Tangs/Rabbitfishes & Crypt, Tangs/Rabbits Crypt 2, Tangs/Rabbits Crypt 3, Tangs/Rabbits Crypt 4, & Paravortex/Black Spot Disease,

Related Articles: The Surgeonfish family, Acanthurus, Ctenochaetus, Naso, Paracanthurus, Zebrasoma , Prionurus, Surgeonfishes of Hawai'i, Surgeonfishes for Reef SystemsInfectious Disease

Related FAQs: Tangs in General, Tang ID, Selection, Tang Behavior, Compatibility, Systems, Feeding, Treating Marine Disease, Marine Diseases 2,

Acanthurids live on and over reefs... Need reef conditions to do well

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Diversity, Selection & Care

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by Robert (Bob) Fenner

8 year old Shoulder Tang      1/27/17
<Howsit? Darrel, you owe me some part of twenty US... your too large file wouldn't load here in Fiji. Had to sign up for the advanced svc. Hundreds of Kbytes mate, NOT megs>
I really appreciate the service wet web media provides. Mahalo. To Bob Fenner and the crew.
<Follow our guidelines then!>
I operate a Marine aquarium maintenance service and recently some thing happened to an 8 year old shoulder Tang that I haven't seen before.
The Tang resides in a 650 gallon Fish only aquarium 8.2pH 40ppmNitr 1.021SG.
<A bit low>
About 3 weeks ago, a golden head goby I added died fairly quickly.. 2 weeks or so after 15 days QT time. A little while after the Tang developed brown splotches and started to hide.
<Mmm; likely not related>
With parameters in line, I immediately suspected parasites of some kind.
Close inspection of some of the other larger fish, 2 yellows, 3 Blue Hippos, and a 10 year old Stars and Stripes puffer, revealed little.
Nothing evident on the fins, clear active eyes, no scratching, etc.
However the fish mostly clustered in one area of the reef insert for about a week.
<Mmm; environmental. Something/s you don't measure are off>
There is also an 8 year old Heniochus that is mostly hiding but has no visible discolorations.
Any advice?
<When, where in doubt, punt! Massive water change (like half), with gravel vacuuming, addition of a few units of ChemiPure and PolyFilter in the flow path
. Bob Fenner>
Thanks in advance.

Re: 8 year old Shoulder Tang      1/27/17
Oh, the system also is running a 120 watt Emperor Aquatics Smart UV (40wx3)
6 months of service for the current bulbs.
<I'd be checking the Fe +2 and 3 coming off the igneous. B>
Re: shoulder tang      1/27/17

Mahalo. I will send you a check or money order. U.S. funds?
<Heeeee! Thank you for the offer Darrel>
I already did everything you suggested prior to contacting you.. the markings improved and then came back albeit in a different pattern. I will repeat process.
Thanks again.
<This Acanthurus (does) suffer/s from many types of environmental (over) stress. IF it's still eating, moving about... I give you good odds of it recovering. A hu'i hou! Bob Fenner>

Sick Tang question; env., likely Cu++ poisoning       12/14/15
Good day crew Brian here with a question... At our shop we have been plagued with certain tang species coming down with this sickness. It affects Tomini, Kole and Blue eye tangs only... All other fish present normal with no symptoms.
<Acanthurids are far more susceptible; on some sort of sliding scale, than most other fish families.... to environmental troubles, common pathogenic diseases>

It appears to only take place in one of our systems however that system is regularly treated with formalin and occasional copper as it is our new arrival quarantine system which is 325 gallons.
<.... environment then likely>
We have been attempting to identify the disease utilizing various books however we have been unable to.
<.... need to sample, use a 'scope. See WWM Re>
The tangs color fades, they being to shake, dart around, stop eating, develop dark circles, they do not scratch, no increase in respiratory rate.
What are your thoughts as we have tried copper,
<...? READ here
: http://www.wetwebmedia.com/crypttangsf2.htm
and the linked files above... till you become aware>

Flagyl, formalin, fresh water dips, medicated foods. Again this only happens to these three species of tang. All others are unaffected and healthy. The other species includes over a dozen other tangs, Angels, wrasses, butterflies, snapper, grouper, lions ( sorry for the non specific species list but it would massive).
Thanks again
<When in doubt, search on WWM and read. Bob Fenner>


Blotchy Skin on Tangs... and comm. QT sys. design        1/23/15
Hi crew,
I've got a fish setup around 1200 gallons with 35 to 75 gallon holding tanks. I have something that I think is spreading around on my tangs but doesn't look like a communicable disease I only suspect it is because its affecting 4 or 5 different specimens. I attached a picture and so far its affected Kole tangs, chevron tangs, powder blue tangs, and a sohal. Some of these like the chevron tangs I've had in the shop maybe 6 months.
Others like the powder blue only a few weeks. Behaviorally they seem normal for the most part, maybe a little jittery but it's hard to say.
I've scoured the web and haven't found much so I was hoping you might have an idea.
<Yes; this sort of manifestation is almost always "environmentally driven"... Tangs are sensitive; and these you've had for too long a while for this to be infectious or parasitic in nature>
I have done a couple bursts of lanthanum chloride
<Ahh; yes; this might do it. You're trying to limit soluble phosphate...

are there Cnidarians in this recirculated system?>
in the system which I've heard rumors may affect tangs but that's just a possible theory and I don't see any real timing correlation between the two. They get fed primarily NLS pellet, frozen mysis, and OmegaSea Nori sheets. Nothing notable wrong with water quality.
<... that you can test for>

The system gets a 50g water change once a week. Everything is bare bottom so ph tends to be low but we keep it buffered and it runs generally 7.9. I've tried 1 hour formalin baths with no noticeable improvements.
<You won't. As stated, the trouble here is not pathogenic>

One other question. I'm planning a quarantine setup and I've got like a 2'x12' space against a wall to accomplish this.
<Mmm; not for treating these fishes I take it. I would improve the environment, leave all in place>
Do you have any references for designs I could use as a foundation?
<Ah yes; archived on WWM>
It seems in designing this there are a lot of things I could really regret and hoping to draw on the experiences of others to have a good system that will work for acclimation, new arrival holding, and specimen treatment, while of course being incredibly easy to maintain =)
<Ah yes>
I've browsed around the web and found a few things but nothing that looked very thoroughly explained or thought out. Thanks as always for the time and advice,
Matt Johnson
<I'd skip the Lanthanum use; apply a few units of Chemi-Pure, possibly a couple pads of PolyFilter in your filter flow path and call it a day. Bob Fenner>
Re: Blotchy Skin on Tangs       1/23/15

