Ich treatment/ copper dilemma  8/25/06
Dear Crew at WWM,
<Kim>
Thanks for your help with my Ich problem. It is a lengthy story, but I will try to keep it simple.
<Okay>
I have a 5 ft , 9 month old reef tank with loads of live rock and thick shell grit/gravel base. Stock - various inverts, 1 Hippo Tang, 1 pair Ocellaris Clownfish, 1 pair Clark's Clownfish.  Very happy aquarium until Ich outbreak on my Tang (regretfully not dipped/quarantined - Lesson learnt.)
<Ahh, yes>
We had a 6 hour power outage 1 week prior to his outbreak, which I am assuming was the catalyst, as water parameters all fine.  My LFS recommended treating my whole tank with "Vertonex" (quinine and malachite green) for 4 days -
<... I would NOT do this>
said "I may loose a coral or two".  So I put my corals in a large crate with air stones and filter, and treated tank for 4 days, with no improvement of Ich - slightly worsened actually.
<Sigh...>
  Which is of no surprise, as I have since researched Ich and treatment, and have consequently lost faith in my LFS.
After extensive review of your site and others, I set up a treatment tank, transferred all fish ( Clark's Clowns also now showing a few body spots), with an aim to copper treatment for 2 weeks (due to Tang) and fallow the main tank for 5 weeks.
<Good>
The only available copper treatment I could get (largish town, eastern coast Australia) was "Oodinaid" by Aquasonic (copper sulphate + Aminacrine), and an Aquasonic copper test kit.  I dosed the tank as per instructions, but was unable to test copper level as the kit was not working
<Likely old reagents...>
(very frustrated, live out of town, unable to make it back to shops before closing in order to change).  3 hours after treatment my Clark's male started swimming on his side,
<Yikes... water changes...>
around in circles, and ended up wedging himself between filter and tank in order to stay upright.  I assumed toxicity
<Very likely so>
( water parameters normal, in particular 0 nitrites and ammonia) and as I only have the one treatment tank set-up, did a 50% water change and added carbon to the filter, with more water changes the following day.
<Good>
  To top things off the heater somehow became unplugged with a drop of water temp when I got home to 70 dF - I was devastated.  Any way, today, 2 days after circling, my Clark's clown has finally come out, and looks 100%, eating again etc.  My Hippo Tang seems a bit frazzled since the temp drop and is eating less (but can see no external signs of Ich).
Finally, my dilemma!  I am assuming that my Clark's male has an increased sensitivity to copper although I cannot guarantee that the copper was not at toxic levels as I was unable to test (did keep some water to test later
<Mmm, these tests have to be done in "real time" to be accurate>
but it was confiscated by my 2 1/2  year old son,
<Heeeee!>
however it was the first treatment, following dosage to the "T". So what do you recommend treating my fish with??
<A chelated form of copper... this product was likely just copper sulfate pentahydrate...>
I am thinking hyposalinity or the 50% water change technique prescribed at Reefkeeping.com.
<Am not a fan...>
My LFS sent my husband home to me today with more quinine to retreat for 7 days, being very skeptical about the water change option. I can't see quinine working this time if it didn't work last time, and I am cautious of exposing my Clark's clown to chemicals this soon.
<Quinine compounds are actually quite safe... can be effective...>
The good news is all my inverts are doing well in the main tank, so I assume (or am I hoping?!) the live rock etc was not damaged severely by the initial treatment.
<Me too>
I am extremely grateful for your time and advise.
Thank you, Kim.
<Do read on WWM re chelated copper and test kits for same... Hyposalinity may forestall further cycling of the parasite, but will not likely effect a cure of its own accord. Are there "mail-order" pet-fish businesses (etailers) in Australia? Cheers, Bob Fenner>

