Chris, normally I'd be looking to the water, flared gills and near the surface usually indicate something isn't quite right. I knwo you say the check out, but....
A bit more info would help, how bisg is the tank and how many fish, w/c regime etc...
Its possible it could be a parasite or similar and it could just be stress too but first line of defence is to up the w/c either amount or frequency (or both) for a while and see how it goes.