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What to do if your fish has Stringy White Poop.

Fish do a stringy white poop for several reasons.
1) Internal Bacterial Infections causes the fish to stop eating, swell up like a balloon, breath heavily at the surface or near a filter outlet, do stringy white poop, and die within 24-48 hours of showing these symptoms. This cannot normally be cured because massive internal organ failure has already occurred.


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2) Internal Protozoan Infections cause the fish to lose weight rapidly (over a week or two), fish continues to eat and swim around but not as much as normal, does stringy white poop. If not treated the fish dies a week or so after these symptoms appear. Metronidazole normally works well for this.

There is a medication (API General Cure) that contains Praziquantel and Metronidazole.
It's interesting that API and the Californian government have listed Metronidazole as a carcinogen. That's a concern considering it was widely used to treat intestinal infections in people.

Anyway, if you use this or any medication, handle with care, don't ingest or inhale the medication, and wash hands with soapy water after treating the fish or working in the tank.


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3) Intestinal Worms like tapeworm and threadworms cause the fish to lose weight, continue eating and swimming normally, and do a stringy white poop. Fish can do this for months and not be too badly affected. In some cases, fish with a bad worm infestation will actually gain weight and get fat and look like a pregnant guppy. This is due to the huge number of worms inside the fish.

Livebearers like guppies, mollies, swordtails & platies are regularly infected with gill flukes and intestinal worms. If the fish are still eating well, then worms is the most likely cause.

You can use Praziquantel to treat tapeworm and gill flukes. And use Levamisole to treat thread/ round worms. If you can't find these medications, look for Flubendazole, which treats both lots of worms.

In the UK look for:
eSHa gdex contains praziquantel that treats tapeworm and gill flukes.
eSHa-ndx contains levamisole and treats thread/ round worms.
NT Labs Anti-fluke and Wormer contains flubendazole.
Kusuri wormer plus (contains flubendazole) - sold mainly for discus, comes as a powder which is quite hard to dose in smaller tanks
Sera nematol (contains emamectin)

Remove carbon from filters before treatment and increase aeration/ surface turbulence to maximise oxygen levels in the water.

You treat the fish once a week for 4 weeks. The first treatment will kill any worms in the fish. The second, third and forth treatments kill any baby worms that hatch from eggs inside the fish's digestive tract.

Treat every fish tank in the house at the same time to prevent cross contamination.

You do a 75% water change and complete gravel clean 24-48 hours after treatment. Clean the filter 24 hours after treatment too.

Do not use the 2 medications together. If you want to treat both medications in a short space of time, use Praziquantel on day one. Do a 75% water change and gravel clean the substrate on day 2 & 3. Treat the tank with Levamisole on day 4 and do a 75% water change and gravel clean on day 5, 6 & 7 and then start with Praziquantel again on day 8.

The water changes will remove most of the medication so you don't overdose the fish the next time you treat them. The gravel cleaning will suck out any worms and eggs that have been expelled by the fish. Repeating the treatment for 3-4 doses at weekly intervals will kill any worms that hatch from eggs. At the end of the treatment you will have healthier fish. :)


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Thanks to essjay for providing the information about deworming products available in the UK. :)
Great post,
Though I wanted to add that with bacterial infections they may not bloat up and may take longer to die than 24 hrs.

In Mycobacteria Haemophilia it causes emaciation and wasting that takes weeks to kill.
 
You do a 75% water change and complete gravel clean 24-48 hours after treatment. Clean the filter 24 hours after treatment too.
The gravel cleaning will suck out any worms and eggs that have been expelled by the fish. Repeating the treatment for 3-4 doses at weekly intervals will kill any worms that hatch from eggs. At the end of the treatment you will have healthier fish. :)

I have a heavily planted aquarium including rocks and wood... I can't do a proper complete gravel clean as I can only reach a very small portion of the gravel with the gravel cleaner... I can only hope that after doing the treatment 4 times all worms and their eggs are gone... Is there additional advice for my case? Do a 5th treatment maybe?

Thank you in advance!
 
You don't need to do a 5th treatment. If you can hoover over the plants (as close to the gravel as possible), it should suck up any worms or eggs on the top of the gravel and remove them from the tank. Then unless the fish are digging up the gravel, they should remain free of worms.
 
I will suggest you read this before you decide to put medication in all your tanks. Not saying the above isn’t correct but I think we should also know the other possibilities for white poop that don’t require such drastic medication before making a decision.

Constipation means not being able to poo, so it is actually true.
Stringy white poo is a symptom of either a bad diet/something they ate, or certain infections such as Capillaria (the usual cause) or Hexamita. Constipation is caused by a blockage in the digestive system, which usually means a bad diet over a long period, although a single meal/food or an inedible item can cause it.

Both of these symptoms need to be cured...

Because fish live in water I don't think they can get Constipated technically.

They can. :)
I noticed the veterinary article contradicts some of these other posts.
 
I will suggest you read this before you decide to put medication in all your tanks. Not saying the above isn’t correct but I think we should also know the other possibilities for white poop that don’t require such drastic medication before making a decision.
cafishvet.com

Stringy White Fish Poop: Normal or Sick Fish? - Fish Vet

White fish poop is not a parasite. Learn what white stringy poop in fish actually means and if you need to be concerned about it in your fish tank or pond.
cafishvet.com
cafishvet.com
(Quoted from the above link)

How can I tell if poop is really a parasite?

Yes, the “white fish poop” does look a lot like an internal parasite. But unless your fish have come into contact with any wild-caught fish, invertebrates or unsanitized décor items, the chance of them getting an internal parasite is slim to none. In the 10+ years we have been in business, seeing over 1,000 clients, we have diagnosed it three times. All of these cases involved wild-caught fish. The biggest different between an empty fecal cast and a parasite is that one is alive and the other is not.
(End quote)

I have to disagree with the section about wild caught fish and inverts being the main cause of internal parasites. In my experience, which is considerably longer than the vet's, wild caught fishes generally have a lot less health issues, diseases and parasites (when taken from the wild or kept in an aquarium) than any fish from a fish farm, especially a tropical fish farm in Asia where over 90% of aquarium fishes come from.

The captive bred fishes from Asian fish farms are regularly fed on live foods like Daphnia/ Moina, mozzie larvae and blackworms or Tubifex worms. These are all grown in sewer ponds and are regularly contaminated with harmful bacteria, protozoa, viruses and worms. A lot of Asian fish farms also use sewer water in their ponds to make the water green and soupy.

In addition to this, most fish farms have parasitic worm infestations (tapeworm & threadworms), viruses (Gourami Iridovirus & Neon Tetra mouth virus) and Fish Tuberculosis running rampant through them. And their mis-use of medications have made many pathogens and parasites develop drug resistant strains that are extremely hard to kill.

The chances of captive bred fishes from fish farms having intestinal parasites is extremely high and much higher than wild caught fishes.
 
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