Ick or something else?

I have a 29 gal tank that recently got some kind of outbreak. I noticed it about 2-3 days ago and I immediately started ick treatment with coppersafe. It started as a couple spots on the tops of their dorsal fins and back. As of today, some of my cherry barbs (8 total) are looking better, but others (especially the males) are now completely covered. They're still eating well, and I turned the temp up to about 81-82°F. I don't know what this is and I'm somewhat new to the hobby, so any help would be greatly appreciated. I added a picture of one of the males.

It could be a thing called Epistylis. You can look that up and get images for comparison.

It could also be a serious outbreak of Ich. Coppersafe is a proven but harsh med. I would check option one, and since you have already dosed, follow the instructions to the letter. Ich doesn't die easily, and it's a tough creature. It can take some time to kill it.

Doesn’t look like Ich to me. Ich spots are all the same shape and size. I’d go with epistylis, especially if the tank is low-flow. If it is epistylis it’s feeding on a bacterial infection on the fish. Treat it with a bactericide and the epistylis (a protozoan) will leave the fish.

I highly recommend reading this post written by a person who works on/studies fish parasites. It's long and detailed, but is amazingly informative for diagnosing ich vs epistylis.

I will give you a rough, short answer for your specific case, but I implore you to read the post I've linked, as it will have more, necessary information.

Epistylis is generally only an infection that arises in fish that you've already had for a while. Ich is an introduced pathogen. If you introduced fish any time within the last month, it's most likely ich. Also, contrary to misinformation, ich spots are often raised, they can be different sizes, not perfectly circular, and can occur on the eyes. Even if you can't diagnose with positivity, it's best to treat with an ich medication, since many of them can also treat early stages of epistylis. Additionally, ich is much more deadly than epistylis, so if you're having trouble diagnosing, it's best to treat for the more deadly disease first.

Ichthys said:

Doesn’t look like Ich to me. Ich spots are all the same shape and size. I’d go with epistylis, especially if the tank is low-flow. If it is epistylis it’s feeding on a bacterial infection on the fish. Treat it with a bactericide and the epistylis (a protozoan) will leave the fish.

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I recommend you read the post I linked. Ich spots are not always uniform in shape and size.

You can find papers that say whatever you want if you look hard enough, all written by people who study fish parasites. I prefer the ones that say Ich cysts are all the same size and shape, because in aquaria that’s nearly always the case.
Epistylis and a few other skin infections are very often misdiagnosed as Ich, and papers like the one you linked only exacerbate these misdiagnoses, imo.

It is true that Ich meds will also kill epistylis, since they’re both protozoans, and it is a valid treatment if in doubt, but with epistylis you also have a bacterial skin infection to treat. Treating that means you don’t need to kill the epistylis, which normally lives harmlessly in tanks and only attacks bacteria.
A fish arriving with bacteria on the skin will suddenly get epistylis if it was present in the tank.
(If there’s any white ‘fluff’ or little white tufts on the glass in any low flow area, that’s epistylis).

Ichthys said:

You can find papers that say whatever you want if you look hard enough, all written by people who study fish parasites. I prefer the ones that say Ich cysts are all the same size and shape, because in aquaria that’s nearly always the case.
Epistylis and a few other skin infections are very often misdiagnosed as Ich, and papers like the one you linked only exacerbate these misdiagnoses, imo.

It is true that Ich meds will also kill epistylis, since they’re both protozoans, and it is a valid treatment if in doubt, but with epistylis you also have a bacterial skin infection to treat. Treating that means you don’t need to kill the epistylis, which normally lives harmlessly in tanks and only attacks bacteria.
A fish arriving with bacteria on the skin will suddenly get epistylis if it was present in the tank.
(If there’s any white ‘fluff’ or little white tufts on the glass in any low flow area, that’s epistylis).

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I'll concede that it's possible for an epistylis infection to occur in a new fish if it already had a bacterial infection upon introduction.

However, picking and choosing which narratives you like best is not appropriate if your aim is to seek the truth of a subject. Many of these papers discuss fish which are kept in laboratories. Those are definitely aquaria too, but I assume you mean home aquaria. Do you have sources that state ich is nearly always uniform in size in home aquaria as opposed to laboratory aquaria? I'm genuinely curious. What distinction is there to be made between home and laboratory aquaria that would meaningfully affect the growth of a well-known parasite? I'd genuinely be interested to read the papers you've found which say ich cysts are all the same size, because if there is a distinction between ich found in home aquaria vs laboratory aquaria, that's quite notable.

One thing I can provide are images. I'll include one from Buchmann (2020) of an Ancistrus with ich.


I'll also include a couple from a non-literature source. These are definitely ornamental fish kept in home aquaria.



The second two cases are very likely to be ich. In the case of the Ancistrus, it is known to be ich because it was in a laboratory setup where it could be tested. In all of the photos, the cysts present with a variety of sizes, and are not perfectly circular. At the end of the day, epistylis is something that can really only be diagnosed with certainty by using a microscope. The same goes for ich, to be honest. Microscopes are expensive, and so most hobbyists don't have them. But ultimately, you can't make any firm diagnosis from a photo. Without microscope images, it's a guessing game. Sometimes it's educated guessing, but it's guessing nonetheless.

Buchmann paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507210/
Source for the second two photos: https://fishlab.com/freshwater-ich/
(I'm not vouching for the fishlab source, just using it for a couple of its photos. It's imperfect, as most online articles are)

Post pictures of the remaining fish.

Did you add anything new to the tank in the 2 weeks before this started?

How often do you do water changes and how much do you change?
Do you gravel clean the substrate when you do a water change?
Do you dechlorinate the new water before adding it to the aquarium?

