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Primary SIBO – Journey to a Healthy Lifestyle

A Story of Our Golden Retriever, Buddy Chosen Friend


Horse, Horse, Zebra, Horse

Buddy presented with diarrhea from the moment we brought him home from a reputable breeder.  He was treated for Giardia twice (no other indication of any abnormality).  Our vet ordered a highly digestible, low fat, low residue food, but surprisingly to no real avail.  We went through several more courses of Flagyl.  All follow-up stool specs, along with a complete diarrhea panel were negative (horse).  The breeder assured us that no other littermates exhibited these symptoms (horse).  All the while negative tests were indicating “horse”, the mom inside of me was screaming, “ZEBRA!!”  Because Buddy periodically responded to new probiotics (e.g. ProstoraMax), our vet wanted to take a wait and see attitude, assuring us that Buddy and would most likely grow out of his sensitive stomach by the time he reached 8-10 months of age.  At 14 mos, Buddy blew his coat (mid-winter) and dropped to 69 pounds, during another siege of diarrhea.  Back on Flagyl☹  While searching the net, I happened upon Epi4dogs.  This website was a God-send to me; it gave me a quick, but thorough education on doggy diarrhea (enough to write a thesis!).  We discussed with our vet the possibility of Buddy having Epi (Exocrine Pancreatic Insufficiency), a disorder that in the past was predominantly found in GSDs (German Shepherd dogs).  Epi is always accompanied by SIBO (small intestinal bacterial overgrowth), [now referred to as SID – small intestinal dysbiosis], leading to diarrhea. In addition, Buddy had blood drawn for B12 and folate levels, along with a complete blood count and full chemistry screen.  Buddy tested negative for Epi, and the B12 / folate results were within normal range, but the vet was now convinced Buddy had SIBO.  One of our trainers recommended the use of Tylan Powder (a low grade antibiotic that is used in farm animals and is specific to the gut).  Tylan can be used in ARD (antibiotic responsive diarrhea) in dogs and does not have the neuro side effects sometimes seen in dogs being treated with long-term Flagyl.  Our vet ordered the Tylan, along with VSL-3, a new (refrigerated) probiotic developed for humans with IBS.  Buddy is currently being maintained with Tylan powder twice/day (6am and 6pm with his food).  Buddy is also receiving two different probiotics: Probiotic Miracle at 12noon and one capsule of VSL-3 at 10pm.  

This was the first part of the journey to help Buddy live a normal life.


The second part of the journey begins with

  1. Maintenance & prevention,
  2. Careful observation & immediate intervention at the first sign of trouble.  


The goal:  to avoid a worsening of infection indicated by adverse physiological signs

(e.g. diarrhea, weight loss, abnormal respirations), along with signs of pain/discomfort.


1. Maintenance & prevention:

  • We use a low-fat, low residue diet.  Buddy has been on Natural Balance LID (limited ingredient diet) Lamb & Brown Rice dry food for over a year now.  He did not do well with chicken; therefore, this worked better than the IAMs veterinary formula.  He was also allergic to the Natural Balance Fish (developed cough).  NO TABLE SCRAPS.  We use his dry food for treats during lessons, but we rarely treat at other times because it is better to give the digestive system a chance to empty between meals (less opportunity for bacteria to proliferate).
  • We try to keep outside areas clean, especially from other dogs/animals and changed our other dog to the same food as above, esp. to avoid any change in Buddy’s diet d/t coprophagia (eating poo).
  • Buddy is a hunter (moles, mice…); therefore, we use Sentinel Spectrum in order to prevent a recurrence of tapeworms and the need for heavier duty antibiotics.
  • We try to stick to a schedule (just like a baby) both for feeding times and “normal” daily activities.  We also try to be aware of over-excitement from company.  If he gets too excited or if he is “on duty” with strangers (e.g. servicemen) and not taking his usual afternoon nap, he may show signs of softer stool the following day.  In winter, we limit playing in the snow to brief periods, reducing over-eating of snow.
  • One of the most useful hints is to soak the dry food for 10 to 15 minutes in warm water so it is more easily and more quickly digested, thus reducing the time it is in the portion of the gut where adverse bacteria multiply.


2. Careful observation & immediate intervention at the first sign of trouble:

  • First indications of impending problem:
    • Whorls become more noticeable (prominent parting of fur)
    • Lack of endurance
    • Increased “recovery time” after play (excessive panting 20-30 minutes)
    • Increased shedding


  • Additional symptoms to those listed above, requiring close observation and treatment:*
    • Increased thirst
    • Passage of very foul flatulence (could clear a room!)
    • Partly loose stool (firm ending with softer stool)
    • More aggressive play


*At this point, we use Endosorb, an, OTC (over-the-counter) medication that helps absorb toxins in the gut.  For our 80 lb dog, we start with 2 tabs twice/day for 3-5 days, depending upon the stool, then we titrate down to 1 tab twice a day for 3 days, then 1 tab once a day for 2 days.  

Always check with your vet before giving any medication.


  • Symptoms requiring the addition of Flagyl**
    • Large, frequent amounts of light-colored “pudding” (no form) and/or liquid diarrhea
    • Tenesmus (straining at end of a bowel movement)
    • Arching of back upon rising from sleep (due to pain)
    • Moaning upon laying down (due to pain)
    • “Prayer” position (folding his front paws underneath him)
    • Bloodshot eyes
    • Reduced salivation (noticed this difference in Pavlov from former dog)


**For Buddy, we begin with 500mg Flagyl twice/day for 3-5 days, depending upon the stool, then 250mg twice/day for 3 days, then 250mg once/day for 2 days (for a total of 7-10 days).  Although we initially add the Endosorb, we stop it after 2-3 days once on Flagyl and the stool becomes firm again.  


[There are reports of keeping dogs on long-term, low-dose Flagyl, but I prefer to use the Tylan that is specific to the gut and save the Flagyl for flare-ups.  Dogs can live normal lives on Tylan and it is relatively inexpensive and has good expiration dating.  Because Tylan powder has a bad taste, the best way to administer is to encapsulate it at home.  It does not need to be refrigerated.  You can make 200-500 capsules at a time and save in a cool place (we keep it next to the wine!).]


At 2 ½ years old, Buddy is now an, 85-pound, well-toned dog.  He is also is a Canines4Christ Therapy Dog, exhibiting an extremely gentle disposition with patients.  He is basically living a normal life; setbacks happen less frequently and less severely, as we stick to the above plan of prevention and treatment.


Side note:  If you were wondering how he got his name, ‘Buddy Chosen Friend’.  It came from a song about John 17, where Christ asks His Father to take care of His chosen friends.  We didn’t choose Buddy, he chose us.  We believe that God had a hand in Buddy choosing us, because Our Good Lord knew we would do our best to take care of Buddy and therefore enable him to bring God’s love to others through the C4C Therapy Dog program.