Category Archives: Ask The Doc

Ask The Doc – The monthly question and answer entry at

Old Dog Tremors – Is it Normal For My Dog’s Leg To Tremor?

Old Dog Tremors – Is it Normal For My Dog’s Leg To Tremor?

Commonly we will see one or two limbs on a dog that simply tremor.
Key elements of a “Don’t Worry About It” response are:
1) Pet seems unaware
2) Happens upon some excitement
3) Pet acts perfectly normal in every other respect
4) It’s not constant at all. Maybe daily.

So, if (in the video) there was thunder, or if the dog was looking around terrified, then you know the tremor is “a thing”.

If the dog is just resting and looking at the TV then it’s ‘nothing’.

(Video formats correctly when played.)



Praziquantel Doesn’t Work Anymore Against Flukes?

“I am a keeper of koi fish and Dr. Johnson has been so helpful to me in understanding koi health and disease. I have been using Praziquantel for a number of years to treat flukes. Recently, a friend forwarded me a comment made on Koiphen saying that Prazi was no longer effective against flukes and that Fluke-M was the new treatment of choice. Does Doc Johnson have an opinion on this? Thanks for any clarification you can bring to this matter!”

The core, active ingredient in Kusuri has been around longer than I’ve been in the hobby, and I started in 1993. It’s spectrum against flukes and intestinal parasites is handsome. Figuring out safe dosing and verifying results enough to come up with a product for the market is worthy of salute.

Here’s Kusuri Fluke-M on its web site at the moment

Here’s a Praziquantel that works every time

Results will change however, when somebody goes to market against Kusuri with a knockoff of the same compound but generic dosing instructions. Then someone will say “Kusuri doesn’t work anymore.”

That seems to be what’s happening with Praziquantel and I’ll get to that later.

From their sales material:

Kusuri Fluke-M contains 50mg/g Flubendazole based

(Supaverm had Febantel “immediate cousin”plus Closantel in it but was lethal to goldfish)

…medication used to eradicate Gill and Body Flukes. This treatment is safe to use without destroying the bacteria in the filter and can be used at any temperature. While dosing with Fluke M you can continue to feed.
This product is designed as a one off treatment, but may require a second dose after 7 days in heavy infestation.

Gill flukes lay eggs and will be harder for any medication to clear because the eggs can’t be killed on the bottom of the pond. So the Praziquantel AND the Kusuri “sometimes” require a subsequent dose to intercept the upcoming egg hatchlings. This is the reason this product says “may require” because if you happen to be dealing with gill flukes, you’ll need to.

For use with all cold water ornamental fish and can be used safely with all tropical freshwater fish.
Kusuri Fluke-M has a four year shelf life from date of manufacture and should be used within three months of opening. Fluke-M can also be used for the eradication of pond snails (##) and Intestinal Helminths Worms.

I would not have guessed it would kill snails. That’s kind of an exciting discovery, as Koi breeders and certain others in the industry consider snails a nuisance, especially in Florida where they’re a vector for certain parasites transmitted by wading birds (Neascus)

For best results use above 15°C. At 10°C a second dose may be required.
Please ensure that you read, understand and follow, all Health and Safety guidelines on the packet.
If the mucus layer is excessive, we advise dosing with Chloramine T at 15g per 1000 gallons, 24 hours before using Fluke M, this will assist in reducing the mucus membrane where body flukes can sometimes get trapped.

This is an interesting note – -because Chloramine-T is also a treatment for flukes. 

Caution: Please check your pH and KH prior to using. Chloramine T can be very toxic in soft water. If your pH is below pH7 (acid) and has a general hardness below 6°dH (soft water) reduce the dose by 75%. Fluke M is safe to use with salt.
Dosage: 11.8g per 1000 gallons (4546 Litres) of pond water.
For best results use above 15°C.
Directions: Shake contents of the sachet well. Measure out the correct dose for pond, and dissolve in a container with boiling water

I plan to engage some testing on a similar compound called Levamisole on behalf of a Koi breeder, which should have a similar spectrum to Febendazole (sister compounds) and I plan to solublize in ethanol. I wonder if Kusuri would solublize in ethanol? So much easier. I wonder if the manufacturer tried it?

