Quarantine tanks and Hospital tanks, are they really different?

[Andy Sager]

There have been recent conversations and confusions here on the proper use of Quarantine tanks and Hospital tanks. These are just some of the questions I’ve seen asked: “How long do I need to keep my fish in QT?” “Do I medicate in QT or in a Hospital tank?” “What do I keep in what tank?” “Should I cycle the tank first?” “WHY do I need to keep my pet in Quarantine?” The simple answer to all these questions is Yes, No and it depends. ( See why there is confusion? ) I will try to simplify a rather complex situation and hopefully, this will help shed some light on why there are so many different answers. This information is from the culmination of my many years of working within every aspect of the tropical fish industry. My hope is that it makes your aquatic keeping experience more enjoyable and less stressful.

Part 1: The Quarantine Tank
There are a number of factors to consider regarding quarantine which I will break down for you. Let’s start at the beginning……..
The goal of most aquarium keepers is to create an environment in an enclosure that is not only pleasant to look at but that also keeps its inhabitants healthy and happy for a long time. Sounds simple doesn’t it? If it really were that simple, why doesn’t it work every time we set up the “correct” setup for our watery friends? The answer to this brings us to the crux of this article.
If you were to look on the internet and talk to people, you will find many sites and people with opposing views on the need to quarantine fish and the benefits or harm for doing so. So how are you to know what advice or site to follow? Here are the facts to help you decide:
First, the best way to achieve the above goal is to put only healthy animals into that enclosure. How can you assure that what you put in is healthy? Quarantine!
Aquatic creatures can carry many diseases and pests that not only affect themselves but that also just use the creature as an intermediate host to get to another stage of life. Snails, for example, are known to carry many different types of parasites that use the snail as an intermediate host ( meaning that its life cycle needs to be completed in the animal or fish that eats the snail.) There are also fish that serve this same purpose. One of the easiest examples of this to explain is on the Silver Dollar fish. Wild Silver Dollars often will have black “pimples” that are actually encysted trematodes that are waiting for a bird or mammal to eat the Silver Dollar so that the trematodes can complete their life cycle. They are doing no harm to the fish other than being an unsightly hitchhiker causing minor irritation if anything. So, if you see a black spot on your otherwise non black fish, there is nothing to worry about, right? WRONG!! There is also a black spot disease on Goldfish (mainly) that looks similar but is much more harmful than the encysted trematode. This is just one example of why you should quarantine new fish but this gets more into diseases that would be best explored in another thread.
Let’s now look at the differences between the fish you are looking to add to your collection.
As many of you know, there are many fish that are now bred and raised or created on fish farms. These farms are found around the world and as such, “local” diseases or parasites can find their way into your pet fish or snail or whatever if they were raised in outdoor ponds or tanks or came in contact with wild or exposed fish.
Then there are the wild varieties that are collected in their native habitats. These fish are collected then sent to a distributor then sent to either a wholesale house for further distribution to pet stores or to end consumers like you and me.
Some of you may be thinking “Well, I have never had any issues before so is this all REALLY necessary to read?” The answer to this is in the following questions.
Are wild fish different than similar ones from the fish farm? Yes they are. Wild fish usually carry parasites and pathogens that are different or different variants than fish on the farm. In their natural habitat, fish in good health (usually in healthy environments) use their natural defenses to keep these pathogens and parasites at bay. It’s usually only when the fish is under such duress that it succumbs to a disease or parasite. Farm fish on the other hand, are often raised with antibiotics and medications to keep them healthy while in overstocked tanks and pools so the fish’s natural defenses are not what are keeping the fish healthy. (I should also say that not all farms overstock their tanks but how do you know what farm type your fish came from?)
Let’s now look at the journey your new pet went through to get to you.
With wild fish, many are caught in areas that are not close to major transportation such as planes and trains so they have to travel to a distributor that is. This can take hours or it can take days depending on the collection site. (The fish may change hands several times before getting to where you got them from. )
Farmed fish are usually grown in one location then picked and housed in a “shipping” tank while they wait to be placed in a shipping bag. The facilities for this are usually closer to major transportation to reduce the amount of time the fish need to be in a bag as well as reducing costs for transportation.
Here’s what you may not know:
At any point during the trip, the wild fish could be medicated to ease the stress of the journey or treat a disease that resulted from the trip. Then, when they are sent to their next stop on their way to you, usually to a distributor, they could be medicated again to ease the stress from their last journey or treat a disease. Then the fish may be medicated when they get to the wholesaler or pet store to ease the stress of the journey or treat a disease that resulted from the trip. Farmed fish on the other hand, are usually sent (delivered or shipped) in medicated water so as to help reduce disease from the overcrowding in the bag during transit or as a preventative against disease caused by shipping stress. At your local favorite fish store, the fish may be medicated as well as a preventative against disease caused by shipping stress. But how would you know since not all medications contain dyes?
“So what does all this have to do with a Quarantine tank or Hospital tank????” you may be asking yourself. Well, I’m getting there.
Now that you know what your new pet has gone through to get to you, that they can harbor all kinds of diseases and that wild fish are different than farm raised fish, we can now explore the reasons to or not to quarantine.