Thanks for quick reply and the plan sounds easy which is always nice.
Re: QT schematics not finding any, searched "multitank quarantine", "Quarantine plumbing", "Quarantine System Design" "Holding systems" all not getting me where I'm looking to go. Maybe I'll just ask a couple questions:
First, intentions for this is more of a holding system for new arrivals vs. a hospital treatment tank. Here's my basic vision tell me if you see any immediate flaws. Rows of 10g tanks on a shelf all with a valved line in and gravity feed line out to a common sump with maybe some good old fashioned bio balls. Lit by the room.
<Install an alternate "red lamp" fluorescent system... Fine for you to see, and MUCH more calming for incoming livestock>
I could run a line from my main fish system to make water changes happen at the same time using the main system water as the new water for the QT.
Buffer the water with SeaChem powders. Keep fish in here for a couple weeks and rotate them out when new orders arrive. Any quick recommendations on that abbreviated plan?
<What for recirculation for this system? I'd incorporate serious UV and as small a particulate mechanical filtration as maintenance will allow. Bob Fenner>

Weird Skin Disease? Env. likely    9/21/13
Good day everyone,
<Hey Lyndon>
Appreciate it if someone could advise what this could be and possible treatment?
Weird discolouration that I haven't come across on a tang so far.
Thanks for the assistance.
<Have seen such "markings" on Surgeonfishes many times. This is highly likely not anything pathogenic (i.e. caused by a biological agent), but a reaction to something "too much" (or possibly too little) in the water here. If it were my fish, and I had another established system, I'd move it there. If I didn't, I'd look into water quality such as we have tests for, and add a few to several pounds of healthy live rock to the existing system... To modify the water, offer other foods.
Bob Fenner>

Mystery of lost Surgeonfishes 9/1/10
Hi M. Fenner,
I have again a question for you...
I have one customer who lose every surgeonfish he put in his aquarium and I can't find why he has a 125g tank
no ammonia, nitrites, nitrates are at 10 about 30x the volume of his tank in water flow
no problem with temperature,
tank mate : one Centropyge angel, 2 Australian clown, 3 chalk Basslet, 2 orange line cardinal fish and 2 watchman goby
he had marine velvet last year, but he wait to put other fish and now all the fishes name above live very well (even reproduce : goby and cardinal) he add one Naso tang (die 4-5 days after)
about 3 weeks after he add one convict tang (die 4-5 days after) the tangs show no sign of illness, the first couple of days they eat and move normally, but on the 4 days stop eating and start breathing more rapidly... by the end of the day stay at the bottom... and die the next day I asked if he add done something (like a water change) before the sign appear, but he told me no I know these tangs are not the easiest... but these 2 fishes came from QM, and I had them for more than 2 weeks each and they were eating very well at the store I ask the customer if maybe the acclimation was done to rapidly, but he told me that the temperature and the salinity (1.025) was the same as his tank when he introduce the fishes and that he took about 1h to make the acclimation
<All sounds, reads as fine...>
he didn't saw any real aggression between the fishes the only thing he told me about the convict tang was that his dorsal was
more yellow tang white he doesn't have a sump...
<This is a clue...>
so the add of freshwater is done in the tank, but with the help of an Osmolater, and with ro/di water (0 ppm)
do you think of a raison why small fishes wouldn't have any problem in his tank but bigger like tangs would?
<I can. The most likely cause of death here is low dissolved oxygen.
Tangs/Surgeons/Doctorfishes absolutely require high DO... 7-8 ppm... In fact, I would encourage this person to lower their specific gravity... this will help with oxygen/gas solubility>
is it's possible that he as electricity in his tank... ground his tank may be good?
<Mmm, no... the other fishes would be mal-affected as well>
I know he put a lot of corals food in his tank, but the other fishes don't mind and the tank as only 10 of nitrates...
he as a really good skimmer (Deltec)
I just don't know where to look to find what's wrong, I never had this kind of problem before with any other customers :(
thank you
<Welcome my friend. There are oxygen testers... and adding a sump (with its increased volume and air-water mixing) would help as well. Bob Fenner>
Thank you!!
I had think about oxygen but with the skimmer and water flow didn't think it was what was causing the death
<Is only a guess... but my best first shot>
thank you very much for your input :)
I'm going to the MACNA, maybe I'll see you there ;)
<Oh! Yes. Please do look for me, introduce yourself. Will be there tomorrow night till Sunday's end>
have a nice day
<And you Marie. BobF>

Sick tang, social, env., Acanthurus... 08/28/08 Hello Crew, Thank you for all your help in the past, it has been invaluable. I noticed about a week ago my Orange Shoulder Tang was getting a few "discolored spots" on his body. <I see this> It seemed to be getting worse by the day until today it seems as if it has covered most of his body with the exception of fins and head. It doesn't appear to have a texture or any depressions/lesions. Each spot just seems to have a lighter coloration than what is normal. I looked in The Conscientious Aquarist and on this site, but am still uncertain. I have included a pic taken this am. None of my other fish are affected (as of yet). Any thoughts? <Something environmental... psychological perhaps...> 125 g reef tank sg-10.25 calcium- 450 KH- 9 nitrate- 0 nitrite- 0 ammonia- 0 phosphate- 0 1 Blue Chromis - Chromis viridis 1 Green Clown Goby - Gobiodon histrio 2 Pajama Cardinals - Sphaeramia nematoptera 4 Blue Streak Cardinals - Apogon leptacanthus 2 Firefish Gobies - Nemateleotris magnifica 2 Saddleback Clownfish - Amphiprion Polymnus 1 Sixline Wrasse - Pseudocheilinus hexataenia 1 Lawnmower Blenny - Salarias fasciatus 1 Dusky Jawfish - Opistognathus whitehurstii <These three above may be harassing this fish> 1Royal Gramma- Gramma loreto 1 Dejardin's Tang - Zebrasoma desjardinii 1 Orange Shoulder Tang - Acanthurus olivaceus 1 Chocolate Mimic Tang - Acanthurus pyroferus 1 Yellow Tang - Zebrasoma flavescens <Or these other Acanthurids> ---------- 20 fish total <Too much, mix for this volume...> thanks in advance, Alan <I would definitely be moving this fish elsewhere... Someone/s' bugging it too much. Bob Fenner>

