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Chloramine-T

by Dr. Jill Spangenberg



Investigation of the Safety and Efficacy of Chloramine-T in the Treatment of
External Fluke Infestations

Jill V. Spangenberg, DVM, PhD (Pharmacology and Toxicology)



ABSTRACT

Chloramine-T (n-chloro-para-toluene sulfonamide sodium salt) was investigated in
the search for an effective and safe flukicide for goldfish and koi. Use of
Chloramine-T for this purpose has been previously described, but details were
not readily available. Fingerling koi maintained at U.C. Davis were exposed to
concentrations of chloramine-T between 5-20 mg/l (ppm) for four-hour static bath
treatments. These exposures were not associated with any mortality or
histological evidence of toxic effect. Furthermore, successful treatments of
infested koi, goldfish and tilapia were achieved with no mortality or untoward
effects following two four-hour bath exposures to 20 mg/l chloramine-T.
Treatments were administered every other day for a total of two times. Water
hardness, pH and temperature need to be considered when calculating a dosage for
chloramine-T; hard water and high pH is associated with a wider margin of
safety.



Gill and skin flukes are common external parasites of koi presented to the Fish
Health Service at the University of California, Davis. Therapeutic compounds
commonly employed by koi hobbyists in attempt to treat external fluke
infestations include salt, potassium permanganate, formalin (alone or in
combination with malachite green), Fluke Tabs®, organophosphates (such as
malathion, trichlorfon or Masoten®, Dylox®) and praziquantel (Droncit®). There
are various difficulties encountered with these agents.



Problems with commonly used treatments center around efficacy (i.e., a compound
may not work effectively) and potential toxicity (to either the fish, the person
applying the treatment, or the aquatic environment downstream). As examples of
the former, we have increasingly observed salt and formalin to be ineffective
for fluke eradication. This is presumably due to increasing resistance amongst
strains of flukes that have been chronically exposed to these treatments.
Potassium permanganate regimens, while usually effective, are sometimes complex
for individual hobbyists to implement, and carry a fair degree of risk if
excessive doses are delivered accidentally. Praziquantel is effective but
expensive, and therefore is not usually a practical treatment for fluke
infestations in the pond setting. Organophosphates, either used alone or in
combination with a carbamate (as in the Fluke-Tab® product), have the multiple
problems of developing resistance in the flukes (decreasing efficacy), potential
toxicity to the fish if over-dosed, and environmental concerns (as well as
safety concerns for the person applying the treatment). It was the desire to
find a safe, effective, and easy to administer alternative that led to this
investigation of the flukicidal properties of chloramine-T with koi.



Chloramine-T (n-chloro-para-toluene sulfonamide sodium salt) has traditionally
been used to treat external bacterial infections in salmonid aquaculture
("Bacterial Gill Disease"; Bullock et al., 1991). It is under review by the FDA
for approval for this use in salmonids, which would make it one of the few
compounds legally approved for use in food fish. It has also been reported to be
effective for the treatment of monogenean trematodes (skin and gill flukes);
this same report (Debuf, 1991) indicates that high doses may be toxic to koi.



Chloramine-T functions by slowly breaking down to hypochlorous acid , with the
release of oxygen and chlorine. The active ingredient is p-toluene sulfonamide
(Booth and Macdonald 1988). Sunlight hastens the breakdown, therefore ponds
should not be treated in bright sunlight, and the powder should be stored in the
dark. Toxicity, as well as effective dose, is dependent upon water hardness, pH
and temperature (Rach et al., 1988). In the hard, high pH water of the Central
Valley of California, I found the following recommended doses to be effective
and safe to small koi (Table 1).



Table 1. Doses of Chloramine-T With Respect to Water pH and Hardness


pH

Soft Water Dose (mg/l)

Hard Water Dose (mg/l)


6.0

2.5

7.0


6.5

5.0

10.0


7.0

10.0

15.0


7.5

18.0

18.0


8.0

20.0

20.0


Modified from Debuf, 1991







The reported dosing protocol for treating external bacterial and monogenean
infections was designed for flow-through systems with four hour turnover
periods. Chloramine-T is applied as a bath treament at the appropriate dose
based upon water pH and hardness; such a system will have completely turned over
(and no Chloramine-T should remain) after four hours. The reference also
indicates that this treatment can be repeated as needed up to four times
consecutively (Noga 1996). In my trials with koi, I modified the protocol in the
following manner to better approximate the recirculating pond environment of
most hobbyists.



Small (2-3") koi were housed at the U. C. Davis Aquaculture Facility in bare,
indoor plasticated fiberglass tanks with minimal organic material accumulation
present. Normally supplied with flow-through well water of 15-17 C (~59-63 F),
the water flow to the tanks was stopped for the four-hour exposure periods
(aeration was maintained). The fish were determined to be free of external
parasites before the exposure (the initial part of the investigation was to
examine toxic effects associated with exposure to normal doses of Chloramine-T
only, not efficacy). Ten fish were maintained in each of six 75 liter tanks,
representing low stocking density in a static but initially very clean system.
No filtration was used during the exposure periods, therefore some build-up of
nitrogenous wastes occurred over the four hours; however, the systems were still
cleaner than the average pond environment. Large organic loads bind Chloramine-T
as well as other compounds applied in the water, effectively lowering available
concentrations; hence, a clean system with minimal organic material would ensure
that the acting concentration was essentially the same as what was calculated
and supplied. This in turn would maximize the potential for any adverse effects
(a high organic load decreases the delivered dose of a compound such as
Chloramine-T, and by so doing decreases the potential toxicity, as well as the
efficacy; it essentially removes a certain amount of the drug from the water
column). Hence, our exposure system approximated a worst case scenario with
regard to potential toxic effects, in that the fish were small, there was no
external filtration, and there was no organic load to remove drug from the
water.



