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Body sores or ulcers
 Ulcer Disease is almost always caused by Aeromonas bacteria or more rarely Pseudomonas bacteria. Clinically, I wouldn't know which because I rarely culture the pathogen. Why not? Because the results could take a week to return, and by that time, all the affected specimens would be dead. I have treated ulcer disease with the following drugs: Enrofloxacin, Chloramphenicol, Gentamicin, Amikacin, Tetracycline, Nuflor and Azactam. I inject these drugs.
No discussion of this problem would be complete without reference to swabbing techniques, antibiotic enriched feeds, injection technique, and prognosis.
Provided elsewhere are drug dosing information, etc, needed to enhance your understanding of this disease. Suffice it to say, that to save these fish, my core recommendations would be to get the fish into a heated environment, provide impeccable water quality by regular testing, swab the wounds with Debride or Mercurachrome, Feed MediKoi feed, inject Enrofloxacin and or Chloramphenicol, and hope that the next spring that the fish does not bloat due to retention of latent bacteria in the kidney after clinical cure.
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Body features patches of raised scales
This fish is generally on it's way to Ulcer Disease
Those areas of raised scales will often "blow out" to reveal full blown ulcers. Sometimes, parasites have chewed those holes, and also very often, the owner will have rocks around the edge of the pond, at the water line. The fish, in their eagerness to eat will bash their heads and napes on the rocks and develop these lesions.
Here's what you do:
- Check your water quality, first. Pay special attention to nitrates. If they are over 100 then there's something wrong and this can make the fish more vulnerable to bacterial and other attacks.
- Then you haul up the affected fish and scour their wounds with hydrogen peroxide, regular strength from the drug store. Afterward, it helps considerably to dress the wounds with Debride. It only takes one or two dressings to achieve a good result.
- Inject any fish which is of particular value, either sentimentally or economically. The details of injection are beyond the scope of this web page and are described here.
- Salt the pond up to 0.3% and seriously consider, if there are no Goldfish, a prophylactic treatment with SupaVerm.
- Observe and remove any ornament or stones which might be contributing to the lesions.
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Body has red blotches on it
Again, I'd be on the lookout for a full blown Ulcer Disease case. I'd endeavor to test my water for all parameters pertaining to nitrogen and pH. Here's a kit that does it. We don't generally "dress" reed blotches with any medication, In these cases I recommend water testing, a major water change with Dechlorinator, then feeding medicated food while applying salt.
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Worms protruding under scales
 Lernea elegans, the most common type of Anchor worm affecting Koi, is a real threat. They attach ventrally, they hold on for about 14 days, and they reproduce copiously. The wounds they create almost always infect with Ulcer disease bacteria, Aeromonas, and then you have two problems.
Treatment can be undertaken with Malathion, Fenthion, Trichlorfon, Dylox, Dimilin, and SALT. Salt works very slowly by killing the freeswimming reproductive forms. Malathion just kills the Lernea dead, but is dangerous to the fish. Fenthion is slow but safer.
Dimilin is great if you can get it. EPA and FDA will trounce you for having and using the agricultural version but there is a form (Anchors Away) easily available.
Caring for the fish: I do recommend removing any adults you see attached and swabbing the wounds with Iodine, Debride or mercurachrome.
I do recommend also feeding an antibiotic food when you see Lernea to head off problems.
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Round "bugs" on skin are greenish and active
Argulus is a crustacean or branchiurian parasite most commonly encountered in ponds, but they are also found in aquaria. They are easily detected when they strike. They are greenish disc shaped organisms with suckers and small legs. They even have a pair of eye spots on the anterior end. They spend their time darting around in the water away from, and also directly on the fish. They lay their eggs in tubular structures on the glass and ornaments.
They can be very destructive to fish stocks.
They carry Aeromonas and other bacteria on their feeding stilletto and thus infect each fish they bite.
Treatment is by the application of the insect growth regulator, Dimilin, or Diflubenzuron.
Another method is more dangerous: Organophosphates like Trichlorfon, Masoten, Dylox, Dipterex, FLAW, Malathion and Fenthion. Anchors Away is also an organophosphate. i resist the use of these, because losses may result. Dimilin is superior to these compounds when fighting Argulus.
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Tiny white pinheads in skin
Ich (white spot disease) rapidly kills smaller tropicals and goldfish, while sometimes sparing the larger varieties (fish such as Oscars and Koi). Damage to the gills is the primary way it kills, but damage to the skin with secondary bacterial infection may also figure prominently.
Its life cycle is roughly 2-5 days, but can be longer (5+ weeks!) if the water is cool, much shorter if the water is warmer. There is the old rumor that warm water eradicates it. This is substantially true when temperatures exceed 85 degrees, however; there are strains coming out of Florida and detailed by researchers at University of Florida that can survive and thrive up to NINETY degrees or more! Recall that many of our bread and butter species of tropicals come from Florida, and so may harbor this heat tolerant strain.