Unknown disease on Naso and Unicorn Tangs  10/25/07 Hello, <Hi there> I have had multiple Unicorn and Naso tangs, both Hawaiian and Blonde, in my 500 gallon aquarium which are dying of an unknown disease. No one in my area can identify the problem. Water quality is excellent. First, they get a white cotton-like grain around the face area. After about a week, the grain opens and flesh is seen. The open wound can grow to be 3" on a 10" Tang. More cotton-like material develops in the open flesh area and the fish stops eating and dies. I know it is not a parasite because copper (Cupramine) is not effective. <Mmm... not really> Is it a fungus? If so, what medication should I use? Please help...I would like to have more of these tangs in the future. Thanks, Jeff <I would take a scraping, look w/o staining under a low-power microscope. I suspect this/these are flukes (monogenetic Trematodes), but could possibly be copepods... treatment is either with a vermifuge (e.g. Praziquantel) or an organophosphate... in the meanwhile, in addition, I would bolster their immune systems with HUFA and vitamin soaking on their algal diets. Bob Fenner>

Re: Unknown disease on Naso and Unicorn Tangs 10/25/07 Hello Bob, <Jeff> Thanks for your quick reply. <Welcome> Which of the 2 remedies are more effective and where can I get either Praziquantel or Organophosphate? <Posted on WWM. BobF> Jeff

Re: Unknown disease on Naso and Unicorn Tangs -- 10/30/2007 Hello Mr. Bob Fenner, <Jeff> I have been using PraziPro for 3 days and it seems to be not working. Attached is a picture of the fish and disease. Let me know if I am using the right medication. If I'm not, please guide me in the right direction. Again, thanks for all of your help. Jeff <Mmm, this eruptive condition looks like HLLE... neuromast destruction. Do you have these fishes under constant copper exposure? Is it possible that there is a vitamin deficiency syndrome here? Please read: http://wetwebmedia.com/hllefaqs3.htm and the linked files above. Bob Fenner, who would still like to see a micrograph... to exclude Hexamita here...>

Re: Unknown disease on Naso and Unicorn Tangs 10/30/07 Hello Rob, <Jeff> thanks for your reply. I know for sure it is not HLLE. I have had the fish for about 2 months and eats a lot of Spirulina. Water quality is good. <Mmm... well, the pattern of involvement closely matches the arrangement of the lateralis system. Again, have these Acanthurids been exposed to copper?> I will treat for Hexamita and hope this is the problem. Thanks, Jeff <Okay. BobF>

Re Unknown disease on Naso and Unicorn Tangs... still not reading, Cu poisoning  10/31/07 Yes, I had Cupramine in the water at .05 ppm. <... Please see WWM re Acanthuroids and copper exposure... This is very likely the root cause of the neuromast destruction here> Possibly a fungus or Bacterial infection? Furan 2 or Fungus Cure as a medication? <... no, no, and no> Jeff
<Please... read. Bob Fenner>

Tang Help sys.-env.-dis. 7/10/07 Hi I have a 3-4 inch Bluelined tang I bought a week ago along with a 37 gallon tank that was up and running. <Way too small of a tank for a tang, needs lots more swimming room.> He looked great when I went to pick him up and looked great when I brought him home. Now he has lost his dark color and swims in the current coming back into the tank all night long and a good part of the day. <Probably feeling a bit cramped.> He still eats krill great and I put some seaweed in there today and he curious about it but wont really go after it? <Ok?> Also he has a slight bump on both sides of his body? Not huge but noticeable. He has very small 2 inch maroon clown as a tank mate. Has 40 lbs of live rock also. He still grazes a lot during the day on the live rock? <?> Any help would be much appreciated. I love your site and I wish the guys around here in the Tampa FL store would read your site more. Oh One last question if I can? Can I use ocean water for a water change to bring down nitrates? I checked the ocean last time I was there and I wish I could keep my tank as good as nature. 0 parts nitrates. <Some concerns here, see http://www.wetwebmedia.com/seawater.htm for more.> Thanks for any help. Rick In Clearwater FL <Chris>

Bubble in Tang's Eye...GBD? - 08/27/06 Hi, <<Hello Deb>> I have a tang who had tiny air bubbles in her eye, then the next day the tiny bubbles became two larger one then the next day they merged into one big bubble. <<Can't say I've ever seen this before...still, is possibly the result of an injury or environmental condition>> Is this the same as POPEYE, or is this something different? <<Something different, as stated.  Popeye infections generally affect BOTH eyes>> Also I see that Epsom salt is recommended for Popeye, <<Mmm, not really...a true Popeye infection would require an antibiotic treatment, but the Epsom Salt may prove beneficial in this case>> if this is what she has can the Epsom salt be added to my tank with the other fish or should she be put into a smaller tank. <<Separation/quarantine would likely make it easier to observe/treat this fish, but the Epsom Salt can be added to the display tank if you so wish (a level teaspoon per ten gallons actual water volume is recommended)>> Also how long can you use the Epsom salt? <<As long as perceived necessary...will not need to be re-dosed until you perform a water change>> She is eating but her balance seems off and she looks like sometimes she bumps into things. <<Indeed...peripheral sight/field-of-view is affected, though the loss of "balance" may indicate another problem...emphysematosis, Gas Bubble Disease>> Can tiny micro-bubbles in tank cause this or is this just something that fish just get? <<Ahh, yes...is this an issue in your system?  If so, definitely remove the tang for treatment...and see here about rectifying the bubble situation in your display: http://www.wetwebmedia.com/bubtroubfaqs.htm >> I thank you in advance for your help. <<I'm happy to assist>> I Love this fish and will try anything I can to help her. Deb <<Remove the tang and treat as described...and fix your bubble problem.  Regards, EricR>>
Re: Bubble in Tang's Eye...GBD?   8/27/06
Hi Eric, <<Deb>> Thanks for your advice. <<My pleasure>> I tried to get into the web site you posted but could not for some reason any other you may suggest? <<How strange...try going to the WWM home page ( http://www.wetwebmedia.com/index.html)...scroll to the bottom of the page...click the 'dot' for WetWebMedia...enter "bubble trouble" in the box and click 'Search'...select the first WWM link at the top of the page.  This will take you to the page I sent in our first correspondence>> Thanks Deb
<<Cheers, EricR>>