 The Merriam- Webster online dictionary defines Quarantine as follows:
 : the period of time during which a person or animal that has a disease or that might have a disease is kept away from others to prevent the disease from spreading
 : the situation of being kept away from others to prevent a disease from spreading

The purpose of a Quarantine tank would be to keep your new pet away from your other pets while it proves that it is not carrying a disease that may infect your current pets. When you take into consideration that your new fish or animal may have already been medicated, possibly multiple times, during its journey to you, the need to immediately or automatically medicate your new fish while in quarantine is not present. A quarantine tank is for observing to see IF your new pet is carrying a disease or subject to disease/infection as well as other reasons that I will get into later. (What to do if your fish gets sick in quarantine will be discussed in the hospital tank portion of this article.)
At this point, I need to digress a bit to explain the different common issues that fish suffer from during transit and in quarantine.
Bacterial and Fungal infections are usually found at wound sites. In the case of fish, if the fish’s slime coat, their natural defense against bacterial and fungal infiltrations, is damaged or removed, bacteria or fungi use this opportunity to infect your fish. Same goes for a damaged fin or a skin wound. So if a fish is damaged during transit, it is common to see a bacterial or fungal issue within days.
Parasites are different to bacteria and fungi in that they have multiple life stages that range in time based on the parasite and temperature. We all know the dreaded parasite “Ich” but there are many other parasitic “nasties” that are much worse than ich and common in fish. So don’t think you are scott free just because your fish didn’t get Ich.
So, what needs to be in a quarantine tank? There is a debate within the aquatic community concerning quarantine. One side states that a fish should be stressed under quarantine to bring out any diseases so that they can be medicated and removed from the fish to shorten the time in the quarantine tank. The other side to this debate is that it should be set up as a place for the fish to be comfortable and stress free while it adjusts to its new surroundings, new water parameters, new foods, new light schedule and the new people performing these things. I personally can’t say that one is right and one is wrong as both methods have merits however, it is my opinion that stress free is a better method all around.
How large or small does a quarantine tank need to be? The answer to this question is “ It depends on what you are quarantining.” You will use a different size tank for quarantining an adult Oscar fish, for example, than for a school of, say, 12 adult Neon Tetras. So there is no one answer for how large or small. If you follow the “stress free” method I described above, you want to have an appropriate size tank for the fish to comfortably live in for some time. It’s a “display” tank to get the fish ready for life in your MAIN display tank and should be treated as such.
How long in quarantine is long enough? That is going to depend on what you are quarantining. Wild fish would be better served if kept longer in quarantine than farm raised fish. Considering that some parasites can have a life cycle of over 60 days, if you don’t know whether your wild caught fish was ever medicated against internal and external parasites, you would be best to keep them in quarantine for at least 60 days or longer. In a properly set up quarantine tank, the fish can stay as long as they need with no ill effects.
For farm raised fish, there are some other considerations to take into account. There are now viruses found in certain Farm Raised fish that are not found in wild fish ( i.e. Dwarf Gourami Virus, Angelfish Aids, Koi Pox, etc). A quarantine period for these fish with known “man made” disease potential should be longer than fish that inherently do not suffer from common diseases. That said, if you follow the theory of “ Better safe than sorry”, all quarantine should be at least 60 days +. In that period of time, any wounds would have become infected then be treated and parasites should be through a full life cycle that you would have seen or had been eradicated. If the fish are still healthy at that point, they should be a welcome addition to your main display tank(s).
Can I use one tank to quarantine all my new fish? It depends. Separate tanks ( or separate times) should be used for wild fish and for farm raised fish. As previously explained, these two types of fish can carry different diseases that can spread to each other as natural immunities to the other’s pathogens most likely are not present.
Do I need to quarantine everything? It is highly recommended. Even fish received from private breeders can suffer damage during transportation. If you know or trust the private breeder’s fish, the quarantine period can be reduced but should not be eliminated totally.
