Are really stringy white poops a sign of internal parasites or is it a myth?

[Brew12]

Here is a scientific article that shows starvation causes an increase in mucus that gets shed past day 3. Can we all accept that starvation can be a cause of white stringy feces?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234480/
" Interestingly, mucin-2, which provides an insoluble mucous barrier that serves to protect the intestinal epithelium [54], was weakly increased at three days post fasting (1.1 fold), but quickly down-regulated at six and twelve days post fasting (2.2 - 2.3 fold)"

 

[4FordFamily]

That might point to the real questions that we always circle around - is that judgement call something that we should accept? What level of experience is sufficient to make such a judgement call? Is time consuming and expense a good enough reason not to get better information before guessing and treating?

A fish with uronema, internal parasites, velvet, etc. may have only a few days to live. Have you ever received anything from a lab in three days? Three weeks? Three months?

So we come back to microscope and proper scientific training on how to use.

Which is more practical/appropriate for most reefers? I guess, that's for each of them to decide.

To answer your other questions:

1) Is that judgement call something that we should accept? Absolutely
2) What level of experience is sufficient to make such a judgement call? This is one thing this forum and other resources aid -- the inexperienced can hear from the experienced and subject matter experts. For instance, I know nothing about SPS coral so I don't bloviate about them! Ha! -- In short, any hobbyist that can read this forum.

 

[WVNed]

You took no Ibuprofen or Advil prior to that 4 weeks of use in your life? I have a lot of trouble believing that.

Again though, that's still ridiculous and unfortunate. I am sorry you endured that!

LOL
I had 2 scopes for GERD. One to diagnose and one to confirm the treatment worked 6 months later else I had to have surgery for esophageal erosion.. I hadn't been able to take NSAIDs for years. After 5 months of treatment I found I could take them with no heartburn. 2nd scope revealed the ulcers. No more NSAIDs for me.

I have found hanging fish iconography over my tank keeps diseases away. I have as much proof for what I believe as you do.

Correlation does not equal causation.

 

[WVNed]

The more the better

 

[Lasse]

I am guessing if you had red poop they'd probably treat you with something, ASAP. Your point of identification prior to treatment is well-taken, but fortunately not feasible for most "aquarists" and very time-consuming. It requires a judgment call.

I have had that and what they said was that this is natural and happens now and when or you have eaten reed beats. Do not needs to treat with medicines. If you refer to
bleeding ulcers - that poops is not red - it is black as night. Only the vomits are red - ask my wife.

Sincerely Lasse

 

[4FordFamily]

Here is a scientific article that shows starvation causes an increase in mucus that gets shed past day 3. Can we all accept that starvation can be a cause of white stringy feces?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234480/
" Interestingly, mucin-2, which provides an insoluble mucous barrier that serves to protect the intestinal epithelium [54], was weakly increased at three days post fasting (1.1 fold), but quickly down-regulated at six and twelve days post fasting (2.2 - 2.3 fold)"

I don't believe anyone has ruled it out, we are discussing:

A) The harm of treating for internal parasites and
B) Which is more likely, and is it really a myth depending on the assumed ratio?

So of course I can say there may be other causes of white, stringy poop. Most white stringy poop I've seen is VERY long, worm-like, and I cannot imagine an underfed fish with some mucous being shed appearing anything like that -- but I cannot rule it out.

 

[4FordFamily]

LOL
I have as much proof for what I believe as you do.

This doesn't really merit a rebut, our strategies were developed from scientific research.

You're absolutely correct about correlation and causality.

The fish stuff hanging on the wall seems legit. I love older retrievers, by the way. Handsome dog!

 

[4FordFamily]

I have had that and what they said was that this is natural and happens now and when or you have eaten reed beats. Do not needs to treat with medicines. If you refer to
bleeding ulcers - that poops is not red - it is black as night. Only the vomits are red - ask my wife.

Sincerely Lasse

I am saying if my stool contains a lot of blood, it's going to trigger a response from myself and a doctor.

