Is clean water really a substitute for medications?

devsi

I lurk around various different places with regards to the fish keeping hobby (FishLore, Reddit etc) and there is sometimes a big contrast in the advice given it got me thinking.

In my short journey in the hobby I've had sick fish, and I've seen a lot of posts on FishLore about sick fish. Generally, the advice on this site is usually (paraphrasing) "Medication should be a last resort. The best thing you can do for a sick fish is give them clean water so give them daily small water changes first".

On other parts of the internet the advice (I'm perusing, not asking) is almost always "Go and get this medication". I've been tempted a couple of times to comment and suggest otherwise, but have realised I'm not armed with enough information to make an informed argument one way or another.

So, purely because I am interested in improving my knowledge.... IS clean water really better than medication and, if it is, why is that? Why would daily water changes/cleaner water be more beneficial than treatments specifically designed to combat the illness your fish has?
 

MacZ

It depends completely on the kind of ailment.

If it's parasites - 99% of cases can only be cleared with meds. Once a fish has worms they won't go away on their own. You can expect at least one fish to be affected once parasites are present. Parasites are the main reason for quarantining. In confirmed cases of a parasites even I, known for my meds are last-resort-approach, advice medicating.

If it's bacteria or fungi - That stuff often only even crops up if there is a fish with an impaired immune system. Usually this is due to stress, be it social (territorial/socially aggressive fish), accidental (injuries) or environmental (food, water quality, bright light, too strong/slow current, wrong temperature). Especially bacteria use the backdoor of stress.
Of course in these cases meds CAN help, but if you don't change the conditions that caused the immune deficiency in the first place, the same or other pathogens will creep up again and again. Especially the cases when people come back here again and again after months of treatments with no effect. Many meds can put so much strain on the fishes system they will rather kill it itself.
Also there is the problem of resistant pathogens. Many strains of bacteria and fungi have developed resistance to the available meds.

And then there are some things that can completely pass by the fish or cause problems no matter what the circumstances. Some internal parasites in a ground dwelling species likely won't affect a surface dweller as their paths don't cross (in a sufficiently big tank!). On the other hand mighty and deadly pathogens may affect every fish no matter how well it's kept and how healthy it is.
But these are special cases which in my opinion only form the exeption to the rule.

It boils down to:
- There are things that have to be treated with meds, no matter what.
- There are things that don't have to be treated with meds immediately.

And of course one thing everybody can agree to:
Only medicate when you know what you are dealing with.

There is nothing worse than preemptive medication with strong stuff causing problems or making things worse with strong meds that do exactly nothing about the problem at hand.

And now I'm off to work. Have fun discussing.
 

DoubleDutch

Clean water is one of precautions to prevent fish get sick in the first place. Then it depends on the sickness that occures. Diseases caused by bad water conditions (finrot, skinissues etc...) often can be reversed by a lot of waterchanges. Other diseases (protozoans, parasites etc.....) can't be cured by waterchanges but are often introduced.

So it depends on what you're facing and in what stage a specific disease is.
 

devsi

Makes sense :) thanks both!
 

SparkyJones

To add to this, I can't fault either of the commenters on the when to do medications and when water changes can and will work. there a time and a place for each.

The most common causes of illnesses in fish, the commonest reports are fin rot, injuries, cloudy eyes, basically bacterial or fungal infections.
You'll see "Ich, Parasites, flukes" or even "leeches" , maybe an occasional "Hexamita". Another one that pops up a lot is Columnaris, which is bacterial.
Theres about 1000 other things nobody talks about that affect fish and different species of fish exclusively, heck maybe 100,000, but those things aren't "catch phrases" in the hobby like the big few are.

