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Forum Home > General Discussion > Tapering off Tylosin? B12? and an update

worriedparents
Member
Posts: 25

Hi, 

We found this forum in December and it was very helpful for us and our St. Bernard, Finn. He didn't test positive for EPI but had a lot of the signs of it, including low B12. He was getting worse and losing more weight, so we started treating him with enzymes, more B12 and finally Tylosin.

He's coming to the end of a 65 day run of Tylosin. I'm not sure why the vet gave him an extra 20 days worth than the standard 45 day course. Unfortunately we are going to run out in a few days and I just remembered the forum members saying it should be tapered down and not stopped cold turkey. What is the tapering rate?

We stopped giving him enzymes over a week ago because he was getting picky with his food again. Since then the smelly muzzle smell went away and his poops have gotten even a little been better than when he was on the enzymes. ****Please note he DID NOT test positive for EPI, so removing the enzymes was an option for him.*** At first we didn't want to change anything that had been working. 

For 6 months prior to finding this forum we were doing B12 shots and getting nowhere. He'd crash again and again with diarrhea and lethargy. He didn't have good reactions to them either. Sometimes he would pant heavily, and be restless and out of sorts 1-2 hours after the shot. We started him on B12 pills with Intrinic Factor. 2 pills every other day and now 2 pills every day.  He's a very playful dog now. Many days he grabs his toys on his own and plays. When we first adopted him he didn't know what a toy was and then got too tired to care. I'd say even his anxiety (and he had lots of it) is better. His appetite is so much better too. He wants to eat, which is so nice to see, and he's gained at least 10 lbs back if not more. 

Something must be working and must have had SIBO and the Tylosin helped. He has normal looking dog poop now!!! Woohoo. Didn't know he was even capable. No real problems since December and none since being on the Tylosin. He used to have gurgly stomach and smelly gas too and that's gone too. The vet mentioned about finding him a lowest effective dose if needed long term. We are interested to see what his numbers will be with a blood recheck. 

Are the WonderLab Pet B12 exactly the same as the human version? I bought a bottle of both and if they are the same I'll give him the human ones when the pet ones run out.

It seems like an easy treatment but it took us way too long to get to this point and see him get better. Hate to think where he'd be if I hadn't found this forum. Thanks again for all the help!!! 



March 17, 2018 at 1:26 PM Flag Quote & Reply

Jean and Kara
Administrator
Posts: 7457
What a great report, what is the dose you have been giving of Tylosin..... we have never stopped altogether, Kara has the smallest dose ever, less than 1/16 th teaspoon twice a day, let us know.......jeanx oh and yes the B12 is basically the same
--



 

 

Kara

 

From Liverpool England


born 21st July 2009


Adopted at five months old 26th December 2009

 

EPI dx August 2010


tli<1.00 folate 8.3 cobalimin 611

Antibiotics  2 Oxytet antibiotics 3 times a day also if we cannot fit the Oxytet in she has Tylan 1/8th teaspoon before her meals as a maintenanance dose

Food- Ashenbank Lamb Casserole  twice daily equalling 3 cups per day possibly more

Zantac (ranitadine) 75 mg 30 minutes before each meal as too much acid was being produced, causing shedding of bowel lining

Enzymes-Panzym 3 gram per meal twice daily ( 3/4 teaspoon ) 

B12 injection once every three weeks

One Chemeyes B12 with intrinsic factor of 40 daily

One Antepsin before bedtime

Allergies to beef, pork, chicken. and white fish confirmed by blood test

33.6 kilos in weight as of 5th May 2013

37 kilos as of 10th June 2014

40.65 kilos, 89.6 pounds as of 3rd March 2015

Vet says she is now processing her food correctly

Very proud of all of us

 

"UNCONDITIONAL LOVE WAS INVENTED BY DOGS"


I am not a vet, nor have veterinary experience, but have lived and breathed EPI for 51/2 years, and hope I can bring some support to others, as others have to me.

 

March 17, 2018 at 1:57 PM Flag Quote & Reply

Barb
Administrator
Posts: 3951

That is wonderful news!  It is the best feeling when everything starts to settle into balance and you see your pup enjoying eating and having good poos!  We had the same response from Kolby when we started giving him 2 pills a day from Wonderlabs.  


Congratulations!


