Avoiding Clownfish Diseases:

    Selection of initially clean, pathogen-free livestock is of paramount importance. Wild-caught/captured livestock should be avoided in place of captive produced (tank-bred and reared) specimens. Wild specimens almost always have pathogenic issues...

    All specimens should be isolated/quarantined for a minimum of two weeks to assure their health, as well as screen any pathogen from being vectored into your main display/s. Do NOT count on your dealer to have performed this crucial task... Even captive-produced specimens can be easily exposed to pathogenic disease agents by careless mixing of gear, water in a commercial setting. If treatment is necessary, this MUST be accomplished in a separate Treatment Tank/System. "Medications" may well kill your other livestock directly and/or indirectly if applied to your main/display system/s. Quarantine, Quarantine Marine Fishes, Dips/Baths

    Provision of an optimized, stable environment and good nutrition is of course necessary. Know and provide a good-sized volume for the species in question. At least forty gallons for a pair of the smaller species, and double this minimum for the larger. Ocean Nutrition's frozen Pygmy Angel formula,  Piscine Energetics Mysis, Cyclop-Eeze, good quality flake (e.g. Omega-C) and pelleted (e.g. Spectrum) prepared diets are good choices for energy-dense, quality and palatable foods that can supply all nutritional needs.

Chart of Disease/Causative Agents vs. Symptoms and Suggested Treatment Moda, ex. photo, Microscopic details? (Mmm, later)
By Symptoms: (ref./links)	Causative Agent/s	Suggested Treatment Moda	Graphic
Discoloration/Mottling, Hiding, Hanging in Corners: Marine Environmental Diseases, Toxic Water Conditions,  Aggressive Behavior,	Most often either environmental or social/territorial trouble/s. Too much crowding (Clowns are NOT social animals... like mostly in pairs in the wild, and NOT found in close association with other Clown species by and large). Some markings are genetically predisposed and not uncommon in tank-bred specimens.	Improved environment and nutrition. Adding Cleaner Organism/s may help.
Raised Pimples:	Bumps/traumas, run ins with spiny, stinging tankmates, subsequent reaction/s to netting, shipping, handling, captive stress. Unless these are numerous, such spots rarely portend pathogenic disease, though sometimes are indicative of encysted worms or microsporideans.	Improved environment and nutrition; anthelminthic and anti-protozoals if indicated. Adding Cleaner Organism/s may help.
Cloudy, otherwise damaged eyes: Pop-eye/Exophthalmia, Cloudy Eyes & Eye Injuries	If unilateral (one-sided) most often due to physical trauma. If bilateral (both sides) or other fish life similarly afflicted, due to poor environment and/or nutrition. Rarely due to infectious or parasitic agents.	Improved environment and nutrition. Adding Epsom Salt, Cleaner Organism/s may help.
Clumpy, loose cottony growths on fins, bodies: <See Protozoan parasites below>	Most often the result of parasitic infestation, but can be just excess mucus production from chemical exposure, poor water quality.	Further diagnosis, formulation of a treatment plan and execution. <See Protozoan parasites below>
Long, white, or stringy feces... possibly "plugged up"  likely not feeding...:	Internal parasites (of the lumen)... usually protozoan (e.g. Octomita/Hexamita) or worms of various possibilities. Even just resultant from poor adjustment, acclimation... Recent moving, introduction to a new setting.	Isolation, feeding of medicated foods (Protozoacide and Anthelminthic), and/or administration of anti-protozoal and deworming agents to the water possibly. Epsom Salt.
Rapid Breathing, Shallow or Deep:	Indicative of either pathogenic, environmental and/or social disease.	Testing of water quality, water changes, diagnosis, formulation of a treatment plan and execution.	Less than twenty or more than sixty gill movements per minute.
Fine Dust Appearance, White to Tan in Color:	Most often Amyloodinium, though other Protozoans can appear this way as well.	Further diagnosis, formulation of a treatment plan and execution. <See Amyloodinium below and Cryptocaryon pix for comparison>
Discrete Pin-head Sized Spots on the Body and Possibly Fins:	Most often indicative of the protozoan Cryptocaryon irritans.	Further diagnosis, formulation of a treatment plan and execution. <See Cryptocaryon below>
Slimy Appearing Aggregate White Filmy Material on the Body:	Most often Brooklynella, but can be Amyloodinium, Uronema, other protozoans.	Further diagnosis, formulation of a treatment plan and execution. <See these Protozoans below>
Clamped Fins, Disoriented Behavior:	Often a response to a reflection of the fish itself. Also general response to low oxygen, poor water quality period. Possibly infectious or parasitic problem.	Check water quality, amend. Where, when in doubt, a good sized (20-25%) water change. Apply dark paper to side of tank being "paced".
By Causative Agents:
Genetic Defects:	Missing pieces of fins, eyes... Bent jaws (as shown), vacuolations/scalloped portions of the head, back... Diffuse, weird patterning, less-bright coloration... Dark spots, areas...	If the animal appears and behaves functionally otherwise...
