How to Use the Fish-QOL Scale
Rate Daily or Weekly: Keep a small log and rate your fish for each category.

Calculate Total Score: The maximum score is 5×7=35.

Establish a Baseline: Score your fish on a few normal, healthy days to understand its "excellent" score. A healthy fish should score close to 30−35.

Determine a "Line in the Sand": A low score (e.g., consistently below 15, or a sudden drop) is a sign that the fish's quality of life is severely compromised. A score of 0 in a critical area (like Breathing or Mobility) should prompt immediate concern.

Consult a Vet: If your fish's score is dropping or consistently low, consult an aquatic or exotics veterinarian for an official diagnosis and guidance on palliative care options or humane euthanasia.

Action: Perform a 50% water change. Check and correct all water parameters (pH, Temp, Ammonia, Nitrite, Nitrate). Add Air Stone for Max Oxygen.

Tiny, distinct white spots (like salt grains) on the body and fins. Fish may be "flashing" (rubbing against objects) or have clamped fins.

Raise water temperature (2-3°C over normal, max 30°C for most fish). Treat with Ich-X, Copper-based medication (avoid in invert tanks), or Malachite Green. Complete full treatment cycle.

Improve water quality first. Treat with a broad-spectrum antibiotic such as Kanamycin (e.g., KanaPlex), Nitrofurazone (e.g., Furan-2), or Erythromycin (e.g., Maracyn).

Treat with Antifungal agents like Methylene Blue or Pimafix/API Fungus Cure. If symptoms worsen, switch to the bacterial treatments for Columnaris (e.g., KanaPlex).

Bloat / Dropsy (Internal Bacterial/Organ Failure)

Isolate immediately. Treat with a strong, broad-spectrum, internal antibiotic, ideally mixed with food (e.g., Metronidazole or KanaPlex mixed with Seachem Focus binder). Epsom Salt baths can help reduce swelling.

Swim Bladder Disorder (Constipation/Infection)

FASTING: Do not feed for 3-4 days. Feed blanched, peeled pea (laxative) on Day 4. If no improvement, treat for bacterial infection (e.g., KanaPlex).

Extreme weight loss (emaciation) despite eating well. White, stringy feces. Red worm may sometimes protrude from anus (Camallanus).

Treat with an anti-parasitic agent like Fenbendazole (e.g., Expel-P) or Levamisole (where available). Repeat treatment after 2-3 weeks to kill newly hatched eggs.

CRITICAL NOTE ON ALL TREATMENTS:

Quarantine: Always move the sick fish to a separate "hospital tank" for treatment to avoid overdosing the main tank's inhabitants (especially invertebrates/plants) and to protect your beneficial filter bacteria.

Remove Carbon: Remove all chemical filtration media (like activated carbon) before adding medication, as it will instantly absorb the treatment.

Water Quality is Key: 80% of fish health issues start with poor water quality. Always test the water before medicating. If water parameters are off, fix them first.

Step 1: Anesthetic Overdose (Clove Oil or MS-222 at 5−10× normal dose). Step 2 (CRITICAL): Decapitation or Pithing. Pithing is a humane technique wherein a sharp rod forcefully and accurately aimed to penetrate the brain of the fish and then pushed quickly and firmly into the skull. https://www.ikijime.com/ can be used to identify edible fishes spikepoints.

Euthanasia agents relying on gill function alone may only induce a coma. A secondary physical method is the most humane way to guarantee immediate brain death and prevent recovery.

MS-222 (Tricaine): Must be buffered with sodium bicarbonate (baking soda) to a neutral pH to prevent a painful, aversive reaction. You do not need a perscription https://www.thepondoutlet.com/tricaine-s-ms-222

ACCESSORY RESPIRATORY ORGAN (ARO) FISH (e.g., Bettas, Gouramis, Labyrinth Fish, Air-breathing Catfish)

AROs allow fish to breathe air, bypassing the anesthetic's effect on gills. They will not die from immersion alone and will suffer prolonged distress. A definitive physical step is the only humane option.

ARO fish must be in a container that prevents access to the water surface once they become lethargic to ensure the anesthetic is absorbed and effective.

Only acceptable as a first step for warm-water fish to induce unconsciousness. NOT for cold-water species (e.g., Koi) who tolerate cold well.

DO NOT perform rapid freezing, flush the fish or suffocate it out of water. These will cause suffering including cell destruction and asphyxiation.

In all of these cases you must follow the initial procedure with decapitation or pithing. This ensures loss of consiousness and zero pain. Use a very sharp instrument. If for whatever reason you are unable to decapitate or perform pithing on your fish your best option is to follow all of these methods up with crushing. Wrap your friend in an opaque bag, like the black ones you get from the liquor store or a brown paper sacklined with wax or parchment paper and then a nice peice of fabric and then pick your blunt instrument of choice. A flat rock, a hammer, a baseball bat, a car, whatever you can manage it with. If you have the stomach for it to open the oblitterated fish, or opted for a more biodegradeable elimination blanket, the fishes remains can be placed in a potted plant or planted in the ground outside.