Tang with Ick Question 10/11/05 
<<Stan, some of my/other input. Cheers, BobF>>
Hello Crew: 
<Hi Stan, James here today>
I currently have a purple tang and a desjardini tang in my QT (20gal)
<<RMF would NOT mix two tang species in QT>>
which I plan on adding to my 150 gal reef system once they pass QT. They've been there for about a week and are both eating like little pigs and seem to be doing fine. I've been feeding them a variety of foods which includes Spectrum Thera-A Anti-Parasitic Formula, Julian Sprung's Seaveggies, Ocean Nutrition Marine Pellets Formula 2, Kent Marine Platinum Reef Herbivore Fish Food which are sometimes soaked in Vita Chem. 
However, in the last couple of days, I've noticed some white spots on my purple tangs body and fins. Can't really see if the Desjardini has these same spots or not because the spots are not as contrasting as on the purple tang. I assume it's ick, or the beginning of it. So I looked here and read some articles that hyposalinity and/or a cleaner shrimp might do the trick without medications. So I added a shrimp a few days ago and then this weekend started researching how to do the hyposalinity treatment. 
<<Not with the shrimp present. RMF>>
Instead of finding out how, I found more articles claiming that hyposalinity was a waste of time and wouldn't work long term. So I guess my question is, how would one go about treating ick long term in QT? Isn't that what a QT tank is for?
<<Not really what "quarantine is for"... a period to review, observe health, behavior, possibly treat there/then... but also for "rest". RMF>>
I know everyone has different opinions, but what do most people do? Medicate? If so with what? Any help would be very much appreciated. 
<Stan, if it were me, rather then stress the fish out with hyposalinity treatment, I would treat with copper. A copper test kit is a must along with daily testing to insure an effective and safe level is kept. Recommended dose to maintain is 0.015-0.020ppm.
<<Dude! Of what? Free copper/cupric ion... PLEASE understand that there is a difference in reading/s with chelated copper and their corresponding kits. RMF>>
I would treat for a minimum of 21 days @ 80 degree temperature. The ick cyst casings are unaffected by the copper so we have to wait till all hatch out where at this stage they can be effectively killed by the copper. The ich that is embedded in the skin of the fish also is pretty much unaffected by the copper. Only in the swimming stage, after hatching and when they have to find a host, is when they are most vulnerable to copper. James (Salty Dog)>

Tang with Ick Question ? - Follow-up 10/11/05
Thanks James (Salty Dog):
OK. So a treatment with copper it is. Any recommendations as to what copper brand / type to use? Isn't there chelated or non chelated ? 
<Yes, there are chelated/non chelated types. If it were me I'd go with Aquarium Systems Sea Cure Copper treatment along with their FasTest Copper Test Kit. Fortunately for me I've never had to treat a tank in 10+ years, but if the problem arose, the above would be my choice.>
<<... three weeks... with an unchelated copper... on tangs? I would NOT do this... I'd go with two weeks, and a chelated make/model with accompanying at least daily tests. RMF>>
And I assume that I need to move the cleaner shrimp to my main tank since he won't make it thru the copper treatments right ? 
<Stan, all inverts must be removed. Google our WWM site on copper treatment for more info. James (Salty Dog)> 

Re: Tang with Ick Question ? - Follow-up 10/13/05
Thanks for the quick replies James (Salty Dog), very much appreciated. 
<You're welcome>
But I'm a bit confused here and was hoping that you could maybe point me in the right direction. 
Just as a reminder, I've left the replies back and forth as a memory refresher. After talking on Monday, I went out to my local pet stores looking for copper but could not find any, believe it or not they were all out. So I ordered it mail order that night.
Well here's the confusing thing. On Tuesday, when I checked in on them and watched them for awhile to see how they were doing, etc. I noticed that my Desjardini tang was laying on its side and the cleaner shrimp was going to town on him. After taking a closer look, I saw that the purple tang no longer had white spots on him either (this is while the lights were on). Am I going nuts ? 
<<James... respond to the question/s! Not going nuts... the "spots" are reactions... do cycle on/off... RMF>>
Unfortunately, I noticed that my Desjardini tang had a two spots missing from the top/rear of his fin. I'm guessing Mr. purple is the reason. However, when I checked on them this morning (lights still off) the purple tang looks like it has
some type of spots on it (not white), and its body was a bit discolored. The Desjardini on the other hand, seems like the spots that were missing on its fins are filling in already.
So here is my dilemma. Do I treat the tangs with copper ? 
<Stan, this treatment must last at least 21 days to be effective and are you using a test kit to insure safe and effective doses?> 
Why do I see spots one day and not the next? Will treating them, if they don't have anything be a bad idea or more harmful then good ? 
<You have gazillions of cysts laying on the bottom waiting to hatch and find a buddy. Continued treatment is necessary to kill all the hatchings.> 
And do I keep pushing my luck in trying to keep two tangs in the same tank ? I'm sure the 20gal isn't ideal but I'm hoping that the extra space in the 150 will allow them to get along. 
<The 150 should be fine, you have to accept the fact there will be occasional aggression. Its recommended that no two alike tangs be kept together.> 
I know it's pushing it. Could go either way. They could get along, with the occasional "I'm boss" reminders, or they may destroy one another.
<<This is something you NEVER want to see.  If the two tangs are also close in size, you are probably pushing it too far with their compatibility, this is not what could be considered "conscientious". MH>>
Should I separate them in the QT tank ? Should I get rid of one of them and just go with one ? 
<If the aggression gets up to the next level, then I'd probably trade one in. James (Salty Dog)>
I know there's a lot of questions here, many of which are hard to answer, with no definite yes or no. But I'd really appreciate any input that you guys might have.
Thanks in advance 
<You're welcome. Do compatibility research in the future if you are considering buying two alike fish.> 

