First step before you start Supaverm or Proform C medication, is to start feeding medicated food to your Koi. On the third day after you have started the medicated food (after 3 days, the blood will have sufficient amount of antibiotics to fight bacteria), treat with supaverm for 14-21 days. Continue medicated food for 14 days. No need to bypass biological filter though you need to shot down UV and carbon filter. Bacteria need about 5-7-days of incubation period to show symptoms of infection. So, if you don't feed antibiotics before and during your treatment, your Koi may be sick after a week of treatment and you conclude that supaverm made your koi sick.

Praziquantel (Biltricide): A very mild fluke treatment, Not as effective as Supaverm. However, it is very useful if a fish is too sick to be treated with Supaverm. It increases permeability of Calcium ions in flatworms which later kills them. Causes diarrhea (you may see floating fish feces). Can also be given in food (Debride anti-parasitic food) to kill internal parasitic worms. Quinine sulfate reduces the effectiveness of Praziquantel. So, don't use them together in a treatment. Praziquantel does not harm biological filter but one must bypass UV and Carbon filter.

Metronidazole: Also known as Flagyl. This kills anaerobic bacteria and some internal worms and protozoa like Hexamita. Known to be a carcinogen. Repeated usage or overdose causes kidney failure. Bypass biological filter, UV and carbon filter.

Methylene Blue: A dye that has antibiotic property. It is known to help in oxygen transport. So, if Koi have suffered Ammonia and Nitrite toxicity, methylene blue is used in water to make recovery faster. Bifuran is a light sensitive antibiotic. I use Methylene Blue along wiht Bifuran so that light does not get through water. Bypass biological filter, UV and carbon filter.

Quinine Sulfate: It is an alkaloid that naturally exists in the brak of Cinchona tree. It was used to reduce fever in Malaria patients. Used for resistant Ich, hexamita, chilodonella and Epistylis. Inhibits DNS and protein synthesis. It is light sensitive.

Antibiotics: Antibiotics are sensitive to light and alkaline pH. They are not very active under 70*F. Solubility in water is also poor making gill-uptake not very effective. But fish do not have good vascular system either. So, injections are also not as effective as they are in mammals .Antibiotics have a very short lifespan. Feeding antibiotics is the best choice.

Baytril: The active chemcial in Baytril is Enrofloxacin, a compound belonging to the family of Fluoroquinolones. It is very effective against both gram positive and gram negative bacteria. However, its overuse has made many strains of bacteria, resistant to this drug. Most aquaculture and poultry farms have been injecting this drug and dumping the water into rivers and streams. FDA banned its usage for poultry in 2005, fearing the release of this drug into water can make Campylobacter, a human pathogen, drug resistant, Ciproflaxin, also a fluoroquionlone, is used to treat Campylobacter.

Shelf-life of injectable antibiotics is quite short, especially after you open them. So, you can not store them forever. You need a prescription from a veterinarian. You must identify the bacteria before treating the fish. For example, if the fish is infected with Aeromonas bacteria, Baytril won’t work. Baytril is also known to cause abnormal growth of cartilage (present in joints) in young animals that are growing fast. Also, it is toxic to the eye and is known to cause blindness in cats.

Amikacin, Gentamycin: Drug names ending in “cin” like Gentamycin, Amikacin, Kanamycin belong to a group called “aminoglycosides” and can cause kidney failure. Should be the last choice.

Bifuran: Contains Nitrifurazone and Furazolidone. Can be used in water or in food. Bacteria can not develop resistance because it makes the bacteria unable to digest their food. Bacteria die from starvation or lack of energy. Extremely effective even against internal infections. However, these drugs are carcinogenic, can cause neurotoxicity. When using, dump the water only after the chemical becomes inactive (by exposing to UV or adsorbing into a carbon filter). While using, mix, Bifuran with ethanol or vodka, to make a paste, then mix with water to make it into an emulsion and drop into the pond. You MUST bypass UV, carbon filter, trickle tower, fractionator, EZPod or any other filter that captures solids as well as biological filter. To prevent degradation from light, add a black dye to the water.

Sulfa 4 TMP: Also called Bactrim or Septra, contains trimethoprim and sulfamethoxazole. Destroys the growth of both gram negative and garm positive bacteria by making them unable to replicate. Bacteria can not develop resistance against these chemicals. However, they can cause kidney and liver toxicity. Best used in combination with Bifuran. I have never injected any of my fish because I never allowed them to get that sick. May be my 3 years of Koi care is not long enough to face Koi deaths. But combination of Bifuran in water and Sulfa 4 TMP in feed has cured many fish that had internal bacterial infections, even some with dropsy. My recommendation is to try Bifuran + Sulfa 4 TMP treatment in Quarantine tank water for 3 days. if there is no improvement, then resort to injections. While using, mix, Sulfa 4 TMP with ethanol or vodka, to make a paste, then mix with water to make it into an emulsion and drop into the pond. You MUST bypass UV, carbon filter, trickle tower, fractionator, EZPod or any other filter that captures solids as well as biological filter. To prevent degradation from light, add a black dye to the water.

Do not use a combination of two antibiotics belonging to the same family (like Amikacin + Kanamycin)

Tricide-Neo Dip: This treatment is good for external bacterial infections only. After the dip, remember to rinse the fish in another tub with plain pond water before putting it back into the pond. If you put the treated fish into the pond, directly after the dip, you will be releasing antibiotics into the pond, giving a chance for the bacteria in water to become resistant to Tricide-Neo because the concentration is not enough to kill them.

Solar salt: Do NOT use salt to kill parasites or bacteria. If you use salt regularly in your water, freshwater parasites may become resistant to salt. And marine parasites may enter your pond water, creating a whole new problem. Salt decreases oxygen in water, reduces fish appetite, makes fish kidney and lungs work harder (yes, quite the opposite of what you have heard before). Salt is useful in conjunction with Supaverm or antibiotics for the first few days of treatment. As described earlier, Supaverm or antibiotics will leave the wounds open for fungus to enter. So, during the first 5 days of treatment (with the EXCEPTION of PROFORM-C), having 0.1% salt in your water will eliminate secondary fungal infections. Salt is also useful if your fish have a thick mucus coat. Addition of salt will strip the existing mucus making supaverm more effective. After 5 days of treatment, you should remove salt from the system even if you are continuing supaverm treatment. This is because salt encourages fish to make new mucus. The new mucus may become a barrier for supaverm!