What is the ammonia, nitrite, nitrate and pH of the aquarium water (in numbers)?
What sort of filter is on the aquarium?
How often and how do you clean the filter?

Have you got carbon in the filter?
If yes, this needs to be removed so it doesn't adsorb the medication.

Seisage said:

However, picking and choosing which narratives you like best is not appropriate if your aim is to seek the truth of a subject.

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Couldn’t disagree more with this statement. Science is all about questioning everything. Papers are often disproved, or at least proven to not be the whole picture. A paper should never be blindly believed, and many scientists disagree with the established “facts”. “Picking and choosing” is what drives scientific advancement.

I don’t have any links to papers on fish diseases.

I’m not refuting the fact that Ich cysts can vary, but I cannot remember any verified Ich in my experience where the cysts were not identical(ish), so I think it’s a great starting point for guessing without a microscope.

Today... For less than a tank of gas...

You can get a nice little compound microscope 100-2000x with filter lenses and phone adapter.

Ichthys said:

I think it’s a great starting point for guessing without a microscope

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I agree with @MaloK. For the price we should get microscopes, if we are serious about caring for our fish. I use a 10-80 dissecting scope for a number of fish related tasks, examining substrates, protozoans in the tank etc, and find it very useful. I am thinking of getting a compound scope, though I wouldn't go too cheap as it is easy to provide 2000 times magnification it is difficult to get that range clear without chromatic distortion, I would probably not get anything that requires oil immersion so likely would stay to a max of 750 to 1000 times.

In regards to the image from the original poster, the spots look very similar to Ich outbreak I had about 5 or 6 years ago that came in with some rams I picked up. I was just starting a tank so they did not go into quarantine. But when I examine the image provided, along the lower edge I see gray protrusions from the bottom of the fish these could be Epistylis. I think it is possible to have both conditions, though I am no expert on fish diseases. In either case your fish looks pretty heavily impacted.

All the literature I have read on Ich suggests that the trophonts can be different sizes. I believe they mostly appear the same size because when the disease is introduced it quickly spreads to the other fish resulting in a generation that has started at the same time. Whereas if the disease starts slower you could end up with different generations of the disease on the same fish. Most experienced fish keepers would notice the behavioral differences of their fish quickly so I believe often it is caught soon.

I found the following paper interesting but easy to read, it has a photo of the trophonts on the gills of a fish that show quite a size range. https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/tomont

By the way your photo is pretty good.

Uberhoust said:

I agree with @MaloK. For the price we should get microscopes, if we are serious about caring for our fish. I use a 10-80 dissecting scope for a number of fish related tasks, examining substrates, protozoans in the tank etc, and find it very useful. I am thinking of getting a compound scope, though I wouldn't go too cheap as it is easy to provide 2000 times magnification it is difficult to get that range clear without chromatic distortion, I would probably not get anything that requires oil immersion so likely would stay to a max of 750 to 1000 times.

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I have 3 at the moment 2 portable that are 40-60x and 60-120x they are perfect to observe small crustacean like pods and the like (you can stick them right on the glass of the tank) and a cheap compound one, that is pretty impressive I must admit... It's a lot better than the one I had in the 80's and still used for 30 years.

Colin_T said:

Post pictures of the remaining fish.

Did you add anything new to the tank in the 2 weeks before this started?

How often do you do water changes and how much do you change?
Do you gravel clean the substrate when you do a water change?
Do you dechlorinate the new water before adding it to the aquarium?

What is the ammonia, nitrite, nitrate and pH of the aquarium water (in numbers)?
What sort of filter is on the aquarium?
How often and how do you clean the filter?

Have you got carbon in the filter?
If yes, this needs to be removed so it doesn't adsorb the medication.

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I appreciate the help but I just got off work and they're all dead besides one, and it looks so bad I'm just going to euthanize it. I did add a pair of Nerite snails recently, which is probably where it came from. I was doing a water change every week or so before they got sick. After I noticed, I'd do a water change every day to every other day. I didn't have carbon and I'd clean my sponge filter every water change. I still have no idea what it was cause the ick medication that I've been using did nothing, and when I increased the temp it got worse.

MaloK said:

Today... For less than a tank of gas...

You can get a nice little compound microscope 100-2000x with filter lenses and phone adapter.

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A tank of gas/ fuel is expensive here. It costs me $140.00 to fill my 4 cylinder hatch and it only has a 40 litre fuel tank.

Did any of the fish rub on objects in the tank?
If not, then it might not have been white spot. The Ichthyophthirius parasites cause fish to rub on objects.

Warm water speeds up the parasite's lifecycle and if the temperature was between 26-29C (79-84F), the parasite would have developed really quickly and spread within a few days. The parasite dies at temperatures of 30C (86F) and above.

I'm not sure if you did this but you should always increase aeration/ surface turbulence when raising the temperature or using medications because these reduce the oxygen level in the water. Increasing aeration helps to maximise the oxygen level and reduces the stress on the fish.

Colin_T said:

Did any of the fish rub on objects in the tank?
If not, then it might not have been white spot. The Ichthyophthirius parasites cause fish to rub on objects.

Warm water speeds up the parasite's lifecycle and if the temperature was between 26-29C (79-84F), the parasite would have developed really quickly and spread within a few days. The parasite dies at temperatures of 30C (86F) and above.

I'm not sure if you did this but you should always increase aeration/ surface turbulence when raising the temperature or using medications because these reduce the oxygen level in the water. Increasing aeration helps to maximise the oxygen level and reduces the stress on the fish.

Click to expand...

I never caught them rubbing on anything, just glass surfing a lot or just float at the top/lay still at the bottom. I did increase the aeration, but I was scared to turn up the temp to 86°F because I didn't know if that would harm them or not.