Cryptocaryon not responding to copper 8/3/05
Hi Bob?
<Yes>
Still battling mysterious spots on Naso Tang Finished copper treatment and crypt appears to be gone '3 weeks now". As you suggested I tried PraziPro and did get some improvement the Naso is in with a Hippo Tang 'Quarantine" for about 6 weeks total now, the Hippo developed some HLLE from copper I assume but is slowly recovering.
<Ah, good>
My thoughts are to move the hippo to the reef for better water quality to help with the HLLE and treat the Naso in quarantine again?
<Mmm, actually... the spots may be something relatively untreatable... like subcutaneous worms of some sort... For all the balance of good/benefit, I would leave it in the main tank... perhaps add purposeful cleaner/s... Lysmata shrimp are very good with tangs>
I have run two seven day treatments with PraziPro., the spots turn from white to a yellow color and some, about a third have dropped off. Can I increase the dose or try a dip possibly?
<Not a good idea... one treatment will do about as much good as can>
And is it safe in your opinion to put the Hippo in my reef, he has shown no signs since the crypt.
Thank you so much for your assistance I believe I am making headway but this stuff is resilient to say the least.
Please read below if you need a refresher
Shaun
<I would run both fishes through a pH adjusted freshwater dip (with aeration) enroute to returning them to your main system. Bob Fenner>

Staying The Course...(Ich Treatment)
Hello Crew!
<Hi there! Scott F. with you today!>
If you don't mind, I would like to update and ask a question.  I have positively ID'd my tang as having Cryptocaryon.  That was a few weeks ago.  I tried hyposalinity at 1.009 for approx. 2weeks, but found it to be ineffective.  Rather than continuing (FOWLR) I decided to bite the bullet and separated my fish into a QT tank.  I have been treating with Copper Sulfate at .25ppm.  After 1-2 days, all signs of ich disappeared.  It has been 11 days since I started the copper treatment.  I had been running the FOWLR tank at low salinity during this time (11 days at approx 85-86F) and slowly raising salinity back to normal (no fish in it).  I would like to ask your suggestion for returning my fish to the main tank-when is it safe-(I have read life cycle of Cryptocaryon is 10 days, but others say possible 30 days-is this possible) and whether it is safe to discontinue copper treatment in 2-3 days (as directions on package state).  Thank you very very much for all your help.  
Jeff
<Well, Jeff, you don't need to keep the copper concentration in the treatment tank any longer than the manufacturer recommends (usually around 14-21 days). I'd keep all of the fishes out of the main tank for a full month, or longer, as dormant Cryptocaryon parasites can strike when the fishes return...No sense rushing things here...Just follow through on the treatment, and keep the newly-cured fishes in the copper-free hospital tank for a couple of more weeks, and you'll be fine! Good luck! Regards, Scott F>

Feeding Copper to Fish (3/11/04)
I've heard that you can take a batch of adult brine shrimp and add copper to their container, wait an hour, and drain the shrimp with a net and add directly to a reef and if the fish eat the brine shrimp, then the copper is going to clear the ich....is that true?
<No way. Ich is an external, not an internal parasite. Additionally, the fish will poop/pee (forgive the pediatrician terms) copper into the water, thereby contaminating your tank. There is only one proven way to rid your tank of ich--the quarantine/fallow technique. Never put copper in any form into your system. Some people have managed to control ich with cleaners, ozone, UV, garlic, and such, but this is rare. You might want to read Scott W. Michael's article in Aquarium USA 2004, which you can find at any PetSmart or Petco. Perhaps some of the things in there will help you, but the fallow/quarantine method outlined on WWM is tried and true. Steve Allen>