Powder Brown Low-Down (Tang Quarantine) 7/14/05 I have a 75gal FOWLR, and I am thinking of adding a Powder Brown (White Faced) Tang. <Just keep thinking, but please don't add this fish to your tank, unless a much larger tank is in the very near future. Your tank really is too small to support this fish for anything close to a natural life span, IMO. You need a tank that is at least 6 feet long, to provide "physical space" for the fish, as well as large water capacity to help dilute metabolic waste...> I have a  20gal hospital tank setup and I know how to perform a freshwater dip. <A good practice> Should I run copper in the hospital for the whole 21 days or just wait and see if anything pops up. <I would not use copper, or any other medicine, on a prophylactic basis.> I'm pretty sure with a Powder Brown it is going to have Ich (even if I don't see it) and I don't want to kill it the copper treatment but I also don't want the Ich in my main. What to do? Thanks Daryl <Well, Daryl- if you were going to get this fish, you'd be well advised to do a full 30 day quarantine, without copper or other medication. Only medicate if the fish shows signs of illness. Just make sure that you run the full 30 day quarantine. Regards, Scott F.>

Tang in Trouble (3/31/05) Hi.  <Hello, Steve Allen here. Please capitalize the proper noun "I" and the first letter of sentences so we can post queries on our website without having to do this for you.>  We have a 30 gallon tank with a fairly new yellow tang. maybe a couple of weeks (also in this tank is a maroon clown, coral beauty, royal Gramma, cleaner shrimp.  <The tang, Clown and Angel do not belong in such a small tank. Each of these needs to be in a tank of at least 75 gallons.>  This last week the tang has stopped eating everything.  <A bad sign in this normally voracious fish.>  I've given it flakes, seaweed and various frozen foods. It won't take anything. It has also started to show some red markings on its fins and near the beginning of its tail. I am almost run dry of ideas to help him and would like to keep him happy and healthy. Can you please help me?  <Three possibilities come to mind right away with the symptoms you describe. One is nitrite poisoning. Is it breathing more rapidly than normal? Get a good test kit and check ammonia and nitrite. Another is oxygen deprivation. Tangs need more oxygen in the water than other species. If your circulation/aeration is inadequate, this could be the problem. The redness strongly suggests bacterial septicemia. If this is the case, you need to remove the tang to a hospital tank and treat with broad-spectrum antibiotics. Details can be found by searching on WWM for "bacterial infection." In the long-run, you need a much bigger tank or more suitable fish for your small tank. This tang needs at an absolute minimum 75 gallons. The Clown will get too big and, importantly, way to aggressive for this small tank. The angel also needs a bigger tank to survive and be healthy.> 

Breathless Tang? Hi Crew, <Scott F. your Crew member today!> I hope all is well with you.  I am experiencing an issue with my 55 gallon QT.  Many of the fish in this tank appear to be gilling rapidly.  I have noticed this with a 6" Powder Blue Tang, a 2.5" Purple Tang and possibly with a small porcupine puffer.  None of these fish are breathing at the top of the water (in fact, they nearly all stay toward the bottom).  I am most concerned about the Powder Blue Tang, which is gilling at approximately 3 cycles / second.  Is this normal behavior? <Seems a bit fast to me, but probably acceptable if the fish is behaving normally otherwise. High oxygenation (i.e.; aggressive aeration of the water) will help meet the fish's needs> Possibly I am just imagining a problem, but this seems very fast to me.  The Purple Tang's gill rate is approximately 4-5 per second but it just seems to be generally excitable and I am unsure that this rate is consistent, whereas the Powder Blue's gill rate never decreases. <Hmm...> I assume this is an indication of low oxygen level in the water (or possibly gill / parasite issues) but I have a skimmer and a dual BioWheel Penguin filter in the tank, which significantly ripples the water surface as the water falls approximately ?" from the filter outlet.  After noticing this rapid gilling, I performed a 25% water change, lowered the temperature by 2 degrees and I have also added a sponge filter, a venturi powerhead and 100 drops of Methylene blue.  This did not appear to reduce the rapid gilling. <Is the fish displaying any other difficulties, such as swimming; any signs of mucus or other discoloration? Is the fish feeding?> Water parameters: Salinity = 1.0235 S.G., Temp = 80 degrees F, Ammonia = 0, Nitrite = 0, Nitrate = 20 PPM.  Cu++ = 2.0 PPM (Chelated - CopperSafe). What do you think is causing this rapid gilling?  What do you recommend for correcting this problem? Greg <I like copper sulphate to cure specific problems, such as Cryptocaryon or Amyloodinium, but I don't think it's a good idea to use it as a prophylactic. It can create some physiological challenges for some fishes, particularly tangs, which may have difficulties digesting food, etc. with continued exposure. Unless you are experiencing some diseases with these fishes, I'd discontinue the copper use for a while. Utilize water changes and Poly Filter to help remove some of the copper. Keep a close eye on things, and be prepared to take action if it becomes necessary. Good luck! Regards, Scott F>
Breathless Tang (Pt. 2)
Thanks for the reply Scott.  Yes, the fish do appear to be acting otherwise normal aside from the rapid gilling. <That's good news!> Once possibly exception is the Powder Blue, which "twirls" slowly on its pectoral fins while sitting on the bottom of the tank.  It is not swimming around rapidly but just slowly rotating around. <Hmm...could be worth keeping him under closer scrutiny> Regarding the Copper; I did not originally have CopperSafe in my QT but, after about one week in the QT I had a minor Cryptocaryon outbreak so I added copper.  The good news is that today all fish appear to be doing much better. <Gotcha...good move. I was concerned that there was a "baseline" copper concentration in the water. Glad to see you treating in the QT!> Maybe I just did not wait long enough for the added oxygenation attempts to take affect, the methyl blue helped ease a gill parasite problem, the previously-elevated temperature was stressing-out the fish or... who knows.  All fish do appear to be looking much happier today though (although the Powder Blue is still gilling a little fast - maybe twice per second) but at least I think we are headed in a better direction now. <Good to hear. I think that the corrective steps you took made sense...> As always, thank you for the terrific service you provide all of us!-- Greg <You're quite welcome! Thanks for the kind words! I think that with a little close observation and TLC, the fish should recover and thrive just fine! Regards, Scott F.