The parasite has a phase that encysts in the epidermis of the fish as previously stated (called a theront). It matures under the skin and finally drops off, falling to the bottom (becoming a trophont) to divide into numerous (hundreds) of tiny swarmers (tomites) that actively seek out a host on which to encyst and renew the cycle of infection. Because an important phase of its life cycle occurs on the bottom of the aquarium, it is for this reason that you can help limit infections with water changes made by siphoning the gravel, removing those dividing Ich packets.
Interestingly, some research at Oklahoma has revealed a strain of Ich that does not have to leave the fish and whose Ich packet (trophozoite) remains under the epidermis (safe from medications) and the tomites swarm out under the epidermis. The lesions look much like Carp Pox lesions, being large, flattened, and waxy looking. This parasite is harder to clear because it is the free swimming tomite that we can kill with medicaments.
1. Remove valued live plants.
2. Raise temperature to 80 degrees, tops.
3. Increase aeration!
4. Add one teaspoon of salt per gallon.
5. Twelve hours later, add another one teaspoon of salt per gallon.
6. Twelve hours later, add another one teaspoon of salt per gallon.
7. Within 48-60 hours of the second salt dose at 80 degrees, the Ich will be gone.
8. Leave salt in the water for another 3-5 days unless you're worried about your live plants.
9. Remove salt via partial waterchanges. (30-40% at a time if desired).
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White waxy globules in fins and skin
 CARP POX is another virus of a dermatological nature, that also has a low transmissibility from fish to fish, and is again, not fatal, merely disfiguring. The lesions are soft and waxy, not warty and rough. The lesions should not be scraped. They may be differentiated from Lymphocystis because they do NOT cause the cells to become huge (megaloblastic) in size. The way Lymph does. There is no treatment, and lesions do not resolve as well as Lympho lesions do. You should be aware that CARPPOX lesions are very, very rare in North America. Many people report that warming the fish up, and salting to 0.3% are sometimes sufficient to remedy these lesions. The belief is that the warmth stimulates the immune response and the lesions clear on their own.
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White patches (slime) on skin
 Often, something is eating at the skin, such as a parasite like Costia. This is the most common slime-causing parasite. Still, many other parasites can ALSO cause the fish to appear slimy.
Just as often as parasites, slimy skin can be caused by a pH which is too low. The fish usually hang listlessly at the surface and develop strings of slime on them. A quick check of the pH will illustrate the point.
A soaring nitrate number as well as difficulties with other nitrogen numbers can cause the slime coat to become thick and plainly white. But usually this is not patches of slime. the fish are entirely slimy.
So, if I had a fish with patches of white slime, I would check (kit) my water for Ammonia, Nitrite, Nitrate and pH as well as carbonate alkalinity. Then I would salt the pond ot vat to 0.3% and if at all possible, get someone to do a scope biopsy on the fish. It is also possible to effect a remedy of the affected fish by swabbing the white slimy patches with regular drugstore strength hydrogen peroxide, one time. This is effective on the fish but not on the parasites or water quality issues facing the group.
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Scales coming off
The fish are flashing for some reason, or they are suffering from some sort of pathogenic attack. I have seen scales knocked out by Herons, cats, or kids with sticks. Fish will also knock out their own scales by "flashing".
Flashing can be caused by several things, including temperature changes, parasites, water quality changes, high pH or low pH, nitrogen accumulation, or bacterial infections. (Test with this all in one kit)
The most common cause of flashing is a pH which is not to their liking, or a parasite problem. Among the parasites, the most common causes of flashing are Flukes and Trichodina.
Stabilizing the pH is a good idea to relieve flashing behaviors caused by pH changes or a low pH.
Killing off Trichodina and other parasites can be accomplished with salt in many instances. Flukes can be controlled by several methods including SupaVerm and Fluke Tabs. Follow all instructions for dosing as most fluke remedies are toxic of overdosed or left in too long.
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Body is rough, no slime coat
Sandpaper skin is usually secondary to a bacterial infection and "rough skin" usually means the fish has pretty much "had it" and the body is shutting down. A reasonably healthy fish with imune system "on line" can generate a slime coat as fast as parasites can chew it off. When a fish is about to "check out" they lose this resilience and the sandpaper skin is the result.
Still, certain parasites can cause sandpaper skin, such as Costia and Chilodonella. These parasites are tough. Costia sometimes resists salt treatments. The problem is then that you might need potassium permanganate or Formalin for these parasites and then, those treatments are really tough on a fish who's already under the maximum US RDA of stress.
Also, crazy people who use Potassium or Formalin, or Salt as a stiff short term bath treatment can also burn off the slime coat. The fish has still basically "had it" but at least you can be satisfied that you did it yourself and that if you'd just leave the rest of the fish alone they'll be fine.
You can attempt to save such fish by smearing them up (all over!) with Debride ointment and injecting them with antibiotics. For some reason, saltless water with A LOT of live plant matter also seems very helpful if you're sure there's no need for salt. (Salt and plants don't generally mix) - What I usually will do, once I am sure there are no parasites, is remove the sandpaper fish to a clearwater vat with a lot of aeration and then put so much Parrots Feather in there that the fish pretty much has to wend it's way like a snake through the strands.
The other fish should be salted to no more than 0.3% and fed medicated food to stave off any infection they were about to succumb to.
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