The Two-Front Approach To Fighting Ich
Hi Scott (if your are doing your thing tonight):
<Ya got me!>
Bonehead calling.  Need some help.
<LOL...Hope to be of service!>
Got a French angel a little over a week ago (goes by the name of batman according to the 3 yr. old).
<Three-year-olds KNOW these things!:) >
About 5".  Amazing fish.  Will already eat out of my hand.
<Awesome!>
Put him in QT, but it is was a 10 gallon tank, he looked fine, was eating like a wild man, but seemed very cramped (guess you know where this is going).  After a week popped him into the display.  Two days later, what looked like fungus on two fins.  
<Uh-Oh...ya jumped the gun, huh...?>
Next day, at night, what looked like little specks of sand doting his body.  Better in the a.m., bought Lysmata grabhami.
<A good biological cleaner...not a bad start...>
Batman went straight for it, got underneath a rock with it and begged for cleaning, but so far no luck.  Specks back again tonight (btw, can only see them on his bask body under the metal halides, to give you some sense of the size).   Read through all the black so guessing from that it's crypt.  Does crypt also manifest as a cottony looking white gunk on the fins?
<No, it does not...You could be looking at a different illness....>
Maybe I am misdiagnosing, or maybe he has two different maladies?
<Possible....>
I think I have actually read too many FAQs and articles (including your "two fronts" which I liked the best) on this subject so want to make sure my plan makes sense, and get any advice you can share.
First, bought a bigger QT (50 gallon) so the fish(es) will be a little happier.
<An excellent idea...>
questions on course of action:
1) Batman is acting fine.  Eating like crazy, has not even attempted to scratch himself (and I have spent a lot of time watching him), eyes are clear, etc.  Should I give him another day or two and see if the shrimp will get his act together or go ahead now with full battle plan?
<Well, it's always a good thing when a sick fish eats. As I like to say, "A fish that eats is a fish that lives!". If you are dealing with Cryptocaryon, it's a good idea to start treatment as soon as you make a positive diagnosis.>
2) All the other fish are acting fine.  Not a mark on them (though sounds like just a matter of time before everyone has it, if it is crypt). Was wondering if maybe I am catching it before it enters its free swimming stage (if he has it) and maybe nipping further infection in the bud, so maybe just start with a QT of the angel and see how the others do?  Or everybody out of the pool now? (yellow tang, two false percs, royal Gramma, purple Firefish, which will take total rock work dismantle job to get him out).
<Gulp...I know- a royal pain in the rear! However, once this parasite gets in your tank, it's IN your tank...and can be really tough to eradicate. Even though the other fishes are not showing signs of the illness at this point- they have been exposed, and the potential exists that they will contract it...Better to err on the side of caution, and, at the very least, remove the fishes to a separate tank for observation-and treatment, if it becomes necessary...>
3) As far as treatment, my plan consists of filling the QT tank about half full to start, half tank water, have newly made, and add more buffered RO water to help dilute wastes and slowly bring down the specific gravity (currently .025).  I think I got this idea from something you wrote.  No lower than about .018, then 25% water changes every other day, assuming everything tests O.K.  Slowly raise temp from current 78 to about 82.  Putting in a powerhead with a sponge filter from the main tank.  This sound O.K.?
<Sounds good....Hyposalinity treatment can be successful if performed carefully. I am not a huge fan of it, myself, but quite a few hobbyists use the technique. If you can treat successfully, without harsh medications, all the better...>
Also, how long does it take for the sponge in my display to collect a good coating of denitrifying bacteria?  I just cleaned them yesterday with tap water.  
<At least a few days...You may want to also "seed" the treatment tank with a commercial nitrifying bacteria preparation...>
4)  Fresh water dip, 5 minutes, nothing added (Meth blue has not arrived yet).  This is another area where I have read a number of different opinions on the site and wondering which way to go.  Anthony says just doing the FW dips and vacuuming out the bottom of the tank everyday to suck up cysts will get rid of the bug in a couple of weeks.
<Anthony is 100% correct! This technique is a very viable treatment regimen. However, you need to be religious about the siphoning. It must be performed every day...In fact, 100% water changes may be the best way to go...That's why environmental consistency is very important...>
Most everyone else seems to favor copper.  If I go for just the dipping/vacuuming,  how frequently should I do the dips?  Daily? If I see the spots reappear? Is 5 minutes (same temp, ph, etc.) long enough?
<I'd do them daily for at least a week, and I'd go for 8-10 minutes, if the fish will tolerate it. Anything less than 5 minutes is not really beneficial...>
Should I just go for the copper (the copper scares me a little, but if it's what will cure him faster/better will do it)?
<I am a big fan of copper sulphate, but it must be administered in conjunction with regular water testing to assure the correct level of copper. Please be sure to follow the medication manufacturer's instructions to the letter regarding dosages, etc.. Alternatively, you could utilize a formalin-based product, with similar precautions taken, in terms of following the instructions!>
5)  Have read some fish are very sensitive to copper.  Bob's book says this particular Angel can take it.
<It can, but do monitor, as outlined above...>
What about Zebrasomas?  Sounded from what I read that it could give him some gastro trouble.
<Exactly- the intestinal fauna that live in the tang could be damaged, creating great difficulty for the fish when digesting food...Copper treatment needs to be quick and precise with tangs. Long term exposure is a potential problem...>
Assuming probably not a good idea for the Firefish either (scaleless)? I suppose if everyone has to go QT I could put the Firefish and yellow tang in the 10 gallon with no copper, although will still face the cramped quarters issue.
<But better than leaving them in the display, IMO...>
Sorry to run on for so long.  Of course my preference would be to wait it out a little and see if the shrimp, water changes, and any other course of action I can do in the display will tip the balance in my favor and avoid what I am sure must be a stressful ordeal (for me and him), but don't want to be dumb(er) about this either.  
<I completely understand. I don't relish the idea of breaking down the tank to get the fish out, but, at the very least, you should treat the obviously sick angel. In the end, I strongly advise you to try the "two front" approach that I advocate, removing all of the fishes-sick or not- for observation and/or treatment (if necessary), and leaving the display tank "fallow" for at least a month...This may "crash" the parasite population, providing the fishes with a much better chance of resisting the disease when re-introduced...>
Thanks for all your help and for all the incredible resources on WWM.  Truly a remarkable website.  Too bad I did not follow the great advice re 3-4 week QT period that has been drummed into my head over and over.  Another lesson learned the hard way.
<Sometimes, that's the best way to learn a lesson! You're doing fine! We're glad to be here for you to lend an occasional hand...Learning the hard way is how most of us got our hobby experience!>
Best regards, Jim
<And best of luck to you! Regards, Scott F>