How can I avoid doing a quarantine tank? (With all I’ve described above, do you really want to not quarantine?? ) The answer is by keeping a single specie tank where all the fish come from the same source at the same time is about the best way to prevent disease spread. Doing this however does not guarantee your fish will not get sick. It just makes it harder for disease to spread to other tanks when using good tank equipment hygiene.
Do I keep the quarantine tank running when I am not getting or planning on getting new fish? It is not necessary to keep this tank running if you have the ability to create a stable environment in a new enclosure in a short amount of time or if you have no plans to purchase or receive new aquatic pets in the near or not so near future. A properly maintained aquarium regimen has a plan. That plan is as simple or complex as you want to make it. A pre determined stocking list always helps so that you don’t overload your display tank, creating an environment that is unbalanced and can cause its inhabitants to get sick, fight with each other or worse, kill each other. While “impulse shopping” is a bad thing when it comes to live animals, sometimes, you just see something that you just can’t resist. ( I’ve been there, done that and can guarantee it will happen again. ) So what do you do? The answer is, keep a quarantine tank running all the time. That way, your impulses don’t have to have potentially devastating effects on your display tanks.
How do I “have the ability to create a stable environment in a new enclosure in a short amount of time? One of the easiest ways is to have an extra filter running in your main display tanks so that it too has a biological bacteria bed. A sponge filter is one of the easiest and cheapest filters to use for this. All you would need to do is move this extra filter to the quarantine tank while the new fish are in there. ( It is recommended to sterilize this filter before resetting it in your display tank once quarantine is completed.) Another option is to keep some extra padding or filter material in the main display tank’s filter that can be used to “seed” another filter in the quarantine tank. This material too should be disposed of once quarantine is finished.
How do I keep the Quarantine tank biologically active when I am not planning on any new purchases? In the past, this was done by keeping certain “ gets along with everything” type fish in the tank to keep the biological filter at good strength. Today, since the development of the “fishless cycle” method, by simply adding appropriate forms of ammonia or ammonium to the tank, you can keep your pre established biological filter running at full capacity at all times so it’s ready for your planned ( or impulse) purchases.
Where do I set up a quarantine tank? A quarantine tank should be kept away from your other tanks when possible. Just a single drop of water with a pathogen, splashed into a neighboring tank, can start the decline of your hard earned display tank so distance is your friend here. Quarantine tanks should have their own equipment (i.e. nets, hoses, buckets, etc.) so that there is no chance that a disease can ‘accidentally” be introduced into a main display tank. That said, this tank should be run in a similar manor to the display tank your new pet will, hopefully, be moving to. Same light schedule*, same water parameters, same feeding schedule and foods, same maintenance schedule, etc. so your new pet gets used to what is going to be a routine once it is moved to the display tank.
* It is recommended that dim lighting be used for the first week or so to avoid excess stress. Dim lighting will help ease your new pet into their new situation. The adjustment to your lighting should be gradual.
Where one gets their fish from will determine how serious it is to quarantine. Without bashing any source here, where you get your fish from plays an important part in how healthy your new fish/pet will be when you get it/them. A healthy fish has a better chance of surviving the quarantine period than a sick or sickly one does. (Better to have a sick or weak fish die in quarantine than in your main display tank for a whole host of reasons.) Some places use a centralized system where multiple tanks share the same water. Depending on how the place prevents the spread of disease, extra care should be used when getting fish from these types of systems if no or poor prevention methods are used. Ask the store how they prevent disease spreading throughout their system. If they use machinery such as UV sterilizers, ask how often they change their bulbs. They should be changed every 8-12 months or sooner when used consistently. If they use medications and you still see sick fish in any tank in the system, consider that either the medicine is not the correct one for the particular disease or that the disease has an immunity to the medication. Neither is a good indicator that you should be buying fish there.

Hopefully, there is enough information here for you to understand that a quarantine tank is not just another tank that is taking up space or that NEEDS to be filled permanently with fish. It’s a piece of equipment, as important as a filter, to protect your efforts in creating a beautiful, healthy display tank for you and your aquatic pets to enjoy. In part 2, I will discuss the Hospital Tank.

