How to tell the difference between Hexamita and Capillaria

Hi, I posted on this forum a while ago when my 'king' discus developed a mystery illness: white faeces, turning dark, lifeless, not eating. Treated for Hexamita with all the available treatments, but to no avail. I then treated with Levimisole, followed by prazi - no result. I did lower the PH to 6.5 and the discus appeared to pick up for a couple of months - gained weight and white poop stopped, but then it came back, stronger and worse than before. Two weeks ago, he finally passed away.

I was actually relieved, because treatment could finally stop and I could enjoy my discus again. But one day later, seriously, one day later, the breeding partner of the dead discus started with the white poop! I couldn't believe it, like something is playing tricks on me. The other discus were healthy the entire time and endured all the treatments (I don't have a QT tank), then one day later after her partner dies, she gets the dreaded white poop.

So now I have to treat again, arghhhh. I've dosed with Octozin, followed by mixing metro into thawed beef heart (that was the one treatment method I didn't try before). The reason I haven't dosed the tank with metro is because I'm in the UK and metro is extremely difficult to get hold of (another reason I didn't try it before). Discus is active and eating again so I was hopeful it is working, but tonight I saw another white poop. It's really thick and fluffy, and having done some research, I can see thick, fluffy poop could be a sign of capillaria, meaning I have to try Levimisole. Again!

Any advice? Should I continue the medicated food, up the dose? or move to levi? I'm so unbelievably fed up of all this. I had my discus in a community tank for years without a problem, now they have their own home it's been nothing but stress :-( I'm even dreaming about discus treatments, arghhh!

Ammonia and Nitrite 0, Nitrate 10, PH 6.5, Temp 30C, tap water used with dechlor. Discus are large, around 6 inches - does this mean they need more medicated food?

This must be tough on you. You are already putting metro in the food so if you have enough metro to complete the 12 day treatment time you should finish the treatment first. But since the look of the poop suggests worms, as you said, you will need to do the levi treatment several days later. Repeat the worming 3 weeks later or if you want to make sure you get all the worm eggs that hatch out treat 3 times 2 weeks apart.

I know how much we hate throwing meds at fish, or any other animal. I just don't see another option in this case. I hope that someone with more knowledge than I have will come up with a solution that is easier on both the fish and you.

Yeah Spacecloud,
I love how Liz put it, boss. I went through a similar scenario over the course of 15 months (good... not good... good... not good... med... good'ish... stupidly stopped early... not good... so on and so forth... the whole time wondering whether or not this was like a self-induced case of blue balls... VERY FRUSTRATING regardless).

At least if you stay disciplined (unlike me the first few times) and go through the whole treatment, then no matter what, you tell yourself to sleep good at night.

The only way to tell for sure is to examine the feces under a microscope.

I think I may have posted prematurely, because tonight, dark poo. Normal, healthy, dark poo!! I can't believe it, maybe I needed to feed Metro all along! I now understand why Americans swear by the stuff. Octozin has always worked for HITH, but maybe I needed something more internal for Hex.

Anyway, I'm not celebrating just yet. Still treating and keeping a close on it, but I'm hoping this means it's not Capillaria and I'm going down the right road with the meds. Fingers crossed!!

It's near impossible to get anything checked under a microscope without paying a fortune for a vet appointment :-(

What is your location? Even a childs microscope would probably be fine. Someone once posted about a microscope that works with a smart phone but I don't remember seeing any photo's for reference. Just a thought...

This link shows eggs at 100X https://www.researchgate.net/figure/..._fig1_51477089

Brian, dumb question time:

Do we look at poop on microscope? Or the fish?

We catch the poop while it's still in the water column. If it hits the tank floor it gets contaminated with all kind of crap. As soon as it's out of the tank you smear a very light smear across the microscope slide and take a look at it under the scope.

You know what, I can't believe I never looked into buying one. I guess I always assumed they were only used by scientists who paid 100s for them! But, yeah, kids microscopes are cheaper than some of the fish meds I've bought. Dammit. Next time (hoping these won't be a next time).
Thanks for the tip.