My adventures with reef syphilis (aka flatworms) and their elimination. With an exhaustive guide for Flatworm Exit.

[chaostactics]

Storytime! (TLR, Flatworm Exit worked fine for me. Know what flatworms and other pests look like and look often)
Getting any treatable parasite/hitchhiker/ whatever is a lot like getting an STD/STI:
1. It takes as little as one slip up to catch it.
2. It's an embarrassing facepalm moment.
3. You should inspect the tank you're getting corals from for signs/symptoms. (even a seemly "clean tank" may not be but eyeball it pretty carefully before committing to corals if you can.)
4. You NEED to let every person you've given corals to and received corals from know you've got it/them.
5. You need to treat it right away before symptoms get worse.

15 years of reefing and this is my first time getting flatworms. The person I purchased from didn't disclose he had them (claimed he didn't know). I was impatient one day with multiple stressors and just trying to get out the door. I let the specimen containers float for temp acclimation and then put the frags right in. Big mistake 1.

My usual practice is to inspect all frags with a lighted magnifier, remove all frags from frag plugs (things like flatworms can get underneath the coral between the frag and the surface of the frag plug), and dip them with coral dip, then RODI, then add them to tank. In an ideal world, everyone would have a frag tank to do QT in, but much like a Ferrari many reefers out there lack either the budget or space or both.

I noticed the flatworms later that day. Panicked vacuumed them out after stabbing as many as I could see with a fine pointed scalpel. I thought I got them all. Big mistake number 2. It was at this point I should have gone to an LFS and bought Flatworm Exit or at least started with an order on Amazon.

Fast forward to 2ish weeks later. I'm now starting to see them on the base of all my rock work. Just 5-6 at any given time. The flatworm exit had come in the mail. I had read all the horror stories about Flatworm Exit and was definitely scared.

In preparation for the treatment, I put together a 20% water change and put fresh carbon* in my reactor and kept it offline. I made an educated guess on my total water volume** and treated with the recommended number of drops erring slightly on overdosing than underdosing.

I came back every 10 min to check on the tank and did indeed see the flatworms dying off. They were either falling from the rocks or swinging in the current from some sort of stringy mucus. After 45 min I did a water change with thorough sand vacuuming and brought my carbon reactor back online. After which I kept checking on my tank every 30-60 min for the next few hours (the directions recommend monitoring the tank for 6 hours) after the water change I immediately made up more make up water for another water change in case of a bad reaction (it never came and I'll be doing another water change later this week to not let the mixed water go to waste.

My biggest fears were my inverts. I have two different species of shrimp, 4 different species of snails, 1 species of hermits, and a sea slug. I also have a variety of softies, and one accidental SPS that I've been trying to kill off, and two anems. 4 different species of fish. EVERYTHING DID FINE. No deaths, no sluggishness, everything accounted for and eating the next day. I get that Flatworm Exit doesn't seem to work for everyone and that a single data point doesn't make a scientific study but from hours and hours of reading, I'm pretty sure almost all catastrophic post-treatment issues are user-errors.
Common user errors seem to be.
1. Waiting entierly too long to treat for flatworms. You should be looking at your rock work at least weekly to check for pests and to marvel at macroscopic life, that's part of the fascination of reef tanks. If you have tons and tons of flatworms the amount of toxic byproduct will be much higher and more likely to wreak havoc on tank occupants.
2. Underdosing or overdosing. Follow the instructions. Not what you heard from a friend of a friend who treated one time. Read the instructions and do the math on your calculation at least twice, have a friend check your work.
3. Failure to do an adequate water change INCLUDING sand vacuuming. Flatworms are tiny, you may not see that their bodies are there but they are there do a water change and vacuum your sand bed especially your corners/dead spots. It's important to keep water flow during treatment but if you can try and decrease horizontal laminar flow/flow across your sand bed so the dead flatworms fall to the bottom and don't get blown all over your rocks.
4. Failure to run carbon* and/or run it properly. If you've got an established reef tank you should own a media reactor period.
5. Failure to change filter socks or other mechanical media. If you've got a sump system there's a good chance some flatworm bodies are going to make it into your overflow and into your mechanical media. Change your media about an hour after successful treatment and probably 6 to 24 hours later depending on your water overturn and/or how bad your infestation was.

