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Discussion Starter · #1 · (Edited)
Fish Treatment Tips
by Marc Elieson

I wrote this article as a general guide to help you along in the process of medicating sick fish. This particular article is not African Cichlid-specific, but the principles here can be applied to most all Freshwater species. While it is meant to be a general guide in its scope, it is still detailed, and I hope that you find it useful as well as helpful.

Hospital Tanks

If you are treating one or just a couple of sick fishes with any type of medication it's a good idea to place the fish(es) in a separate "hospital" or quarantine tank. You will want to do this for at least a couple of reasons. First, the medication would destroy the beneficial bacteria that have been established in your substrate and filter. Most medications advertise that they target only harmful bacteria, but this isn't always as true as we would prefer. It also makes sense to isolate the sick fish and prevent further exposure to your still-healthy fishes. Plus, there isn't any need to subject your healthy fishes to the stress induced by most medications. There are times; however, when you have several sick fishes, in which case, it makes most sense to treat the whole tank.

The tank used for isolation should hold at least five to ten gallons of water and be provided with lots of aeration. A simple air pump and stone will suffice. A box filter containing only floss, no carbon, may also be used. You will want to remove any carbon in your filters because it will very effectively remove the medication. It's also a good idea to use a heater to maintain a stable temperature, if not to raise it. Gravel and other decorations are not necessary, although I like to use gravel so that the fish will feel more comfortable with the new environment.

There is no need to cycle the quarantine tank or use an established filter. As stated above, medications will kill off a healthy bio-filter making it pointless to use an established tank or filter. If you are not using medications, you should perform partial water changes on a daily basis to protect fish from rising Ammonia levels. But, if you are using medication, follow the drug's instructions, as some clearly indicate not to do water changes. With these drugs, you will want to do a water change before and after treatment.

Water Changes

While regular partial water changes, gravel vacuuming and filter maintenance are always vital to the health and well-being of your fish, these things are even more important during times of illness.

Fish become sick when the immune system is compromised by poor water quality, improper or unstable water conditions and/or water chemistry, fluctuating temperatures, overcrowding, shipping (as in newly purchased fish) or any other stressful situation. A lowered immune system inhibits a fish's natural ability to fight off illness and disease. Keeping water in top condition will help to strengthen fishes' immune systems, enabling them to use their own natural defenses to fight the illness.

Water changes and gravel vacuuming may also help to partially remove the cause of the illness. For example, the parasites that cause an outbreak of 'Ich' fall from the sick fish's body to the bottom of the tank where they reproduce and then swim freely in the water. Performing extra partial water changes and vacuuming your tank's gravel will help to remove some of these parasites before they are able to infect another fish.

If you're going to perform water changes in your quarantine tank, make sure the temperature and pH match those of the water you're replacing. You don't want to stress the fish anymore than it already is because stress is what inhibits a fish?s immune system from functioning optimally.

Remove Carbon

Activated carbon is used to remove chemicals, medications, and dyes from the aquarium; therefore, it should be removed from all filters before and during treatment. If you do not remove the carbon, most medications will be rendered useless before they have a chance to be effective. When you have finished treatment and performed a partial water change, you should replace the carbon in order to remove any remaining traces of the medication.

Raising the Temperature

Higher temperatures (i.e., roughly 4-6 degrees F higher than normal) can prove beneficial for the recovery of your sick fish. Higher temperatures increase a fish's metabolism and boost their immune system. Depending upon the pathogen, higher temperatures might speed up their lifecycle, bringing them out of resistant stages faster, thus making it possible for medications to eradicate them more quickly. And some pathogens do not tolerate higher temperatures at all and will die off when the temperature is increased, even without medicating.

There are a few things you should consider before raising the temperature of your aquarium. First, you must be sure that the species of fish you are keeping will be able to tolerate the increase. Next you must be sure the aquarium has adequate aeration, as an increase in temperature will lower oxygen levels. Once reasonably sure that an increase in temperature will be safe for your fish you should proceed slowly and cautiously, monitoring your fish at all times for signs of stress. The increase should be made slowly, by no more than 3 degrees per day, and should never exceed more than 90 degrees. For African Cichlids, an optimal medicating temperature is around 78-80 F. If your fish shows signs of stress due to the increased temperature slowly lower it back into a reasonable range.

Using Salt

Salt, when used in moderation in a freshwater aquarium, can be beneficial. Salt is particularly effective in treating parasitic infestations. The salt reduces stress by improving gill function and reducing osmotic pressure. It also aides in the healing of wounds, promotes a healthy slime coating, compromises parasites' viability, and reduces the fish's uptake of toxic chemicals such as Nitrite.

Freshwater fish maintain a natural balance of electrolytes such as potassium, sodium, chloride, calcium and magnesium in their body fluids. These electrolytes are extracted from the water by the fish through cells located in the gills and are essential for the uptake of oxygen and release of carbon dioxide. When fish are sick or stressed, their gill function is disturbed and fish may suffer from a loss of electrolytes through the gills, also known as Osmotic Shock. A lack of electrolytes can cause breathing difficulties along with various other health problems. Adding the proper type and amount of salt to the aquarium will help to replace electrolytes that the water may lack.