 

[Brew12]

I don't believe anyone has ruled it out, we are discussing:

A) The harm of treating for internal parasites and
B) Which is more likely, and is it really a myth depending on the assumed ratio?

So of course I can say there may be other causes of white, stringy poop. Most white stringy poop I've seen is VERY long, worm-like, and I cannot imagine an underfed fish with some mucous being shed appearing anything like that -- but I cannot rule it out.

I'm not sure how it could be argued that treating for internal parasites cannot be dangerous to a fish. I don't think that anyone would argue that Metro targets internal microbiota. This study clearly shows the importance of that microbiota in supporting the fishes immune system.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598590/


Here is a scientific study that shows having microbiota, including eukaryotic organisms is normal.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946678/


White stringy poo due to parasites only happens when a parasite causes enough intestinal irritation to trigger excess generation of mucus. A healthy fish can have internal parasites and not have stringy white poo. A fish with stringy white poo could have other issues (such as starvation) without having excessive internal parasites.

 

[4FordFamily]

I'm not sure how it could be argued that treating for internal parasites cannot be dangerous to a fish. I don't think that anyone would argue that Metro targets internal microbiota. This study clearly shows the importance of that microbiota in supporting the fishes immune system.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598590/


Here is a scientific study that shows having microbiota, including eukaryotic organisms is normal.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946678/


White stringy poo due to parasites only happens when a parasite causes enough intestinal irritation to trigger excess generation of mucus. A healthy fish can have internal parasites and not have stringy white poo. A fish with stringy white poo could have other issues (such as starvation) without having excessive internal parasites.

Again, I don't think anyone said it's not harmful to the fish. My viewpoint is that it's less harmful than the potential parasites and more likely than another ailment.

No sweeping statement is made that it's the only cause of white poop, nor that metro isn't harmful to the gut of a fish. I'm also saying a microscope and proper scientific training or sending results to a lab which is likely to take weeks or months is not a viable alternative -- in response to the suggestion that we ID before treatment.

I don't have all of the answers, but I do think the preponderance of the science supports treatment of white, stringy poop in marine fish. I don't see enough evidence that 14 days of treatment has a worse impact on the fish than internal parasites.

Only my viewpoints. Not everyone need share.

Despite taking antibiotics dozens of times in my life, I am quite healthy -- as are tens of millions of others.

 

[EmdeReef]

That might point to the real questions that we always circle around - is that judgement call something that we should accept? What level of experience is sufficient to make such a judgement call? Is time consuming and expense a good enough reason not to get better information before guessing and treating?

Nuance is important. Everyone should learn as much about their pets as possible and decide on the best course of action. I’m not for overmedicating but we have to be honest and admit that the aquatic veterinary science is way too lacking to rely on some definitive scientifically accepted diagnosis of a disease before taking actions. As you know better than most, more often than not fish diseases are only properly diagnosed post mortem. On a fish farm that’s more than acceptable for as long as the diagnosis is somewhat timely to treat the majority of fish...

 

[Roc83]

LOL
I had 7 bleeding ulcers after taking Advil. Confirmed by gastroscope. If I were a fish I would be dead.

Lol

 

[Brew12]

I've had plenty of issues with fish but internal parasites haven't been a big one. I have treated very few of my fish for internal parasites but most have had white stringy poo when I first got them. I only worry if it doesn't clear after 2 or 3 days.

I would point out that Metrodonazole, when used internally on people, is often needed to be accompanied by pre and pro biotic replacement therapy. Without this therapy, the treatment can be more dangerous than the cure. We don't have any way to effectively replace this in fish. I use LRS fish frenzy largely because it contains probiotics but it is far from a complete mix that is necessary for fish health.

I understand that the treatment can be necessary and that Metro is used because of the limited availability of more nuanced medications. The risk in using it is that the fish will be more susceptible to bacterial, viral and parasitic infections in the future.

 

[Roc83]

I miss the days when the debate was over how many fish can you stuff in my tank, good read though, loving all the input and information.[emoji106]

 

[eatbreakfast]

But if starvation is the more likely culprit why aren't we seeing that discussed as a possibility elsewhereb such as discus and high end koi, where multi day starvation is standard?