Barb

--


March 17, 2018 at 3:29 PM Flag Quote & Reply

Doc's Mom
Administrator
Posts: 3134

So glad Finn is doing so well.  It's such a relief when they start feeling better.  As for the B12 - if you are referring to the WonderLabs B12 with Intrinsic Factor for humans then yes it is the same as the Pet Factor pill.  WonderLabs is a great company and big supporter of EPI dogs, so to make things easier on the customer, they created a new label specifically for Pets but it is the same pill.  If it does not have the Intrinsic Factor then it is not the same as the Pet Factor.  With regard to tapering Tylan - you can taper as you see fit but typically we suggest reducing it over two weeks or so.  If you're giving 1/2tsp 2x day you could reduce to 1/4tsp 2x a day for 3 days then reduce to 1/8tsp 2x day for 3 days then 1/8tsp 1x a day for 3 days then 1/8tsp 1x a day every other day etc.  Hope that helps.  Keep us posted and a big pat on the back to you for doing such a great job with Finn

--

MADELON and DOC aka "BUBBY WUBBY"

Nashville, Tennessee

DOB: 4/3/2014 - Diagnosed EPI and SIBO: 5/22/2015
EPI Test Results: 1st test 7/2014 = TLI 16.5, B12 894, Folate > 24; 
2nd test 5/2015 = TLI < .4, B12 406; Folate >24; 3rd test 10/2015   TLI < .4; B12 >1000; Folate 14.4

Weight: 95 (highest 1/2015) - 76 (lowest 5/2015) - goal met 100lb (7/23/15) - 101.8LBS 12/3/15 - CHUNKY MONKEY

History prior to DX:  May/June 2014 (2mos old) - DX coccidia and bladder infection; July 2014 (3mos old) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Diagnosed SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May  2015 vomitted several times, diarrhea and eating poop.

History since DX: has maintained weight between 95-101lbs since July 2015; extreme yeast and rod infection in ears; yeast infection paws (ongoing); bacterial eye infection; bacterial skin infection on legs; poops LIVE fly larvae; diagnosed with mild, focal superficial pyoderma (bacterial infection) - rare lesions on inner thighs; bacterial and yeast overgrowth lip folds; yeast overgrowth feet and left ear; metacarpal/metatarsal draining tracts/fistulae (infection and/or immune mediated disease; probable underlying allergy (food vs. environmental ); staphylococcus pseudintermedius infection in sores on paws; recurring metatarsal fistula - all issues resolved after NutriScan Food Sensitivity Test and switching foods.

NUTRISCAN Food Sensitivity Test (12/2015): reactive to chicken, turkey, white fish, wheat, white potato (mild), venison, soy (mild), pork (mild), duck (mild), corn - switching food based on test resolved all skin issues.

Serum Allergy Test (5/2016): Too many to mention

CURRENTLY :  6 cups Forza10 Legend Skin - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 2 scoops TotalBiotics 1x day; 600mg vitamin E; 1 Zyrtec 10mg 2x day; Milk Thistle during heartworm/flea/tick meds

I am not a vet.  All of my suggestions are based on my personal experiences, information gleaned from EPI research and information from other EPI owners.  Please always share anything and everything recommended on this forum with your vet

SO THANKfUL FOR OUR EPI4DOGS GUARDIAN ANGELS!!!!!!!!

YOUR PAWS LEFT PRINTS ON MY HEART (in loving memory of Bugsy aka Boo Boo - Boston Terrier 14yrs - not EPI but medically challenging and totally worth it)


March 17, 2018 at 5:10 PM Flag Quote & Reply

worriedparents
Member
Posts: 25

Yes he’s on the WonderLabs B12 Pet Factor. Good to know we can use their human version with IF. I bought a bottle for myself but he takes 1st priority. I'm thankful the bottles last quite a long time before I have to reorder. 

He’s on Tylosin capsules. We went for capsules because he was sooooo picky with his food, we didn’t want to risk the powder. Long term I would prefer getting the DIY capsules and the powder to cut down on cost.

The bottle says 300 mg per capsule and he gets 4 a day. (2 every 12 hours/1200 mg/day.) Thanks for the tapering info.

We weighed him a couple weeks ago and he was 140 lbs. We were sure he looked at least 145 and were a bit disappointed but it’s better than 130. He looks like he’s gained more in the last week, but it’s hard to tell on a dog his size. It appears to fluctuate too or we are hypersensitive to every little change now. His collar got tighter at one point, so we knew he chunked up.

Booked him into the next available appointment for a recheck in 12 days. If we start going down to 1 pill every 12 hours and gradually from there we should be able to last till that appointment or close to it. And of course it will be interesting to see how that affects his poops.

Thanks again. I’ll update on what his B12 numbers are. He was high the last time with extra shots, but his symptoms sure didn’t reflect that. I’m curious to see what it will be now on the pills with IF and no symptoms like he used to have. I wish everyone on the forum could see improvement with their dogs too. 

