Great info RD...just wish I'd came across this sooner....I have a fish that has been in my care for nearly 11 years, he was around 3" when I got him so I reckon he is around 12 years old, he was my first fish and has survived all my stumbles down the fishkeeping learning path. He is a Tilapia Mariae, around a month ago he went off his food I never worried as he does this often he will not eat for 2 or three days maybe every 3 months or so, sort of a 'detox' he always returns to eating with gusto ....but not this time...after he would not eat for over a week I started to worry so I added Epsom salt to the tank as I have always done first line of attack, in case its nothing more than simple constipation(he had been eating bloodworm as I was feeding it to my grow outs and he sulks when he doesn't get any lol but I know it can cause constipation), I added 1tspn per 10gal(60 gal tank)....and sure enough faeces appeared within a couple of days(normal in appearance)...but still not eating another week went by and for the first time in 11 years I felt forced into giving him meds I started him on a course of 'Octozin' this is the only med in the UK which has Met in it, I gave him half the stated dose as I thought with him being unused to the antibiotic it would be very effective....sure enough after the 3 doses it states to give, he did indeed eat.....but just once ! That was nearly 4 weeks ago, since then I gave another course upping the dose to 3 quarters stated....gave him a few days off, water change, then started again....I am now on my 7th consecutive day of treatment I did 3 at full dose followed by three at partial....still he refuses all foods....really worried about keeping using the meds - my logic is that if I'm killing off say 75% of the parasite in the stated 3 days surely when I back off it will multiply again putting me back to square 1. He is excreting thread like mucous trails daily ......So now I'm desperate I would be devastated to lose my old boy....amazingly he still looks the same, there doesn't seem to be any apparant emaciation, he is very lethargic though and just stays in the one place most of the day(still midway up the tank though not on bottom, and he is still upright no listing). So what would you suggest next ? Force feeding with the Epsom solution and pellet while still dosing the Met meds ? Not sure how he will take to having a syringe shoved in his mouth though.....he used to grab anything that went in his tank vac tubes and fingers, but now is so lethargic I will probably have to coax him and he will probably bolt....I really don't like the idea of netting him out of the tank to do it but if needs must!!!! Any advice would be welcome......