 

[Brew12]

But if starvation is the more likely culprit why aren't we seeing that discussed as a possibility elsewhereb such as discus and high end koi, where multi day starvation is standard?

I'm not sure if starvation is more likely. I can't even find a single scientific study that directly connects white stringy poo to internal parasites.

If I had to guess it is because starvation induced white stringy poo regulates back on it's own very quickly with no treatment or risk to the livestock. Since it is a non-issue there isn't typically need for discussion.

 

[eatbreakfast]

I'm not sure if starvation is more likely. I can't even find a single scientific study that directly connects white stringy poo to internal parasites.

If I had to guess it is because starvation induced white stringy poo regulates back on it's own very quickly with no treatment or risk to the livestock. Since it is a non-issue there isn't typically need for discussion.

Its not a non-issue. There are plenty of discussions on white stringy feces on discussion boards and care sites for discus and koi, and they all point to parasites, not explaining it as part of the shipping process where starvation is a always a multi-day step.

 

[Brew12]

Its not a non-issue. There are plenty of discussions on white stringy feces on discussion boards and care sites for discus and koi, and they all point to parasites, not explaining it as part of the shipping process where starvation is a always a multi-day step.

How many are science based?

Even a quick search shows that even these discussions don't all point to parasites. It seems that even at the hobby level for discus and koi they acknowledge that white stringy poo isn't always an indication of a parasite issue.
https://discus.fish/diseases/white-feces/
"Although, in most of the time, the white lumpy feces in discus could be an evidence of existence of a disease, it is not always the case. So before using any medications, make sure whether your discus needs it or not and bear in mind that all drugs and medicines have potential side effects, so unnecessary prescribing of antibiotics and anti-parasite medications carries major risks for fish health . Here are the most common Non-disease-related causes and reasons for stringy white poop in discus fish."

https://www.koiphen.com/forums/showthread.php?115076-Lets-talk-Koi-poop

"Mine had a fair amount of floating and/or stringy, mucus type when I first started to feed coming out of winter. I may have started too early and they weren't digesting completely. Now that it's warmer, it's been just as Dustin described."
For reference, here is what Dustin described.
"I think if it is digesting properly then it should be solid, sinking, and breaks in small 1/4 in to 1/2 in pieces"

 

[eatbreakfast]

Even a quick search shows that even these discussions don't all point to parasites. It seems that even at the hobby level for discus and koi they acknowledge that white stringy poo isn't always an indication of a parasite issue.
https://discus.fish/diseases/white-feces/
"Although, in most of the time...

So while parasites are not always 100% the cause it is still regarded "MOST OF THE TIME" as the cause of white stringy feces.

Sorry - could not find anything in your long quote that named white poop as an indication of internal parasites - not either that it needs prophylactic treatment to handle internal parasites. I´m nor argue against that text - I argue against that stringy white poop and eating fish indicate 100 % parasite infection. My question is - can you find anything in the well-studied fish farming industry that even indicate this statement that give so many hits in hobby forums or associated business if you Google fish - white poops. If you instead use the term "White feces syndrome" - you get a lot of hits according to shrimp farming, but it is not linked to parasites – it is linked to a bacterial disease.

However – your link should be read of everyone here because it strengthens us that argue against chemical prophylactic treatments – the author only recommends prophylactic treatment with freshwater and/or formalin – stressing that freshwater is the recommended prophylactic treatment method.

I have been in the aquaculture business for a long time - never ever heard about white poops indicate 100 % sure for internal parasites. It has been shown as one of other indications for infections of diplomonads (aerotolerant anaerobic, binucleate flagellates) - but not as an indication of internal parasites all over and not as the only indication

Here is a very used handbook in the European fish farming industry – section 24 cover parasites – interesting in this section is the first lines


Here is the marine version. Both these booklet is worth reading

When working with the African Bloat we send some fishes into the national fish health authorities in Sweden in order to investigate what it was. The answer about the stringy white poop was that it was mucus from the digestive tract – released because of starvation and/or other irritation of the system.