March 17, 2018 at 7:37 PM Flag Quote & Reply

maddie ann
Administrator
Posts: 3658

Hello you may want to consider slippery elm as a back up plan if when you have tapered the dose down the poop doesnt appear good. or the weight drops..its another option to tylan and for some people works as well.You need the powder and the dose depends on your dog so 1tsp per meal for dogs over 100lbs given twice a day with food like the tylan.

--

 ANN (UK).

Maddie DOB 01-10-2007 she is now  10  DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2.

After 15 months on the B12 tablets with the intrisic factor she was retested and her b12 was 902 which gave me the confidence to continue without injections.

Weight was 22.3kg now 33.2kg (04-05-12) she is a small GSDbut she gained .(24lbs)

Feed a mixture of foods she does better on fibre 3% and below she has  b12 tablets daily (imported from the USAhttp://www.wonderlabs.com/itemleft.php?itemnum=6881) now changing to the uk version from http://www.chemeyes.co.uk/

She has panzym altough over the years we have had to increase the dose she currently has 1/2 tsp per feed.


March 18, 2018 at 7:34 AM Flag Quote & Reply

worriedparents
Member
Posts: 25

Thanks Maddie.

Could he get slippery elm and Tylosin at the same time? We gave slippery elm prior to starting Tylosin but didn’t notice much improvement on slippery elm alone. It took a while for the Tylosin to make a noticeable difference so maybe I didn’t use the slippery elm long enough before stopping it.

He’s been down to 1/2 the Tylosin amount for almost 2 weeks now (1 pill in morning and 1 in evening). We didn’t taper him off it lower than that because the vet asked us not to.

His poops haven’t changed in appearance but the smelliness of the stool is creeping back in. When he went on Tylosin to begin with stopping the foul poop smell was the first positive change we noticed. We've heard more gas from him since the Tylosin was cut back and we had one scary episode at 4 am of air licking. And another shorter episode a couple days later. He used to do that enough to concern us but not since the fall. We were worried it was the start of bloat. Gave him a Gas-X both times and he stopped it. I wonder if it’s maybe a sign of acid reflux or some sort of discomfort because the one happened when he’d been sleeping. He doesn't do it right after he eats for example. Whatever it is, it freaks us out.

He had his vet recheck this morning. With subtle changes in behavior plus the gassiness we think he did better on 4 pills vs now 2 pills. We are going to put him on 3 pills a day and see if that improves things a bit. We aren’t going to recheck his blood work for a couple months yet. The vet is thrilled he’s been doing so well on Tylosin and the B12 pills. She suspects he’ll be on both for the rest of his life.

He now weighs 143 lbs. When we found the forum in December he'd gotten down to 128. She thinks this a good weight for him to try to maintain and not get bigger either. 

March 29, 2018 at 10:52 AM Flag Quote & Reply

worriedparents
Member
Posts: 25

I think I read you shouldn't feed Tylosin and slippery elm at the same time or it can affect the Tylosin? I meant can you give them together at all, even at different times of the day? Thanks

March 29, 2018 at 11:07 AM Flag Quote & Reply

maddie ann
Administrator
Posts: 3658

We dont recommend that you use the 2 togther Slippery elm puts a mucillage lining which stops the absorption of the tylan...that smell is sibo ...some just have to be on tylan for life ..with SIBO they say its about finding the correct food,,,easier said than done !Well done with the weight.

--

 ANN (UK).

Maddie DOB 01-10-2007 she is now  10  DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2.

After 15 months on the B12 tablets with the intrisic factor she was retested and her b12 was 902 which gave me the confidence to continue without injections.

Weight was 22.3kg now 33.2kg (04-05-12) she is a small GSDbut she gained .(24lbs)

Feed a mixture of foods she does better on fibre 3% and below she has  b12 tablets daily (imported from the USAhttp://www.wonderlabs.com/itemleft.php?itemnum=6881) now changing to the uk version from http://www.chemeyes.co.uk/

She has panzym altough over the years we have had to increase the dose she currently has 1/2 tsp per feed.


March 29, 2018 at 12:28 PM Flag Quote & Reply

worriedparents
Member
Posts: 25

We’ve put Finn back on 4 pills of Tylosin a day. His poop was getting gradually softer, smellier and he was less interested in his food. The couple weeks on 2 pills obviously wasn’t enough, but didn’t cause a dramatic sudden change to his poops. Maybe we didn’t give the increase to 3 pills enough time to help but we were afraid he was going to head into diarrhea again. His poop this morning seemed a bit better already with a few days back on 4 pills. Maybe after this course of Tylosin we could try 3/day and see if that is ok for him. It’s all trial and error I guess.