Salt may be used as an aid in treating illness with most species of freshwater fish or on a regular basis with some species, particularly Goldfish and various Livebearers such as Mollies, Guppies, Swordtails, but not African Cichlids. Africans require hard alkaline water. Other "salts" can be beneficial in raising and maintaining pH, GH, and KH values. See my article on Aquarium Salts for more on this.

Type of salt to use:

Non-iodized. This type of salt contains no additives that could potentially cause problems for your fish and/or tank. This may be sold as Freshwater Aquarium Salt, Kosher, Canning or Rock salt and can be purchased at either a pet/fish shop or a supermarket/grocery store. The salt used should contain no additives such as yellow prussiate of soda or iodine. Iodinized salt may be used for Tanganyikans, as trace amounts of iodine are found in Lake Tanganyika. In fact, goiter is not an unusual occurrence with N. leleupi, which can be prevented by the moderate use of iodinized salt.

Administer 1 Tablespoon of salt for each 5 gallons of water.

Note: This dosage may also be used to ease stress when acquiring new fish, to ease Nitrite toxicity when a tank is cycling, or in combination with various medications when treating a variety of illnesses because the salt prevents a fish uptake of nitrite.


Salt should be dissolved in a separate container using water from the tank before being slowly added to the aquarium. Caution: Salt does not evaporate and is not affected by filtration or the use of carbon and can only be removed through water changes. To maintain a proper level in your aquarium the full amount should be added only once initially. Only the amount that has been removed with each water change should be re-added. For example, with a 10-gallon tank, you would only add 2 Tablespoons of salt initially. After a 50 % water change you would only need to re-administer 1 Tablespoon of salt.

Dosage Amount For Treating Parasites:

There are two methods; you can either treat the whole tank or do a "dip."

1. Treating the Tank:

Add 1 Teaspoon (not Tablespoon) of non-iodized salt for each 1 gallon (not 5 gallons) of water every 12 hours. Repeat this three times over a period of 36 hours to equal 3 Teaspoons of salt per gallon of water.

Length of treatment:

Salt should remain in the tank for 7 to 21 days depending on what you are treating. For parasites such as Ich, 7 to 10 days should be sufficient. For more stubborn parasitic infestations, a longer duration may prove necessary. When treatment is completed salt can be removed by performing a series of partial water changes without re-adding salt.

2. Salt Dip - Bucket Method:

Using a clean bucket, add ½ cup salt to 1 gallon of fresh dechlorinated water having the same temperature and pH as the tanks water. Once salt has dissolved place fish in bucket for no longer than 5 minutes (time it!). In most cases the fish will immediately float to the top of the bucket and lay on its side, this is normal. However the fish should still be moving. Should the fish stop moving entirely immediately remove it from the bucket and place in freshwater. Never dip for more than 5 minutes, doing so could kill the fish.

Salt Usage Caution: Although salt may have many benefits a word of caution may be advisable when using salt with certain species of fish. It has been noted that some scaleless species as well as certain types of catfish, most notably the rarer species of the Corydoras family, may not tolerate the use of salt. However many would argue this point.

Medications Caution

Medications made especially for aquarium use have the potential of saving your fish's life if used cautiously and correctly. However, if not used properly these same medications can kill it. Almost all medications are chemicals that can be quite toxic to fish, humans, and other pets if not properly used, stored and controlled.

The basic principle behind medicating is to only kill what is causing the illness (e.g., bacteria or parasite) with the appropriate chemical. The two major dangers of medicating are overdosing and overusing.

Medicating, even with the proper dosages, is always stressful to fish. However overmedicating is not only stressful but can be toxic. Using too much of any medication can be lethal. When medications are improperly used, pathogens can build a resistance to them, making them ineffective upon subsequent application. For this reason, it is very important to only medicate when your fish are sick and that you follow all instructions for the medication. Never use a medication if you are not reasonably sure of a diagnosis or if it's not specifically designed to treat the illness at hand. Using a medication that is not made to treat the illness that your fish has will not only prove useless, but may in fact cause both immediate and future harm to your fishes.

Reducing Stress

Sick fish are stressed fish. Stress generally plays some role in a fish becoming sick in the first place, as stress lowers the immune system's ability to deal with parasites, which in turn leaves fish open to disease. If you consider all of the factors contributing to the stress of your sick fish, you might get an idea as how important it is to reduce that stress. The sickness itself, a new environment (quarantine tank), and any medication definitely cause stress.

Anything you can do to reduce the stress of a sick fish will help to hasten its recovery. Keep lighting dim. Cover the tank with dark paper or cloth if necessary. Take care not to startle fish by making sudden movements near the tank. When you remove the fish, remove it with a cup (full of water) instead of a net. Use water from the tank from which you removed the fish for the quarantine tank.
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