 

[Andy Sager]

Part 2: The Hospital Tank
There are going to be times when even doing the most for your new pets does not stop them from getting sick or injured. When the condition is serious enough to medicate, this is best done in a separate “Hospital” tank than the quarantine tank for multiple reasons.
If you have ever been unfortunate enough to have been in a hospital as a patient or as a visitor to a patient, have you ever noticed that there is not much in the room for the patient? There’s a bed for rest, a bathroom for showers and eliminations, a closet for cloths and a sink for washing up and brushing teeth. Anything else in the room is more for the visitor than the patient. ( TV sets are not standard in all hospitals around the globe. ) The purpose of the hospital room is for the patient to recover from whatever ails them. That is how you should think about a hospital tank. It’s a place for the pet to be treated for and recover from what ails them. The less stress they have to go through during this recovery, the faster the pet will recover. This is what makes a hospital tank different from quarantine. In a quarantine tank, you want the fish or pet to be active and adjusting. This takes strength and energy. When you medicate a pet, they can often suffer from a lack of energy so you want them to have to expend the least amount of energy to help them recover.
I can see the wheels turning in your heads and you now are thinking “I have to have another tank just for a hospital tank?” Actually, it doesn’t have to be a “tank” but it does need to be able to hold a measured amount of water. Since most fish are not medicated by their weight, the medicine companies offer a pre measured amount of medication for a certain amount of water in the form of powders and pills. And just like you don’t take a whole bottle of aspirin when you have a headache, you don’t use more medicine for your pet than you have water for them. Here in the U.S., in many cases, these powders and pills are measured for 5 or 10 gallons of water. That means 5 or 10 actual gallons of water. A 5 or 10 gal tank does not hold 5 or 10 actual gallons of water so make sure your container can hold actual amounts of water. Depending on what medicine needs to be used, here’s a list of things I have used as “Hospital” tanks: Glass tanks ( better than acrylic in case of using dyes), Buckets, Bowls, Plastic filing containers, Plastic shoe boxes, Jars, Bags and Garbage cans. As long as I can measure water in it and it holds enough to medicate in it, I’ll use it. Obviously, what I am medicating determines which of the above I will use. You just need to use a container appropriate for the size of the fish being medicated. Keep in mind that medications can be expensive so you want to use the smallest best option to keep the costs down without sacrificing proper treatment.
**The first rule to a hospital tank is that it should be sterile to start with.**
What needs to go in a Hospital tank? If you recall what I said earlier was in a human’s hospital room, even less than that needs to be in a hospital tank. The pet needs rest and a stress free environment, and that is simple to supply. Keep the hospital “tank” ( I will use the word “tank” instead of container from here on out just for simplicity’s sake) somewhere away from high traffic areas and bright lights. Bare bottom tanks are better than tanks with gravel or a substrate for a variety of reasons. If you are treating for internal parasites such as worms, you want to be able to see when they have left the fish’s body. If you are trying to eradicate an external parasite naturally, you don’t want the parasite to be able to hide in gravel or substrate to move on to its next life stage. If you are medicating for an external parasite ( i.e. Flukes or Anchor worms), you want to see them on the bottom of the tank to know that the medicine is actually working. If you have treated your pet and it looks healthy enough to return to the quarantine tank, you want to make sure the fish is defecating and that is easiest seen in a bare bottom tank.
In place of a bed for resting in, choose items that do not absorb any medication you may be using for your pet to rest in. Rocks and decorations that are calcium based are not good ones to have in a hospital tank as they can absorb as well as alter the chemistry of the water. Woods and other items that can absorb the medicine or alter the water’s chemistry are also not good for a hospital tank. I like to use PVC fittings and pipes for my Hospital tanks. That way, when I am treating a single fish, I use a single piece so that the fish stays in it in one place and does not expend energy going from place to place. If I am medicating several fish, I will use one fitting per fish plus one or two extras only. Remember, the object is for the fish to not be stressed so as long as it has a place to hide, it is stress reduced.
Filtration: Depending on what Medication you are using, some inhibit the biological filter ( bacteria bed) so just an air stone will serve as your aeration. Generally, when you start with a sterile environment and the fish are eating regularly, it takes a few days or even a week to see any appreciable amount of ammonia buildup. The Ph of the water can also effect the effects of ammonia. Depending on the medication, in a week’s times, you will have already done multiple water changes as per the directions on the medicine, so the biological filter is not necessary. In cases when the fish is/are not eating, the ammonia production is down to almost nothing so biological filtration is not necessary while in the hospital tank as well. It is important however, to check ammonia levels to prevent any buildup due to overcrowding. To remedy this, the use of a larger Hospital tank is recommended as well as water changes opposed to chemical cures such as Seachem’s PRIME or SAFE, etc. to correct the situation as you don’t want anything to interact with the medication you are using. You can check with your product’s manufacturer to see if there are any interactions with the specific medicine you are using however, ammonia buildup due to overcrowding is best remedied by a larger tank.
