How long for SIBO to start?

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
Chance
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Pet name: Chance
My name: Andrea

How long for SIBO to start?

Post by Chance » 06 Nov 2022, 18:48

I think we're heading back into another SIBO setback...again. I'm pretty certain it's triggered by trying to get Creon dose.

He's on Tylosin (400mg twice daily). Has back since last setback about a month ago.

We switched to Creon a few weeks ago or so. And I do really like it. He seemed okay at about 4.5 capsules of Creon 10. Last prescription, vet said it would be easier to just give 2 capsules of Creon 25. I thought so too. But 2 capsules (Total Creon 50,000) seemed too much. He got bad acid reflux!

A few days ago I tried giving roughly 1.5 capsules of Creon 25. That proved not enough. He started with very large poops, with a lot of food. Today he's got the obvious signs of SIBO again.. despite Tylosin.

Would SIBO start up after just a few days? To me timing is too much to be coincidence. Or would it take longer 🤔

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Olesia711
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Re: How long for SIBO to start?

Post by Olesia711 » 06 Nov 2022, 19:19

yea, it probably is SID..... but just to clarify ALL dogs with EPI have SID present... our objective is to keep it under good control via right diet, enzymes, B12, and if still out of whack, then add pre/probiotics and if that fails, then do Tylan.

SO..... in your situation... yes, the SID is most likely getting out of control cuz you have not found the magic formula of CREON for your dog.

here are some pointers:
1. open the capsule(s) and sprinkle the little enteric coated pellets onto some moist food (moist food give the pellets something to stick to)
2. DO NOT mix the pellets in the food,
3. DO NOT incubate CREON in the food
4. Start with one CREON 10 or 12......
5. if the above doesn't work.... try CREON 10 or 12 with 1+1/2 capsules
6. If the above doesn't work, .. try two CREON 10 or 12 capsules, opened and sprinkled on top of food, served immediately.
7. If the above doesn't work, try giving the capsule whole approximately 3 to 5 minutes prior to giving the meal (you can tuck it in something soft/pasty like canned pate cat food.
8. If the above doesn't work, try giving a capsule(s) whole during the middle of a meal.
9. if the above doesn't work, try giving a capsule(s) whole right after a meal.
10. if the above doesn't work, try giving a capsule(s) whole about 3 minutes after a meal.

What you are trying to figure out is not only (1) the right dose but also (2) the best administration technique for that individual EPI pet.
CREON does work, but it takes time to figure out.

Once you figure out these 2 aspects of giving CREON, all should be well.

Please keep us posted.

P.S. allowing the Creon pellets to incubate destroys the coating and then the potency of the CREON with be further destroyed going thru the digestive system by up to 70% so by the time it gets to where it is needed, there is not much of the working enzymes left..........hence why you should never incubate CREON....
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

Chance
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Posts: 197
Country: Canada
Pet name: Chance
My name: Andrea

Re: How long for SIBO to start?

Post by Chance » 06 Nov 2022, 19:56

Yeah, sprinkled on his (raw) food. I think that method works, as it was ok until I gave too much. He's on Proviable DC (Only about 2 weeks). His last B12 was injected yesterday. He's been on Tylosin, which obviously isn't enough right now.

It is a very sensitive thing, this EPI!

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Olesia711
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Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: How long for SIBO to start?

Post by Olesia711 » 07 Nov 2022, 10:58

Yes....Finding the right balance to effectively managing EPI can be a real pain in the butt..... until you find the right balance of the 4 aspects.... and then all of a sudden, everything finally falls into place . so keep written records of everything you try (one-at-a-time) and little by little you will discover trends of what works and what doesn't..... this method works, but OMG.... it sure does require a lot of patience.... something i was a wee be short on many times... so i sure can understand frustration!!

BW....Your thought that too much CREON probably didn't agree sounds about right too :)
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

Chance
Member
Posts: 197
Country: Canada
Pet name: Chance
My name: Andrea

Re: How long for SIBO to start?

Post by Chance » 08 Nov 2022, 01:46

I got another prescription for Creon 10 today. And the prescription for Creon 25 is still active. So I now have more options for tweaking doses. The magic number is somewhere between 40,000 and 45,000. It's going to take time to work out where exactly. But I know 50,000 is too much and 37,500 is too low. But he was at 45 for several days without getting sick before; so I think I will try that first.

I ordered a probiotic paste, which I hope will help with things while getting dose tweaked.

One thing I have noticed is that this is a lot less forgiving than the powdered! Enteric coated is much more bioavailable, so a tiny bit goes a long way!

And yeah, it does take patience! For both the dog and humans!!

Sorela
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Country: Romania
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My name: Sorela

Re: How long for SIBO to start?

Post by Sorela » 08 Nov 2022, 08:00

Hi,

I really hope you find the right dose of Creon, for Chance, I know that fight!My girls are stable now with Lypex, and we had the same problem with SID , until we find the right dose with Lypex, but boy, what a fight! Lypex is very expensive, Creon is a little cheaper.

I'm looking into trying Creon also for my dogs, I know every dog is different, but for my clarification could you please tell me:

at what quantity of raw food... do you give around 45000 creon units?

do you give Creon with the meal? or before the meal ....3-5 min before the meal?

and also, very important, what weight has Chance ?

Thanks,
Sorela
BECKY, SHEEVA+BLACKY 13 years each, ideal weight 15kg, 13 kg, 18 kg(each girl have lost around 1.3 kg), since june 2022 chronic pancreatitis ; since 5.10.2022 CPL over 1000, hyperlipidemia, malabsorption, SID. TLI not tested yet, waiting the CPL to be stable.1 poop/day/dog, with form, orange and soft

Present: 5 low fat small meals / day/dog ;all are taking: 1cps lypex/120 gr food/dog + 1/4 tsp slipp elm/dog: 2 x/day + B12 chemeyes+selenium+ zinc+ E: 1x/day/dog+ 1/4 tsp/dog beef tripe powder: 1x/day+1/8 tilozina(Tylan) 2x/day
Ideal Poops. Weight gain 450 gr/girl
Hills low fat+Homemade: rice+ chicken breast+quail egg+Cheese 0,5% fat +sweet potatoes+boiled carrot.
We fight to decrease CPL

Chance
Member
Posts: 197
Country: Canada
Pet name: Chance
My name: Andrea

Re: How long for SIBO to start?

Post by Chance » 09 Nov 2022, 12:38

Sorela wrote: 08 Nov 2022, 08:00 Hi,

I really hope you find the right dose of Creon, for Chance, I know that fight!My girls are stable now with Lypex, and we had the same problem with SID , until we find the right dose with Lypex, but boy, what a fight! Lypex is very expensive, Creon is a little cheaper.

I'm looking into trying Creon also for my dogs, I know every dog is different, but for my clarification could you please tell me:

at what quantity of raw food... do you give around 45000 creon units?

do you give Creon with the meal? or before the meal ....3-5 min before the meal?

and also, very important, what weight has Chance ?

Thanks,
Sorela
Meal sizes are between 250 to 300g. (3 meals per day). But it's very high in fat. (I am picking up more food tomorrow as I am almost out) This time I tried ordering more of the leaner meats and less of the higher fat. Like about 20 lbs of leaner meats and 10 lbs of high fat. So next batch of food, that I have to make Friday, will be lower in fat than he's been on.

I do know that the 37,500 units was too low. Poop became massive, and a considerable amount of raw meat came out. Increase to 45,000 units much, much better. (I had him okay at 40,000 units very briefly, but the poop was yellow/orange and some residue. I went to 45 after a few days to see if color would improve. A day and a half later, he had perfect poops! But it was only a few days he was there until I needed a prescription renewewal and the vet thought it would be easier for me if we just gave 2 Creon 25....which is too much.

Now I have the Creon 10 and 25 here; so it's easier to tweak doses.

I'm sticking with that for the coming days at least, unless the dog tells me it's too much again. 😁 I will eventually try cutting back to 40,000 units...but not until I know SIBO is controlled. (*might* be possible then, since food will have less fat). Someone told me the formula for dose was weight of food in grams x fat% x 20. (Her example was 130 x 14 x 20 = 36,400, and was fine at 35,000). Others have also argued that formula is correct. But I don't know! But if it is, my fat content might be a reason why he's been needing so much!

He's about 32.5kg. (Still working on gaining. Almost there. He's gained approximately 8kg so far).

I have just been opening the caps and sprinkling on his food.

Tuckaboo Pam
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My name: Pam H.

Re: How long for SIBO to start?

Post by Tuckaboo Pam » 09 Nov 2022, 17:32

Hey, Andrea. Sorry for your quandary. Two things---1) Tucker has setbacks two or three times a year. Possibly due to eating something he shouldn't. We just deal with it. It starts with unbearable gas, and I up the Tylan dosage. He is a Tylan lifer, and it usually keeps him SID symptom-free, and 2) Be careful with Proviable. Tucker weighs 95 pounds, and I only give him about 7/8 of a capsule. 1/8 goes to my IBD maltipoo, 10 pounds. Did you start out slowly & work your way up to the whole capsule? It's important to do this, or you can give them diarrhea. ---Pam
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

Chance
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Posts: 197
Country: Canada
Pet name: Chance
My name: Andrea

Re: How long for SIBO to start?

Post by Chance » 09 Nov 2022, 23:00

this is only 2 weeks after treatment for the previous setback. He was doing quite well, until the enzyme dose was too low. I increased enzymes again, and was good for a day or 2, then the symptoms of SIBO set in. I do really believe it's from trying to tweak the new enzymes. The vet says definitely that's it (only went in to get a new prescription for the new dose).

He's already still on a full dose of Tylosin (400mg, twice a day), so I did not think to increase that. I suspect that either Tylosin was not enough to keep up with things with enzyme doses still being tweaked; OR its not the drug of choice for him. Vet said it could be either; but won't know until we do find the right enzyme dose.

He's been on proviable just over 2 weeks. I started giving about half capsule, but went up to a full capsule after a few days. He's been on one probiotic or another from the beginning. I started this one before he finished the last round of antibiotics (keeping only Tylosin).

I know he did not get into anything. And thats not really the same type of symptoms as SIBO. This was definitely SIBO. He had the discomfort, less interest in food that I have never seen until SIBO (being a Lab...Labs don't do that. It is literally in their DNA to be starving all the time...even when sick)! It was absolutely SIBO, and it was only going to keep getting worse. He knew it. He remembered.

Anyway, I hope the enzyme dose is correct now. I know it's definitely not too low at least. I don't think it's too high, but if it is, I'll take it down slightly

Sorela
Member
Posts: 30
Country: Romania
Pet name: The little Countesses
My name: Sorela

Re: How long for SIBO to start?

Post by Sorela » 10 Nov 2022, 02:44

Andrea, you said you give Chance 400 mg Tylosin 2x/day? and Chance has 32,5 kg... well I believe that the dose is half the dose he should get, at his weight.
I believe is too little

Look at this chart, maybe it will help, it says 25mg/kg ....2x / day(that means 50 mg/kg /day) . So after my math Chance should get(a full dose) at 30 kg... around 750 mg at 12 hours( that means 1,5 g /day) if he is in a SIBO flare.

https://epi4dogs.com/antibiotics/

I have a Tylosin that has 58 % (tartrate powder) of the strenght of the american Tylan(that has 100 % tartrate powder), so my pharmacist adapted the dose for my dogs, so I have to give 39 mg/kg- 2x / day (that means 78 mg/kg in a day) for a dog that has 17 kg.

My american Tylan arrived, and when I will give that product, I will give only 25 mg/ kg at 12 hours; means 50 mg/kg in 24 hours.

Sorela
BECKY, SHEEVA+BLACKY 13 years each, ideal weight 15kg, 13 kg, 18 kg(each girl have lost around 1.3 kg), since june 2022 chronic pancreatitis ; since 5.10.2022 CPL over 1000, hyperlipidemia, malabsorption, SID. TLI not tested yet, waiting the CPL to be stable.1 poop/day/dog, with form, orange and soft

Present: 5 low fat small meals / day/dog ;all are taking: 1cps lypex/120 gr food/dog + 1/4 tsp slipp elm/dog: 2 x/day + B12 chemeyes+selenium+ zinc+ E: 1x/day/dog+ 1/4 tsp/dog beef tripe powder: 1x/day+1/8 tilozina(Tylan) 2x/day
Ideal Poops. Weight gain 450 gr/girl
Hills low fat+Homemade: rice+ chicken breast+quail egg+Cheese 0,5% fat +sweet potatoes+boiled carrot.
We fight to decrease CPL

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