Testing the Efficacy of Disease Treatments

[Frisco]

Another thread about the use of garlic to treat white spot prompted me to start this thread - anyone interested in reading it can use this link: http://archive.reefcentral.com/vbulletin/showthread.php?threadid=10003

I'm didn't start this thread to discuss the merits of any of the commonly promoted treatment options; instead, I thought it would be good to have a simple discussion about the things involved in setting up some sort of test to understand the efficacy of the treatments that many of us use when a fish comes down with white spots. It sounds like an enormously complicated task with the limited amount of thought I've given it so far. I'm definitely all for helping out to get something initiated and work through the potential details, but we undoubtedly need to think through it thoroughly if it's to provide any useful information.

I should preface my comments by saying that I don't know a whole lot about fish biology, diseases, treatments, or even fundamental testing protocols used in drug development. But it's bound to be an interesting discussion and I'd like to contribute to whatever extent possible, so bear with me when I show my ignorance. :D I'll write some comments up offline and post back shortly.

[john f]

Thanks for starting the thread Frisco.

My previous ideas can be found in your linked thread above.
I still think small tangs would be the best as they seem very willing to get crypto infections.
The idea of damsels has also been advanced but I personally have never seen a damselfish with Ich so I'm not sure they are very likely to contract it.


John

[Frisco]

This thread sure doesn't seem to be getting anybody's attention, so this might just be a quiet discussion between the two of us... :D And sorry for lagging so long in my response; things have been a big busy with work the last couple days... Like I said, I think that this is a great idea that will be very hard to get to produce good results. Specifically, one would seemingly need to have a whole lot of fish to be able to draw any conclusions about any of the treatments, just because of the potential for skewed results due to the small sample size. I would guess that you'd need several hundred fish at a minimum in each testing group, otherwise, you could really get mislead by anomolous results. Just as important, it would seem to be very important to know something about the history of the fish - genetically and historically (species, collection location, transportation conditions, etc) - to be able to know that the results are a good reflection of what we really want to know. For example, is the treatment efficacy related more to the treatment or the fish's immune system condition. Captive raised fish seem like a good idea, because the collection practices and transportation issues presumably aren't as variable as those used during "open ocean" collections. This seems (at first pass) like something more appropriate for an individual that sees large numbers of fish on a regular basis - an importer or wholesaler for example - instead of one of us. I'll ask a local importer the next time I'm back home to gauge his experience with typical treatments...

[john f]

This is the very thing that ticks me of Frisco.
Everyone on the regular board will not hesitate to gush on and on about their treatment of choice and how they are sure it works. Even some well repected names will chime in and speculate on the efficacy of a treatment like Garlic. I have twice now offered my own time and money, in combination with help from others, and none was ever offered. People who have ripped me for mentioning my prefered treatment are silent when I offer to actually put our theories to the test in a more scientific way.
I don't know what to make of this.
Maybe most of us are just lazy and don't want to expend any energy on this type of venture.
I think soon I will simply do a small scale test on my own. I will take digital pictures and record all the data as carefully as I can, and report the results here.
And not one soul had better question my methods or conclusions as they have clearly had the opportunity to be invloved in the process and have chosen not to.

John

[Frisco]

Chill Dude! This is all supposed to be fun... a friendly discussion amongst friends... I'm definitely not trying to tick you off by talking about something that you feel strongly about... :D Not to get dragged too OT but I do want to understand why you seem to have such strong feelings about this... I definitely don't always follow all of the fish related threads on this site (and I definitely don't follow any of the other boards) so maybe I've got the wrong picture of what people seem to imply by the way they phrase their comments based on what I've read... but from what I've seen, people seem to talk about garlic in a very qualified way... I mean, I can't say I've ever seen anyone adamantly arguing that this is a fool-proof method with no possible adverse complications or drawbacks. People generally say that it seems to have worked for them, appears to work in many different cases, appears to be pretty benign, and is worth a try. And considering the potential drawbacks of all of the other prescribed treatments, garlic seems to be a good candidate in some cases IMO. Whether you're talking about garlic, kick-ich, high temps, hyposalinity, copper, or any of the other typical treatments, they all have some drawbacks in certain circumstances and there's never a guarantee that things will work out the way you hope...

I'm more than happy to discuss the idea of the experiment and the things that would be important to make it useful. While I still don't think you're likely to get a really good picture of some of the implications of the treatment, it's bound to be better than nothing and add to the base of knowledge that we're working from. Hit me with your idea for the test and I'll happily play devil's advocate and help iron out the details.

