sibo and b12 - Page 1

Hi,

Five months ago my 2 1/2 y.o. dog was diagnosed with sibo. He had lost 7kg and had severe bouts of diarrhoea. He was tested for EPI but this came back normal (he wasnt fasted) His B12 was <100(norm 275-590) and folate 11.4 (norm 8.2-13.5) TLI 12.9 (norm 6.0-35) UK guidelines. His treatment for the past five months has been 500mg oxytetracycline 3 times per day, 1 level measure of Protexin Pro-soluble probiotics twice a day and i B12 injection per month for six months. He has regained the weight that he lost but is still having occasional diarrhoea . Also after 6weeks of treatment our vet tried him off the antibiotics but the diarrhoea came back with a vengence and he was put on the tablets again.   After another bout of watery diarrhoe last week we decided to go back to the vet as we remembered she hadnt given him a B12 injection since August nor checked his blood since the diagnosis five months ago.  Anyway she gave him another B12 injection and took some blood beforehand, We got the results yesterday and his B12 has not improved at all it is still <100. She has agreed to give him an injection every month for the next four and check his blood inbetwwen but i am wondering if he should have them more often since ther was no improvement . Is it possible the diarrhoea is because of his very low B12 and maybe if we got that back to normal he could come off the antibiotics or at least reduce the dose. I would be gratefull for any ideas.

First, I would have the dog checked again for EPI--this time fasting.

Tetracycline is generally not the treatment of choice for SIBO. The drug of choice is Tylan powder (made by Elanco Animal Health--a Division of Eli Lilly). If your vet has any questions, he may call the company 1-800-428-4441.

Tylan powder is an off-label drug designed to treat respiratory diseases in chickens. The correct dosage for dogs is 10 mg/Kg given 3 times daily for at least 2 weeks. Because Tylan powder has a concentration of 4000 mg/ teaspoon, it is almost impossible to titrate the dosage down to a precise canine dosage. However, the drug has a wide range of safety and is well-tolerated.  It is usaually administered to dogs at the rate of ~1/4 teaspoon given 3 times daily.

Tylan is very bitter to the taste and must be mixed with food. If the dog objects to the taste in food, place it in empty gelatin capsules.

You may find a better source of probiotics to be Fastrack gel made by Conklin Company www.conklin.com.  Dog Town USA (http://www.dogtownusa.net/page/page/3937148.htm or 1-888-364-8961) usually gives good bulk prices for Fastrack in both gel and powdered forms.

If your dog truly has SIBO (with or without EPI), in addition to B12 injections, you may also wish to consider giving him oral folate daily.

Finally, a excellent way to firm up a dog's stool is to add bentonite clay powder to his food each meal. Bentonite powder is a bulking agent and may be purchased at most health/natural food stores.

I have had a dog with SIBO as well. Our vet put him on Eukanuba Low Residue food, the ingridients in it can't be absorbed by the intestinal bacteria so it actually starves the bacteria. My dog had to be on the food for 4 months and after that he was great, he was never put on antibiotics, just the food. He also had low B12 levels so we gave him a few tablespoons of Nutrical once a day for 3-4 weeks. Good luck.

A Vitamin B12 deficiency will cause diarrhea, but since diarrhea is the symptom of sibo, its hard to know which is the reason in your dog's case. Since your dog has a Vitamin B12 deficiency, I would think a weekly injection would be much more applicable in your case. Bodybuilders  who inject B 12, do so every day or every other day.

Perhaps you should get a second opinion from a different DVM. I would be afraid to advise you, for fear of giving you bad info. At least B 12 is water soluble and should not harm your dog. I get all my Vitamin injectables from this site in Australia. I always keep a couple of bottles of Vit C around for my dogs in the summer, in case of snake bites. You should add a few tbsp of canned pumpkin daily in your dog's feed. Not pie filling, but 100% canned pumpkin.