Powder Brown Problem? Hi, <Hi there- Scott F. here today> I'm hoping you can help me diagnose what is affecting a new fish of mine.  I've begun the process of carefully adding livestock now using your advice.  I added a powder brown tang to my main tank about a week ago after quarantining him for two weeks. Very good, but I recommend a full 30 day quarantine procedure> He appeared very healthy up until a day or two ago.  The symptoms he's showing are pale coloration on top of the head and towards the dorsal area and a more slight paleness overall.  He darts about and thrashes around a bit.  There are no visible spots of any kind on his exterior and I haven't really seen him scratch, so I don't think it's ich or velvet.  I've tried to see if there is rapid gilling, but it's hard to tell with him. <That's somewhat encouraging. If he's eating well, that's a good sign, too.> I have a Picasso trigger in there too and he seems fine right now, but then again that fish is seemingly bullet-proof.  Do you know what this might be or what else I should look for? < Well, hard to say without a picture, but it could be anything from acclimation/collection trauma, water quality or dietary issue to a disease. In the absence of poor water quality parameters (i.e.; detectible ammonia, nitrite, etc.), I'd suspect that this may be the beginnings of a more serious parasitic illness...I still would not rule out Cryptocaryon or Amyloodinium here.> And what treatment should I use?  I have the QT ready to go.  Is there anything I should do immediately, like a freshwater dip?  Thanks so much for any help. Tim <Well, Tim- I'm inclined to recommend removing the fish to the treatment tank (I commend you on the preparation of the "hospital facility") for further observation. Yes, I do like the idea of a freshwater dip here as an initial start. If other symptoms indicative of a parasitic illness manifest, I'd begin a treatment regimen utilizing a formalin-based product. I'm a big copper sulphate fan for many fishes, but you do need to be careful with tangs and copper, as this medication can damage the fish's digestive system and cause other difficulties for the fish. If this does prove to be one of the aforementioned parasitic illnesses, I'd consider removing all of the fishes for observation and/or treatment. Meanwhile, you may want the main tank to go "fallow", without fishes for about a month, to allow the parasitic population time to "crash" for lack of hosts. Quick action is vital here...Regards, Scott F>
Powder Brown Problem? (Pt.2)
Follow up on previous email: My tang has gotten seemingly a little worse.  He is now twitching almost constantly with erratic movement and sometimes swimming with his body at an angle.  It looks like something is irritating him for sure.  But no spots or anything I can see on the exterior.  His paleness isn't like it was yesterday, but coloration is still off a little.  This is puzzling because I don't what to do for treatment.  His is definitely being by bothered by something and it is getting worse.  Thanks for any info/help you can give. Tim <Well, Tim- I'm inclined to think that this is either a result of collection trauma of some sort, or maybe, just maybe some sort of parasitic problem (assuming that you mean "itching" when you describe this as "irritating"- signs of parasitic problems). I'd consider executing some freshwater dips to see if any improvement comes from this. Do monitor basic water chemistry parameters in the display, just to rule out ammonia, nitrite, or other problems. Sometimes, a good water change can get a fish back on the right track. However, don't rule out the parasitic angle, here either...Good luck, and keep me posted! Regards, Scott F>
A Cure For The Powder Brown Blues?
Scott, thanks for the reply.  Well I took him out and placed him in the QT and he was just fine, no signs of irritation or anything. <Excellent! Glad to hear that!> I left him there for a few days, and in the mean time I thought maybe an old power head that I had in there that quit working might have something to do with it since it was still plugged in but had quit running properly.  So I unplugged it and put him in a few days later. <I wonder if "stray voltage" or some other unusual phenomenon caused this problem? Hard to say what it was...> He seemed ok but I noticed he gets real frisky and aggressive along the glass. I think he's seeing his reflection and it's driving him nuts. <Definitely a possibility> Or maybe I'm nuts, but I don't know what else it might be. <Well, that's an entirely different matter, LOL!> He started this when I first put him in there initially, but now I he just acts kinda crazy.  He zooms around and gets all twitchy and stuff. <Not a totally unusual behavior for a tang...> I tested it by turning out the overhead lights so there is no reflection on the glass and he calms down.  It probably sounds strange, but I think he's just a little too high strung. <Again, not out of character for tangs..> Anyway, he seems totally healthy other than that.  His coloration is beautiful as it was when I got him and he's definitely full of energy.  Having so many problems with parasites in the past, I thought for sure he had something.  It's good that he doesn't, because I'd be ready to pull my hair out.  The tank sat fallow for 6 weeks and I'm taking a lot of precaution now.  All seems to be well for now, thanks for your help. Tim <Well, Tim, even though your procedures were conservative, I think that they were the way to go...The potential risk of skipping this process is not worth it, IMO. I hope that things continue to go well for you and the fish! It was a little "touch and go" there for a while, but I'm glad to see things are looking up! Regards, Scott F.>

Tang Lost His "Mojo"! I have a 45 gal salt with wet dry pump ph is slightly off- 7.4 but added ph guard salt is a little low at 1.019-1.020 due to adding water. <That's a really low pH! Do your best to get that up there to the "normal" marine range (8.0 plus). Look into your husbandry techniques. Are you doing regular water changes? Possibly overfeeding? Check the quality of your source water as well.> All fish are in excellent shape, but my yellow tang has lost most of his color. and is  getting slightly lethargic. I have lost other fish this way need to know what I'm doing wrong and how can i save this fish. Thanks, Ron <Well, Ron- hard to say from here. Could be the stress brought about by the low pH, and possibly other water quality lapses. Do a complete suite of tests on your water to see what levels need to be corrected. This fish may require removal to a separate tank for observation and/or treatment should disease symptoms manifest themselves. Do a review on the Disease section of the wetwebmedia.com site for more information on diseases to see if you are dealing with one. In all likelihood, this lethargy may be due to the low pH and possibly other water quality anomalies. With decisive moves to correct these levels, your tang should get his "Mojo" back soon! Good Luck! Regards, Scott F>

