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It is possible to make a guess – but most guesses are usually wrong. Unfortunately fish disease, as with any other animal pathology, is a complex subject and unfortunately it simply isn’t possible to make a full and accurate diagnosis without examining the both affected fish and the water they live in. The vast majority of problems can be diagnosed fairly easily by testing a range of water parameters and carrying out a thorough examination of one or two fish. It is important to bear in mind that we need to establish what disease is present and any underlying causes. However, this does presume that the fish keeper has both the necessary basic equipment and skills to carry out the examination. If not, then it is important to try and get professional help, either from a fish-friendly vet or an aquatic specialist who will carry out the examination for you. The only alternative to a proper diagnosis is “dartboard” medication in which the water is treated with a succession of different chemicals in the hope that one will work. But such an approach usually makes matters worse.