Interceptor heartworm meds needed for corals: I need a real vet who knows corals!

[hahnmeister]

Hello F&S,

I have a unique situation. My reef system has developed a 'red bug' or 'acro bug' infestation. These little arthropods, aka Tegastes acroporanus, burrow into the acropora corals, eat the polyps, and kill the coral.

The only known treatment for this is the chemical milbemycin oxime... aka interceptor heartworm/mange treatment for dogs and cats from Novartis. It is ground up and mixed into the aquarium water.

I have exhausted my local options to get this medication, as most vets have no experience with reef aquaria or corals, and so they wont write a prescription for interceptor. The only people who know about the problem are biologists and hobbyists, but they cant write prescriptions.

My hope was that since Drs. Foster and Smith are vets themselves, and I know Race at least is familiar with reef aquaria (from past conversations as well as postings on reefcentral.com), so they may be the only guys in the whole state... heck... the whole country, who could write a legitimate prescription for me to get some interceptor (and then I could buy it from F&S when I get the problem again).

Here is some info on the 'red bugs' and how they are treated with interceptor:

http://reefs.org/phpBB2/viewtopic.php?t=45859

http://www.reefland.com/forum/reef-aquariums/14894-interceptor-treatment-our-experience-day-1-a.html

http://www.ericborneman.com/Tegastes-content/Treatment.html

I would need at least 6 tablets of the 25mg interceptor, so I would most likely get 12 since sometimes the dosage needs to be 'upped'. 6 tablets is the suggested amount for 380gallons, and I have 300g in my system total. Luckily, Im not a believer in hermit crabs or other crustaceans, so I wont even have any casualties from the treatment besides copepods and mysid shrimp.

Can you guys help? I know I can get it 'grey-market' and all, but I just wanted to get it legit so that in the future (cuz you know it will happen again at some point) I can get more easily. Also, who knows how long the 'grey-market' stuff has been laying around, or where... and from what I have read, the active ingredient has a shelf-life and is neutralized if chilled.

Regards,

Jon

[dfs/la2]

Hahnmeister,

Thank you for your post. We understand your concern and have had conversations regarding this exact subject. We do have licensed veterinarians on staff. However, they are not able to prescribe for any animal that they have not personally seen and examined. This includes aquatic animals. If you live near a university or research center, this would be a good place to start a search for an aquatic veterinarian or one that is familiar with aquatic species. Our Pharmacy would certainly be able to fill a prescription for Interceptor written by a licensed veterinarian in any compounded form or dose prescribed.

We would also suggest using a biological control of the red bugs. You could introduce Dragonface Pipefish (Corythoichthys haematopterus) to the aquarium. Once the fish are settled in and adjusted to the aquarium conditions, the small pipefish will anchor themselves on the branches of Acropora and begin to feed on tiny crustaceans as well as red bugs.

Another approach would be dipping the Acropora into a concentrated iodine and aquarium water mixture for approximately 15 minutes using a clean plastic container. Lugol’s Solution is the preferred iodine base for this procedure, along with other commercially available coral dips, such as Reef Dip by SeaChem.

Cassie Z.
LiveAquaria
Drs. Foster and Smith

[hahnmeister]

Thanks for the info. I will use some of those prevention tips in the future... like the iodine dip. I am familiar with the local universities, and although they do have biologists, they lack a vet that can write the scrip since there is nobody even in Madison that deals with anything simpler than a fish (special species wont even touch it).

The pipefish wouldnt like it in my tank... I have anywhere from a 60-85x turnover rate in my SPS tanks. If you think it can stand that... Ill try them. Have any in stock? Also, the royal grammas, cardinals, and tangs might be a problem.

Right now, I have waaay to many corals to quarantine and treat all the acros that are infected anyways. My only option is to get interceptor and dose the whole tank. Luckily, im not a big fan of shrimp or crabs, so that wont be a problem. I can get interceptor locally it turns out (just got a call back from a vet that will sell some directly but not write a scrip), but its $8 per pill... and F&S has it for $5... so for the long term, it would be nice to set something up.

The active ingredient in the interceptor is the Milbemycin oxime (a mixture of the macrolides milbemycin A3 oxime and milbemycin A4 oxime that interact with gamma aminobutyric acid (GABA)). It seems that this in itself is not a controlled substance or anything, so would it be possible to get just the chemical, without the 'flavored coating', and bypass the requirement for a prescription because it wouldnt be a med for a dog then? Then it could be sold as a non-prescription 'acro-bug' medication.

What do you guys do when the coral farm gets an infestation? Take the coral to the vet or something? Who might that be (thats who I should be talking to, right)? I find it hard to believe that I still need a scrip even though I dont have or plan to use it on a dog or cat. There has to be a way of writing a scrip w/o live examination... a photo or something should do.

[aquaticvet1]

The Food and Drug administration regulates the sale of prescription drugs. To use them against the label is prohibited unless directed by the attending veterinarian. Our coral farm is owned by us and therefore it is not illegal for me to direct the use of medications within our own facility. I cannot however dispense or prescribe regulated drugs except for use in patients which I have personally examined and within a state in which I am licensed to practice medicine.
Your personal veterinarian can prescribe the needed medications as long as you are explained all associated risks. Once we have the prescription on file--- then we can dispense the medications with a label as written by your veterinarian.
I wish that I could be of more help but I must comply with all Federal and State laws.

Thank you, Race Foster, D.V.M.

[hahnmeister]

The problem is trying to find a vet that even comes close to understanding what I am doing is impossible. Even the vets I called through http://www.aquavets.com/ dont have a clue about corals. The most they might see is a fish with ich it seems. So they cant even address the risks... because they dont know. And some even said that using the the meds for anything other than cats or dogs would not be allowed since the drug is designed for them... it seems everyone is too worried about the 'liability'. Even Novartis said it was a no-no... odd... because they were also quite aware of its alternative uses with corals! I keep getting the run-around for a legit way to buy... so I just got it from the local clinic. Even the university hospital in Madison was a dead end... they might have some people with aquaculture experience, but they either arent vets or they arent familiar with the intended use. I just figured that the F&S vets would be the only vets in the state, perhaps the nation, who could write a legit prescription for this stuff.

It would seem that if there was a way to merely produce this med in a non-flavored, as in non-doggie form, that it could be sold as a over-the-counter med for corals though... like buying malachite green, formalyn, hex-a-mit.... those are drugs that I can buy without a scrip. Just an idea for you guys to make a killing on. It almost seems like all it takes to change the prescription requirement is to change the intended use from cats and dogs to aquariums. If there was some reason for me to use brom-blue or meth blue on a cat or dog, then I would have to get a scrip? But if I just use it on my fish, its over-the-counter.

So, since I'm in WI, in the future I could bring my corals up... that way they could be treated as 'patients'? Is that right... my corals would be 'patients'? Wouldnt a simple macro picture do? Thats what gets me... its like prescribing medication for crop-duster chemicals... there is no patient in the usual sense.

[DFS]

Jon,
To answer your question, a picture of a coral would not be sufficient for one of our veterinarians to prescribe medication. If you were to bring one of your corals with you when you attend the frag sway on June 29, 30, and July 1st, Dr. Foster would have to consult with you face to face, examine the coral, and explain the risks associated with this medication before he could write a prescription for any medication that is not sold over the counter.

Thank you,
Kevin Kohen
Director of LiveAquaria
Drs. Foster and Smith

[hahnmeister]

Thank for the call today. I didnt know it was a controlled substance... so it all kinda makes sense now.

See you guys at the frag swap!