Yellow Tang with Red top fin Hello and thanks for your valuable time. <And you for yours> I have a 75 gallon fish only tank, with only two small live rocks.  Fish wise I have a velvet blue damsel, three yellow tail damsels, a saddle puffer, a clown and five turbo snails.  All seem to get along dandy.  I had two Condys that were added a week ago, but died the last two days because of lack of light (my fault and working on getting better lighting and will try an anemone again some day in the future).  I don't yet have a protein skimmer and no QT as of yet. The Yellow Tang has a dark reddish/orange area at the base of his top fin, closest to his head.  It's come on in the last three days.  He eats romaine, and frozen food.  He doesn't seem to like the dried algae.  He seems happy, but does do a little rubbing on occasion on the back of tank glass and some rocks (but not necessarily on the reddish/orange-ish area). What do you think this is? <A reaction to less than ideal environmental conditions. You should definitely acquire and place a skimmer (you'll be amazed at the gunk this tool removes)... All your livestock will benefit from this and the use of a QT system. Please do read through here: http://www.wetwebmedia.com/mardisease.htm Bob Fenner> Thanks! Steve
Yellow Tang with Red top fin
Bob, Thanks.  I didn't realize that the skimmer would be that critical.  I had one in my last tank and it worked great.  Guess I just didn't think it was an absolute. <You will soon see the difference> Do you think that's the main thing that's causing the sot on the Tang? <Yes. Amongst all the factors you mention, probable causes, it stands out as number one> I read through the recommended html page.  I think I have all the other items covered in large degree.  Since I don't have anything but fish in the tank, I think the increased lighting can wait until I have the $$. <Yes, much less important than improved overall water quality. Get, use the skimmer first. Bob Fenner> Thanks, Steve HJ

Help! Purple Tang has turned brown-green and won't eat Hi, Thanks for your excellent web-site. I've kept marine aquariums for almost 5 years now, and have a problem I've never encountered, and can't find a reference on the web.  My purple tang, who for 3 or 4 months has been very fat and healthy (along with all the other residents of the tank) has over the past 10 days: 1) stopped eating, and 2) changed color over most of his body (looks like he's been covered with grey/green dust). (He's still purple on his sides where his fins fold back against his body) 3) I don't observe any ulcerations, holes, or fin damage. I've tried enticing him with different foods (Ocean Nutrition's "Formula 1", "Formula 2", and "Brine Shrimp Plus", Frozen brine shrimp, frozen bloodworms, Waltham's "Aquarian", Aquatrol's "Spirulina 20", "Nutrafin Max", freeze-dried krill...  but he still has no appetite. He won't even eat lettuce, which he used to devour. He has become more shy, and will hide when I walk up to the tank (he used to do this on occasion, but now does it every time). When he doesn't know he's being observed I can see that he is still pretty active, but has started to look really gaunt in the back half of his body. Specs: 100 Gallon Uniquarium, fish only, habitually understocked (other inhabitants are 6" blonde Naso, 5" Foxface, 3" flame angel, 3" long-nosed Hawkfish, 3 small damsels) Uniquarium has: - venturi protein skimmer - foam-block pre-filters - carbon bag chemical filters - wet/dry bio-balls biological - I don't know the gpm on the power head, but it's the one that came with the Uniquarium Feeding - I usually feed mostly flake (variety of Formula 1, Formula 2, and Brine Shrimp Plus), and usually a full leaf of Romaine lettuce daily. <Ahh, much here. I would look to environmental/nutritional causes from the above. The bio-filtration produces nitrates which should come down to less than 40. The lower the better, but difficult with the type of filtration you have. Now, for primary cause in my opinion...diet, which is contributing to parasites, bacterial, or fungal condition. This fish eats vegetative matter in the wild and needs it in captivity. Land based foods like lettuce are inadequate. Feed Nori, algae, perhaps Caulerpa, etc. The Formula 2 *frozen* food would be a good addition as well as soaking foods in Selcon. Brine shrimp is like Ho-Ho's or Twinkies. Brine shrimp plus is like those frosted donuts.> Maintenance - I do 15-20 gallon changes every 2 weeks; ammonia & nitrite always at 0, nitrate sometimes as high as 80ppm but usually 20 or 40. Copper is 0. Temp stays at 79, salinity at 1.023. Everybody else in the tank is very fat, healthy, active, peaceful, and happy. Help! Thanks -  Joel Sweat <I would work on optimizing water and diet. QT if needed to control disease and treat as needed. Start with a FW dip. Raise temp to 83 in QT. Most likely ick/velvet or bacterial from overall stress, diet, nitrates.  Please write if you need further assistance, Craig>

Powder Blue Blues! I have had my Powder Blue Tang home for a week now. I don't have a quarantine tank. <Gotta get one of those!> He has been fine up until now but today he seems weird. He is going back and forth from one end of the tank to the other really fast. Hasn't done this before constantly. He seems to be rubbing on the rock a lot more than he used to. My levels are PH 8.2, Ammonia 0.5 which has been like this for about 3 weeks, Nitrite 0, Nitrate 20. My Lionfish's behavior hasn't changed at all. <Detectible ammonia is not normal-please re-check and verify the reading. Take appropriate action to see that you don't see any ammonia reading in the future.> I am starting to get real concerned and am going to get a quarantine tank tomorrow and set it up. <A good long-term move. Keep a sharp eye on the lionfish, as well. Be sure to quarantine all future purchases for 3 weeks before placing them in your main system> I know this fish is hard to keep in captivity, what should I do? <The first thing is to take a good hard look at your tang. Are there any apparent spots, sores, parasites? At this point, removing him to a hospital tank may be a prudent move. You should perform a freshwater dip before placing him in the hospital tank (see www.wetwebmedia.com/dips_baths.htm for more information). Keep a close eye on the tang during its stay in the hospital tank, and be prepared to take appropriate action should symptoms continue. These fish require careful feeding (lots of algae in their diet) and above average water quality for optimal long-term health.> I don't want to lose it. What is the fastest way to get the quarantine tank running with sufficient biological filtration? <Generally, you should keep a sponge filter or media in your sump at all times for such emergencies. At this point, you may need to rely on one of commercial nitrifying bacterial cultures to "jump start" your filter. Keep observing your fish carefully, use the resources on wetwebmedia.com, and always, always quarantine! I'm sure that your tang will do okay if you act promptly. Good luck! Scott F.> Thanks, Ian Roff
Powder Blue Blues II
The tang seems to have a few very small spots on his side and his face has kind of turned white instead of black. The blue areas are starting to go pale as well. He has seemed to settle down a lot bit but is still rubbing on the rock. What should I do? <Well- sounds like Ich, but difficult to be certain from here. If it were me, once I verified that it was Ich, I'd perform a 3 to 5 minute freshwater dip, followed by a stay in you hospital tank. I would administer a commercial copper sulphate treatment and follow the manufacturer's instructions for use. Always test for copper if you elect to go this route. You need to make sure that you are maintaining a proper therapeutic concentration. Keep a close eye on your fish during the treatment period, maintain high water quality in the hospital tank, and good feeding. Copper is very effective, but is tough on tangs if administered for long period of time; do be certain that Ich is indeed the condition that you're dealing with. Check out this FAQ: wwwmarparasitcurfaqs.htm to make sure. Good luck, Scott F.>