[billsreef]

Hey guys,

Sorry I didn't join this earlier but my free time has been rather limeted the last couple of days.

John I think you got some decent experimental input from both Terry and myself on this earlier thread:
http://archive.reefcentral.com/vbulletin/showthread.php?threadid=10003

The main way of gathering data of this sort is to run several experimental tanks and one or two control tanks. All tanks are set up identical and and maintained the same way. The experimental tanks are treated with whatever is being tested and the controls left untreated. All observations are recorded and your conclusions drawn from those observations. The real key in proving your conclusions is repeatability, can you duplicate those results over several repeated trials and more importantly can anyone else repeat those results using the same methods.

[Terry B]

I just wanted you to know that I just sent emails to Doctors Angelo Colorni and Edward Noga asking them for their thoughts on using garlic to combat fish parasites. Angelo is considered to be the worlds leading expert on Cryptocaryon irritans. Dr. Noga is one of the most highly respected aquatic medicine specialists in the USA. I have talked with these two people before and they were quite generous with thier time. Dr. Noga reviewed my first magazine artilce about hyposalinity therapy before it was submitted for publication. I corresponded with Angelo in putting together a two part series that will soon appear in FAMA that updates our knowledge of Cryptocaryon irritans and treating for an infection.
I can't guess if either of these people have experience using garlic with fish, but their comments may be interesting.
Terry B

[john f]

Terry,
Want to chip in or volunteer some time for this study I propose?
Getting opinions from "experts" will not help unless they have done scientific studies on Garlic treatment. I am not aware of any studies to date. If there are some I would love to know as I would rather spend time on other projects (Like the 1000 gallon tank I'm putting in my new house!)
than duplicating old studies.

Also, did you get my e-mail with Dr. Jedlickis' e-mail address?

John

[john f]

Frisco,
I was not ticked at you in any way.
I really appreciate the post you started over here and your willingness to open up the dialog.

What I am ticked at is the unwillingness of anyone else to contribute time or money to this project.
I am not the only reefer concerned about Ich outbreaks. Just do a search for Ich and watch the computer grind out the posts. Unfortunately none of the more advanced members of the hobby want to do any work on this??

I understand as one gets better at fish and reef keeping the number of Ich outbreaks decreases dramatically, but certainly we can't forget our own early days.
Many if not most beginning reefers have Ich problems at some point and to be able to offer them no proven reef safe treatment is a serious problem I think.

John

[Terry B]

John,
We will just have to wait and see what Dr. Colorni and Dr. Noga have to say. Maybe I can motivate one of them to investigate the uses of garlic with fish. You never know, it may have other application than just treating ich. Garlic has been used in veterinary medicine for treating internal parasites. I also sent an email to the originator of the garlic treatment. They haven't gotten back to me yet either. I don't know if I will have any spare time. Between work, kids, commuting and writing my schedule is limited. I am being pressured to help put together a lenghtly survey about mandarins and I am not sure how much time I can contribute right now.
Terry B

[john f]

"I am being pressured to help
put together a lenghtly survey about mandarins and I am not sure how much time I can contribute right now."

I'm with you on this one. Mandarins: If you don't have enough little critters (copepods, amphipods, etc) in your tank, you can't keep a mandarin. I understand the desire for more knowledge but I actually agree with you on this one. Mandarin keeping is not complicated: Most starve.
I can tell you this....I will have one in my 1000 gallon reef, and I think I can support 1 fish for sure in a tank of this size.
BTW, The longest I have kept a mandarinfish is for 1.5 years. I had during that time quite a hair algae problem which I believe provided food for the amphipods. When the hair algae left, the mandarin starved within 2 months :(

John

[Doug]

Hi Frisco,

This is a good topic.

Would it be any use for me to setup a single small tank and try to test this theory? I have a 6g Eclipse that I could load up with some liverock and some low light corals. I am sure I can find a sick fish at an LFS without trying too hard.

I know it is really a small scale but if it helps I don't mind doing it. I can take pictures and document everything if you can come up with some guidelines.

The only problem is that I have never used garlic in any of my tanks and all of you would have to figure out the dosage and other details.

Tell me if this will help.

