Some confusion on directions after medication

[Kaidonni]

Here in the UK I've finally been able to get my hands on a product containing Levamisole Hydrochloride, Chanaverm. Now, I recently used Fluke-solve (~168mg) on the 13th January, and conducted an 8 litre water change (replaced with 10 litres) on the 20th. Tank can take up to 50 litres, it's at 44 (I plan on increasing it...didn't realise it was that low). I emailed the company that manufactures both products, and they advised that, if I can, to wait a little longer for the Fluke-solve levels to go down (a couple more water changes should do that, they said) before dosing with Chanaverm. Here is confusing part - they advised to leave the Chanaverm in for a minimum of 24 hours, and even up to a week before any water changes, but also a major gravel cleaning after dosing is a good idea...but to do a gravel clean and extract any paralysed parasites, won't I end up *removing* water in the first place?

[mattyd]

A gravel vac will remove water, but that is okay, since it doesn't really remove that much water by comparison to how much is in a normal size tank.

my recommendation:

Do a water change, as per normal.
Dose with the de-wormer stuff.
Leave in for 24 hours.
Do a gravel vac. Top up the water, or leave it at the lower level.
Wait a few more days, then do another gravel vac and take the water level down to your normal water change water level. Top up the tank, as per normal water change.
Leave the tank for 3-5 days.
Dose again, repeat above steps.

[Kaidonni]

My plan was to dose tomorrow morning in case anything goes wrong (I'll have time to respond during the day...if I dose tonight after a clean to remove some more Fluke-solve, I don't think I'll want to be doing anything at 1am!) Then, Sunday afternoon, a 15-litre change (replaced with 10-11), same on Monday, then a top-up of 8 on Tuesday to get it back to normal levels (with no more removed). Then, possibly a 10-litre change just before the next dosing. I'm somewhat unnerved by all the water changes (I do use dechlorinated water), and stressing the fish out.

[mattyd]

I guess if you do your water changes really slowly and ensure the water is well oxygenated with lots of bubbles or lots of water movement then you are unlikely to have too much go wrong.

If you are worried, maybe just dose 1/3rd the amount first off, then 1-2 hours later dose the next third, so that by midday you have given them a full dose, but also given yourself time to see if 1/3rd or 2/3rds has caused the fish any concern (it probably won't, well it never did in my tanks).

[Diana]

General instructions for many meds, but probably not all meds:

When the treatment is complete, and you are ready to remove the medicine:
Do as large a water change as you can. 50% is commonly suggested. Include vacuuming the substrate. If you cannot have that much water available all at once you can do several smaller water changes back to back, or a few hours apart. Just remember that doing 2 water changes of 25% is not the same as a single 50% water change. The second 25% water change is removing somewhat diluted medicines. If you can do 50% water changes, then do two of them, twelve hours apart.
Add activated carbon to the filter.

More concepts about some medicines. These ideas do not apply to all medicines, so if the label directs you to do something different, follow the label directions.

Many medicines work by attaching to almost any sort of organic matter the contact. If the tank is overdue for a cleaning, or there is debris built up in the filter, then thorough cleaning before dosing is a very good idea. I know this is valid for Melafix and Pimafix, also many antibiotics. I am not sure about medicines for internal parasites. Still, it sure cannot hurt to have the best possible water parameters while the fish are under stress from some sort of infection.

Some medicines are deactivated or removed from the water by other treatments that we might be doing with the tank. Obviously water changes dilute the medicines, and most medicines specify that activated carbon needs to be removed from the filter. Here are some more hints:
Many medicines break down in the light. Common lighting included with most aquariums is not usually bright enough to cause a problem, but the higher energy lighting over a planted tank might do this, and I would turn off an Ultra Violet Sterilizer unless I knew for sure it was OK. (UV is OK with salt). For another reason it might be a good idea to reduce the lighting over the tank. Fish are less stressed in dimmer surroundings. This is not good for a planted tank, though. Perhaps dosing at night, just about the time the lights go out will maintain the medicine at higher levels, if it would break down in the light.
Some medicines are based on dye. Some dechlorinators will lock up or break down the dye. Read the label on both the medicine and your dechlor. Amquel and Amquel Plus say right on the label not to use with dye based meds. Many Ich meds are dye based.

Some medicines are more active at certain pH levels, and the dosing may be based on the pH of the water. Do enough research, and test your water to be sure you are dosing at the correct rate. It sure is not impossible that other meds may react with some other water treatments, so be sure to research the products you are using (aquarium plant fertilizer, water chemistry materials, pH adjusters, algae killing chemicals, other) and the medicine to make sure that it is safe.

Medicating fish (or anything else) is often based on the concept that a particular dose will kill the disease organism or parasite while doing the least harm to the fish. This does not mean 'NO harm'.
Do not combine medicines unless both are labeled for use with each other. If you use 2 meds that have a similar low level of harm to the fish when used separately it is quite possible that the combination will cause too much stress or even kill the fish.

Some medicines may cause changes in the water parameters for example reducing the oxygen. Also, fish under stress may not respire like they normally would. Either way, increasing the aeration in the tank is a good idea for sick fish.

Make sure you know the actual capacity of the tank and filter. Dose based on the actual volume of water, not some arbitrary name the tank has. If you have a lot of rocks in the tank they can take up a significant volume of space, so there is less water in the tank. At least once in the life of the tank figure out as accurately as you can the real volume.
One simple way (before fish are added) is to fill the tank from a known container, or drain the full tank into a known container.
Remember that an external filter (HOB, canister or sump) will hold some water, and include that in your calculations.

[Kaidonni]

I've dosed around 5-5 & 1/2ml (6ml for 45 litres). Just have to wait and see now. The fish specialist did originally suggest combining the treatments, and I informed the manufacturer of my tank's capacity, the dosage of the previous med, and the water changes conducted since, and they said it should be sufficient. I have emergency water on standby, plus I have carbon filters around if need be. The only other product I use is Nutrafin Aqua Plus to dechlorinate tap water for 24 hours.

[Kaidonni]

Well, it's now almost 26 hours after dosing and I can't say I've seen any of those worms in the tank (knowing my Clown Loaches, they ate them ). I'll try moving the castle that they hide in to check if there are any in there, but if I vacuum no worms out of the gravel...

I also dosed 5 to 5 and 1/2 ml to be completely safe (hoping that under-dosing hasn't messed up the treatment). I keep forgetting to check how much volume the filter takes up, but even so, the tank is currently in the 40-44 litre range. I am aware I need to rehome the Clowns, which I will be doing after the current crisis has been resolved (I have OCD, and have been so terrified of moving them these past years since an emergency evacuation to the tank a few years ago, which they somehow survived without so much as Ich despite great stress). Only the one Clown Loach is affected *touch wood*, and I can't say it's definitely parasites (it could be bacterial, as a Minnow who vanished was also wasting away, and didn't appear to have anything protruding from the anus).