Fin Problem Bob, <Craig> I've had a saltwater aquarium for about a year. During the early time, I had water quality problems (since resolved) which affected my yellow tang. His fins have eroded; are uneven, and have holes in the upper fin (I don't know if this is fin rot or HLLE). He appears healthy otherwise. I don't have a hospital tank set up. Are there any vitamins I can try; do I need to quarantine him? Will it gradually heal on it's own? <Hmmm, could be water r elated, could be physical damage re: holes. If this were water quality you would expect to see improvement over a week or two or... If lateral line it could be dietary. Tangs like a lot of vegetative matter in their diet, Caulerpa, Nori, etc.  Keep an eye out, it could physical damage from crabs, shrimp, maybe fish tank mates. Otherwise, if you have resolved your water problems he should show improvement. Fins on fish are fast healing in the proper conditions.> For more info try: http://www.wetwebmedia.com/tangfeedingfaqs.htm http://www.wetwebmedia.com/Tangdisease.htm Hope this helps, Craig>

Please help big problems Hi, I have a 90 gallon tank with 90 lbs of live rock and 90 lbs of live sand. About 3 weeks ago, I added a blue regal tang. In the tank at the time was a yellow tang, 1 blue damsel, and a tank raised clown. There are about a dozen snails, a serpent star and sand sifting star also. About 2 weeks ago, the regal tang broke out with ick. <Very common for this species. That is why quarantine is so necessary.> I immediately moved him to a quarantine tank I setup. About a week after that the yellow tang and clown broke out with it. I moved these 2 fish to the quarantine tank also. I treated the quarantine with Rid-Ich+. I have been doing daily water changes of 50% in the quarantine tank. Despite this, the ammonia is really high, <Please read over our coverage of setting up a proper QT tank on www.WetWebMedia.com. A good, cycled sponge filter hidden in your main system and ready for use would have eliminated the ammonia problem you (and particularly your fish) are now experiencing.> like 0.5 (not sure what units). <Parts Per Million, ppm> Both of the tangs are very good size. I have only been feeding them like 3 flakes each to try and keep the ammonia down. <Somewhat helpful> The yellow tang wouldn't eat anything at all, though. The fish kept looking worse and worse, not with Ich but just being stressed I guess. <Likely a combination> The fish were not moving much and looked on the verge of death, but the ick wasn't reappearing. <Ich has a tricky, deceiving lifecycle. It appears to have run its course only to pop back up.> In a panic, I freshwater dipped them and put them back in the main tank this morning. They are all looking much better now but I'm sure they are going to break out with the ick again since the tank only went fallow for about a week. <Agreed> There is only one fish store in the area and they don't have the facilities to quarantine other peoples fish. <Few stores do.> I know this is long. My question is I know if I add copper to the main tank the live rock and invertebrates will suffer. <The will do more than that.> If I was to add the Rid-Ich+ to the main tank what would be the consequences. <Yep> (its formaldehyde and malachite green or so it says on the bottle). Would this kill the live rock? <Yes, the animals and plant on it.> the snails? <Yes> the star fish? <And yes> I don't mind if I have to get rid of the invertebrates and never put them back in keeping the tank fish only. <Ok> I just want the fish to live and be happy. If I shouldn't use the Rid-Ich+ what would be your suggestions. <You are kind of stuck between a rock and a hard place. Your quarantine/hospital tank was not setup properly. You do not have a lot of options with the live rock and invertebrates in the system. I would try a lowered salinity (1.018) and garlic foods and see if that makes a difference. In the meantime, get that QT working properly so you can QT all new fish for four weeks and treat these fish if these lesser aggressive treatments do not work for you.> Thanks for the help. Sincerely, Matt <Good luck! -Steven Pro>

White Spots on Tangs Hi Bob, <Steven Pro in this morning answering a few questions, before Bob, Anthony, and I head off to LA to visit saltwater fish wholesale facilities.> Recently I added to my 60 gallon tank a blue tang and a Naso tang. <Too small of a tank to house two tangs comfortably. There will be too much aggression between the Surgeonfish. Also, a 60 is way too small for a Naso, even if there were no other Tangs.> I already had a yellow tang in there. <Ugh, even worse to have three.> It took a few days for these new fish to get accustomed to my tank. After about 8 days, they started feeding properly (brine shrimp, lettuce etc...) <Neither of these two foods mentioned is appropriate for your fish. Do archive the site looking for recommendations, including Nori and Formula II.> and few days ago I noticed white spots on my blue tang. <Very typical with these fish. I strongly advise you to quarantine all new livestock for one month prior to introduction to your main tank.> I tried to look again few days later it was gone, then it came back again. I saw the same thing on my yellow tang. When I turn on the light in the morning, I would see white spots all over the yellow tang and blue tang. When I come back at home in the afternoons, the yellow tang is clean but the blue tang would have some on it, but not as much. <Typical pattern due to the lifecycle of the parasite, Cryptocaryon.> I do have a cleaner shrimp in my tank and I see it cleaning them. Yesterday, I decided to give my blue tang a fresh water bath, since the white spot had increased on the body. <I like freshwater dips. I would use them and quarantine at this point.> I also put some copper in the fresh water. I dipped it for about 8-10 minutes and since I have returned it in the tank, it's been breathing heavy and I think I'm going to lose it. Anything I can do to help it survive? <Many things can and could have been done. Please educate yourself using the vast resources of WWM regarding Marine Ich, Cryptocaryon, quarantine procedures, and even compatibility issues.> I have successfully done this procedure (fresh water bath) in the past many times. <And it should be continued with other protocols.> I cannot treat my tank with copper because I have live rock and some inverts in my tank. This morning I saw, again white spot on the yellow tang and the Naso tang. Few hours later I stopped by at home and again, I could not see the spots on both fish. Do the parasites get on them in the dark? <They live, breed, and die in 24 hours. The fish are constantly reinfected with new parasites.> I'm just confused again and I need your help to clean up this mess. Thanks, Sam <You are welcome. -Steven Pro>

