Visible symptoms present in diagnosing coldwater fish health

*Please note any combination of the symptoms may be present INCLUDING no visible symptoms at all. Symptoms listed are not necessarily in order of likelihood. This is not a definitive list of all possible causes, signs and symptoms, just more commonly seen issues.

**Diagnosis is advisable by microscope exam, or in some cases elimination (fix the water!).

Visible
Symptom
Potential cause (not in order of likelihood).
Gasping at
surface –
lethargic
Oxygen compromisation, Nitrite toxicosis, elevated
levels of TDS (Total dissolved solids), General poor
water quality
Floating
upside down
at surface
including
buoyancy
issues
Compromised or failed swim bladder function, genetic
defect (present inherently in some fancy goldfish
through selective breeding), air in gut through
‘gulping’ (quite common in fancy goldfish and some
sturgeon species – notably juveniles).
Laying on
side on
bottom of
tank
Swim bladder compromised, temperature issues
(excessive cold can influence fish in this manner)
Redness of
fins, may
include
bloodshot
streaking or
fraying
High ammonia, parasitic (Flukes, costia, chilodonella,
tricodina,whitespot…), high nitrite, high TDS,
poor/cramped living conditions, damage.
Fins rotting
away
Bacterial infection – columnaris/flexibacter
Milky
appearance
to
skin (excess
slimecoat/
mucus)
Parasitic infection (costia, flukes, trichodina,
chilodonella, whitespot…), poor water parameters or
dirty water, chemical in water,
Fluffy
Fungus on
body, eyes,
fins
Saprolegina, highly likely to be a secondary infection to anything on the list.
‘Waxy’ lumps
appearing on
skin
Koi/Carp Pox – generally worse in lower temperatures.
‘Lumpy’
tumors on skin
appearing to
originate
from under
scale(s)
Benign tumors. May grow to large sizes. More
common on ornamental species.
‘Lumpy’
tumors on
skin – may
appear
ragged or
unsmooth
Hikui (on red/orange pigments), benign growth, excessive breeding tubercles in
male fish (notably large common varieties of
goldfish)
Small red
patches
appearing on fin. May show scales being
damaged
Bacterial infection, damage through injury
Ulcers on
body and skin
Bacterial infection, damage though injury (excessive
flicking and rubbing due to parasites and/or poor water
quality).
Dropsy –
pineconing of
scales
Organ failure, infection through injury – Unable to osmo-regulate correctly.
Emaciation,
sunken
eyes
Starvation, parasites – heximita, internal worms (too many to list and varies by species), genetics, poor quality food. Distress caused by any of the above causing the fish to avoid food.
Colour
change of
fish
Natural colour changing  (particularly cyprinids), Areas of black pigment appearing can indicate damage repair and usually recedes, some chemical treatments
when combined can induce a full colour change –
usually to black.
Flicking/
Flashing
and
erratic
behaviour
Parasite infection, poor water quality, neurological
issues, electric shock, oxygen compromisation.
Fish
deceased –
no visible
issues
Any of the above, organ failure, genetic complications or
just end of life (old age).

A word of warning, there are many general treatments available and some aquatic retails are bound by brands they supply and will try to push certain treatments and offer a general pond tonic. These generally are not sufficient without accurate diagnosis.

Advice: Do your own research (not on social media or down the pub!), eductate and upskill yourself, and contact an independent specialist if available in your area. This may involve a fee (experience and knowledge has a value! And it is their employment!). You can save a lot of money and heartache this way. Your fish should be treated as a pet like any other animal.