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SID/SIBO in Brief

SID (previously known as SIBO) in Brief
revised 5/23/2017 
  • SID (small intestinal dysbiosis) formerly referred to as SIBO (small intestinal bacterial overgrowth) is usually present in all dogs when they are first diagnosed with EPI just because of the very nature of EPI.
  • This page discusses various options to manage SID:  (1) Prebiotics (FOS) (2)  Antibiotics (Tylan preferred)  (3) Symbiotics (4) certain Probiotics (5) Fecal Transplant (promising).
  • The preferred antibiotic of choice is now Tylosin (Tylan) twice a day (breakfast and dinner) with food approx 12 hours apart, 30-45 days depending on the patient (see research below).After enzymes are implemented wait a week or two to see “if”  the enzymes are enough to allow the gut imbalance to correct itself.  Another drug commonly used is Metronidazole (Flagyl) not always successful..Some dogs relapse after antibiotics are completed. If so, do a repeat course of antibiotics.
  • Some dogs require an minimum management dose of antibiotic for life. However some can come off antibiotic use  once the right diet is found.
  • In a recent study dogs with SID were divided into two treatment groups. 1/2 received FOS (prebiotic), 1/2 received Tylan (antibiotic). Both groups improved. However some in the antibiotic group relapsed, those in the FOS group continued to do well.
  • SID may encourage low B12. Be sure to keep B12 levels at upper-mid range levels.  
  • Different types of stools and possible causes listed near bottom of page
  • Acid reflux possible causes and treatments discussed at the bottom of the page

Here is a good overall review of SID, what it is and how it is treated From Blackwell Veterinary Consult: