Confused on prebiotic,probiotic for long term management

[Fepi]

Hi all.
I am wondering if anyone could share insight on the correct use of prebiotic, probiotics to help with managing SIBO (or small intestine issues) and/or maintaining/preventing once he is stabilized.

I am slightly confused on the routine I should be establishing with my newly diagnosed EDI dog. We will be starting him on the enzyme suppliments (pancreatin 6x)soon, we are giving him the B-12 injections and will be adding the pet factor b-12 with intrinsic, and he is on Tylan.

He is also currently on a probiotic, proviable-forte. But here is where I am a bit confused. Should he be getting a prebiotic? Or both pre and pro? I am not sure what best practices are on what I should be giving him long term going forward in this area (prebitic, probitic, both??) alongside the tylan to help with SiBo and manage/prevent it once he is stabilized.

[jilbert57]

Good morning and sorry for the confusion. There are a couple of things you can try.
Once the enzymes are implemented it might take care of the SIBO and nothing else needs to be added.

The Tylan will(should) take care of the SIBO given 2 times a day for 45 days when implemented with the enzymes, grain free diet and B12. A lot of pups are on a small maintenance dose of Tylan for life as when their 45 day course is done SIBO returns. Tylan is very forgiving that way.

Some give Slippery Elm in lieu of Tylan with 2 meals and the Epi protocol and that works for them.

I hope this helps.

Here is a journal you can download and track what you are fiving daily that works or not. It's all about the poop.

https://epi4dogs.com/epi-log/

Jill

[Fepi]

Thanks Jill.
So basically, if I understand this correctly, he will be starting the enzyme supplement, we will be giving him B-12, and for the next 45 days give him Tylan (2x day).
…And you are saying he does not need to be on a prebiotic or probiotic at the same time he taking tylan because that is what will be helpful to clearing up the SIBO.— correct?

Question- Once he is stable and had 45 days of tylan, should we then take him off tylan add a prebiotic, or probiotic or combo of both as preventative measures?

Or alternatively, when he is stable and had 45 days of tylan do we just keep him off tylan and not add a pre or probiotic and just observe his stool and other symptoms like if he start regurgitating etc. Then If he becomes unstable we just put him back on Tylan (2x day)?

Of course I know I should confirm with vet but I just wanted to get a sense of what to do so I can better communicate with my vet (as she can be be a bit vague on instructions if I don’t ask specifically what I need to do - she is so busy understandably).

[Eddiespaghetti]

After the 45 days of Tylan you will want to back off tylan slowly. Try half a normal dose twice and see if they are still doing well. If they are, you can probably take them off of it completely after a week or two of weening.
Best practice is, around day 30 start implementing the pro/pre biotics. If the Tylan does help with SIDs and no diarrhea it will be trial and error between probiotics, slippery elm, tylan, anything else to find what works.

[jilbert57]

Well, it's not always cut and dried.
Please read this article from our site:

https://epi4dogs.com/possible-alternati ... tibiotics/

Your pup is already on Proviable and Tylan. I would stay this course when you get the enzymes and implement them in with the B12 protocol. I would keep a diary and see if things improve. After a 45 day course of Tylan you need to wean off, not just stop it.

The B12 if shots need to be given weekly for 6 weeks. Oral B12 caps from Wonderland with Intrinsic Factor work great. Level needs to be kept at 600 or up.

It is up to you if and when you wean him off you add pre/probiotic or not.

A lot of folks come here and have not started a antibiotic. Sometimes the enzymes resolve the SIBO with out antibiotics.
Some only try Slippery elm in lieu of antibiotics.

Now someone else may come on here with a differing opinion.

Jill

[Fepi]

Great advice and suggestions. I really appreciate it. His enzme supplements arrived today Thank you all.

[Olesia711]

Hi Febi,

Welcome to the confusion of owning an EPI dog

You have been given good advice above, but, as with any EPI dog..... there is a "recommended" protocol but then it often has to be tweaked (slightly adjusted) to best address each individual EPI dog.