Trauma; Physical & Social: Aggressive Behavior,	Obvious physical damage, psychological expression (hiding, not feeding...), from tankmates (here one stung by a cnidarian host; Euphylliid), decor, rough netting, pump intakes, jumping up to the hood, lighting...  Jaws stuck open (may be from an obstruction that may be cleared).	Moving the aggressor or victim/s. Improving water quality, bolstering immune systems with vitamin/HUFA supplementation. Cleaner organism presence may help.
Poor Environment: Marine Environmental Diseases, Toxic Water Conditions,	Nitrogenous et al. metabolite accumulation effects. Burning of gills, sores, broken fin membranes, labored breathing, bilateral exophthalmia...	Corrective action... water changes, chemical filtrant use.
Poor Nutrition: Nutritional Diseases	Shows as wasting, poor activity, poor color, death...	Offer foods of high palatability, soak same in appetite stimulants.
By Viral & Infectious Disease:
Lymphocystis (Lymph, viral): Lymphocystis, Viral Disease	White to gray clumpy, cauliflower-like appearing bunches most often on unpaired fin membranes. Expresses itself most often in stressed individuals, poor environments.	Pulling off large/r masses seems to trigger the host immune system. Improved water quality, nutrition. Possibly the addition of a purposeful cleaner organism.
Bacteria, Fungi: Infectious Marine Disease (Bacteria, Fungi)	Almost always secondary to some primary trauma or poor water quality issue. Appear as open, un-demarcated/non-emarginated sores, cottony patches.	Find and rectify the root cause/s. Water changes, improved water quality and nutrition. Rarely are antibiotics necessary or useful.
By Parasitic Agents:
Octomita/Hexamita, other internal protozoan and possibly worm parasites	Not eating, wasting away, disorientation, occasionally shows as bloat...	Consecutive or concurrent application of an anti-protozoal and possibly an anthelminthic
Amyloodinium (Velvet):  Velvet Disease/Amyloodiniumiasis	White film to small discrete tan to whitish fine dotting... lack of appetite, rapid respiration, lots of mucous. Rapid onset disease... may kill within a day.	Copper, Formalin can work... with diligence, testing (at least daily), replenishment... But the anti-malarial Chloroquine diphosphate  at 5-10 mg/L for 10 days is the best route to go.
Cryptocaryon (White Spot Disease, Ich): Marine Ich/Cryptocaryoniasis, Marine Ich: Fighting The War On Two Fronts	Discrete, "salt" sprinkled spots on the body and fins.	Formalin or Copper-based medications. FW dips/baths are not efficacious by themselves.
Brooklynellosis (Clownfish Disease): Brooklynellosis, "Clownfish Disease"	Detached threads/shreds, thick cloudy mucous on skin. Very common protozoan parasite in wild-collected specimens, and with others exposed to systems with these in it...	Formalin baths are recommended, with sterilization, movement of affected fishes to new quarters. Not often treatable with copper.
Uronema:	Smooth depigmented, pitted, lesions of defined borders, often pinkish (flesh showing through). Hyperactivity then listlessness.	pH-adjusted freshwater baths, formalin dips. Must be caught, treated early to avoid systemic infestation.
Crustaceans: Copepods, Isopods... Parasitic Crustacean Diseases, Isopods, Pill-Bugs that aren't such a hoot	Isopods most often in the mouth, though do occur attached to the body. Segmented, grey, unmistakable. Copepods often as "sticks" with heads buried under scales or attached to the skin of the fins.	Adults are best removed via careful tweezering. The system needs to be treated (generally with an organophosphate) to kill the intermediate stages.
Worms: Parasitic Worm Diseases (Trematodes/Flukes, Nematodes, Turbellarians, Acanthocephalans...	Various phyla (mono- and di-genetic trematodes aka Flukes, Acanthocephalans, Nematodes... External ones may appear like spots (dark or light colored), worm-like... internal species can manifest themselves as bloating, prolapsed colons, a lack of feeding, general malaise, stringy, white feces...	Application to foods and/or water with a purposeful anthelminthic.
One more time: Other Protozoans, Worms (e.g. Black Ich/Paravortex): Many	Various appearing... bloody markings, torn fins, black spots..., to no symptoms...	Good livestock selection, quarantine, possible regimens of pH-adjusted FW dips, with formalin... Use of anti-protozoals... and anthelminthics...

About Definitive Diagnosis:

    Assuredly, the only real means of determining the root cause of expressed disease is through scientific testing... And for causative organism determination, through microscopic techniques... This last is not difficult, nor need it be expensive, and much can be discerned with a low-power scope (a couple hundred magnifications) of simple skin/slime prep.. As I have long-attested, the investment in a simple microscope like the QX- series by Intel/Mattel can more than make up its small expense in saved livestock, medications, thrown away water etc. The single best reference book actually costs more. Ed Noga's work, Fish Disease, Diagnosis & Treatment is an excellent (though expensive) resource.