Copper usage
Hi again Anthony. I understand the problems of coppering most display systems; as it happens, I have very little substrate, although a fair amount of rockwork;
<Yes... all calcareous media is a problem: sand, rock, gravel, shells, coral skeletons, etc. More importantly, any substrate beyond a bare glass bottom is an invitation for larval parasites to fester and develop>
I have always thought that, assuming the parasites (e.g. ich) are
discovered on day one (i.e. as they are first attaching) a shot of copper maintained for a day or two would slow them down enough to keep them off at least some of the fish. Is this wasted effort?
<yes, my friend. You are mistaken. Infections begin in the gills and soft tissues as much as two weeks before a single spot is observed on the exterior of the fish. And the life cycle of many is well under 24 hours for some... so your chances of catching them with copper are unrealistic>
I am really not a big fan of any medication, and in my experience long-term copper ( even the 14 day treatments) too often result in a fish that never eats again,
<agreed... it concentrates in their flesh. A precarious pickle... not enough is useless and too much kills all. I personally never use copper... ever. FW and Formalin baths for my fishes. No "biomagnification" here>
particularly with smaller specimens and angels.
<yes... angels are ultra copper sensitive, agreed>
But I would appreciate your thoughts on this question: do you think ich, crypt, Ood and the like are always inevitably present, waiting for a trigger?
<yes... no such thing as a sterile fish, dog or human>
Or are there truly (possible) parasite-free systems?
<impossible>
This business of temperature change as a common trigger bugs me; I do a fair amount of collecting on vacations, mostly snorkeling in 4 to 10 feet of water, and the temp changes are considerable, especially near shore; then again, I can remember several years ago meeting a lot of Moorish idols who loved wonder bread; quite a difference a closed system makes.
<many flaws to this theory here and real scientific data in closed systems exists (redundantly) to quantify the effects of temperature on rates of pathogenic incidence. We cannot possibly compare the ocean to a closed system when aquariums have so many parameters deficient compared to the large stable open ocean (which boosts fishes immunity). Oxygen saturation (HUGE difference here between home and ocean), DOC levels, etc. Furthermore... of the hundreds of species you see in the shallows, how many of them actually stay there during low tide, monsoon rains and hurricanes. And how many (most!) move down the reef nightly and as necessary. We could go on for quite a while here <G>>. Good question though. Thoughtful indeed>
But I would love to have system where little accidents could
happen without the revenge of the parasites. Do such exist?  
<yep... huge understocked aquariums. An old story but tried and true>
Thanks again, Steve.
<kind regards, Anthony>