Chloramine-T was generously donated for this study by Argent Chemical. Tanks
were dosed at 0, 2.5, 5, 10, 15, and 20 mg/l for four hours. The fish showed no
visible signs of irritation or distress during the exposures. At the end of the
exposure period, the fish were removed from their tanks, euthanized by overdose
of Eugenol (an anaesthetic frequently used by hobbyists in our area), and
tissues were collected for histologic examination . Gill, skin, kidney, and
liver were the primary tissues of interest for potential toxic effects
associated with the exposures. The tissues were examined by Dr. Gary Marty, our
Board-certified veterinary pathologist who specializes in fish pathology. Dr.
Marty found no evidence of any toxicity associated with any of the different
Chloramine-T doses in the 60 fish used in the study (he did, however, observe a
few unrelated conditions, such as incidental internal parasitism; such findings
increase our understanding of normal and common disease conditions of koi).



Efficacy of Chloramine-T for treatment of fluke infestations was investigated
more empirically. Over a two month period, I treated several tanks of small koi
(2-3"), goldfish, and tilapia with 20 mg/l Chloramine-T as both static, four
hour bath treatments (for the goldfish and koi) and flow through bath exposures
(for the tilapia). Water in our area is very hard, and pH measures around 8.0,
requiring the higher end of the dosage scale. I found that flukes did
occasionally recur after a week if the fish were only given one treatment, so I
increased the protocol for small koi to include a four hour static bath exposure
every other day for a total of two treatments. If I had continued to observe
flukes, I would have added a third treatment on the fifth day; this was never
required at our facility.



In summary, Chloramine-T appears to be a safe and effective bath treatment for
external fluke infestations. It is likely that the margin of safety in koi ponds
may not be so great under conditions of lower pH, softer water, and high
temperatures; therefore, hobbyists are advised to experiment with conservative
doses (in quarantine tanks if possible) and proceed with caution if they have
these water conditions. I would recommend taking the filter off-line during the
four hour treatments, as I was not able to investigate effects of the compound
on filter bacteria. During warmer weather, I would apply the compound when
oxygen levels are highest (late afternoon usually, unless there are extensively
cloudy days), and continue to aerate vigorously during treatment. Should the
fish show any signs of distress, remove them to clean water (if treatment is
applied in a quarantine tank), or perform a 20-50% water change on the pond. I
repeat that it would be best to experiment with a small isolation tank before
treating one's whole pond, especially if unsure about the chemistry of the local
water supply. This is worth checking, as municipalities do vary their water
sources without notifying consumers, and alternate sources may well have
drastically different characteristics than the normally supplied water.

Chloramine-T may well have efficacy against external bacterial infections in
koi, as it does in salmonids; it may thus have a role in managing these problems
as well (as an adjunct to the prime goals of keeping the pond clean, the water
quality excellent, and the system not over-stocked). Chloramine-T is marketed by
Argent as "BGDX", for the treatment of bacterial gill disease, and is available
through pond supply stores; it is also produced by other companies. It is
advised that Chloramine-T not be used with formalin or benzalkonium chloride,
and that users avoid skin or eye contact with the product. The powder and strong
stock solutions should also not be allowed to come into contact with metal. Many
suppliers consider it an under-utilized compound in the home pond arsenal. These
results indicate that it may be an effective and more user/fish friendly
alternative to some of the other compounds currently used by koi hobbyists.



ACKNOWLEDGEMNETS

On behalf of the Fish Health Service at U. C. Davis, I would like to gratefully
acknowledge the financial support of the AKCA, which partially funded this
study, as well as the generous donation of the BGDX product by Argent. I would
also like to acknowledge the assistance of Chris Wilson, DVM, and Ms. Jenee
Mukai in the completion of these experiments.



REFERENCES

1.       Bullock, G. L., Herman, R. L., and Waggy, C. 1991, Hatchery efficacy
trials with Chloramine-T for control of bacterial gill disease. J. Aquat. Animal
Health, 3:48-50.

2.       Booth, N. H. and McDonald, L. E. 1988. Veterinary Pharmacology and
Therapeutics (6th ed’n.). Iowa State Press, Ames Iowa, pp. 774-777.

3.       Debuf, Y. (ed.). 1991. The Veterinary Formulary. London: Pharmaceutical
Press.

4.       Noga, E. J. 1996. Fish Disease: diagnosis and treatment. St. Louis, Mo:
Mosby, pp.88-93, 280.

5.       Rach, J. J., Bills, T. B., and Marking, L. L. 1988. Effects of physical
and chemical factors on the toxicity of Chloramine-T. United States fish and
Wildlife Service Information Bulletin, pp. 69-88.











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