Sick Tangs (Hippo and Goldrim) Help, I am at a loss and am unsure what to do. We have noticed some brown and white Pimple like spots that are a little inflamed on our blue tangs. Our baby blue tang has them all over with one BIG white bump near it's tail. The bigger (fat) blue tang has some brown inflamed dots/little bumps on her body and some spots look like they may be scars or places where these bumps were removed by shrimps or Heniochus. We cannot figure out what is going on. We have two true Perculas that are fine, Heniochus have Ich like spots in the morning as well as the gold rim tang. <This probably is Ich> All eat great and we feed a variety of food with Vita-Chem and Zoecon. We also occasionally mix Garlic elixir in with their frozen food. I check water a few times a week and noticed that Ammonia is at 1.0ppm, <Yikes! This is way too high... should be zero. I would not feed this system any foods at all at this point... and prepare to do a water change...> nitrites are 0 and PH is 8.4... Phosphates are also high. We will do a 10 gal water change today, but still are unsure what to do about brown and white bumps/spots... Could Freshwater dips help?  <No to the freshwater dip... the best "treatment" at this point is to cure the causes of the high ammonia (et al.)... What do you think the cause/s are here?> or will it stress fish more? We don't think it is an infestation in tank as not everyone has it. <The tank itself IS infested... Please read here: http://www.wetwebmedia.com/mardisease.htm and beyond via the posted links> Also, two of the fish we have had about 4 weeks, the others for 13 months.. So how could they have gotten these Parasites (if that is what they have?) <Latent organisms on the new fishes likely> Please respond as soon as possible so I can work on getting them well. Also, we are on a fixed budget and cannot get a hospital tank and have inverts in our tank, so medication is limited.... <Perhaps no need. Do study where I've sent you, and soon, thoroughly. Bob Fenner>
Re: Sick Tangs (Hippo and Goldrim)
THANKS FOR SUCH FAST RESPONSE!!! My fishes will appreciate! High Ammonia, not sure what it could be. We have been medicating tank with Melafix (Big Hippo Bites baby Hippo and we were trying to help heal his bites, which are gone now and have not noticed bigger hippo biting smaller in a while) We also have been feeding Lots of medicated flakes trying to get rid of white and brown spots/bumps. Could be too much food.  <Yes> We have a 50 gallon tank with two decent sized tangs, one baby tang, two small Perculas and two small Heniochus (don't think overcrowding is issue) I need to feed them or big tangs "pick" at other inhabitants in tank, but honestly think should maybe stop feeding medicated flakes and only feed Spirulina and Mysis shrimp and Formula two. Also, we put a few pieces of Seaweed selects in tank that got stuck on filter area and clogged up tank while we were gone this weekend (also could be problem) <Yes... best to use an all-plastic clip for strips of prepared algae foods> This is first time ammonia has been high in over as year. Should I stop all meds and just worry about ammonia at this point? <I would, yes> Why are problems only on my tangs? <They are more susceptible to Ich, these sorts of insults/challenges> And what is the big white bump on my baby hippo tang as well as inflamed black/brown dots? <Likely environmental. Please read where you were sent. Bob Fenner>
Re: Sick Tangs (Hippo and Goldrim)
 Mr. Fenner Thank You so much. I printed out about 25 pages from your site, will thoroughly read and take action. Will stop all meds, but can I still put VitaChem and Zoecon in their food? <Ah, yes. Please do so> Also, Phosphates are VERY high, should I add something to lower that or just focus on Ammonia?  <By doing what is advised to reduce ammonia, you will concurrently lower the phosphate> And sorry to seem redundant but will ammonia cause all these problems (according to your site yes, but just want confirmation).  <Yes> How many times a day should we normally feed fish? Also (sorry) how can I keep temp constant. We are in Southern California where it is pretty warm during the day and the temp rises to about 83F, then at night dips to about 80-81, we have heater, but hard to keep constant... Any suggestions? THANK YOU AGAIN!!!! <Please peruse the WWM site, the Google search feature there for general husbandry questions. Bob Fenner>

Fish Dying Hello Bob, I have a 105 gallon saltwater tank. I have lost a clown, powder blue tang and blue and yellow-tail tang. At first I thought is was Ich but now it seems to be something else. The gills of the fish are extremely red. We have tried copper and are now using (also killed our starfish, and three anemones) using Organicure for the treatment of marine fish diseases. The rest of the fish are breathing very heavily and I am concerned they are all going to die. Please help if you can, I am sure you can appreciate the urgency of the matter. Oh also added live rock over the last couple of weeks. Denise <<Hmmm, something wrong here... and I don't think it has to do with your system. I fully suspect that the source supplying you with these surgeonfish's is guilty of poisoning the tangs before you got them. Hear me out. The Powder Blue (Acanthurus leucosternon) is not a very hardy fish species for aquarium use, and the Clown (A. lineatus) can die easily, w/o apparent cause as well. The Yellow Tail (Paracanthurus hepatus, aka Hippo, Palette et al. tang) is typically tough... but all three dying? This isn't right. Please do stop using copper, OrganiCure on these fishes... this is very likely what really doomed them... that is, being kept under "medication" (i.e. selective poisoning) by people ahead of you for too long. Not to be mysterious, Surgeonfishes/Tangs/Doctorfishes (family Acanthuridae) have an assortment of beneficial microbes in their digestive tracts (sort of like you and me and E. coli). These "bugs" help the Surgeon to digest foodstuffs... and, unfortunately, if these fishes are kept in coppered systems for too long (more than a couple of weeks), these microbes are wiped out. If the animal can't get them re-established (in the wild by eating the fecal pellets of conspecifics) they're ultimately done for. Please don't be discouraged by any of this supposition; but do relate this information back to your source and look for a "fresher", kinder one. A bunch of support for this possibility can be found in articles on the surgeons on my wetwebmedia.com website. Bob Fenner>>

Surgeonfishes: Tangs for  Marine Aquariums
Diversity, Selection & Care

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