Stir and allow the mixture to cool before adding slowly to the return of the pond over a 1 hour period. It is recommended that you turn off the UV(##). Fluke-M is safe to use with salt.
This product is designed as a one off treatment, but may require a second dose after 7 days in heavy infestation.

What about Praziquantel not working anymore?

First, people say “always” and “never” crap like that. It’s ridiculous. They MEAN “Praziquantel doesn’t work as much for ME anymore and I’ve treated a LOT of cases and confirmed what I’m asserting with my talent with microscopes, [which the person can’t say either, making them an ass hat.]


The KEY to Prazipro from Hikari is THOROUGH shaking and application to the system WITHOUT filtration and WHILE it’s still crazy-agitated.

Has been produced and provided to the Koi and pond fish industry for an easy 10 years. When it first came out it was tablets from the vet and impossibly expensive. Then some folks came out with it in a liquid and powder form, and solubilized it a variety of ways. Purity and concentration varies drastically and now, non-business people can buy a kilo of “Praziquantel” on line for a reasonable sum.

The purity of that bulk powder is impossible to confirm.

Purity is “probably great” though, but dosing must be carefully done to make sure you’re using ENOUGH and that’s not ‘easy’. If you’re having trouble all-of-a-sudden with “Praziquantel not working” anymore, check your product and dose because with PraziPro there’s no problem in my hands. I’m no genius.

Water conditions and circulation matter as well. If you don’t solublize the Praziquantel correctly and distribution around the pond is incomplete, and if there’s a lot of organics in the system to hide the Flukes and bind the chemical.
System organics play a role in both medications’ distribution and survival in the water column.
Intercepting eggs hatching later is the BIGGEST factor.

Solubility with both Kusuri and Praziquantel is huge

It has become almost common place, for people to buy Praziquantel powder (raw) and attempt to solubilize it and does it correctly which IS NOT EASY. The savings, I suppose are great. But mistakes and inadequacies happen.

A product called PraziPro put together by Hikari has worked around the solubilty issues, and I’ve used it, and confirmed kills in Flukes of both species. The key is the SUBSEQUENT dosing also recommended by Kururi. They’re on the right track with that.

In many instances, in the broader perspective, the whole conversation is moot, because formalin/malachite green are such a good broad-spectrum medication, dosed properly in water of a reasonable temperature and properly aerated, using an expensive single spectrum drug like Praziquantel or Flubendazole is just additional legwork.

In systems of any considerable size, the conversation Tails to exist separating single spectrum drugs because both Praziquantel and Flubendazole would become prohibitively expensive. So, by and large the considerations go to treating flukes specifically, in smaller systems. I would expect properly researched products with a proven track record like PraziPro, to work on par with Kusuri Fluke-M

Someone going in with a homemade version of Kusuri, or a homemade mixture of PraziPro may have different results. And then they’ll pronounce the compound ‘useless‘.

It is frustrating when someone in the hobby says that “this particular widget doesn’t work anymore”. Especially if it is intended to sell more of another widget. Because parasites don’t suddenly become globally resistant to something just because a couple of people are having trouble or think they’re having trouble dealing with a parasite with one particular medication. But blanket statements are made. It is human nature.

I have talked to a couple of very credible people who double check their results with a microscope and have heard that there are certain strains of flukes, particularly the egg laying ones, that may resist Praziquantel. After talking to a few of these people, we realized that there were consistencies between dosing and water quality as well as the egg-laying (Gyrodactylus) nature of a particular species of flukes that made Praziquantel less effective for those people but more effective for others.
The last five times I’ve treated flukes, I used Clout twice, formalini/malachite on two occasions, and PraziPro from Hikari on the fifth occasion, and got clearance with each of those medications respectively.

The Kusuri product utilizes a flubendazole dewormer that could have been expected to be very effective. I am sure that there are individuals who have used it, and then confirmed their kill with microscopes. I would love to believe that individuals who assert that it’s amazing have all confirmed their kills As opposed to the fish just getting better.

