Most of the newer studies point to water quality issues and diet, rather than the actual parasite being the cause. They suggest that people who use metro believe the medication is solving the problem when in fact, it is the increased frequency of water changes as a result of using the meds that is making the largest difference. Larger cichlids are more likely to end up with it as a result of inadequate filtration and/or water quality. Larger fish use up the electrolytes in the water much quicker than smaller fish. Fish that produce a lot of waste either in the form of leftover food or poop will greatly impact the water chemistry. The water change routine that worked when the fish was little may not be advisable for a larger fish.
