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General Treatment for Ill Fish

Last Updated: 4/28/10

I wrote this page after making the same e-mail and forum reply so many times that I should have written this page years ago! What follows are general treatments and specific treatments for sick fish when you do not always know what is wrong. After the mention of each specific product, there are photo links to the products at Drs. Foster and Smith (DFS). Those links no longer work because they discontinued their affiliate program. I left them up because the photos at least show you what the products look like so you can recognize them at your local aquarium/pond store.

Generic Treatment
Treatment for Bacterial Infections
Treatment for Fungal Infections
Treatment for Parasitic Infections

I wrote this page off the top of my head on 2/9/07 and 3/6/07.

For more information on bacterial, fungal, and parasitic infections of fish, check out my fish health page two.

Generic Treatment

Sometimes, we do not have a clue what is wrong with our fish. Probably more often than we do! We can ask people on the internet, as the local pet store, and so on but we do not always know. If you really do not know what is wrong but there is something wrong, I suggest the following. These are the specific products that I use.

Check your water's pH, hardness, ammonia, nitrite, and oxygen levels to be sure they are okay. I did not find the test kits I have at DFS but here are some others.
Do a 50% water change. I do weekly 50% water changes on my tanks with gravel vacuuming.
Add the following: Aquarium salt at a tablespoon per five gallons, MelaFix, and Stress-Coat. To read about the benefits of salt, go to this section. MelaFix by Aquarium Pharmaceuticals is an all natural antibiotic. Stress-Coat by Aquarium Pharmaceuticals is a dechlorinator with aloe-vera. Alternatively, use aquarium salt and another brand of dechlorinator (also called water conditioner). The link below to MelaFix has a photo of PimaFix (a related product) but if you click on it, it goes to both products.
If the tank does not already have good filtration and aeration, improve those things. Put fresh activated carbon to the filter to help remove unseen problems. If the fish is in a bowl, upgrading to a tank is the best thing you can do to help save ailing fish.

Treatment for Bacterial Infections

For bacterial problems, you basically follow the treatment above plus add an antibiotic. Bacteria are very common in tanks. They only become a problem when a fish can no longer fight them off. Bacterial problems can include internal and external infections. Internal infections include dropsy, septicemia (blood streaking, bacteria in the blood), fish tuberculosis, eye infections (like popeye), and more. They are hard to treat. External infections include fin and tail rot (fin loss), columnaris (white patches), and local infections that normally are sites of injury.

The antibiotics that I normally use are Maracyn I and II by Mardel which are erythromycin (kills gram positive bacteria) and minocycline (kills gram negative bacteria) respectively. Gram positive bacterial problems may include fin and tail rot, popeye, columnaris (which sometimes looks like a fungus), and bacteria that take advantage of physical damage. Gram negative bacterial problems may include dropsy, popeye, fin and tail rot, and septicemia. You see there is some overlap because different species of bacteria can cause the same problems. There are many antibiotics out there from which to choose. Some may work better than others for a particular problem. Keep in mind that some antibiotics kill good bacteria which will send up the ammonia levels. That happened to me years ago when I added penicillin to a tank.

Treatment for Fungal Infections

Fungal problems appear as fuzzy, hair like white stuff that often occurs at the site of an injury. For this reason, it is often good to treat not just for the fungus but also for bacteria. That means you would do the generic treatment above and perhaps the bacterial treatment as well. In addition, a fungal treatment may be required if there is truly fungus (some bacteria like columnaris can resemble fungus). The fungal medication that I have used is MarOxy. It is also supposed to help with some bacterial infections. The all natural PimaFix by Aquarium Pharmaceuticals is a safer alternative but, in some cases, it may not be strong enough. Note, that as we go down the page on my site, the medications become stronger and more dangerous for fish who are less tolerant of chemicals such as scaleless fish like catfish.

Treatment for Parasitic Infections

Parasites are the easiest problem to diagnose. Which treatment you follow depends on the specific parasite. There are hundreds of medications out there to treat parasites. Some of those "medications" will kill shrimp, snails, and/or sensitive fish (catfish, scaleless fish, orfe, etc.) so it can be a gamble to try these harsher treatments. I suggest using the generic treatment above in addition to a parasitic treatment. Also, sometimes parasites cause a secondary bacterial infection requiring treatment against bacteria as well.

There are external and internal parasites. External ones include ick/ich (white spots), velvet (gold flaking), flukes (gill, body), fish lice, anchor worm, and fish leeches. Internal parasites include worms.

For ick and to treat quarantined fish for parasites, I have used Aquarisol. For general (unknown) parasites, something like Clout or Maracide by Mardel might work. I've also used Parasite Clear which are fizz tabs. For worms, metronidazole (which also kills bacteria) might work. All of these medications may prove deadly for snails and shrimp and some more sensitive fish.