Re: Ich-What Else
Jason <Hi.>
Thanks as always for the fast reply.  I have been monitoring the copper levels which I try to keep at .015-.02.  Occasionally it dips to .01.  I have 10 fish which will be too crowded for a 10-20 gallon QT which is why I treated the main system.  Assuming that I can keep the level at .015 how long should treatment last? <If I recall it's about 14 days - two weeks or so.>
Thanks again, Joe
<Cheers, J -- >

Can you help with ich?
Hope this the right address for Q&A!!!
Hello,
<Hi Vicki>
I have recently discovered what appears to be ich in my 75 g tank (on a Sohal, porcupine, and Klunzinger Wrasse). I tried removing them to a 10 g. quarantine tank treated with Coppersafe (I followed instructions EXACTLY!). My fish were fine for about a day...then WHAM, they all started breathing rapidly, sitting at the bottom of the tank, and looking generally awful. My wrasse was on his last fin, when I decided to get them back into the main tank. All have regained their vigor, but also retained their ich.
<A 10 gallon QT is a little tight for these guys, depending on their size....>
What am I doing wrong?! I already tried Sea Cure Copper for ich on a dwarf angel--same results:(. Again, I was meticulous following those directions! My water tests fine for ammonia, nitrite, nitrate. I am afraid of copper now, and am feeding anti-parasite food/doing freshwater dips to keep the ich at bay. Have also added a UV sterilizer for future problems. I think I'm getting ich-obsessed. Please help me--I don't want to lose another fish! Vicki
<Alright Vicki, you need the copper and more importantly, you need the test kit for the copper you have. PLEASE go to WetWebMedia.com to the copper FAQs http://www.wetwebmedia.com/coppertestfaqs.htm ands read the faq's about the types of tests and the copper they test for.
Maintain the free cupric ion at 0.25 for two weeks and test daily.
DON'T overdose!!!!! I bet you have too much copper. There are a ton of links and FAQs on copper at WetWebMedia. The tests can be had from most of the WetWeb commercial sponsors. Craig>

Copper/Disease Treatment
I have another question. I recently removed all my fish from my main tank into (potential) treatment tanks. I did this because my blue tang had white spots and was scratching. My flame angel and coral beauty also had white spots. I had been attempting to treat with Kent Marine's exp (I know, I've read your opinions on this, but I was desperate until I got the tanks set-up and had time to remove them and live rock). The fish did well for several days, but then the flame wasn't eating. By the time I got them transferred the flame angel was in bad shape, and died shortly after. The other fish have now cleared up and don't have spots. They are in bare bottomed tanks, but I have not yet added copper as they seem to have improved. I assumed I was dealing with ick, but I'm now not quite sure. I was going to leave the fish in their current holding tanks for 4 weeks to allow the main tank to go fallow, but they definitely do not seem to like them, especially the yellow "Coris" wrasse who is constantly searching the bottom at night for a place to bury himself. Any suggestions as to my next course of action? Sorry for the length, and thank you ahead of time. Rich.
<Yep, would treat w/copper as per WetWebMedia.com quarantine/copper info. Give the Wrasse some plastic pipe, some plastic plants and the like to hide in and feel comfortable. They don't have to be totally bare, just inert. I wouldn't trust that whatever it is is necessarily under control, although the freshwater might temporarily help and then have a population explosion. Could be velvet or ick. Treat both w/copper. Follow the WetWebMedia copper info. Craig> 

Ich
<<Greetings...>>
In my 240 gallon I noticed on my regal, and purple tang that they have ich. I always keep my copper at .15 in the tank, 
<<constantly? This won't promote long-term good health in your fish. Copper is toxic.>>
 and I'm surprised the fish got it. 
<<Well... your decor and substrate would be absorbing some of this. I assume you are using a test kit to determine these values?>>
 I boosted the copper up to .20 Now the fish in the tank are regal, purple, Sailfin, and yellow tang, blue ring angel, SFE, and chainlink eel, male blue jaw trigger, Niger trigger, blue line trigger, and a small queen trigger. 
<<That is a lot of fish, even for a 240 - I hope your filtration is robust.>> 
Do you have any tips to give me against ich? 
<<Do you quarantine these fish before you put them in the main tank? That would be my suggestion.>> 
Please help me. Also, I have been looking for a queen trigger for a year and finally found mine a month ago. Now I don't want to loose him, because he is so cool. 
<<They are cool, but are well known for being quite hostile towards just about everything. Hope this choice works out for you.>> 
If the ich does get worse, can I set up a smaller tank, do a Fw dip on the queen and move him to the smaller tang (by himself). 
<<Should have done this from the start, you may find soon that you need lots of smaller tanks to take everyone out of the main tank and run it fallow for a while.>> 
Is this a good idea or should I keep him in the big tank? 
<<pH-adjusted freshwater dips and isolation in quarantine are a good plan, yes.>> 
If the small tank idea works, what should be the minimum tank size for him for about a month. 
<<Something large enough to move/turn around in - you didn't reveal the size of this fish. I like 20-long as an all-around good quarantine tank, if this will work for you.>>
 Thanks!
<<Cheers, J -- >>

