They are definitely not the same. But identifying them as one or the other is kinda hard IMO. I have seen both and experienced both, and sometimes the spots are smaller than normal white spots from ich. And this leads me to believe that it may be velvet, but then it clears up. If it was velvet, that would not be the case, if by what I read is correct. Velvet attaches to the gills first and by the time you see it on the fish it is too late, and the fish are usually dead within 48 hours. I had 2 fish in a 10 gallon go this way. Now the situation is my tangs in my DT have shown spots in the past that cleared up, but the ones appearing on the kole tang are very small and resemble the velvet, but I am leaning towards a minor case of ich, just by how the fish is responding. No scratching, no flashing, no heavy breathing, eating and behaving normally. This is what is frustrating to me, because I don't what the best action is to take.