Mouth rot is a patch of white stuff on a fish’s lips. As the disease advances it produces toxins that erode the lips of the fish. Advanced cases get very ugly and the fish can’t eat. Names for this disease include cotton-mouth, mouth fungus, and flexibacter.
This is most often gram-negative bacteria (columnaris, aeromonas, etc.). Many people mistakenly think this is caused by fungus. It isn’t.
Treatment
It should be treated with broad spectrum antibiotics (Midland Vet Service Aqua-Mox, VetDepot Amoxicillin, Fishbiotic Ampicillin, Mardel Maracyn 2, SeaChem KanaPlex, API Fin And Body Cure).
Bacterial infections are most effectively treated with antibiotics in the food. Many believe (and the instructions on the antibiotics say!) that antibiotics need to be added to the water. They are simply incorrect. This controversial topic is covered in the following link:
12.5. Fish Don’t Drink
It is easy to make medicated food. Heat 1/4 cup water (two ounces or 58 milliliters, not a lot) in the microwave. Then blend seven grams of plain animal derived gelatin (Knox gelatin, one packet) into the hot solution with vigorous stirring. Take two tablespoons of dry commercial fish food (pellets or flake) and mix it with just a little of the hot water/ gelatin mixture. Add hot water/gelatin until you get a paste like consistency. If it gets too watery just add more food. To get gel food to float simply mix in a little whipped cream at this point.
Then add just a “smidgen” (roughly 1/16 teaspoon, a 1% to 2% addition) of medication to the mud. If you are using more than one medication mix the medications together, then use just a “smidgen” of the mixture. If you are using a packet of medication, take just a “smidgen” of the packet contents. Mix and mash the whole mass thoroughly. Spread it out into a pancake about 1/8th inch (3 mm) thick on a plastic film or a plate. Then put in the refrigerator. If you plan on keeping it for more than two weeks put it in a small plastic bag and freeze.
All the fish in the aquarium should be fed a steady diet of the antibiotic laced food for at least ten days. Note that the exact amount of medication which goes into the food is not very important. Antibiotics can be overdosed pretty much with abandon as they are only toxic in large doses over a period of months. Note antibiotics in the food do not affect the filters so they can be left in place and operating.
If you can’t resist the urge to treat the water, remove the biofiltration media (including sponge and/or foam) in the filters and put it in an open container for the duration of the treatment. Sometimes antibiotics kill the beneficial bacteria and sometimes they don’t. In any case the filter media will denature the antibiotics. Monitor the ammonia and would do a 50% water change if it spikes above 1 ppm. Reduce the amount of food fed by 2/3 rds.
Note that if antibiotics are not available, it is quite easy to take a pill or capsule of human antibiotic and use it for fish. If it is a pill just grind it up. Just be aware that the human antibiotics are about ten times more potent than the aquarium antibiotics, so just a “smidgen” in the food is more than enough. This is a very good option for the folks in Europe or Canada, where fish antibiotics are illegal.
If one has fish with a bacterial disease, one must treat the whole aquarium. This is an emergency. Don’t fool around with herbs, tree leaf oils or some ineffective treatment. Ben Ochart treated a bacterial infection with Pimafix and Melafix. They did nothing to stop the infection. He lost a lot of large beautiful fish before he stopped the infection with antibiotics. This link covers the snake oil medications such as Melafix and Pimafix:
12.4.1. Natural Medications
The entire topic of bacterial infections in tropical aquarium fish is covered in more detail in this link:
10.3.11. Treating Bacteria
Return to Disease Menu
Return to Bacterial Menu
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Dave says
In reply to Bill Jackson ….. “dabbing” medication doesn’t work. Think of inside food, inside a pipette into the throat, or in large proportions in a shallow bath.
Bill Jackson says
I got a free 50 gallon breeder tank with fish 2 Buenos Aires tetras 2 large angel fish and 1 albino cory . The water looked awful and smelled. actually did not even want to put my hands in it. I put the cory cat in my 55 gallon and all the other fish into a 20 gallon with other fish till i could get the 50 gallon cleaned and set up again. One of the Buenos Aires tetras developed the moth fungus and i noticed that it was thin and would not eat. It died soon after. I finally moved all the fish back to the 50 gallon with some Mollies and two yo-yo loaches and a pleco.
I bought a replacement Buenos Aires tetra. This was about 1/2 a year ago. Noticed today one of the Buenos Aires tetras now has the white around it’s mouth it looks thin though it tries to eat or is eating a little. Not sure if this is the replacement or the original BA tetra. I think I will isolate the BA tetra and treat in a 10 gallon. was wondering if taking the fish out and actually dabbing any meds on the infected parts with a q-tip would work.
Anonymous says
My fish refused to eat much infused food either and results were minimal. I did move to introducing to water (Kanaplex), and after removing filter, infection began to reduce. I think you have to try everything combined with thoughtful water changes that improves water, but does not remove too much good bacteria. No one answer and my fish are still not out if the woods. This kind of thing is probably hard to completely eliminate once established. Good luck
Dave says
in reply to Carrie … Just keep feeding Kanaplex and Maracyn 2 loaded food. Feed every day till the infection clears up. Do NOT put in the water. Do NOT pull or stop the filtration. Just put small amounts of medicated food in every single day.
Carrie Deisenroth says
Hi all, I’m feeling desperate now as I have been treating what very much appears to be lip rot in our Angel fish for 3+ months with no changes at all.
We did multiple doses of a combination of ick guard and marycyn 2. We did 6 treatments of this combo, carbon removed from the filter and a water change (water quality tested good all around but we also brought a sample to one of our 2 local fish stores and was told it was fine as well).
There is only 1 other fish in the tank, a plecko. I never see the 2 interact so I don’t notice any aggression or a reason why this may have originally developed.
We were then advised to try Kanaplex. We did another water change (1/4 tank)…We have done 3 treatments (every 2 days as advised on the box). We put it into the water to dissolve. The back of the package talks about mixing with food. We could not understand how this was to be done until just reading how you made this paste. Which then makes me wonder HOW woukd the fish eats this? The Angel has spent weeks(!) disinterested in food or “engaging” with us. Just recently(about 2 weeks) she appears “interested” in food but doesn’t seem to eat any. At this point she HAS to be getting nutrition somehow bc it’s been 3 months with the condition of we’d think she would have died from starvation by now. She doesn’t appear to have a sunken belly. Does it make sense to make this “paste”??
She also had some little “dust bunny” type hanger-on-ers at the tips of her fins. One such one floated in the tank to a piece of wood and it just appears mucousy of sorts?
Feeling desperate bc nothing has worked. How often should we do a water change? How many doses of Kanaplex can we do ..,the box says “no more than 3”, the store says you CAN do more but wait a week before redoing”… do I put the full filter back in during that break? Do I NOT take a break?
ANY advice would be greatly appreciated.
Cheers