White spots again
Dear Bob,
We have a Naso tang we got 4 weeks ago. Two weeks after purchase, he got white spots. The white spots went away with hyposalinity/hi temp treatment but some more came back 2 weeks later (now). We need some advice.
<Okay>
Temp is 84 and specific gravity is 1.019. The two large cleaner shrimps
jump on him and appear to feed. Now one of the damsels looks like he has a spot on his fin and on his body. The tang spits out food treated with Selcon (he appears to hate it--any better tasting vitamins?). 
<Not really>
He's getting much thinner. He feeds but is feeding less. No other disturbing behaviors (i.e. heavy breathing, scratching) and he still is active. We first noted the spots on Friday and it's Monday. Last time the white spots looked a little bigger and when they fell off, he had grey spots (that's our guess because white spot became grey spot and then disappeared). Still, we weren't sure if we had a new disease or whether these dark spots were residuals but they went away. 
<Cycled off, to reproduce... >
My darkest fear is that we don't have Cryptocaryon but Amyloodinium which you say requires "early" treatment. Your book is the only one I could find that has at least a diagram that demonstrates the differential diagnostic pattern of spots. In the Amyloodinium, it looks like the spots in your diagram are more dense at the top (dorsal fin) of the fish. Ours are more dense at the bottom. Last time the spots looked bigger. I don't want to say that these look powdery but they look finer.
<Yes... and the fish/es may have both...>
Last time the spots were worse in the morning. I'm not sure if that's true now but they're gradually getting worse. I don't see the distinctive dark spots again.
Now for the hospital tank issue. It's a 29 gallon and we put in an Emperor 280 filter with a Biowheel. Last time we put him in, 8 hours later there
was a terrible ammonia spike and he was cowering in the corner with alerting spots. Surprise, hospital tanks need to cycle too (stupid). We were cocky when the white spot went away 2 weeks ago and just let it run and didn't track the hospital tank. The temp was VERY low and now, after a 5 gallon water change, ammonia is .1 and nitrite is .01. Can helpful bacteria grow in very cold water? 
<Yes... though more slowly, and with lower metabolism>
I don't want to leave him unattended in that tank but what are our choices? 
<At this point, not many... to return the fish to the main tank, lower temperature (to allow weight gain) and lower still the spg (to about 1.015)...>
I'm getting desperate. On your web site, you say that tangs need to be allowed to feed continuously. Given that algae won't grow in the copper treated tank, what are our options? How can we give him food when we're not there? Last time we tried to copper him, he still ate a lot.
<As stated, I would return the Naso to the main tank, feed human-intended algae from a feeding clip (mounted near the surface)>
People told me damsels are not very vulnerable to this. 
<Not so... wide range of susceptibility, some very much so>
Is the fact that one of them has it a bad sign that this disease is pernicious? 
<Not necessarily>
If we take all the fish out and put them in copper, will the live rock house the parasites?
<Yes... for a period of time... your system has these parasites as well as the fish hosts...>
Finally, we got Cupramine. Last time we added the specified amount to the specified amount of water and the measure on our kit was low. Is Cupramine (nonchelated copper) harder to get and keep at therapeutic levels or could it be that our kit is off?
<Both... copper does not stay in solution in the alkaline environment of saltwater in any format...>
This is very very painful. Thanks for being there. Allyson
<Return the fish, lower the spg... and let's hope that the combination of the ich-impugned environment, use of cleaners (they may not make the transition to lowered spg) and vitamin feeding do effect a cure here. Bob Fenner>