There was a similar product called Supaverm they used one of the same ingredients but because of another ingredient (Closantel), it was terminal for Goldfish. Ultimately it faded from view as Praziquantel took over the market. Sometimes would still be nice to have it in case you wanted to get rid of all your goldfish and just keep Koi LOL

I said all that to say this, if you treat with Praziquantel at the proper dose, properly dissolved, in a clean system with a middle of the road alkalinity, making sure to jump back in and treat on day five and/or seven, you’re going to get repeatably remarkable results.

Deviations from the above contribute largely to the reason behind finding flukes 10 to 14 days after you treated with project Cuanto.

I am sure that if you treat with Kusuri according to label instructions, which are admirably specific, using their specific compound, you’re going to get excellent results as well. But the same thing is going to happen to their product as happened to Praziquantel: more people will come to market with that compound, they will use generic dosing, they will be much less specific with dosing instructions, they’ll just push it out there, and it won’t work as well as when you were using a specific product with the specific instructions that went with it.

The hobbyist is encouraged to develop a skepticism of people who say always, and never. I recall when there was a “expert“ walking around that said “Baytril (injection / antibiotic) never works anymore“ and yet, still popping up on sensitivity lists to this day and an excellent drug. Problem is, it doesn’t work in every case, but that doesn’t stop some people from commenting on things like every case is the same..

It’s true, that the more you know about fish health, and fish medicine, the more you realize that you don’t know.

Can a human get coronavirus from their dog?

Some of you probably have read that you can get coronavirus from your dog, there are retired pharmacists and retired Cardiologist and Retired human dentists who have made themselves experts in veterinary medicine since their retirement. I would never ever retire from veterinary medicine and then hold myself out as an expert on human cardiology.

The following podcasts attempts to straighten out the hysteria and miss information being presented by certain “experts“ in the field trying to sell immune boosting supplements for dogs.

You can listen to the podcast below:


Koi and Goldfish and KHV Cross Contamination

Dr Johnson,

I got your address from my friend Jason who you recently helped with a pecan nut problem.

I may or may not have a KHV problem. If I can give you the story I hope you can tell me if there is anything I should do.

I dug a pond last fall and have 2, 5 inch koi doing fine in it. I have 5, 4 inch koi inside doing very well.

I have a lotus in a whiskey barrel that I’ve had for sometime and put cheap goldfish in for mosquitoes. They usually die quickly and I never thought much about it until I started reading about KHV and saw pics of Koi with KHV. I remember one of the gold fish having a dark patch on its gill cover that looked like a post mortem shot of a koi with KHV.

I have wintered umbrella palms in the lotus barrel.

So my questions.

1. Should I be concerned

2. Is there a nucleic acid test that can test water

3. Is there a non-invasive nucleic acid test for fish

4. At what point should I bring the outdoor fish to you before I move the indoor fish out.

5. Should I throw out the plants or is it safe to put them in the pond

If there are any products I need to purchase from you, please let me know.

Thank you

My Answer:

Koi Herpes Virus is not a legitimate liability to goldfish owners.
Testing is a mixed bag – – because if you test and it’s positive, you have to (by law) go on record with the Federal Government. It’s a “legally reportable” disease so the testing agency has to ‘tell on you’ and that COULD POTENTIALLY mean that you have to surrender your fish to the Fed and the pond gets drained and closed.

Any Koi that carries KHV in cold water will “break” with it when it’s warmed to 70-78 DF
Any Koi that is infected with KHV will ‘get over it’ when it’s warmed to 84 DF.
They’re not considered ”cured”. By anyone but me, and also everyone in Israel.

The plants (left without fish for a week or two) will bring no diseases with them to a receiving facility. I can say that with even more certainty if the plants are in the seventies DF when you quarantine them.

So if you think the Koi outdoors are harboring KHV all you have to do is bring one up to 75 degrees and give it a week to break.

And if it doesn’t, you’re golden, on the KHV issue.

Besides a few recommendations on about heaters and air pumps, I don’t officially “sell” anything so you’re good there 🙂


Making Dechlorinator – Sodium thiosulfate

How should I make a good dechlorinating solution? I have read about some pretty high doses, like 250 grams in 500ml of water to make a stock solution.
A: First, let’s tell our reader how to get dechlorinating granules, Sodium Thiosulfate:

See below for link to find like, 5 pounds of sodium thiosulfate for overnight delivery.