*Carbon: The instructions for the volume of carbon to be used are astonishing (I know I just preached running enough carbon but the amount recommended is HUGE) the instructions recommend something like a pound per 50 gallons. I'm guessing that means old pelleted style carbon, I used Rox .8 carbon and doubled the dosage. I don't have any scientific evidence to back up that calculation but even with 2 largish media reactors, I would not have been able to pack in enough carbon for a pound per 50 gallons.

**Water volume, when calculating water volume there are tons of factors. A "100-gallon tank" doesn't hold 100 gallons, whether you have an all in one or sump the overflow system means that water isn't all the way to the rim of your tank. Don't forget to subtract the volume of water between the rim of your tank and the operating water height determined by your overflow depending on the length/width of your tank this could be a couple of gallons to tens of gallons. Don't forget to subtract water volume in your overflow again could be a fraction of a gallon or a few gallons. Don't forget to subtract water volume displaced by sand/rock work. Sand it pretty easy you again run a LxWxH volume calculation on your sand bed and subtract. Rockwork is harder but you can sort of eyeball the LxWxH volume displaced by your rock. Don't forget to add your sump and equipment volume in. Again a "50-gallon sump" doesn't hold 50 gallons during operation. Make sure you account only for the water present during operation. Some equipment holds a considerable amount of water that's not going to be accounted for in your sump calculation alone. Skimmers, media reactors, algae reactors, etc. Fractions of a gallon to multiple gallons.

Good luck and prevention is key. Learn from others' mistakes so you don't have to learn from your own.
Happy reefing.

[TatorTaco]

I'm currently dealing with flatworms.  How often/when would you suggest re-dosing?  I did a fantastic job of not following the instructions and nuked my tank.  Somehow, I still had flatworms just 2-3 weeks later.  

 

I plan to dose 2x a month now, but I'm not sure if I should do it more frequently or for how long?

[chaostactics]

1 hour ago, TatorTaco said:

I'm currently dealing with flatworms.  How often/when would you suggest re-dosing?  I did a fantastic job of not following the instructions and nuked my tank.  Somehow, I still had flatworms just 2-3 weeks later.  

 

I plan to dose 2x a month now, but I'm not sure if I should do it more frequently or for how long?

This is my first (damn well better be my last) time getting flatworms in almost 20 years of reefing. Im going to guess one treatment is going to do it for me, but ill keep an eye out forever and retreat as needed. 

if you're having to do more than 1 or 2 treatments Id guess youre either under dosing based on water volume, not getting enough circulation during dosing, or have something besides common red planaria. Check this page for good images. https://www.melevsreef.com/articles/how-to-eliminate-flatworms-red-planaria

Keep in mind this is my first battle with flatworms so the above statements should be taken as "fairly"-educated guesses and with a grain of salt. 
 

[EfrainChicagoDeepdish]

The only way of prevention is abstinence.  That's why my tank is empty.  

 

Glad you got it under control @chaostactics. Good luck @TatorTaco.  

[Lypto]

I've learned that the flatworms can build up a crazy resistance to flatworm exit, so its very important to follow a strict schedule, its like antibiotics and bacteria. I'm still scared to transfer anything from that tank.

[Oldfishwife]

I had flatworms a few months ago. I was scared silly of using Flatworm Exit, but finally decided it had to because they were multiplying. I read the directions, read everything I could find online, prepared my carbon, water and steeled my nerves. 
 

I put in the lowest # of drops and began to see the flatworms reacting. When they would release and start floating into the water column, I would net them out. I kept sweeping the net back and forth in the water and would then rinse it under the faucet. Then I added more drops for a total of 10. They really started dying then and I netted for probably another 45!minutes. Then I did a 50% water change and added fresh carbon. 
 

a few days later I noticed a couple of worms and went through the whole process again except I did the 10 drops right away. A week later I treated again even though I only saw 1  or 2 worms. 
 

