How I Cipro

Amoo

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Many of you have probably already seen this before as it's part of a sticky on another forum, but I'm moving the information over to this site as this is where I spend most of my time and want to link this in my Sig.

Amoo's Sick Nem Treatment Protocol:
Let me start by saying most of my research wouldn't exist without what OrionN (Mihn) started on rc years ago. Most all of my treatments have been done on H. Mag and BTAs so my experience applies in different areas. For the sake of this treatment I am only going to go over how I treat H. Mags from the time they arrive until they hopefully go into a DT. I've had good luck with not bleaching my nems and getting most of them to survive.

Medications:
While I am experimenting with other medications, the only drugs I am comfortable recommending at this point are the same basic ones Mihn uses. I get 500mg Ciprofloxacin (Cipro) tablets and 400mg/80mg Sulfamethoxazole and Trimethoprim (SMZ & TP) tablets. Individual dosing will be explained below.

Arrival:

Upon arrival of the Nem I immediately float the Nem bag, to acclimate it to tank temperature. This is done for 30 minutes. A clean 5 gallon bucket is then used and the contents of the bag are placed in the bucket. At this point I visually inspect the Nem for signs of damage and immediately give it a condition score. (I will explain the scoring system at the end of this article.) 9 times out of 10 I will drip acclimate the Nem for about 30-45 minutes before placing it in quarantine tank (QT). There have been times I have had a Nem arrive in such bad shape and water that I have immediately moved it to QT without drip acclimation. Note: This is not the preferred method, but as I buy almost all of my specimen from the same vendor I know what water params to setup my QT for (I still double check to ensure).

QT Setup:
My QT setup is slightly different then Mihn's so I will go into detail about it here. I choose to use a two tank approach. I believe in using two tanks because it allows me to fully clean EVERYTHING in the tank. As I am working with a smaller species I can afford to get away with two 10g tanks. Both tanks are equipped with a divider, heater (79F), power-head, fresh salt water, a coffee mug AND a cycled bio-wheel HOB filter. There is a full spectrum light (Par 38 14000K Full Spectrum Dimmable Reef Light (Coral Compulsion))with a manual dimmer hanging 12" above one tank at a time (I manually move it when I move the nem). Remember this is still a QT tank until we begin treatment.

My first order of business is to slowly begin light acclimating (12 hours with 10 hours of full light) the Nem and observe it. I will not start treatment for a minimum of 6-8 hours on a freshly shipped Nem. I first allow it time to adjust to the new tank conditions and lighting. If it has not shown any signs of improvement (scoring system) I will then begin treatment. Usually there is some improvement and I will give the Nem until the first lights out period to see if it continues to improve. Typically anything above a 5 and I start treatment after 6-8 hours. Anything below I let it ride until "sundown". Once I make the decision to start treatment (Tx), it immediately becomes lights out, I remove the Bio-wheel HOB and dose 250mg/10Gal of Cipro. I then give a strict 12 hours until further action is taken.

Treatment:
IMPORTANT: At the same time I dose the occupied tank with 250mg/10gal of Cipro I dose the second "empty" tank with Cipro as well.

After the first 12 hour, medicated lights out treatment, I immediately move the Nem to the second tank which already had it's HOB removed before dosing. I move the clamp light and begin it's light therapy for the day. At this point I tear down the first tank, take all components outside to clean and dry. Once dry, I bring everything back in and fill the tank with fresh SW and all of it's gadgets. Once it's time for complete lights out, I move the Nem again to this fresh tank and dose 250mg/10gal of Cipro, only to this tank this time.

Note: I feel the 12 hour water changes are important for the first day and a half, beyond that I allow a nem to remain in the same tank for 24 hours unless the tank becomes extremely cloudy.

Once through that first day, I have my second tank setup and ready to go by lights out and move the Nem over for his nightly Cipro dose. Prior to moving him is when I score him for the day. I maintain a 250mg/10gal dose of Cipro for the first 3 lights out periods regardless of score.

Increasing Dosage or Changing Medications:
After 3 lights out periods I check my pictures and scores and determine if my current treatment appears to be working. If he has come down 2-3 points from where he started, I continue on the same path. If he has not shown improvement or his score has increased I change my dosage. My first line of action is to increase the daily Cipro dosage to 500mg/10gal. This is again done for 3 lights out periods.

After three lights out periods I assess my pictures and notes and determine where to go from there. If things are improving I back off on my Cipro dose, back down to 250mg. If things are not improving, I still back down on my Cipro dose to 250mg but also add 400mg/80mg of SMZ & TP. Things are again maintained for 3 lights out periods.

If you're still reading, things aren't going well and it's probably decision time. Hopefully by this point your nem is close to a 2-3 at worst, but if it's still above 5 and hasn't shown significant improvement it's time to start really hitting it hard. If things are still bad I will double my dose of both Cipro to 500mg/10gal and SMZ & TP to 800mg/160mg. I do this for 3 lights out periods. Anything beyond this point with the Nem not improving significantly is still experimental and not something I'm ready to recommend yet.

