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internal parasite

Internal parasites / wasting disease

Progressive weight loss and sunken belly despite normal or increased appetite, often with abnormal feces (stringy, white, or mucus-laden). Caused by various internal parasites including Hexamita, Spironucleus, Capillaria, or other nematodes. Common in wild-caught fish and recently imported specimens.

Medium prioritypattern match not diagnosis1 source note

Do first

  • Observe feces closely white, stringy, or mucus-laden feces are a key indicator.
  • Move the fish to a hospital tank for treatment if possible.
  • Do not attempt to feed heavily compromised fish with internal parasites often cannot absorb food efficiently.
  • Do not share equipment between hospital and display tank without sterilization.

Escalate if

  • Fish declining rapidly despite treatment consider whether humane euthanasia is appropriate.
  • Weight loss so severe the fish cannot swim or feed effectively.
  • Visible worms at the vent see camallanus-worms entry for specific protocol.

Water clues

These readings can push this pattern higher or lower in the triage result.

ammonia above zero+1

Poor water quality can worsen condition but is not the primary cause check water anyway.

nitrate above 80+2

Very high nitrate combined with internal parasites accelerates decline.

Care protocol

Follow only the steps that fit your species, tank inhabitants, and medication label.

Differentiating internal parasite types

  1. Hexamita/Spironucleus (protozoan): white stringy feces, wasting, sometimes hole-in-the-head; very common in cichlids and discus.
  2. Capillaria (nematode): white thread-like feces; can cause dramatic wasting; common in discus and wild-caught cichlids.
  3. Camallanus (nematode): red or pink worms visibly protruding from the vent see the camallanus-specific entry.
  4. Cestodes (tapeworms): extreme wasting despite good appetite; white segment-like material occasionally visible in feces.
  5. Definitive diagnosis requires microscopic fecal examination or necropsy.
Cautions
  • Do not treat blindly with multiple antiparasitics at once.
  • Some parasites require different medications incorrect treatment wastes time and stresses the fish.

Treatment protocol

  1. For protozoan parasites (Hexamita, Spironucleus): treat with metronidazole in food if eating, in water if not.
  2. For nematodes (Capillaria, etc.): treat with fenbendazole (Panacur) available in food or water formats.
  3. Treat for the full course protozoan treatment typically 5–10 days; nematode treatment may need 2–3 rounds.
  4. Maintain excellent water quality in the hospital tank throughout treatment.
  5. After treatment, offer highly nutritious food to help the fish regain weight.
Cautions
  • Metronidazole is hard on the liver avoid repeated courses without confirmed need.
  • Fenbendazole kills helminths slowly do not expect immediate improvement.
  • Do not treat with both simultaneously unless advised.

Source notes

References and context notes used for this triage entry.

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