I haven't seen any flatworms since and everything that goes into my tank gets a good long soak in coral dip. 😍 I didn't lose anything and nothing even looked slightly stressed. I think that's probably because I treated so early that even though there were several hundred worms, there weren't thousands. 

[mcarroll]

A lot of posts and not one mention of what the flatworms were doing that was problematic.  Is that just coincidence that nobody has mentioned anything, or are you guys treating the tank mostly out of fear and worry?   (No details on the worms or their offensive activities, but lots of mentions of fear in only six posts....go figure.)

On 2/25/2020 at 4:35 PM, chaostactics said:

My biggest fears

On 2/29/2020 at 4:40 PM, Oldfishwife said:

I was scared silly

On 2/25/2020 at 4:35 PM, chaostactics said:

definitely scared.

 

If the repeated lacks of mention are only a coincidence I'm curious what if any damage you saw them do or that you're otherwise attributing to them?

 

Also, were you able to identify the flatworm in question?   It would be cool to see pics at least since there are so many kinds. 

 

Everyone in the conversation seems to be presuming they have (or had) the same type of flatworm, that all types of flatworm are bad, and that this drug treats every type of flatworm.   All kinds of potential problems in a set of presumptions like that.  (Glad no bad side-effects have been mentioned!!)

 

@chaostactics you mentioned some particulars like 50 pounds of carbon that aren't from the instructions.....can you mention what other resources you used in your guide?  Links would be awesome, if possible.

 

Just for reference....have the product's instructions changed from this?

 

Quote

Instructions:
[...]

• 1 drop for every 4 liters or 1 gallon.The dropper contains approx. 300 drops (10ml). The dropper cap holds approx. 90 drops. So 1 cap full is good for 360 liters or 90 gallons. 
• Add it in a high flow area of the tank. If you want to treat a refugium only and if it`s volume is too small for using a powerhead then mixing should be done manually. 
• It should start to work within 30 minutes.
• If within 45 minutes no visible death of flatworms occurs add 50% more. 
• As soon as the flatworms start to die, commence with the activated carbon to take out any toxic body juices. Also see the above given important remarks. Do Not wait more than 2 hours, add carbon to flow, do not just drop a bag in the sump.

 

After an hour or so you can turn any UV or ozone on again

 

[chaostactics]

@mcarroll I treated my tank out of fear that the flatworms would get out of control and be aesthetically displeasing and make it impossible to sell anyone frags in good conciousness. 

 

The instructions state to use 1 lb of carbon per 50 gallons of water. I think that's referring to old school pellet carbon with a low surface area to volume ratio. 

 

I was treating specifically for Red Planaria which is easy enough to identify with a magnifying glass. To my knowledge things like coral eating flat worms aren't as susceptible or not susceptible at all to flat worm exit. 

 

See this post for identification https://www.melevsreef.com/articles/how-to-eliminate-flatworms-red-planaria

[TatorTaco]

I agree 1000% with @chaostactics with the same fear of giving/selling frags.  This was also how I identified red planaria. 

[mcarroll]

18 hours ago, chaostactics said:

I treated my tank out of fear that the flatworms would get out of control and be aesthetically displeasing and make it impossible to sell anyone frags in good conciousness. 

Interesting.

 

18 hours ago, chaostactics said:

The instructions state to use 1 lb of carbon per 50 gallons of water.

The instructions on your carbon say that???

 

1 cup per 100 gallons +/- a little bit is pretty much standard across all the carbons that I know the instructions for off-hand...seachem and BRS included.

 

After a back of the napkin calculation with a little help from Google for references, I think a pound of activated carbon would treat something like 150 gallons.

 

Plus Flatworm Exit is a product from Europe.....seems strange they'd use "pounds" and not something metric like grams or liters.

