Unsure if worms or velvet

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Colt13

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TLDR; multiple fish scratching on sand/rocks, white stringy poo, little appetite, white sugar sized grains on face, possible fin rot. One fish has died but didn’t have the grains, one fish that does (that didn’t before) is not acting right and is breathing heavily ish

Long story, I had a fire fish that died from some sort of parasite white thing coming out of its side (at least that’s what I think killed him). The royal gramma in the tank with him at the time looked fine so I didn’t treat for anything. (Stupid). I then got a coral beauty and it and the gramma looked fine for a few weeks. I then got an ignitus anthias and 2 clowns on the same weekend. This is where things went bad. I noticed the anthias would scrape on the sand every once in a while and it was a very picky eater. After the first week, it died. It’s tail was rotting I believe but I’m not positive as the coral beauty got Territorial and would scare it, although I never saw them make contact so it’s possible it’s tail was picked at. Then, I saw the coral beauty scraping on stuff and a few days later saw the royal gramma doing it. I thought it was flukes so I freshwater dipped the CB. These long things that seemed to be worms of some sort came out but he ate them immediately. I then gave the CB away to a friend who said they’d take him and treat him. (I also wanted him out as he was being territorial). So now I’m down to the clowns and the gramma. I saw my larger clown scrape on my gyre once I think, but that’s all I’ve seen. My gramma started swiping on the sand a lot, every 5 minutes or so. I then dosed GC into the tank (Sunday night) and prepared GC food with focus. I noticed the big clown had white stringy poo 2 days ago (Monday). Haven’t seen any since. Now, since Monday, the gramma has been acting poorly and isn’t in his caves as usual, he’s just resting on the bottom near the back wall a the base/under a rock. This morning, I looked at him and he has small sugar sized grains on his face and is still breathing relatively heavily. So do I have a worm problem? Or velvet? Or ick? Or all? I could set up a QT but I’d rather not have a tank with no fish for 76 days. Unless that’s my only option. Thanks
 
If it’s more white specks than you can easily count it’s most likely velvet. Not sure about the worm.
 
Wow! Sorry for all your troubles.

Sounds like you've got the internal parasite issue addressed. Keep feeding the GC food for 10-14 days. Can add plain USP epsom salts to help the fish pass the dead worms. 1 tablespoon per 5 gallons of tank water. Can redose once the next day or so.

Salt sized spots and just a few of them sounds like Ich. You've got a decision to make. Here's a thread that may help you. A freshwater dip can help remove some of the parasites on the fish's gills so it can breathe a bit easier and buy you some time.

 
Wow! Sorry for all your troubles.

Sounds like you've got the internal parasite issue addressed. Keep feeding the GC food for 10-14 days. Can add plain USP epsom salts to help the fish pass the dead worms. 1 tablespoon per 5 gallons of tank water. Can redose once the next day or so.

Salt sized spots and just a few of them sounds like Ich. You've got a decision to make. Here's a thread that may help you. A freshwater dip can help remove some of the parasites on the fish's gills so it can breathe a bit easier and buy you some time.

They’re more like sugar sized and there were a decent amount. I’ll try to get a picture or see the progression when I get home later and update. Thanks for the help
 
If it is velvet, is quarantine with copper the only thing I can do? And are my clowns already infected even if they don’t show any symptoms?
 
Chloroquine Phosphate or copper are your medication choices.
You should assume, as velvet reproduces almost exponentially, that all the fish in the tank have been exposed. Velvet often attacks first within the gills unseen. Clowns BTW are often the "last man standing" in a tank of velvet infected fish.
More info:

 
I know this pic isn’t ideal, but can anyone tell? Could it be ick? Or velvet?

DB6EB08C-7855-4EBE-A423-3A2424F366B2.png

Note: it looks worse and the dots are more numerous in person
 

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