It's been from my working experience that there is always bacteria in aquariums, some good, some bad, it's water that supports life in the aquarium, and if you give the right environment to grow nitrifiers or denitrifiers you will get them and they will colonize, and if you provide the right environment for all the bad bacterias,,,, they too will colonize. But if a fish has a strong immune system and the tank is cared for and cleaned (and nitrates kept low, because lets face it, higher nitrates is a sign a tank has been neglected and could use a water change and vacuum), a fish with a strong immune system may go unaffected while one with a weaker immune system starts picking it up and letting it multiply and can't fight it, as this continues even the strong immune system fish can't resist it anymore and it ends up passing to them too.

Now some fish might have a weak immune system, and some strong, just like us and everything else. Some of us catch everything, and some of us rarely get sick. Stressors can increase the frequency of getting sick in people and animals. Stress causes anxiety, anxiety causes more stress, then you aren't eating right, you aren't resting right and your immune system is getting run down. That's a fact and happens to strong or weak immune systems. The downward spiral.

Medications have their uses like has been said by others already. There are things water changes and clean water can't cure. But many, many things, the majority of what affects people's fish on a regular basis, can be cured by water changing and vacuuming the substrate and staying on top of it. Especially the external bacterial and fungal infections, especially the injuries and damages, but yes some things, if severe enough like I dunno, a big hole in the side of a fish, might take further action than simply keeping things clean to speed along healing.

Why would simple daily water changes and keeping a tank clean be more beneficial than just dosing some sort of medication? Well again depends on what the issue is, but if it's cloudy eye, fin rot, bacterial infections, external issues, lets think about it.....

Say you have a cold and strep throat, someone with their infinite wisdom thinks its Bronchitis and treats for that, maybe treatment doesn't work, so then they think must be Pneumonia, and they treat for that, and it doesn't work, so now in their wisdom and checking the internet as they did prior twice, they are now thinking "lung and esophageal cancer". and deciding to treat for that......

You are gonna be run way down and shot out with all that, and actually doing more harm than good, and really all you needed was to ride it out and sooth it for 1-2 weeks with comforting teas and lozenges and relaxation and rest, and no drugs at all.
Maybe you needed some penicillin to get over the hump to avoid having to baby yourself for a week or so, but you really didn't need to go to Doxycycline, Cipro, or be contemplating Chemotherapy or exploratory surgery. All of that puts you in a worse and worse situation. Another form of a downward spiral where helping is doing more harm than helping. Maybe a bad analogy, but we all aren't taking out fish to the vets and having experts diagnose our fish troubles and most vets aren't fish illness experts either.

Clean water/Clean tank, consistent temp, an extra small feeding or two, keep bacterial counts low, it reduces stress and it strengthens a fish and the fishes immune system to boot. That is the fish equivalent "pampering and bed rest" to boost the fishes immune system that allows them to get over the hump on their own. it doesn't work for everything under the sun.
But I got to say, If I have a cough, and it sticks around for a good long while and I get concerned and look it up on the internet, I'll get anything from Acid reflux to Pertussis to lung disease. The internet will tell you the worst and who to see what someone can sell you to fix it every time.
Maybe it's just pollen and needing to clear my throat more than usual for a longer period of time than usual, and I just need some cleaner air and some extra rest.
Maybe it's lung cancer, but most likely I just need to change the air filters in the house and car and say away from the woodlands for a while.

I'm not a big supporter of holistic treatments essential or tea tree oils, burning incense or Reiki or acupuncture, but bare minimums of sanitation practices revolutionized the medical treatment field and extended our lifespans tremendously, the proof is in the pudding that it works and can treat the problems 90% of the people that come on here asking about and thinking of the 4 things that are the worst from the internet search. That remaining 10% need a medication and have parasites or viruses or BAD bacterial or fungal infections that simply keeping the environment clean and relaxing can't cure. it happens.

But the truth is a whole lot of people think it's fine to let nitrates run up and do a small water changes every two weeks or once a month or every 3rd month and don't have a consideration for what's building up, or how much of it, in their water, or what they really need to be doing to maintain the water quality.
Heck there's people coming on here and are doing a fish in cycle for 6 months to a year and think their tank is cycled and fine and their fish must have necrotizing fasciitis or something crazy when it's ammonia burns, because they followed the directions on the internet and the instructions that came with the HOB filter.
 