If you put 130 grams in a liter jug, then add water quantity sufficient to make 1 liter, your stock solution will contain 130 grams/Liter.

Each teaspoonful [5 cc] will contain 650mg active Sodium Thiosulfate. This is a 13% solution.
Simply add 2 drops of the stock solution per 1 gallon of the body of water to be treated . One liter of your solution can treat 10,000 gallons. Over-dosage is virtually impossible.

Another method with the same results is to put 500 grams in a gallon jug, q.s. to 1 gallon then you have the same 650mg per tsp. [13% solution] Add 2 drops of the stock solution per gallon.
One gallon can treat 37,850 gallons or more. 

Why you need dechlorinator (Click)

Making Dechlorinator – Sodium thiosulfate


What is “Flashing” in Koi or Pond Fish?

What is “Flashing” in Koi or Pond Fish?

“Flashing” is basically just a fish that is “scratching” itself on the pond / tank bottom, or ornamentation. It USUALLY doesn’t mean anything, unless it’s “more and more common” or it’s happening at least hourly. There are lots of causes of flashing koi illuminated here (click).

Just some images (that may load slowly) of koi flashing:

flashing in koi

What is “Flashing” in Koi or Pond Fish?

koi itching

Vitamins For Freshwater Fish Are a Waste of Money

Vitamins in teleost freshwater fishes are another way to spend money. But before you buy vitamins for freshwater fish, please put the money in an envelop and mail it to the Department of Labor. It will do you about as much good there as it will in your fish tank.

Freshwater fish are inundated by water through their skin and gill. Indeed, if they never took a single sip of water, they would always be over-hydrated. And so they are. Their kidney is engineered to excrete colossal amounts of water all the time, while recovering precious electrolytes and solutes. The freshwater fish never does take a sip.

So how do the vitamins get into the fish?

“Indeed, they are absorbed!” reply the marketing weasels.

“But nay” say I, “The fat soluble vitamins cannot passively cross the gill membrane nor the skin.”

“So perhaps the water soluble ones can!” Exclaim the marketing weasels.

“But they don’t!” I say, “Because as soon as an organic water soluble vitamin encounters another organic molecule of almost any type it becomes bound out of solution, not to mention that most of these vitamins are already so unstable they must be kept in brown glass bottles. How long do they actually last in the water, so that they might be absorbed by the fish?” I query.

“Less than five minutes.” Comes the sheepish reply.

“Perhaps we could recommend that the vitamin-fortified liquid we have put so much ‘R&D’ into could be applied to dry food and fed.” Suggested the other weasel, nodding hopefully.

And so they did.

What’s the Best Dog Probiotic on Amazon?

What’s the Best Dog Probiotic on Amazon?

  1. We’ve almost forever known that our gut contains germs.
  2. We learned a little more recently that many of the germs in our gut a “good” and necessary.
  3. In the recent past, science learned that we can implant / transplant beneficial germs to the gut.

Very recently, we realized that if we put “good germs” in the gut while we kill other germs with antibiotics, that the gut remains “pretty healthy” in spite of the antibiotics. Yeasts are less likely to overgrow and the bad germs left in the gut don’t get “the upper hand”.

So until lately, science has been putting milk-based germs (lots of lactobacillus) species into the guts to pretty good effect. They’re easy to get, to grow and to give. But they’re by no means “native” germs. They’re still “outsiders” and just holding a place.

What's the Best Dog Probiotic on Amazon
What’s the Best Dog Probiotic on Amazon

VERY very recently, science has started growing colonic germs (poop germs) commercially in the lab and those are actual REPLACEMENTS that benefit the gut. Since the germs are grown in petri dishes, it’s not like anyone’s being exposed to poop anymore than someone giving lactobacillus are being exposed to milk.

But dogs do better with native poop germs. So do people. (FMT) (These people should have a probiotic supplement!)

And so the probiotics that are the best have germs (in addition to the standard-bearer Lacto’s) germs that are ‘native’ or nearly-so, to the animal’s own gastrointestinal tract. Germs like:

L. Acidophilus, E. Faecium, L. Rhamnosus, L. Plantarum, B. Bifidum, B. Longum, B. Breve, L. Casei, B. Coagulans, B. Lactis, S. Thermophilus, L. Fermentum

When you see a germ with “faecium” in the name, go ahead and get grossed out, because that’s a poop germ, but it’s also a HERO among germs because it literally belongs in there. 