The below product gives 1000mg of B 12 per cc. You can give it Sub Q(under the skin)

http://www.animalcare.net.au/p/243162/vitamin-b12-100ml---value-plus-.html

My male was also diagnosed at 2 1/2 with chronic SIBO, B12 deficiency, and IBD (Inflammatory Bowel Disease).  After months of misdiagnoses, it was confirmed via endoscopy almost two years ago.  Has your dog been scoped?

I agree with previous posters.  Tylan is often the antibiotic of choice for SIBO.  It works in the intestine as an antiinflammatory, and unlike some others like flagyl can be given indefinitely without serious side effects.  It is also available online without a prescription from several sources.  Because of it's bitterness, I make gel caps for Xanto.  He will likely be on it the rest of his life.

We also give him a weekly B12 shot ourselves.  We tried to reduce it to once a month with dire consequences.  B12 is necessary for digestion, so his inability to absorb it causes things to shoot through undigested.  The shot is subcutaneous, so it is easy to give, even for non-medical people like us.  Our vet taught us how to give the shots and sells us the liquid B12 and syringes at cost.

He also is on two other drugs at low doses for the IBD.  Again, when we tried to reduce the dosage all hell broke loose, so he is likely on these for life.  Food is the final part of the puzzle.  After half a dozen failures, Xanto eats prescription Royal Canin LF canned and kibble, with an occasional cooked potato as a treat (sad).  It has taken this combination of things to stabilize him.  Often there are food allergies at work as well.  Corn and chicken are big culprits.

I would suggest that you work with your vet intially, trying both Tylan and increased B12 injections.  However, if that does not control the diarrhea, you may be dealing with something more complicated and should consider endoscopy by a gastroenterologist to get a definitive diagnosis.  Treating symptoms can be costly and frustrating and sometimes does no good.  Having a diagnosis lets you eliminate all the things with similar symptoms and treat what's really going on.  Things began to improve for us once that was done.  Good luck.  It's frustrating, but manageable.

I agree that a second opinion may be helpful. When you go for this, be sure that your dog has fasted for 12-18 hours if the new vet wishes to do another round tof testing for EPI immediately.

When one of my males came back, from "training" in Germany, had a heavy load of Giarda which wasn't diagnosed immediately. As a consequence, his gut was in sad shape--probable SIBO. After treating him for the Giardia, I found he that he occasionally had symptoms (very minor) of SIBO and treated him accordingly.

A low residue, but high calorie diet is helpful. Even more helpful is that all off my dogs are fed RAW. They particularly do well when raw green tripe is added to their diets. I use the tripe mixture Performance Dog put out by Oma's Pride.

BRADY BEE, before going to the enormous expense of endoscopy (which requires general anesthesia and which may tell you only what it isn't instead of what it is), I would treat the dog symptomatically and with dietary changes.

 

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HI

 Thank you all for your replys. Lots of suggestions to think about and discuss with my Vet. As regards the EPI I did ask my vet a t the time if it would make any difference that he hadnt been fasted before the test. She said that it wouldnt as on the form sent to the lab with the sample she had informed them that he wasnt fasted. You see , even when he was at his most skinny and the diarrhoea was at its worst he always maintained a beautiful health shiny coat, and has never show any of the othr symptoms of EPI. We have tried many different foods and eventually found one that seems to suit him . He looks very healthy and has managed to maintain his wait so far despite the odd bout of diarrhoea. The only thing that hasn't improved over the past five months is the B12 level. I know his stools may never be perfect but i am convinced this occasional diarrhoea is because of the B12. He normally produces a good stool in the morning then it gets softer later on, but he did have a period when he was recieving the B12 injections when his stools were good all the time. I found an article on B12 on the GI Lab in Texas and it states that no matter what the cause of the gastrointestinal disease, if there is a low B12 injections must be given untill that is put right, and to continue giving them untill all symptoms have gone. The amount of B12 and frequency  differs from the reccommendations here in the Uk but I will go along with my vet for a while longer and if his B12 doesnt improve then I will ask her to increase injections (maybe even show her the article)  If we can improve his B12 level then perhaps we can try reducing the antibiotics Hopefully!