Dropsy in Aquarium Fish

Also called edema, this condition is a serious health threat

Dropsy in a betta

Clintus / Flickr / CC by 2.0

Dropsy is an old medical term for a condition that today would be more likely called edema or ascites—the swelling of soft tissues in a body cavity, such as the abdomen, due to an accumulation of water and other fluids. The English term derives from the Middle English word dropesie, from the Old French word hydropse, and from the Greek word hydrops, which is itself a derivation of hydro, meaning water.  

What Is Dropsy?

Although the term dropsy is rarely heard in human medical science these days, it is still used to describe a particular health issue with aquarium fish. Dropsy refers to a condition in which fish often have hugely swollen bellies, and the continuing use of the term probably has to do with how it so accurately depicts the visual symptom: the belly drops down. Sometimes the condition is also known as bloat. 

A Disease of Immune-Compromised Fish

Dropsy in fish is actually a cluster of symptoms caused by an infection from bacteria commonly present in all aquariums. Consequently, any fish may be exposed to the dropsy-causing bacteria, but healthy fish rarely fall prey to the disease. Fish are only susceptible when their immune system has been compromised by some other stress factor. If all the fish in the tank are under stress, it’s quite common for the entire tank to become infected, but it is also possible for only one or two fish to fall ill, especially when prompt action is taken to prevent the spread of the bacteria.

Signs of Dropsy in Aquarium Fish

As the infection progresses, skin lesions may appear, the belly fills with fluids and becomes swollen, internal organs are damaged, and ultimately the fish will die. Even with prompt treatment, the mortality rate is high. Successful treatment is very unlikely unless a fish is diagnosed in the early stages of the infection.

Symptoms of the underlying bacterial infection can vary widely. Some fish will have the classic swollen belly, others display skin lesions, while still others show few symptoms at all. This variability is what makes diagnosis difficult. In most cases, a number of symptoms are observed, both physical and behavioral.


  • Grossly swollen belly
  • Scales that stand out with a pinecone-like appearance
  • Eyes that bulge
  • Gills that are pale
  • The anus that becomes red and swollen
  • Feces that are pale and stringy
  • Ulcers on the body, along the lateral line
  • A spine that is curved
  • Fins clamped together
  • Redness of the skin or fins
  • General lethargy
  • Refusal to eat
  • Swimming near the surface

These symptoms occur progressively as the disease advances. Internal organs are affected, most notably the liver and kidneys. Anemia occurs, causing the gills to lose their normal red color. As the abdomen fills with fluid, organs are pushed aside, sometimes causing the spine to curve. Scales protrude from the body, giving the appearance of a pinecone. This symptom is a classic indication of a severe infection.

A GIF displaying the symptoms of dropsy in a fish
Illustration: Kelly Miller. © The Spruce, 2019

Causes of Dropsy

The agent that causes the symptoms of dropsy is usually the very common Aeromonas bacteria, one of several gram-negative bacteria present in most aquarium habitats. The bacteria are known as gram-negative because they do not take on a specific stain used in the Gram Stain method of identifying bacteria species.

The bacteria will only lead to serious infection in a fish that already has a compromised immune system. This can happen as the result of stress from a number of factors, such as:

Generally, a single or short-term exposure to stress will not compromise the ability of the fish to fight infection. In most cases, the stress exposure must be present for an extended period of time, or several stress factors must occur in rapid succession, in order to affect the fish's immune system. 


The infection causing dropsy is not easily cured. Some experts recommend that all affected fish be euthanized to prevent the spread of the infection to healthy fish. Also, when combined with popeye, the prognosis is bleak. However, if the infection is detected early and the fish are isolated for proper treatment, it is possible to save affected fish. Treatment is geared toward correcting the underlying problem and providing supportive care to the sick fish: 

  • Move the sick fish to a "hospital tank."
  • Add 1 teaspoon of salt per gallon of water in the hospital tank
  • Feed the fish fresh, high-quality foods.
  • Treat the fish with antibiotics, either in the food or in the water.
  • Test the water in the hospital tank daily to ensure it is appropriate for the fish.

It is important to move any infected fish to another tank to separate them from the remaining healthy fish. While the affected fish are quarantined, perform a water change on the original tank and monitor the remaining fish closely for the appearance of symptoms.

Salt should be added to the hospital tank, again at the ratio of 1 teaspoon per gallon of water. Low levels of salt in the water aid in the osmotic balance of the fish by making the water salinity closer to the fish's blood salinity. That helps the fish get rid of excess water accumulating in the body, causing the dropsy. But, don't add too much salt as that can be unhealthy for freshwater fish. Keep the hospital tank scrupulously clean, and perform weekly partial water changes, adding salt to the new water being added to the aquarium.

Provide the ill fish with a variety of fresh, high-quality food. Often this is enough to resolve the infection in cases that are not too far advanced, if the fish is still eating. Keep the fish under observation for several weeks after the symptoms disappear.

Antibiotics should be used if the fish does not immediately respond. A broad-spectrum antibiotic specifically formulated for gram-negative bacteria is recommended, such as Maracyn-Two. A 10-day course is ideal for ensuring the infection is eradicated, but you should always follow the manufacturer's directions for duration and dosage.

How to Prevent Dropsy

As with many diseases, prevention is the best cure. Almost all the factors that stress fish enough to make them susceptible to infection can be prevented. Because poor water quality is the most common root cause of stress, tank maintenance is critical. Factors to keep in mind include:

  • Test the aquarium water regularly to ensure it is healthy for your fish.
  • Perform regular water changes.
  • Keep the tank clean.
  • Clean the filter regularly.
  • Use a gravel vacuum to remove wastes from the bottom of the tank.
  • Avoid overcrowding the tank.
  • Do not overfeed fish.
  • Use flake foods within one month of opening the packages.
  • Vary your fish's diet.

If the tank is well maintained and the fish are fed a healthy diet, outbreaks of infections causing dropsy are unlikely.

If you suspect your pet is sick, call your vet immediately. For health-related questions, always consult your veterinarian, as they have examined your pet, know the pet's health history, and can make the best recommendations for your pet.