So this is the full guide I use now. Some folks will begin with a FW dip but i think that is pretty stressful. My current setup is a 30 gallon long, with a reliable heater, a couple of cheap powerheads, a Seachem Tidal 55 hang on filter with just filterfloss in it, PVC pipe for the fish to hide, a seachem ammonia alert badge, and since I had an extra one laying around - an ATO. I siphon out up to a gallon of water a day and replace that gallon of water with replacement seawater. For the first month, the replacement seawater has the same concentration of CP as the original tank had. I then run a few days of carbon between the CP and Prazi treatments in the hang on filter. I was using a small skimmer in the QT tank but it really didn't do that much so I no longer use one.
Here is my blueprint for treatment in detail based on what Humblefish provided me:
TREATING WITH CP:
Chloroquine phosphate: Treats Ich (Cryptocaryon irritans), Marine Velvet Disease (Amyloodinium), Brooklynella hostilis & Uronema marinum.
How To Treat - Chloroquine phosphate (CP) is a “new drug” that actually was widely used to control external protozoa in saltwater aquariums back in the 70s & 80s. It was even used in some aquarium medications sold at LFS. Nowadays CP requires a prescription to purchase legitimately, making it more difficult to obtain. Fast forward to today and thanks to the power of the Internet, CP has come roaring back! The biggest obstacle to overcome is obtaining pharmaceutical grade 99% pure CP. I cannot stress the importance of this enough. Do not buy it from some guy on eBay or even an online vendor. The only way to be sure you are getting 99% pure CP is to get your vet (or an MD) to write a prescription which can then be filled by a compounding pharmacy.
CP is a “one and done” medication, meaning you dose once and that’s it. There are no test kits for CP, so it’s important that you dose accurately using a digital scale. Also, don’t forget to dose any replacement water (from water changes, but not top-off) with CP. The dosage rates are as follows:
Prophylactic treatment is 40 mg per gallon.
For active infections (visible symptoms present), I typically will up the dosage to 60mg/gal. However, I cannot say if this is anymore effective than the "standard" 40mg/gal dose.
For Uronema marinum and really bad infestations, you can dose up to 80mg/gal. However, I have noticed appetite suppression and lethargy at this concentration.
As you can see, there is quite a bit of wiggle room between the minimum & maximum dosage. Practically speaking, 40mg/gal will treat all external protozoa issues… its just that the higher dosages may get the job done a little faster. Treatment lasts 30 consecutive days, and no carbon, UV, etc. may be used during this time (although it can be used later when you wish to remove the medication from the water.) A little quirk about CP is that light will degrade it; however it appears this mainly applies to the powder itself, so store your CP in a cool, dark place. Once in water, you may use an aquarium light with CP - however fish with velvet are light sensitive so I would only use ambient lighting (ex. lamp across the room) if treating for that. CP is NOT reef safe. In addition to killing your corals, it is a very strong algaecide.
Pros - Gentle on most fish (see DO NOT USE list below), a “one and done” medication that treats most external protozoa. CP is the closest thing there is to a “wonder drug” in our hobby.
Cons/Side Effects - Expensive, hard to get (requires a prescription), powder is heat & light sensitive - so store in a cool, dark place. Attempts to feed CP laced food are usually not successful due to its bad metallic taste.
** Based upon anecdotal experience (mine and others), DO NOT USE CP on Anthias, Wrasses or Hippo Tangs. For the time being, chelated copper (exs. Coppersafe, Copper Power) is the best alternative to use on these species. **
** Finally, a place to buy Chloroquine:
https://www.reef2reef.com/threads/a-place-to-buy-chloroquine.252610/ **
** Special thanks to @svogun for providing this link, which can be used to find aquatic vets in your area for sourcing CP:
Aquavets Online portal for finding aquatic veterinarians and diagnostic labs **
TREATING WITH PRAZIPRO – before or after CP
Prazipro (praziquantel): Treats flukes, black ich, and some internal parasites (worms).
How To Treat - In either a quarantine or display tank, dose Prazipro at the rate of 1 teaspoon per 20 gallons of water. DO NOT OVERDOSE (especially with wrasses), try not to mix with other medications (for various reasons), and provide additional gas exchange while treating with Prazi. Wait about a week, do a 20-25% water change and then repeat dosage. The reason for the second dose is to eradicate the “next generation” of worms before they can lay eggs of their own. Because while Prazi does kill worms, it doesn’t eliminate any eggs they might leave behind.
If you are treating a known prazi sensitive species (ex. wrasse), you can run carbon or perform a water change 24 hours after dosing in order to limit exposure time. While praziquantel does remain active in the water column for up to 72 hours, only 24 hours are needed for it to eradicate external worms. Don't forget to still do the second round though!
Prazipro is generally considered reef safe, although it may kill any tube worms/feathers dusters you have. It may also eradicate bristle worms. If you have mass quantities of these, the resulting die-off can lead to an ammonia spike. After treatment is done, activated carbon may be used to remove any residuals (if you need to use a different medication next). If using a protein skimmer post-treatment, be advised that it will “over skim” for at least a couple of weeks.
Pros - Reef safe, effective dewormer that is relatively gentle on most fish.
Cons/Side Effects - Mild appetite suppression, moderate oxygen depletion, wrasses are sensitive to overdosing.
Edit: You can use this treatment calendar to determine when is the best time to add the second dose of Prazipro:
Marine Parasites
ANTIBIOTICS
Antibiotics: Treats bacterial infections, which are oftentimes “secondary” to preexisting parasitic (and worm) infestations.
How To Treat – Follow the directions on the label of whatever product you are using. Always use a broad spectrum antibiotic medication i.e. one that treats both gram-positive and gram-negative bacterial diseases.
The following are medications I have experience using which contain wide spectrum antibiotic(s):
• Nitrofuracin Green Powder
• Seachem Kanaplex
• Furan-2
• Triple Sulfa Powder
• Maracyn 1 (erythromycin) + Maracyn 2 (minocycline) used in combination together
When battling a severe bacterial infection, combining Furan-2 + Kanaplex + metronidazole (ex. Seachem MetroPlex) can be both effective and safe.
The following are medications I have no experience using but these still contain wide spectrum antibiotic(s):
• Seachem Neoplex
• Seachem Sulfaplex
• Maracyn Plus
When using antibiotics, it is very important to treat for 10 consecutive days. Follow the instructions on the label - which may say to dose every 24 or 48 hours, do water changes, etc. But use the product for 10 continuous days (as directed). Sometimes a fish will look & act better after just a few days of treatment; however the infection can return if you end treatment prematurely. Or sometimes the opposite will happen, as antibiotics can be notoriously slow acting with fish. If a fish shows no signs of improvement after 10 days, then it’s time to try a completely different medication. Just like with humans, sometimes a certain fish will respond better to a different antibiotic. Or you have to find the proper antibiotic which will successfully target the offending bacteria. The latter is best accomplished by taking a skin scrape of the affected area(s) and identifying the harmful bacteria/infection on the fish's skin by using a microscope.
For internal infections, it is best to soak the fish food in an antibiotic such as Kanaplex. However, you'll need to use a binder, such as Seachem Focus, to prevent the medication from leaching out into the water. (The ratio is 1 scoop of Kanaplex + 1 scoop of Focus per 1 tablespoon of pellets or frozen food.) This approach will sometimeswork on external infections, but for those it is better to treat the water in a quarantine tank as outlined above.
Pros – Can be mixed with other medications; however still watch out for a bacterial bloom (cloudy water), especially when combining with Prazipro.
Cons/Side Effects – Suppresses appetite, depletes the water of oxygen (so provide additional gas exchange).
