Fish Sickness, part 2

This one might be a bit more organized.
Recap from the last post: I have 4 betta in a split 20 tank with good parms*. One of them has a symptom called popeye. The other three have problems that wouldn't be a concern for a single fish, but having four fish with these conditions together points to a bacterial infection. The whole tank is being treated with a 4-day treatment of API's Tetracycline. Tetracycline is a broad-spectrum antibiotic.

So, treatment day 2:
STEP 1: Water parameters. Something I forgot to mention is that if you're doing a several day course of treatment, you can't do water changes during. This means if your nitrates are at 35, you'll want to do a change before you do the treatment, to prevent them from going over 40.

Even if all the water parameters were fine yesterday, test them again today. This double-checks that your tests were right the first time, and it's important to know anyway. If your water quality is not perfect, always fix that before going to another treatment, unless the symptoms are life-threatening.

My tank temp is between 78 and 82. Because of the dividers, some parts of the tank are cooler than others. I have two thermometers to make sure the warm sections don't get too warm, and the cool sections don't get too cold.

I tested my ammonia, nitrite, and nitrate and came up with 0/0/10, which is good and normal. It's important to test your water ~12 hours after putting a treatment in your tank, in case it killed some of your filter bacteria.

The surface of my tank is covered with foam. This is from the tetracycline, and as long as it's not interfering with  the fish's ability to breathe, I'm willing to just keep stirring it back into the water. If I was running a hang-on-back or internal filter, I'd probably have the foam in the water chamber. Undergravel filters don't have a water chamber, so it comes out on the top of the water instead. I googled "API Tetracycline foam" to double check. Google is your friend for whenever you don't know what to do.

STEP 2: Now it's time to look at the fish. Because Twister is my sick boy, and because he was easy to cup, I put him in a cup for a few minutes to get a good look at his eye. It's still cloudy and swollen. Bo and Mr Tipsy's tumors (which both look like internal tumors, but could also be hemorrhagic septicemia, which is also bacterial) are still the same size. Bo's fins look like normal, as do Fierce Mango's. I'm feeling extremely stupid at this point for assuming that all my fish had unrelated, non-contagious diseases. That's the problem with google. You search until you find an answer that sounds right or feels right, and then you stop looking.
We all make mistakes. What's important is that, when you realize you made a mistake, you admit it and re-evaluate your plan of action.

The good news is that tetracycline can treat bacterial fin rot, popeye, and hemorrhagic septicemia, if they're all caused by the same bacteria. Since this is a shared tank, there's a good chance that's the case.

STEP 3: Take a look at your fish and make sure your plan of action is still a good plan.
First things first: Have you already started a treatment? In my case, I have. If you've already started a medicine, you need to do the complete treatment, even if the fish look or act like they've healed. Do you want antibiotic resistant bacteria? Because running an incomplete course of antibiotics is how you get antibiotic resistant bacteria.
The only exception to this is if the fish is having trouble breathing after you put the treatment in, but wasn't before you did. If it looks like the fish is having trouble breathing with the treatment in the water, you need to get them out of there.
Did you do any non-medicine treatments? These include aquarium salt added to the water or aquarium salt baths and epsom salt baths. Do those things look like they've helped? If it helped, do it again.
Do the symptoms look worse? More swollen, more ragged, anything? This might mean that you need to get more aggressive with your treatment.
How's the fish acting? Did he go from being active to being withdrawn? Did he go from swimming to lying on the floor? Is he having trouble breathing, staying afloat, or sinking? Did he go from withdrawn and back to active? Behavior is a good way to judge how your fish is feeling.

STEP 4: So now what?
If your water quality was bad, and your fish is not having any life-threatening symptoms, wait to see if their condition gets better with clean water.
If the fish had damaged fins or sides from contact with another fish or decor in his tank, are the edges of the wound looking infected? Are they looking like they're healing? Does he have new damage?
If the treatment was working, keep doing it. If you started a medicine, keep treating until you've finished the course.
If the treatment wasn't working, or wasn't working well enough, look for other options or ways to make the treatment stronger. Now might be a time to add medication, if you weren't already using it. Remember to check if you can continue salt baths or adding salt to your water while using another medication. Don't mix treatments unless you know they won't interact.
If the treatment's working, but there are other life-threatening symptoms, you need to treat those too. Sometimes you need to do whatever you can to keep the swelling down, so the antibiotic can cure the infection before the fish dies of the swelling.
If the fish is significantly worse and clearly suffering, now might be a good time to buy clove oil in case you have to put him down. It's not easy to think about it, but it helps to have it on hand.

It's frustrating, but there's a lot of taking care of sick fish that's just about waiting and watching.

It's also scary, because betta fish are small and can go into organ failure quickly and without a lot of outward warning signs, so keeping an eye on them is important.

Quick note on bettafix: I wrote a song about bettafix. It goes bettafix isn't an antibiotic. Bettafix is an antiseptic. Don't use bettafix on things it isn't designed to treat.
And then you repeat that for five hours. I have an EP i'm releasing in april.
Also, when using bettafix, watch out for an oily shine on the water. If you see that, skim it off. A lot of people say it can damage a betta's lung-like labyrinth organ.
In general, there are treatments out there other than bettafix, and bettafix is popular because it's so cheap. Like with any treatment you use on your fish, google is your friend.