What i personally recommend is if you are doing Tylan...... about halfway thru the Tylan regimen (30 days is a good halfway mark) then introduce a good pre+probiotic . THe good probiotic brands will have prebiotics in them. Prebiotics are proven to work. Prebiotics FEED the bugs (probiotics). Probiotics are just more types of bugs.. .. that will not survive unless they are fed.
https://epi4dogs.com/prebiotics-and-probiotics/


Regarding Tylan, what i like to suggest is the withdrawal system... at the end of 45 days...
for the next week give 1/2 dose morning & night
for the second week give 1/2 dose once a day
for the third week give 1/2 dose every other day
then stop.. cross your paws and fingers that this works, if not, do a 2nd course of Tylan

REgarding probiotics that include prebiotics, some of the products i like to recommend (although not limited to these) are:
Proviable
Visbiome
VetriScience Mega Probiotics

IMPORTANT regarding probiotics. ALWAYS, ALWAYS, ALWAYS!!!! start with less than 1/2 the recommended dose and work your way up to a full dose over the course of a week or two.
Not all dogs need probiotics... if all is well, no need to try and fix something that is not broken.
Also.... it is a good practice if using probiotics to switch brands every couple of years.

The problem with probiotics is that just because 1 product works for 1 EPI dog, this is no guarantee that it will work for another EPI dog.

This is why we strongly recommend keeping an EPI Log (or journal) so you can record what works and what doesn't... and keeping a journal will save your sanity if and when your dog has a set-back...(and almost ALL dogs with EPI have a SID/SIBO set back at one time or another) you will then more readily be able to get your dog back on track then if you don't keep a journal https://epi4dogs.com/epi-log/

Regarding SID/SIBO set backs..... very often many folks don't need to give Tylan antibiotic when a "set back" happens.... often times, SLippery elm powder does the trick.
Sometimes, although not always, but worth trying... In the beginning when trying to get the initial SID/SIBO under control, sometimes even then Tylan is not needed and the Slippery Elm powder (Slippery Elm has prebiotic properties) works.... but in the beginning of an EPI diagnosis, when trying to get SID/SIBO under good control.... sometimes you just need to do the Tylan regimen.

[Fepi]

Olesia711 This information is very helpful! Will just take things one step at a time and adjust as needed for sure. I will let you kmow how he does. Thank uou.

[Olesia711]

Hope the info helps..... and if you can, start keeping an EPI journal....doing so really, REALLY helps to effectively manage an EPI dog. What you will start to see are "trends" and then you will pick up on what seems to agree or not agree with your EPI dog.

And YES! please do keep us posted!

[jkblack]

This information about pre/probiotics really helps. And the statement about noticing "trends" and keeping a log really helps. After my sweet lab, May was diagnosed at the middle of Sept, I had tried several things; increasing meals from 2 to 3, adding in Tylan, changing from B12 intrinsic factor to B12 injections, lowering pre/probiotics from 2.8mg per day to none (BTW my vet asked me why I eliminated pre/probiotics but it just seemed that I should simplify what I was doing and somewhere I read she may not need pre/probiotics with Tylan) and I tried to decrease from 1tsp to 3/4 tsp of enzyme (also changing enzymes but I had to go back to 1 tsp)... I imagine whoever reads this is in shock about how many adjustments I have made over the last 2 months...but now my dog is finally stable with a good weight gain (60-67 pounds) and stools of #2 on the (epi4dogs) fecal scoring chart. ........ Now she gets 1 cup food with 1 tsp enzyme 3x/day, 1/4 tsp Tylan 2x/day, B12 injection once per week. My questions are,,,, if her fecal gets worse, should I (1) re-introduce pre/probiotics? (2) add in B12 intrinsic factor (do I need intrinsic factor with B12 injections?) and also (3) At the 45 day point, I plan to lower Tylan to 1/8 tsp 2x day...at that point, would it be good to introduce slippery elm or pre/probiotics? I realize all of this is subjective but, all of you on this Forum have a wealth of experience in this and I am tremendously appreciative of your thoughts on this. Thanks you all SO much!