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Unexplained Weight Loss in Fish

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If you have fish that are eating, but still losing weight, there are several possibilities. Tuberculosis is common, especially if the fish have “been through a lot” and start losing weight after a long stress. You can learn more about tuberculosis at drjohnson.com 

If they have good water and are chronically infested with Flukes, they can lose weight, or ‘fail to gain’ because the flukes are bleeding them dry.

Otherwise, the following chart can help you deworm the fish and treat intestinal Hexamita.

Treating Intestinal Parasitisms in Fish

If you just want to deworm your fish and make sure you get every kind of worm, you need the Anti-Parasite Quad Flake
If you're trying to control Hexamita, Hole in the Head, Chronic Wasting, Malawi Bloat, you need the Anti-Parasite Duo.
If you're ONLY trying to get rid of Camallanus worms, and the rest of the helminths and nematodes of fish, you can use the Levamisole Flake

Anti-Parasite Quad Flake
Active ingredients are levamisole, praziquantel, epsom salt and garlic crafted into Gourmet Cichlid Flakes.
Directions: Offer as the only food source for 10-14 days. At least twice a week do a deep gravel vac to lift out any excreted parasites or their eggs before hatching. If gravel vacs are not thorough it is possible the parasites will attack again in a few weeks. Therefore it is highly recommended to repeat treatment in 3 weeks as this can break the parasite life cycle.
There are 5 different package sizes of the food. 

Anti-Parasite Duo 1 mm Pellet
This tiny 1mm pellet is fine for the smallest fish and contains metronidazole and praziquantel. Metronidazole is an anti-protozoan treatment and praziquantel is a broad spectrum deworming treatment. So with one food, you can control Hexamita AND many of the intestinal parasites of fish. For Discus Wasting disease, this is the best. 
Shown to treat hexamita, Malawi bloat, body slime, chilodonella, freshwater ich, epistylis, schistosoma, liver flukes, gill flukes, flat worms, tape worms and turbellarians.

Treatment: Begin with a water change of 25% or greater. Then feed 1-2 times a day for 7-10 days. May be repeated if necessary.
There are 3 package sizes of this medicated food.

Levamisole Flake 
Is an often recommended medication for treating parasites, especially camallanus worm. One added benefit of treating with Levamisole is that it gives the immune system a boost and the fish may appear to be healthy suddenly.
Treats: Stomach worms--Haemonchus spp; Ostertagia spp; Trichostrongylus spp; Roundworms-- Nematodirus spp (which include threadworms); Cooperia spp; Nodular worms--Oesophagostomum; Chabertia spp; Hookworms--Bunostomum spp; Necator spp; and Ancylostoma spp; and Lungworms-- Dictyocaulus spp.
Does NOT treat ..........Cestodes (tapeworms) or Trematodes (flatworms or flukes)
Safe for invertebrates and plants
Treatment Plan: Feed 1-2 times a week for 3 weeks. The following day, after each dose, do a large water change (50% or greater) with deep gravel vacs. Keep lights off on treatment days as this medication is light sensitive.
Five package sizes of this medicated food