86 ssinit

For me clean water has allways been best. I’ve said it many times I don’t check nitrates! It’s not that I don’t believe nitrates are bad it’s because I change water. 50-100% weekly. Clean water has always been the best medication for fish. I believe fish even healthy fish carry some bad bacteria and parasites. But because they’re healthy their immune systems keep it at bay. Clean water clean tank and good food will keep your fish healthy. Now in tank stress factors can happen. Light,temp and other fish can cause a fish to start showing signs of stress. When this happens it’s time to qt the fish. Me I add salt 1tbs per 10g if no result 1 tbs per 5g. You can go higher but most of the time this works.

Thing is there’s so much info on the internet and so many people trying to get away from changing water. Many of these people have over time found ways to do this that work. The problem is other people think it’s going to work on everything with as many fish in the tank as they want. This is where the problems begin. So many new keepers are looking for ways to not change water.

Same thing with meds. As already stated. Some people have put a lot of time into medicating and have very good ideas what will work. When you find someone like this stay with them. Many people have had luck with a med or maybe even read about someone else who had luck and than forward this advice. The second group always falls down the rabbit hole of med after med till the fish die anyway. Meds are very tough to use. You have to know first what the fish has. Than what’s best to treat with. Than the amount to treat. Do you use the store bought meds or should you buy the pure meds…. Even the pros are not always positive. So much is guesswork. I had a cross contamination in my discus tanks awhile back. I tried 2 different ways to solve it in 2 different tanks. Both ways cured the fish in about 14 days. But the salt and meds Combo of one tank cause damage to those fish. In the year+ passed I’ve lost all but 2 of those fish. I now know what I’ll use if it ever happens again.

Again as stated when buying new fish qt them first. Give them a month in there own tank. See how they do. Nothing worse than buying new fish and dropping them into an existing tank. Most new fish may have traveled for days without eating and already moved through a few different tanks till they end up in yours. Their stress levels are up already and some may just outright die. Next the old fish see these new ones as targets. There already weak. The new guys stress further and those things their immunity was keeping at bay just can’t keep up. These fish now die and may just spread something through the whole tank. If they were put in a qt they would have had time to destress and adjust to your water. Being fed they would have gotten stronger. When introduced to the main tank they would have been much stronger to survive.
 

Cherryshrimp420

Why would daily water changes/cleaner water be more beneficial than treatments specifically designed to combat the illness your fish has?

This is the flaw. Aquarium medications are not medication. They're not FDA approved, they are not clinically tested, and they are not evaluated for purity nor effectiveness. You cannot assume that they will treat an illness.

There are certain substances that kills bacteria, or parasites or fungus or whatever. So the logic is if you apply them to the fish tank you will kill those organisms. But this is not medication and not manufactured nor stored nor handled as such. That's also why aquarium meds are not allowed to claim "drugs" or "medication" on their label.

Ornamental Fish Drugs and You
 

MacZ

They're not FDA approved, they are not clinically tested, and they are not evaluated for purity nor effectiveness.
Except "FDA-approved" you can very much assume European products are tested and evaluated. Companies like Sera deliver all necessary information in the instructions (active ingredients, other ingredients, dosage, concentration, indication, contra-indication, side-effect...) and they do indeed call the stuff medication, as they are entitled to (at least here). Some ingredients are only available on prescriptions here, so those are only avaible from the vet and pharmacy. The openly available stuff is regulated nonetheless either as generics or under one of the other possible agencies, either agriculture/food or environment/consumer protection (yes, we have things like that.)

The whole intent of the article you linked is: Don't take the stuff yourself.
To me this is just revealing about the state of health care over there and nothing else. That article has more legal reasons than anything else, as at least the stuff imported from here has all the necessary work done, they just don't have anyone responsible and as such disclaim any responsibility.

