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Entubating Koi

Over the years koi keepers had to adopt very ingenious ways to treat sick fish, mostly because there are very few Veterinarians that specialises in fish. Who can blame the Veterinarians? In today’s modern setup, very few will make house-calls and very few koi owners will put the fish on a leash and walk to the Vet! No the easiest way is to try and figure it out yourself, or phone around to ask friends. A very few lucky koi keepers will phone the correct friend.

A quick rundown of the various ways to administer drugs to koi are mentioned, just to get to the procedure of ‘Tubing”. This technique may assist koi keepers where other techniques fail.



Baths and dips

This brings me to the crux of the matter of attempting to fight parasites and bacterial infection with various techniques. First there is the process of treating a pond against both these pathogens. It evolved through a few brave people who experimented with dipping fish in stronger solutions to help cure the fish. In most cases the pathogens on the cuticle were destroyed or the fish severely stressed, but the problems with internal parasites and systemic bacterial infections remained unsolved.

Medicated Food

The next step is to turn to medicated food. In my view it is one of the least reliable techniques. A simple bit of research will highlight the fact that almost all antibiotics have a limited shelf life. When you actually start to dig a little bit deeper you will realise that the actual effectiveness of antibiotics once injected, may vary from a few minutes to a few days. That is the reason why some antibiotics must be injected intravenous. Now most home made antibiotics are mixed with either hot water/propolis/honey/olive oil and pellets are either soaked in or covered with it. Some koi keepers even go the extra stumble to dry it in the oven or in the sun. This process alone will severely reduce the effectiveness of antibiotics and make the dosage very difficult to determine accurately. Paste food is also a favourite way to feed antibiotics.  After the preparation, it is either kept in the refrigerator or thrown in the pond where some of the remaining stuff will leach into the pond water and create further future problems. The healthy koi will consume most of the “prepared” food while the sick fish will get a few scraps. The above explain the reasons why mixed results are obtained with this technique. Even when using medicated food to combat internal parasites, most of the above will apply.

Another technique to get medication into the intestines is the practice to inject the required dosage of medication into a favourite koi snack and feed it to the koi. A favourite though expensive way is prawns. If the correct dosage can be injected and the fish is willing or able to eat the correct amount immediately, it is a better technique than mixing the medication with koi pellets. It is also a requirement that the fish are alone or the competition should be limited.


Injecting koi with antibiotics is the most accurate and reliable of administering this type of medication. It is relatively simple to measure or weigh a fish, determine the correct dosage and administer the amount. The medication is delivered directly into the blood, body cavity or muscle. The only real negative impact on the environment will be an under dosage or if the contraction of the muscles forces the medication out of the fish.  However injecting koi requires some skill and the responsibility remains that of the owner to ensure that it is done properly and correctly.

One of the few down sides is that when the fish struggles, the sharp bevel of the needle may cause internal damage, especially when attempting an IP injection. Some koi keepers also find it difficult to physically push a needle into their pets.


Tubing as it is mostly called is a widely used technique to feed animals. The technique is especially prevalent in ensuring the survival of very young birds and mammals abandoned by parents. My first introduction to tubing was many years ago when we had to raise a whole litter of puppies that were born prematurely and for various reasons the mother did not produce milk.

Tubing, when used to administer oral medication to koi, is a crude adaptation of the Dobbhoff technique utilized in humans. For instance when a patient is unable to meet his nutritional needs by normal ingestion of food, a feeding tube can be placed, allowing nutrition to be delivered directly to the stomach or intestines. A feeding tube can be temporary or permanent, depending on the needs of the patient.

This adapted technique is utilised by koi keepers in a slightly different way. Firstly it is utilised for “force feeding” anorexic fish to deliver the correct amount or food directly to the intestines of the fish. Tubing is mostly used in cases where a diseased or stressed fish is slowly wasting away mainly because it doesn’t want to eat. In such cases it is essential to start the digestive track up again in order to save the fish. In cases where a fish is starved for whatever reason, it is a different story altogether because the fish will stay hungry and are willing to eat when food are offered.  The only similarity is that the feeding regime when resumed, should start slow and it should be frequently repeated.

The use of this “tubing” technique is utilised most frequently in treating diseased fish to ensure the uptake of nutrients, or the uptake of nutrients and the delivery of a measured amount of medication directly into the gut. This medication can actually be delivered to the gut to combat internal parasites or bacterial infections.

The advantage of tubing is the fact that various oral medication can be administered although not necessary simultaneously. Koi rarely regurgitate after the procedure so there is no danger of an ineffective dosage or medication that is released into the pond water. The medication can be prepared and immediately administered while fresh and potent. To do tubing with a koi, you will need a syringe capable of holding the required oral medication plus the volume of the tube that are going to be used.  A two to six mm tube will suffice, but a rule of thumb is that the calibre of the tube should be the same diameter as the pupil of the fish. This rule caters for the different sizes of fish. The tube can actually be a catheter tube because it is rounded and smooth at the tip. Alternatively a length of silicone airline tube can be used because it is soft and will not damage the fish.


Enough gruel should be mixed to make provision for the tube to be filled as well as the syringe. The calculation should keep in mind that if one ml oral medication is needed, that the dosage of the gruel will contain one ml.

Draw more gruel/slurry into the syringe than needed and connect the tube to the syringe.
Depress plunger until the tube is filled and the correct dosage remain in the syringe. Place the fish into a bowl and sedate it. When the fish do not respond to touch, measure the distance between the mouth and a position just behind the pectoral fins and mark the length along the tube with a permanent marker.



This mark will ensure that you do not push the tube too deep into the fish and cause damage. Place the tube into the mouth and push the tube through the entry way, a muscular valve at the back of the throat until the marker reaches the lips. You will be surprised at how easy the tube slides down the throat. Fish do not react the same way as mammals, so rest assured, they will not gag!

Please make sure that the tube do not damage the gill filament or emerge from under the gill cover. At this stage you can depress the plunger gently until the correct amount of the mixture is applied.


You can now remove the tube and place the fish in the recovery bowl. At this stage it is important to ensure the recovery of the fish from the anaesthetic and to watch for regurgitation. Regurgitation is unlikely but can happen.

Koi do not have a stomach as such and large volumes of gruel/slurry should be avoided. Small volumes are used depending on the size of the fish. As a general rule, 1cc per 15 cm can be used.

Please remember that the medication should be oral medication because it was developed to ensure good gut absorption.

In the case of antibiotics, remember that it kills bacteria indiscriminately and may have a negative impact on beneficial bacteria in the digestive tract.


Last Updated on Wednesday, 29 February 2012 12:50