By Stacie Grannum, DVM Q: What’s the best way to avoid dropsy? It seems to be the most prominent condition affecting bettas nowadays. A: Dropsy in bettas isn't really a standalone disease; it's more of a symptom that indicates something deeper is going on. When you notice that “pineconing” or swelling, it usually means the fish is experiencing organ failure or a severe fluid imbalance. This often stems from chronic stress, infections, poor genetics, or long-term care issues.