The only thing I have to agree to, which means you are circumstantially correct: The stuff made in the US is criminally underregulated (explaining why so many antibiotics are available over the counter). When it comes to those the warning is especially important. There are some ways to solve that problem, but I know then it will go fully political.
 

Cherryshrimp420

Except "FDA-approved" you can very much assume European products are tested and evaluated.

Tested and evaluated by who? Im primarily addressing North America so I do not know the process for drug approval in the EU.

Here, FDA is the starting point from which the clinical results are discussed and evaluated and all manufacturing, storage, handling, and ingredients are submitted. These information constitutes the bare minimum to even consider that the company does what it claims to do.

Whether you like the FDA or not, there needs to be a third-party non-profit driven agency to evaluate the effectiveness of these medicinal claims.

The Journey of an Animal Drug through the Approval Process
 

MacZ

Tested and evaluated by who? Im primarily addressing North America so I do not know the process for drug approval in the EU.
EMA, the European Medicine Agency, basically the EU equivalent to the FDA (which as far as I know has no saying in Canada or Mexico, am I right?). They are responsible for the whole of the EU, Norway and Iceland. And just a few months ago they prohibited some meds after some ingredients have been banned from use.* It may not be a North American agency, but at least things they approved have gone through a comparable process. Even if they are sold unregulated with the other products, they are technically tested. That's all I wanted to say.
(* Something that I criticize is the regulations make no difference between ornamental and food fish, resulting in regular bans on certain active ingredients. That usually means 4-5 years of no effective treatments until something else gets through the approval process.)

Whether you like the FDA or not, there needs to be a third-party non-profit driven agency to evaluate the effectiveness of these medicinal claims.
The only thing I don't like is that they leave barn door-wide holes the regulations as a whole so people can sell the stuff unregulated.
Complete bans like in Canada are also not a constructive way of dealing with that.
 

SparkyJones

Tested and evaluated by who? Im primarily addressing North America so I do not know the process for drug approval in the EU.

Here, FDA is the starting point from which the clinical results are discussed and evaluated and all manufacturing, storage, handling, and ingredients are submitted. These information constitutes the bare minimum to even consider that the company does what it claims to do.

Whether you like the FDA or not, there needs to be a third-party non-profit driven agency to evaluate the effectiveness of these medicinal claims.

The Journey of an Animal Drug through the Approval Process
Realistically speaking here they don't need approval becuase it's not intended for human use, and realistically nobody cares about pets although dogs and cats at least there are prescription type meds for that do have approvals, and technically could be used by people as well. It's just not like that with fish, mostly because it's seen as a hobby, and not as a pet or animals. Same kind of thing happens with plants and gardening. Nothing is approved there either.

There's a whole lot of snake oil sales in both hobbies.
 

TClare

although dogs and cats at least there are prescription type meds for that do have approvals, and technically could be used by people as well.
When our dogs have anything wrong the medicine prescribed by the vet is nearly always meant for humans, we buy it at the farmacia, not from a veterinary supplies shop! We can buy Seachem medicines in aquarium shops, and while most human medicines can be bought over the counter (unlike in the EU or UK), antibiotics are an exception, a prescription is necessary whether for humans, dogs or fish. If I needed a specific antibiotic for fish (other than seachem stuff) my vet would give me a prescription, but I would probably have to tell him what I needed as he doesn't know much about fish diseases. Once someone took a sick flowerhorn to his clinic and he called me to ask if I knew what could be wrong....

I would rather not use drugs on fish if at all possible, but obviously there are cases when it is necessary.
 

MacZ

I'd like to add something I find important to mention:

You have surely noticed I recommend humic substances (for softwater) and salt (for hardwater) parallel to waterchanges a lot.

I want to make clear - NEITHER are allround medications. They help with osmoregulation, bacterial/fungal concentrations in the water column and make the fish produce more slime to shed things on their skin.
Only few things (like certain bacteria and parasites, e.g. stress-columnaris with humic substances and Ichthyophthirius with salt) can really be treated that way. In all other instances both is to support the actual recovery and both can be well used as a precaution.
 

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