It is important that if you are using a mechanical filter in your hospital tank, you remove any carbon or similar agent that can remove the medicines from water. Follow the direction of the medicines to know if this is necessary for your particular treatment.
Heater: Depending on what you are treating, you may need to raise the temperature so make sure whatever you are using as a Hospital tank can safely house a heater. You don’t want a heater to burn through your tank. ( Talk about stress. )
Plants: I don’t suggest them as they can pollute the tank if they react with the medication. That goes for live or fake. A dim light works for stress reduction for your pet.
Cover: In most cases, the pet would best be served with a cover on the tank. Movement outside the tank can cause the fish to unexpectedly jump so keep the tank covered.
Water: Use of new conditioned water is best when treating your pet. Medications are designed to work best under certain parameters. Ph, GH, KH, Calcium, Ammonia, Nitrite, Nitrate, Redox levels, to name a few, all play a role in how effective a treatment will be. By using new, conditioned water, all these levels can be addressed, if necessary, without interaction from the ecology of the display or quarantine tank.
Medicine: The most important part of the hospital tank is the treatment. If you are using a medication, you need to know under what circumstances the medicine works best. For example, some medicines work better in higher Ph levels while others work better in low Ph levels. You can either check with the manufacturer of the medicine to see what is proper or use sites like these: http://www.americanaquariumproducts.com/Aquariumtreatments.html or
Fish Disease, Diseases of Fish, Medications & Fish Health Treatments to research the medications you will be using. Another option is a good book on medications and treatments. There are many on the market as well as threads on this site regarding best books to have in your library.
Treating a sick fish that was in quarantine: You have taken all the proper steps to quarantine your new pet(s) but something goes wrong and the pet(s) are now sick or have an infection. What do you do? The answer depends on what is wrong. Let’s use a school of six (6) fish for this example. For a single infected fish with a bacterial or fungal infection, that single fish can be separated from the school and removed to the hospital tank for treatment. If the issue is a parasite such as Ich or Flukes or other parasites that can effect multiple fish at the same time and/or that can spread from fish to fish, the entire school of six fish should be removed to the hospital tank for treatment and prevention. In some cases, all the fish may not show infestation but are harboring the eggs of these parasites and need to be addressed. Once again, there is no “one size fits all” answer to “What to do?” It all depends on what is wrong. By knowing what you are dealing with, it prevents the over medicating of healthy fish and prevents healthy fish in an infected tank from getting attacked.
Do I need to keep the hospital tank running all the time? No. This is one of those times that you set it up as needed to ensure that it is as sterile as possible just prior to you putting your sick pet into it. Just keep a container or containers of conditioned water at the ready.
How long do I keep my pet in the hospital tank? It is most important that you follow the directions on your medicines that you use in the hospital tank. That determines how long they will be in there. Doing water changes when directed, helps prevent toxic conditions from forming in the Hospital tank. Using the correct dosage and complete treatment helps the pet get better faster and prevents the creation of resistant strains of the pathogens you are trying to treat. Once the pet is recovered, it is strongly recommended that the pet be returned to a quarantine tank for a full cycle of observation before placing it back or into the main display tank.
Feeding your per while in the Hospital Tank: In many cases, if the pet is severe enough to be in a hospital tank, it is not eating so trying to feed during treatment is just creating a poor environment in the hospital tank. After a full round of treatment, smaller portions of foods can be used to help the pet recover before being moved back to quarantine. Small frequent feedings will best serve the pet at this point. Removal of uneaten food will be necessary to prevent ammonia buildup in a hospital tank with no filtration.

Part 3: Conclusion
As you can see, a quarantine tank and a hospital tank serve two very different purposes. To properly set up a quarantine tank means to improperly set up a hospital tank. To properly set up a hospital tank means it is not an ideal quarantine tank. You have spent hours of your time and many dollars of your hard earned money to create that “perfect” tank so why ruin it with sick or infected animals?
Considering that you do not know what your new pet(s) have gone through before you got them, by using these two pieces of equipment, you can prevent that from happening and enjoy your display tanks for many years to come.