So while some companies are using the trusty old Lacto-team, which is GOOD, more progressive companies are adding actual “proper poop” species. Species that literally belong there.

Where to buy the recommended Probiotic
^Where to buy the recommended Probiotic

What else is in a good probiotic?

FOS. Fructo-Oligo-Saccharides. This is “inulin” (not insulin)  – – a soluble fiber from a lot of sources. Chicory was at one time the most common source but Jerusalem Artichoke is coming on. Inulin is literally “all that’s good” about soluble fiber. When you eat a pumpkin, sweet potato or black bean, you get some “inulin” soluble fiber. When you eat chicory root, or jerusalem artichoke, ALL you’re getting is “inulin” so you can see that FOS Powdered Chicory Root is a the best, purest source for inulin. Better than pumpkin or anything else.

But pumpkin is tasty. Dogs like it. So, we go with that.

What are Probiotic s made with, besides germs?

A great “vehicle” or “powder” to mix your probiotics in is FOS, or inulin powder and that’s often from Chicory or similar as listed above.

Other probiotics are mixed in oat powder. I say “Meh, okay. Overpriced oat meal with some germs in it.”

And some are based on Whey. Which is good. I would be HAPPIER seeing FOS/inulin as the base vehicle / powder, but whey has distinct palatability advantages.

So when you go over to you want to see:

  1. Ingredients only from America. (Not Italy, not China.)
  2. Based on Whey or FOS/inulin. (Not wheat, oats or any other grain)
  3. That contains E. faecium and S. thermophilus at least.

Which is the best one? (Best germs but Whey based, more tasty)

Which is the SECOND best one? (Most of the same germs but FOS based)

Runner Up With a Twist:  I’m including this because this company has done a little more research and decided: “You know what? Screw the milk germs, all a dog’s actually gonna benefit from are native species anyway, so give ’em LOTS of E faecium!” and so they did. Then they chocked it full of Vitamin C and Taurine, zinc and other goodies. They’re one of VERY few manufacturers who “put it in writing” that their germs are LIVE. Sadly, there’s no inulin, or soluble fiber, or whey in it, but it’s a good one:


My Koi Ate TWO PECANS Whole! Should I Be Worried?

My Koi Ate TWO PECANS Whole! Should I Be Worried?

“Before I go any further, I am self employed, and nothing annoys me more than folks expecting me to do what I do for a living for free.  In this regard, I intend to pay you for any consultation, so please let me know your rates.”
(That was super classy, but I did not charge the fellow)
“Regarding Mini the chargoi, I spoke to Joe Hatter of the Koi Club last night, who opined that she probably either passed them through her gills or spat them out after she submerged where I could not see her.  He advised to keep an eye on her for the next couple of days, and check that she’s not swimming around with her mouth open.”
“This morning she was swimming around with the others, and came up to see me – so I fed them.  No apparent issues this morning…
I’m interested to hear your thoughts, Dr. Johnson.”
Kind Regards,

Koi Who Ate Whole Pecans

My Response:

Great case!
She’s big enough to engulf a PECAN?
Here’s something that you probably did not know. Well, you probably do know that Koi have teeth, in the back of their throat and those teeth go up against a diamond shaped bone to crush what they eat.
can koi eat nuts
They can crush a snail like it’s nothing.
If you got your pinky finger between the teeth in that bone, they probably would fracture it at the size I think Mini is.
I said all that to say this:
My wife and I used to target practice over the pond with Ruger P 89‘s which are 9 mm semi autos. Interestingly, they have a forward eject of the shells meaning that the casing flies away from the shooter and they happen to end up in the pond!!
Well, I didn’t think anything of it because they’re made of brass and that doesn’t dissolve into anything important, and why would a Koi eat a brass casing?
Well one day my doitsu Kohaku stopped eating and eventually wasted away. She was substantial so I put her under a flower pot so her bones would get picked and I could perhaps recover a sizable skull and teeth. It also helps to find out, postmortem, whether or not it was a piece of gravel that blocked them. Much to my chagrin, what I got was a 9 mm brass casing that had been flattened on the open end by her teeth.
koi ate pecan
9mm casings ejected into the pond were flattened by a 17″ koi and swallowed. Fatal outcome.