Amoo's Severity Scoring System:

0 - Healthy Nem
1 - Tentacles shortened, still fully inflated, mouth tight, responsive to touch
2 - Tentacles shortened, still fully inflated, mouth slightly droopy, responsive to touch
3 - Tentacles shortened, still fully inflated, mouth slightly open, responsive to touch
4 - Tentacles shortened, still fully inflated, mouth open, responsive to touch
5 - Tentacles shortened, still fully inflated, mouth gaping open with insides exposed, responsive to touch
6 - Tentacles shortened, partially inflates, mouth gaping open with insides exposed, responsive to touch
7 - Tentacles shortened, inflates and deflates multiple times daily, mouth gaping open with insides exposed, responsive to touch
8 - Tentacles shortened, most always deflated, mouth gaping open with insides exposed, responsive to touch
9 - Tentacles shortened, always deflated, mouth gaping open with insides exposed, barely responsive to touch
10 - Tentacles shortened, always deflated, mouth gaping open with insides exposed, non-responsive to touch
11 - Mush (Sorry )
 
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Akida17th

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I'm sure you'll be hearing from me, thanks again for the guidance. Once I get home from work I'm going to give her 4 hours of T5 light (48 total watts) and then after lights out you suggest dosing then? After the first dose, should I do a water change in 12 hours or wait 24 hours? I only have 1 10 gallon hospital tank but I could get another if needed?
 
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1 tank is fine buddy, I choose to use two as for me it's easier to be able to clean the tank entirely and minimize the time I have the nem just sitting around in nothing.

ALWAYS dose Cipro and give a minimum of 12 hours with lights out. Cipro degrades in the light and you minimize your efficacy if you have any lights on at all.

I do the 12 hour water change with shipped Nems and usually don't on ones I've already had in my system. The theory behind this is we know that they inflate and deflate, taking on water from their surroundings. I make the change after 12 hours to attempt to get as much of the "unknown" water out of my tank and try to have it in 100% fresh. It really honestly probably doesn't matter much, but it's how I always do it and it works for me so I continue to do so.

I use a 10G most of the time myself so you should be fine.
 

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Making 10 to 20 gallons of water a day is tough. My lfs sells ro I don't use it but it seems like it would come I hand in a situation like this however it's 15 ppm water compared to my 0 ppm water. I'll probably make my Rodi water just so I have peace of mind.
 
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I have 2 brute trash cans, I usually empty out of my DT into one, to a certain point and then refill from the second. When I run into a situation where I am expecting to need a lot of water (new shipments) I will clean out both cans well and use them both with fresh IO and just use a pump to pump it into the tank after I've cleaned and dried it for the day. At minimum you'll have to use ~10g per day while doing treatment. I wouldn't recommend leaving the water in for any longer then 24 hours. Remember along with the medication you're flushing the nasties from the water.
 

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What is the best source for the meds? I have only one of four wild nems still alive, maybe meds would have saved the one in my avatar.
 
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I own a vet clinic so I can source directly from the manufacturers. I would just google them and find who sells them, Amazon or maybe one of the major distribution websites carry it. I have seen it around, but have no need to look for it commercial, just know it is available without prescription.
 

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I have 2 brute trash cans, I usually empty out of my DT into one, to a certain point and then refill from the second. When I run into a situation where I am expecting to need a lot of water (new shipments) I will clean out both cans well and use them both with fresh IO and just use a pump to pump it into the tank after I've cleaned and dried it for the day. At minimum you'll have to use ~10g per day while doing treatment. I wouldn't recommend leaving the water in for any longer then 24 hours. Remember along with the medication you're flushing the nasties from the water.

Do I have to clean all equipment and tank after every treatment? If so, I'm going to be forced to use tap water (150ppm near me) to clean.
 
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Do I have to clean all equipment and tank after every treatment? If so, I'm going to be forced to use tap water (150ppm near me) to clean.

It is highly recommended. I wouldn't worry about using the tap water to clean things honestly. Just use tap water and vinegar and as long as you dry everything off appropriately and don't leave any drops of water at all I don't see it causing any issues. It's not like you're washing off something extremely porous which will absorb the nutrients right out of the water and wait to spit them back out once back in the tank. You really want to get the most amount of gunk out as possible, especially once you've been using the meds. A towel and the wife's (or your) blow dryer work well for me for the powerhead cages.
 

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Just got home and touched my purple gig and noticed she isn't sticky. My other 2 greens are though. She never deflates and neither did the haddoni which doesn't make sense. The purple gig looks fine besides the no stickyness which I wouldn't of known unless I touched her so she'll be next to get treated unless you think I should wait and see how it goes? I'm not sure what is going on if this was caused by bad shrimp (food) or the dying mini maxi with a bad wound or something else. I hate not knowing the source of what caused this.
 

Akida17th

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Some pics of my haddoni after 3 days of 250mg cipro treatment (using 2 tank approach). Looks to be doing better he is very sensitive to touch now but his mouth is still open. He is gaining his stickiness back but not fully (don't worry about that as much). He plants his foot in the bowl I use and I've been giving him 4-6 hours of 48 watts of 6500k T5 lighting. Amoo what do you think? Should I stop dosing the cipro and give him more light each day?
 

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Amoo

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I would up him to 6 hours of light a day and treat for three more days. You generally want to Antibiotic for a week. Kind of how when people take meds the doctor always says take this for "X" days, but folks stop taking it when they fell a little better after 2/3 days. Same thing here. I should add that to the OP.
 

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Amoo, this info has been posted time and time again, but thanks for another thread because I don't think people treat sick nems as much as they should. Minh and I have posted several times here even before I saw you start poping up at Reef Central and treating Magnifica's. Others have posted as well...Trex, TaylorT, Humblefish, Clorox, Justin, Antonio, etc, etc.
 

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Can I ask what every one does with the old tank water with medications in it. Sure hope its not getting flushed into the water systems.
 
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