Are there some SIBO dogs who can never go on a lower dosage or need to be on a higher dose for a long time before they can be put on a lower one?

I just saw on the WonderLabs Pet Factor B12 pill bottle it says to empty the contents of the capsule onto the dog’s food. We just give him the capsules with some cheese as a treat. Does it really need to go on his food?

Thanks

April 4, 2018 at 5:39 PM Flag Quote & Reply

Jill
Administrator
Posts: 3719
Hi. Some dogs need to be on a dose of Tylan the rest of their lives.I am pretty sure that it doesn't matter if you throw the whole B12 caps in with the food or open and put on the food. Probably what works best for your pup.
--

   Jill-  Washington State

Mickey 6/21/99 - 8/29/2014 

17.5 lb  jack russell, chronic pancreatitis, hyperuricosuria,high blood pressure, hypothyroid, spinal stenosis

diet of  hard boiled eggs, macaroni,  RC Hepatic, mashed potato

2 #2 Dianes enzymes 6x premeal

 2.5 mg Amlodipine, .15mg soloxine am/pm, 100mg ursodiol started for gall bladder thinning

arthritis:  6.25mg tramadol 1x/day, 12.5mg gabapentin every 12 hrs,  Assisi soft loop used on back and elbow, 1- 540meq potassium citrate nightly

Denamarin once a day, 1/16 t tylan (150mg)  2x/day ,  Senilife started 12/14/13, Trixsyn sirup for arthritis, .1mg Adequan weekly by shot. 75mg Tylan 2x./day for SIBO

Optimmune for Dry eyes

 Kiya is Mickeys sister, 3/4 aussie, 1/4 blue heeler born 9/2006.  She thinks she is a 44 lb jack russell who tries to heel Mickey!!

TJ is the newest addition.  He is in the bottom picture with Kiya.  He was born 7/05/2015. 

I am not a vet, just a pet owner sharing what experiences I have had in helping my dogs with other pet owners.  If you have an emergency please call your vet.





April 4, 2018 at 9:38 PM Flag Quote & Reply

Barb
Administrator
Posts: 3951

You don't have to open the B12 capsules.  You can give him the capsules  whole without emptying them.  We just put the capsule in Kolby's food.


I am glad you are giving Finn the Gas-X.  We give Kolby two Gas-X gelcaps after the evening meal every night.  He bloated last summer, so our vet said that giving him  Gas-X every day is a good precaution.  She originally wanted us to give it to him morning and evening, but he only seems to need it at night. 


Barb 



--


April 11, 2018 at 9:12 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 17178

Sorry i am so late to this post, but so glad to hear that Finn improved once you implemented the Tylan and the Wonderlabs B12 pills.... and yes (as mentioned above) both the Trinfac (human product) and the Pet Factor B12 (dog product) is identical :).   And you can give the whole or broken up, it doesn't matter. I give my EPi gal (and her sibling) the B12 pill whole and tucked in a small blob of cream cheese.


Ahh... regarding the Tylan (antibiotic) and Slippery Elm (prebiotic).  To keep things simple, we have a general stance... to take any prebiotic approximately 2 hours away from any antibiotic.  Most antibiotics will destroy the prebiotic if given together (although not Tylan since Tylan does not kill all bacteria but very simply pu) rather inhibits reproduction of bacteria).... BUT.... because f the wonderful mucilage properties of Slippery Elm.... which would slightly inhibit the effecticeness of the Tylan (which is very slight and usually not a problem) BUT.... since Finn really sounds like he is one of those dogs that will need Tylan full dose for life... you probably would be better off not to give the Tylan and the SLippery Elm together.    


Also, regarding the Slippery Elm..... try giving less.... Slippery Elm is loaded with Butyrate (one of the 3 main SCFAs) which is known for helping keep SID in control.... but......too much of this will have the opposite affect and sometimes cause loose stools... so some appear to do better with a lesser dose.  The new dose recommendations are: 1/8 tsp for dogs under 10lbs, ¼ tsp for dogs 10lbs to 30lbs, ½ tsp for dogs 30lbs to 80lbs, 3/4 tsp for dogs 80lbs to 100lbs, and 1 tsp for dog 100/+lbs. Mix in meal, add 1 to 2 tablespoons of water, mix and serve meal as you normally would- -given with Breakfast and dinner. Incubating not necessary.... and again..... sometimes even less is better.

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

April 15, 2018 at 10:54 AM Flag Quote & Reply

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