I do not deny that a stringy white poop can be a sign of flagellate infection – I only deny that this symptom lonely and always is a 100 % sign of an internal parasite. In this very in deep article about Diplomonads (aerotolerant anaerobic, binucleate flagellates) the stringy faeces is one of the symptoms.

This article also address the issue

This link gives a description of the hole in the head disease. Interesting with this link is that you can play with the numbers in the HTTP address and access nearly all known fish diseases with treatment tips if there is any. It also give the same explanation for the stringy white poop as I do

And this link provides a disease diagnose wizard – using that you will understand how difficult it is to make a diagnosis with help of visual symptoms

According to use of Metronidazole: It is banned from use in the treatment of food fish in Europe and the USA due to its potential carcinogenic properties, persistence in the environment and toxicity to aquatic organisms. It is not a harmless drug! Resistance to metronidazole has been documented too.


Another thing - you first state that nearly all wild fish have parasites with a long quote and afterwards ask me for evidences that fish with internal parasites can have normal poop. If your first statement is true (could be) than is my statement true for sure because all imported fish have not a stringly white poop. - if your statement is untrue - when my statement could be false. It is logic.


Sincerely Lasse

Lasse provided a link citing white stringy feces as an indicator in one of the links in this post.

 

[Brew12]

So while parasites are not always 100% the cause it is still regarded "MOST OF THE TIME" as the cause of white stringy feces.

First, this is non scientific, it is a hobbyists opinion. If we are going to accept his opinion on this as true, why not also accept his recommendation? "it is not always the case. So before using any medications, make sure whether your discus needs it or not and bear in mind that all drugs and medicines have potential side effects, so unnecessary prescribing of antibiotics and anti-parasite medications carries major risks for fish health ." which we seem to be completely ignoring.

Lasse provided a link citing white stringy feces as an indicator in one of the links in this post.

It was listed as an indicator for Hole in Head Disease.
That same section also listed this. "Excrements of the infected fish is a whitish-slime discharge that is cause by irritation or injury of the intestinal wall. " which still points back to anything causing irritation to the intestinal wall will cause white stringy feces.

 

[eatbreakfast]

First, this is non scientific, it is a hobbyists opinion. If we are going to accept his opinion on this as true, why not also accept his recommendation? "it is not always the case. So before using any medications, make sure whether your discus needs it or not and bear in mind that all drugs and medicines have potential side effects, so unnecessary prescribing of antibiotics and anti-parasite medications carries major risks for fish health ." which we seem to be completely ignoring.


It was listed as an indicator for Hole in Head Disease.
That same section also listed this. "Excrements of the infected fish is a whitish-slime discharge that is cause by irritation or injury of the intestinal wall. " which still points back to anything causing irritation to the intestinal wall will cause white stringy feces.

So then how do you propose determining whether or not it is a parasite or something else? Most hobbyists are not pulling out a microscope to examine the feces..

By the time other symptoms present themselves it is often too late.

 

[Brew12]

Most hobbyists are not pulling out a microscope to examine the feces..

This is completely ineffective, anyway. As I previously linked, we should see all sorts of living "stuff" in fish feces.

My recommendation has always been to wait for 3 or 4 days to see if it clears up on its own. If it is persistent, or if it is accompanied by other confirming symptoms, then I think even @Lasse would agree treatment is necessary.

And to be clear, I'm not going to claim that this is what I practice. I will admit that I prophylactically treated the last fish I got in (Anthias) with General Cure (contains Metro). I wouldn't have done that just based on white stringy poo but it has been my practice for reasons other than internal parasites. I also acknowledge that my methods are not in the best long term interests in the hobby and I own that.

I feel the science supports what @Lasse states in this thread. There is a reason Metrodonazole requires a prescription almost everywhere in the world. I feel his concerns are absolutely valid and should be shared publicly. People can act on his warning and information or not. I'd much rather have this available for people to make an informed decision about treatment than to bury it or try to discredit it.