She had apparently carried it around chewing on it until she thought it was small enough to engulf and she swallowed it!!!

A decent size 16-17” Koi can crush a 9 mm brass casing!

A pecan is no challenge.

That other fella was right, the only time it goes awry is when the nut can’t get back to the teeth and fills the oropharynx and can neither be spat out nor passed out under the grill cover.
Diagnosis of an oropharyngeal obstruction is the Inability to eat, so if Mini is eating, you win!
I would not expect any problems, if however she stops eating, we might be having a problem with some of the shells in her stomach however I doubt it because in nature these animals have no problem eating whole snails and freshwater clams.

I Need To Find a Home For A Rescue Dog

I Need To Find a Home For A Rescue Dog

I’m figuring in Cobb County, Marietta because I don’t know any other “market” for rescues.
So, there’s like, four or five avenues, besides dropping a pet off at the dog ‘pound’.
Angels Among Us is one of my favorite rescue organizations, I do NOT know what they have to help you, or if they have the resources to help at this time, but it would seem they would operate in the right circles and could point you in the right direction. may have a listing service you could use. I’ve gotten a dog off Petfinder and it’s pretty neat. is a great way to reach your neighbors and that means, they’re LIKELY to be ‘pretty good’ people in a certain economic class that will take good care of him. You never REALLY know. But if the adopter is your neighbor, it stands to reason you can sort of keep up with the adoptee.
Ugh…  <= kind of risky. I think stories about laboratories getting test dogs off Craigslist are SERIOUSLY embellished if not outright fabrications. But who knows whether the adopter from Craigslist is any good or not?
Finding a home for a rescue dog
Finding a home for a rescue dog may take some phone calls if you have a page, definitely put him up!

How I can help you find a home for a rescue dog

You can make a color sheet, 8 x 11′ with the little ‘tear off’ phone numbers, pictures, and put it up here in my waiting room?

The Difference Between Heartworm Treatments

The Difference Between Heartworm Treatments

My friend is fostering a dog through a rescue and the dog is heartworm positive. I was wondering what is involved in slow kill treatment for dogs with heart worms? This rescue seems to be preferring the slow kill treatment while the foster is unsure of the slow kill treatment. I’d like to ask your expert opinion on what is involved in the slow kill treatment.
Brilliant question.

Here are the actual facts on heartworm treatments.

  • Slow kill has a 1:1,000 Chance to kill the patient with anaphylaxis
  • Slow kill has a 1-out-of-2 chance to cause further damage however slight, to the heart valves, and function over 18-24 months.
  • Slow kill has a 1:200 chance of embolism and death over 18-24 months.
  • Fast kill is organic arsenic. It’s just a ‘different’ delivery system than the older IV Caparsolate.
  • Fast kill is a risky and carcinogenic compound.
  • Fast kill has a 1:500 chance of anaphylaxis but only for the first 3 weeks.
  • Fast kill has a 1:200 chance of further consequential damage to the dog, at the heart or organs.
  • Fast kill has a 1:200 chance of embolism and death, but only over 6 weeks.
The Difference Between Heartworm Treatments
The Difference Between Heartworm Treatments

Slow kill is a long process which leaves the door open to embolism and heart damage. But it’s unarguably safer.

Fast kill closes the door on long term issues by ‘wrapping up’ the infection in weeks instead of years, but on the very short term, doubles the chance for problem of consequence.
My decision would be based on the value of the dog sentimentally or economically, the age of the pet, and the pet’s realistic activity level and “years-left-to-live.”
My dog Ajax is 3 years old (2019) and I love him so, so much. If he contracted heart worms I would perform an electrocardiogram and find out if it was a heavy burden. If his heart was compromised in any way I would give him Fast Kill via Immiticide.
If the case were a rescue and costs were always a factor, I would let Slow Kill do the job. That would be predicated on whether I trusted the foster to give the preventative without fail.
Doc Johnson