When Flowerhorms have facial deformities, it can be Hexamita. I am currently treating a Blue Flowerhorn which I almost gave up on. For one year, he swam on his his head, but did eat. I assumed it was swim bladder. recently he has taken a much worse trun and this week had a lesion that looked like cottage cheese on his head. I retreatied him with with metranidazole at 40 mg/gallon e days ago. The lesion is now gone. Today I tried to give him a pea stuffied with metranidazole, and he jumped all over my counter and spit it out. I caught him again, left him in the net and stuffed the pea dowbn his throat with a Q-tip. He hasn't eaten in about 10 days, but the external anomalies are gone and he is swimming correctly. I hope tjhis helps.