Re: white spots again
Wow! What a prompt response. Thanks.
Let me clarify. We have not yet put him in the hospital tank for fears of another ammonia spike. Can we just put him in there for the several hours that we are home and return him to his tank when we go to work in the morning? Or are the transitions more dangerous than the cure? We could consider it a prolonged "dip" to give him an edge on the fight.
<Moving this fish is not a good idea... very stressful... I would leave in place>
You suggested "human intended algae" on a clip. He's refused Nori in the past (great idea). Any specific brands? We have lots of green algae in the main tank which is why I'm reluctant to remove him.
<No specific brands... the "Red" algae (like Porphyra species) though they look green when prepared, are best>
Do you think he's eating less because of the heat??? Man, that's so simple.
<Yes... and its metabolism is being accelerated by the same...>
We can reduce the heat. How low a salinity do you think the shrimp and hermit crabs can tolerate (1.015)? 
<More a matter of how quickly than how low... do trend down a half to a full thousandth maximum in any 24 hour period>
Right now I just wish I had a bare tank I could copper. Everyone on the list server poo-poo'ed the idea that tangs and invertebrates were incompatible (I think Dakin said that)...
<Very surprising... Nick knows better>
This stuff is all consuming...Thanks again for being there.
<Agreed, stick with your plan... you will be successful. Bob Fenner>
Allyson

Re: white spots again
Bob,
I stopped by our Japanese store. Found lots of "kombu" which is dried kelp (which he would not touch).
<This is mainly a matter of familiarity... our tangs eat kombu... but not for a few days to weeks...>
<No specific brands... the "Red" algae (like Porphyra species) though they look green when prepared, are best>
Are there any warning signs to look for where we'll have to copper him? 
<Yes, levels with test kits are useful, but the animals appearance and behavior are paramount... rapid breathing to labored, sulking in corners, the bottom, blanching with white large areas on its sides (Much like the animal looks in early morning with the lights off/on)... are signs that there is too much exposure.>
How long should we wait? If he has trouble breathing, is it too late (he doesn't--yet).
<Not necessarily>
I lowered the temp to 82 and he is eating well again.
<Yes. Bob Fenner>
Allyson

Re: white spots again
Sorry, I might not have been clear. We're leaving the little guy in the main tank and feeding him as much as we can and slowly lowering the salinity. We love our invertebrates (hermits and cleaner shrimp) so we're watching them carefully. The Naso tang with white spot ate less today and I'm getting nervous. He's a fussy eater but I'll keep trying the kombu.
Perhaps I can just leave it in the tank and hope he'll try it. 
<Also try strips of Nori... soaked with a little Selcon, Zoecon, vitamin prep.>
Our damsel with a little white spot looks like his fin is being eaten a bit. He's an aggressive fellow so out doubt it was from another fish. Do you think we should copper him or hope that the lowered salinity will take care of things.
<Hard to judge from this end of the keyboard... would leave it/s/he be for now. Bob Fenner>
Al

Ich again <I'm not so sure>
Hi Bob,
I don't know if you remember, but I wrote you a couple of weeks ago concerning my fears of getting ich again (I was the one with two tanks, a 30 and a 75 gallon which was devastated by ich). 
<Yes, I remember>
Any ways, as you recall I had coppered the tanks and have kept them coppered for about six weeks now. I was going to remove the copper and eventually add live rock, but now I have noticed that my purple tang has several white spots on him.
<These may not be "ich"... more likely symptomology of the treatment... you could make a smear slide of the fish's body coating and look under a microscope. The "white dots" that people see with ich (both freshwater and marine) are likewise not the protozoans themselves by the mucus produced by their host in response to their presence...>
I don't understand it! I have been diligent keeping the copper level at 0.15ppm often measuring copper levels twice a day. Could the parasite have developed resistance?? 
<Not to copper, no>
Furthermore, I gave the tang a fresh water dip, but he started to go crazy after less then two minutes so I put him back in the tank. None of the parasites came off. Should I try to dip him again tomorrow? 
<Not if it were mine. I'd place the fish with cleaners and leave it as such>
He is really stressed out right now! To make matters worse I am expecting a fish in the mail tomorrow ( flame angel) and my quarantine tank is leaking like a sieve. What should I do? 
<Place a bag in it as a temporary fix... maybe two bags thick, one inside the other... trash can types...>
In five years with the 30 gallon I have never had a problem, but I've had nothing but problems with the 75 since I got it. I don't want to give up but its becoming a money pit if you know what I mean. If I could just get it stabilized it would be beautiful!
Thanks again for your help. It is great to have someone like you to go to in these situations. Much appreciated!! Jeff
<As stated, I would "take the risk" and replace the fishes, including the Purple Tang with cleaners... band-aid the leaking Q-tank, and place the Flame there. Good luck my friend. Bob Fenner>