 

Anyway, I tried to look at the product instructions on Flatworm Exit in case that's what you meant (and I quoted what I found into my post earlier) but I didn't see anything about "pounds of carbon". 

 

Not really a big deal either way, but can you post a pic of the instructions that say "1 pound per 50 gallons" just for my curiosity?

 

18 hours ago, chaostactics said:

I was treating specifically for Red Planaria which is easy enough to identify with a magnifying glass.

Seems like a subject like dino's were a few years back where 100% of the focus had been on eradication instead of on education.  Thankfully these worms are harmless by comparison.

 

I found a couple of interesting points about them on a quick survey just now.

 

Honestly there are more than a couple of potential avenues for control that seem at least worth experimenting with that are mentioned in here:  

 

"Convolutriloba macropyga sp. nov., an uncommonly fecund acoel (Acoelomorpha) discovered in tropical aquaria" 

[PDF] mapress.com (2007)

• They are dependent on light, even with access to prey. 
• They can't tolerate salinity <1.018 or >1.035. 
• They are photophobic. 
• They bolt from physical disturbance. 
• They are thermally intolerant.

Without listing more, that last one seems the best.....they indicated "immediate 100% mortality" above 82.4 degrees Fahrenheit and below 64.4 deg. F.

 

We can take our reefs comfortably into the mid- or even upper-80's. 

 

Anyone ever tried this?

 

[Lypto]

I had an outbreak that caused issues with the toxins they produce, they also crowded out all my corals and a few seemed to munch on GSP. They might be interesting but not a guest I want to keep. Upper 80's makes corals start to bleach as far as i've seen. Though with otherwise good parameters, and with a slow transition, a high temp might  work.

[mcarroll]

18 hours ago, Lypto said:

Upper 80's makes corals start to bleach as far as i've seen. Though with otherwise good parameters, and with a slow transition, a high temp might  work.

Not impossible, but bleaching would def. make me think something besides the temperature was going on.

 

(Temp's in the 80's were pretty common before LED lighting...wouldn't it be funny if these worms had been around the whole time but LED's and the ensuing cooler tank temperatures allowed them to go nuts?  Apparently they were first even seen and identified from an aquarium population....so they were unknown in the wild.)

 

21 hours ago, mcarroll said:

above 82.4 degrees Fahrenheit

Temp's in the 80's are more common in the Tropics that a lot of folks think....I was told 86 is about average for Palau.  Surface waters in the 90's around Indonesia aren't totally rare.  (Of course the story is different the deeper you go...)

 

But you don't need upper 80's.....anything over 82.4 is what the study found.  Low- to mid-80's should work from the sounds of it.

 

My first reef was kept purposefully at 82.9 just to keep there from being a huge day/night temperature swing due to the halide lights....SPS did great in that tank.  (So did mushrooms....grrr.)

 

Temperate reefs may be a different story....if you're keeping critters from Aus. or HI or the Caribbean, for example.   While 82-83 might be on the high side in those areas I'm not sure it's dangerously high even for those areas.

[Lypto]

Huh that's interesting! Palau and Raja Ampat are kinda special because the corals there are pretty resistant to bleaching in high temps and high acidity. I like the theory that they've always been in the hobby, just kept down by metal halides and t5s. If I find any flatworms I'll set up a test and try it out! I'm also curious to try higher temps vs. growth.

[chaostactics]

2 weeks post treatment no flat worms no livestock loss

[chaostactics]

Nearly 3 weeks, no signs of flat worms, no live stock loss to speak of.

[Lypto]

Have you treated it since then? It might not be a bad idea to make sure there's none hiding. 

[chaostactics]

On 3/16/2020 at 12:32 PM, Lypto said:

Have you treated it since then? It might not be a bad idea to make sure there's none hiding. 

Welp that's a 100% accurate statement. I found some again yesterday 😭. Treated again this time with about 20% higher dose. This time around I'm planning to re-treat in 2 weeks.