Doug

[billsreef]

Hi John,

I can understand your wanting to see more people willing to put up time and money to do such testing. Some time ago I did such testing on Hyposalinity, when Terry first brought it to the forefront back on AL, and also a controversial reef safe "remedy" that spawned some famous internet wars. At the time I was able to do such experimentation at the store I was working at. Currently however, due to changes at work, family demands and trying to get a new business off the ground, so I can give the hassles of working for others, I am not in the position to offer more than technical support. Hopefully if things go well I will be able to get back to performing such experiments in the near future.

[Agu]

John,

A couple of thoughts regarding testing garlic. First, there are various forms of garlic, fresh squeezed, juice, and oil that I'm aware of. Which formulatation would you be testing? As you know ,someone will say you used the wrong type. Controling outside parameters is the most important factor in side by side testing. Variance in water quality, temp, etc will possibly influence results. If you could divide a single tank into sections it would limit variables (and be a lot less work for preliminary testing). The problem would be keeping treated food from migrating from section to section. This could be done using fiberglass screening over eggcrate as dividers and feeding foods that won't easily pass through the screen. Using tangs and feeding treated and untreated nori would possibly work.

I have yet to save one fish once infected with parasites by treating it, (yeah Bill, the pb tang didn't last 48 hrs)and would love to find an effective treatment. Where do I send a donation? Donated to Dr Rons study and felt it was well worth it.

Agu

[john f]

Agu,
Thanks for the offer of help.
I'm not sure how I will end up doing it. I was thinking about not starting until after the holidays when I have the most time.
I will probably go to my LFS and ask him to give me his best prices on some 10 gallon tanks and a bunch a fish.
I will probably just use dead sand bottom cover and sponge filters to run the tanks.
I think I could set up 6 tanks for around $120 to $150 total with fish included. Maybe 2 control tanks, 2 garlic in food tanks, and 2 garlic in water tanks.
I am open as to type of garlic to use. I have heard most people recommend the water soluble types like Kyolic, but Mccormick is also used.
I'll keep checking this post as ideas come in and after the New Year I'll post my final plans.

John

[Terry B]

Most of the reports I have heard from people that felt garlic worked for them used a water soluble form. That is not to say I haven't heard good reports from people using other forms. The person that is supposed to be the originator of the ides of treating ich with garlic used gel caps (garlic oil). It is interesting to notet that garlic could possibly have applications other than treating ich. Garlic has been used in veterinary medicine for other types of parasites, bacteria, etc. I heard back from Dr. Colorni today and he does not know of anyone that has tested garlic as a treatment for ich. However, Dr. Colorni did conduct and experiment using garlic for its antibacterial properties. He said it has "mild antibiotic properties." He thought I might be interested in reading his report in a scientific journal. If you want to find it here it is.

Colorni, A., Avtalion, R., Knibb, W., Berger, E., Colorni, B., Timan, B.,
1998.

Histopathology of sea bass Dicentrarchus labrax experimentally infected
with Mycobacterium marinum and treated with Streptomycin and Garlic
(Allium sativum) extract. Aquaculture 160; 1-17.

Best wishes,
Terry Bartelme

[Frisco]

Lots of people have seemed to have some hesitation to use the oil because of the possible Valdez effect... ;) I've only used the oil and haven't had any problems; it takes a bit of creative preparation to make it a clean process, but it's certainly not impossible.

I too would be interested in hearing more about the upcoming tests; it's too bad that none of use could rig a series of large holding tanks to run sided by side tests of the different treatments... Setting them up segregated with semi-open circulation systems and a common water supply seems like it would be good to remove some of the potential variability in the entire process. I still think you'd want at least a hundred fish in each group to remove some of the statistical fuzz, and being able to treat the animals differently (but simultaneously) would help give some information about the relative benefits. Using captive raised fish would be helpful to ensure that you know where they came from and have some reasonable understanding of how they've been treated... Seems a bit expensive but certainly a fun project... So who's going to setup the fish farm??? ;)

John - definitely keep us up to date about how things are coming - I'll be very interested to help out in every way possible!

[Terry B]

I just wanted to update you guys on what I am doing. I just heard back from the person that has been credited with developing the idea of using garlic to treat ich. They told me that they have written an article about their three years of research on garlic, and said they will be submitting the article for publication soon. They did not tell me where it would be published, perhaps in a club newsletter. I sent them another email asking for more details.
Terry B

[john f]

Who is this person? Jedlicki?
Why not mention the name?

John

[Aaron Shelley]

Sounds interesting! I'll throw in $20. Let me know...

Back to the top with you!