Notes on Moda Above & Therapeutic Agents of Use

About Quarantine, Treatment and Main/Display Tanks: All incoming Clowns should be isolated for at least two weeks, particularly wild-collected specimens. Isolation-only systems are termed Quarantine... Treatment tanks are where actual medications are applied. It is extremely rare that fishes should be treated in their Main/Display tanks... for fear of killing off other livestock, biological filtration microbes, and the very real likelihood that the presence of materials there will counteract the efficacy of treatments. Quarantine, Quarantine Marine Fishes, Dips/Baths, Acclimation Articles

Improved environment and nutrition: Stable optimized water quality is key. Total absence of ammonia and nitrite, minimum (less than 5 ppm) or nitrate are requisite. Undercrowding, live sump/refugium (with macroalgae, DSB...) use, careful maintenance, regular upkeep of skimmer, use of chemical filtrants... Foods that are entirely nutritious (e.g. Spectrum pellets), soaked in Vitamin and HUFA supplement (e.g. Selcon). Vitamins in Marine Systems, Iodine/ate/ide Use

Copper Compounds: Free cupric ion or chelated formats (e.g. CopperSafe, Cupramine). MUST be administered carefully, as there is a narrow range of cure to kill in exposure... MUST be tested for concentration at least daily with a matching type Copper Test Kit... Copper Use

Epsom Salt: Epsom Salt, Magnesium Sulfate and Other Salts & FAQs,

Formalin/Formaldehyde: I encourage folks to only use Formalin, or a formalin-based remedy as a dip/short bath... is very toxic (a biocide...) to all life, including aquarists- I'd use 1 drop per gallon of a stock (37%) solution. Do aerate the dip/bath solution and observe the fish VERY carefully during this procedure for signs of distress and remove if things look bad after a few minutes. If you can, a 5-10 minute dip is efficacious, moving the fish/es afterwards to a new/un-infected setting. Formalin, Formaldehyde Use

Quinine Compounds: Quinine Compounds & FAQs,

Organophosphates: Are "economic poisons", intended for use in killing terrestrial insects mostly. They can be used to advantage (with care) in treatment for crustacean parasites in aquatic settings. DTHP/Masoten/Dylox/Trichlorfon... Dimilin (diflubenzuron)... variously sold in products such as "Fluke Tabs" (tm), Clout (tm),  Med-Aqua (tm)... Organophosphates (DTHP, Masoten, Dylox, Dimilin...

Anthelminthics (anti-worm agents): Prazi tm (Praziquantel), Pipzine tm (Piperazine), Hexamit mixed in food or water, Jungle Anti-parasite Medicated Fish Food Metronidazole/Flagyl

Protozoacide:  Chemicals introduced into the food and/or water to kill single-celled animals/parasites. Most notably Metronidazole (Flagyl tm); New Life Spectrum Thera+a

Antibiotics/Antimicrobials: Materials used to kill and reduce the virulence of bacteria, fungi... Kanamycin, Spectrogram, Chloramphenicol, Furan compounds (Nitrofurazone e.g.), Triple-sulfa (sulfathiazole, Sulfamethazine and Sulfacetamide). Antibiotics, Antimicrobials and  Pet-fishing & FAQs, Furan Compounds (Nitrofurazone/Furacyn...) & FAQs, Sulfa Drugs & FAQs,  

Cleaner Organisms: Biological Cleaners, Cleaner Shrimp, Neon, Cleaner Gobies/Elacatinus, Gobiosoma,

Phony Non-Cures to be Aware of:

Hyposalinity has been advanced as a "for sure" cure for various Clown ailments. Unfortunately such lowered specific gravity trials rarely effect cures in the short or long-term. As you might assume, these fish species, living in close association with their invertebrate hosts, are sensitive to the same sorts of environmental changes and challenges... This being stated, pH-adjusted freshwater baths, with or w/o additives, can be of use in temporarily relieving specimens from external troubles and efficacious in removing external disease agents. Placing host fishes back into infected/infested systems is of course contra-indicated.

There are a mix of "reef safe" "cure-all" "remedies" touted/sold on the market for treating the various maladies listed above... Most all of these are outright scams... with parasites "cycling off" with their application or no... to return in force later... What can I say/write but "let the buyer beware"... Do investigate (thoroughly) such curatives... If they don't list their ingredients, ignore them... If their clams are specious, keep shopping... Tea/Leaf extracts, "Vital" this and that, pepper sauces (sigh, yes)... are not useful. Garlic... best used on pizzas, pasta dishes, some soups.

Bibliography/Further Reading:

Mattel/Intel QX Microscopes: http://www.compuvisor.com/qx5diblmicom.html?gclid=CIG74-zWjowCFQv1YAod5GB46Q

Noga, Ed. 2000. Fish Disease; Diagnosis & Treatment: http://www.amazon.com/Fish-Disease-Diagnosis-Edward-Noga/dp/081382558X/ref=sr_1_1/103-2945648-4573462?ie=UTF8&s=books&qid=1179180675&sr=8-1

Wilkerson, Joyce. 1997. Clownfishes: http://www.amazon.com/Clownfishes-Joyce-D-Wilkerson/dp/1890087041/ref=sr_1_1/103-2945648-4573462?ie=UTF8&s=books&qid=1179180712&sr=1-1