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Out, Damned Spot!

Lady Macbeth: Yet here's a spot.
Doctor: Hark! She speaks. I will set down what comes from her, to satisfy my remembrance more strongly.
Lady Macbeth: Out damned spot! (Macbeth, V.i.)

Out I say! (V.i.)
Unfortunately for Lady Macbeth, words alone would not remove the spots from her favorite pet piranha. And her doctor really should have told her so, before she got a little too emotional about the whole situation. So what WILL do the job?

There you are sitting at home, staring at your tank, watching your new fish swim this way and that, when all of a sudden you see it. No, them. The spots!!! You know they are probably bad. But what are they, and what should you do? If you don't remember whether the fish had them before, they could be a number of different things. . . .

If you are like a lot of people, you recognize the fact that these spots could be Ich. But you should also realize that the white spots could be several other things. And do you know what Ich really is or how it lives? (Contrary to popular belief, "Just like Robert Stagno" is not the right answer).

Good things by day begin to droop and drowse. While night's black agent to their preys do rouse. (III.ii)
Hmmm . . . let's see . . . could it be . . .

Lymphocystis?
What the ?#**/@ is Lymphocystis, you ask? Lymphocystis is a viral disease of fish. Lymphocystis virus causes infected cells to become so big that one single cell may be larger than one millimeter! Usually Lymphocystis only effects the skin or fins of a fish and appears as small nodules, often grouped in a larger cluster. This disease tends to be self-limiting, meaning that over time the fish will rid itself of the disease and survive. Often times even the largest of nodules will fall off after weeks or months, and the fish will appear normal again. Lymphocystis can spread rapidly both on the fish and within the tank among the same species. There are presently no known treatments for Lymphocystis. Although many fish can get this disease, it is fairly common in, among others, painted glassfish and scats.

Encysted trematodes?
Encysted trematodes are juvenile stages of a worm/fluke which become encapsulated on the host fish as part of their life cycle. Usually the fish is considered only one of a number of hosts, i.e. animals which carry the worm during developmental or mature stages of its life. The final host is the animal in which the worm will become mature and reproductive, being something which will eat the fish, such as a bird (these particular worms are often called "bird worms" for this reason). Usually the fish has been infected in the wild or on the farm where it was raised. There are no known treatments for encysted trematodes other than surgical removal, and the disease does not spread under usual aquarium conditions.

Myxosporidian parasites, such as Henneguya?
Henneguya and its relatives are frequently seen as cysts or nodules on the skin or gills. These nodules or cysts can be small (microscopic or less than a millimeter) to as large as several millimeters in diameter. If these cysts are disrupted, you may see whitish almost pus-like discharge. In some cases, Henneguya lesions may slowly disappear. These parasites have a complicated life cycle and are not spread easily within an aquarium. Usually there is no major harm to the fish except for damage to its appearance. However, if lesions are extensive enough and in the right place, such as a very heavy load in the gills, then the parasite may be a problem. Many different species can be and are affected. There are no known treatments for this, other than lancing the cysts and treating the resulting wound topically.

Epistylis or related protozoans?
Epistylis is a ciliated protozoan which microscopically resembles a contrasting vase on a stalk when viewed with the naked eye, groups of Epistylis areas on the fish. Epistylis normally is found attached to vegetation or crustaceans, but under conditions of stress and in very organically rich waters such as ponds, it can be a problem. These parasites actually are filter feeders, taking food out of the water. The actual damage they cause to the fish is due to their method of attachment through the skin of the fish, which often becomes secondarily infected by bacteria. I commonly see tufts of Epistylis on catfish which have undergone some sort of net trauma, usually to their dorsal or pectoral fins, but also on the rest of their bodies. Formalin treatments and clean water often are enough to cure fish of this disease, although antibiotics for secondary infections may be warranted.

Mucus or skin cells?
Sometimes excess build up on parts of the fish are due to stress or some other cause may appear to be spots or nodules.

Double, double, toil and trouble . . . (IV.i.)

Okay, okay, let's get to your favorite and number one choice - Ich. Ich is probably the most famous of all fish parasites. Its full name is William Shields, oh, I'm sorry, I meant Ichthyophthirius multifiliis. The marine relative, the cause of saltwater Ich, is Cryptocaryon irritans. Ich is a ciliated protozoan parasite, one of the largest. All freshwater fish can be affected by Ich. Ich generally become a problem under times of stress. This stress can be any number of causes: a sudden drop in temperature, deterioration of water quality, or shipping and transport stresses. In these instances, the immune system of the fish is compromised, allowing Ich to infect the host rapidly.

Ich has a somewhat complicated life cycle. In the free swimming stage known as tomites, the parasite burrows under the skin, becoming encysted, and as an adult of theront, feeds on the host. At this stage, it is considered untouchable. No treatments can kill this stage of the Ich life cycle very easily, since encysted organisms are very well protected. When the time is right, these adults will come off the host and drop to the bottom of the tank, attaching to gravel or tubing. They are then called trophonts. These trophonts divide and within 18 to 21 hours at about 75 degrees F, hundreds of free swimming tomites are released into the water column. These tomites must find a host and penetrate the skin within 48 hours or they will die.

The entire life cycle is temperature dependant. It may take three to four days for the parasite to develop on the fish at 72 degrees F or it can take as long as a month at 54 degrees F!

Fire burn and caldron bubble . . .

Knowing the life cycle of the parasite makes treatment more understandable. Because the life cycle is temperature dependent, we usually try to increase the temperature to speed up the life cycle. This allows the untouchable adult stages to reach the treatable tomite or free-swimming stages more rapidly. Most treatments on the market include formalin and/or malachite green. Treatments which have formalin and malachite green in combination are the most effective. Formalin treatments are at 25 ppm (milligrams per liter) as an indefinite bath and malachite green treatments are 0.1 ppm. Treatments are generally given every other day, with major water changes in between times after about four to eight hours. Usually about three treatments are necessary. As with all bath treatments, it is important to remember to remove carbon filtration and not to pull medication through an under gravel filter, if possible. Formalin uses up oxygen in the water so be sure to have adequate oxygination or your fish will be stressed even further. Also, as with all medications certain groups of fish are much more sensitive (i.e., they get worse or DIE) to formalin and malachite combination treatments. Scale-less or small-scaled fish such as pictus, knifefish, elephant nose and tetras are much more sensitive, so extra care and caution should be exercised when treating these species.

Cryptocaryon irritans has a life cycle similar to Ich although microscopically it has a different appearance. Copper or combination formalin and copper treatments are effective against Cryptocaryon.

So, you ask, Roy, what is your point? Here it is . . . .

White spots often times are Ich, BUT NOT ALWAYS! So if you have been treating a fish for Ich and it doesn't seem to be getting better, you may not have Ich as a problem (assuming you are treating properly for Ich). Also, just because your fish is sick, doesn't mean it has Ich. Double check water quality, reduce other stresses, provide adequate nutrition. Finally, just because you don't see white spots, it doesn't mean your fish doesn't have Ich, Ich can be (although rarely) just in the gills or if the fish is white or pale anyway it may be difficult to see.

Over medication and improper medication will harm your fish and aquarium. If you're not sure, ask someone who knows. If possible, become familiar with using a microscope or find someone who has one and learn how to use it. You don't have to kill the fish. A gentle scrape or small tail or fin biopsy or gill clip seen under the microscope will be very helpful in determining what your problem is. Flourish. Exeunt Omnes. Finis.