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How to Treat Flukes in Freshwater Aquarium Fish

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How to Treat Flukes in Freshwater Aquarium Fish

PraziPro is the treatment of choice

Flukes on Bettas or in Tanks
For these small facilities and with their relative delicacy, I really recommend PraziPro. Hikari (manufacturer) has doped out solubility and all you do is shake it up VERY well, and deploy per label instructions. 
In Bettas, you may actually SEE flukes on the bodies and face of the Betta. How can you tell it's not Ich? 
Answer: Uneven distribution. And a microscope. 

The fish at left biopsied FLUKES not Ich. Not the lesions are gill and eye intense and not all over the body evenly. The lesions are BIG and seem "on" the skin and not throughout the skin. I would not hazard a guess. Not a bad idea to treat BOTH Ich and Flukes in a case like this. Salt and PraziPro knock all that right out. 
Unless you have live plants -  then, NO salt. 

Flukes in Goldfish Tanks
Again, people have scaleless goldfish, baby goldfish, etc and you need something safe and economical in tanks under 150 gallons, PraziPro according to labe instructions making sure to visit it upon the fish one last time at the 7 day mark - good idea. 

According to one expert, Praziquantel has stopped working, suddenly, globally, and recently. Read this

Flukes in Smaller Koi Ponds 
I would STILL reach for a Praziquantel product, whether it's PraziPro or something with Prazi in it. BUT - dosing and solubility of dry Praziquantel can be hit or miss
At right, Hikari's PraziPro in a gallon size. That will treat a lot of water and at $250 it's expensive but then, so is a single 18" fish. 
For alternatives in larger or large ponds, keep reading. 

Flukes in Larger Koi Ponds
If the pond is large, but not under 55 degrees, and not OVER 78 degrees, you should consider using Eco Labs or similar Formalin Malachite Green. 
At left, each bottle treats 9500 gallons, and you get two bottles. Good price. And you're going to be treating at least 5 times. Possibly 6. So do the math. 
Treat daily x 4 times and then every other day for two more treatments to intercept eggs. (Between 55-78 DF)

Flukes in Large, Cold Ponds
In large ponds you try to find cost-effective medications. And in cold water, one stands out. Potassium permanganate. The 'at right' is 500 grams available by Prime shipping so you get it promptly. 
It's a staining powder. Dosing is best provided in detail, see DrJohnson.com 

Flukes in Large, Warm Ponds
You really just need to spend the money and get a Praziquantel compound. You can try Kusuri-M, I am still waiting to try it. It's flubendazole and I don't have first hand experience with it yet.
If you go a BSDT Formalin route, I highly recommend you redouble aeration, and perhaps cool the pond with a pretty-big water change before starting. I really don't like Formalin Malachite over 80 DF. 

If you go a BSDT Formalin route, I highly recommend you redouble aeration, and perhaps cool the pond with a pretty-big water change before starting. I really don't like Formalin Malachite over 80 DF. 
At right: BSDT in gallon size. 

Chloramine-T For Flukes
If you've confirmed flukes, and it's Springtime and the fish ALSO have ulcers or signs of bacterial infections, some consideration should be given to using Chloramine-T 
Problem is, the stuff's quite expensive and in my hands, has been 'hit or miss' on flukes. Still, it's good for bacterial infections when you can't handle the fish. 
Here is the data on treating flukes with it.