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SID/SIBO in Brief

SID (previously known as SIBO) in Brief
revised 11-19-22
  • 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.
  • Some times, all goes great the first few weeks when starting enzymes, and then the loose stools return. This does not mean the enzymes stopped working but rather you are seeing the results of SID….
  • There is a recommended protocol of how to manage SID:  (1) Prebiotics  (2) Symbiotics : prebiotics with probiotics  (3) Antibiotics: Tylosin Tartrate/Tylan (4) Fecal Transplant .
  • 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, but those in the FOS group continued to do well and stayed well for a much longer duration then those given an antibiotic group.
  • The preferred antibiotic of choice is now Tylosin Tartrate  (Tylan) twice a day (breakfast and dinner) with food approx 12 hours apart, 30-45 days depending on the patient (see research below). Some dogs relapse after antibiotics are completed. If so, do a repeat course of antibiotics and instead of stopping the Tylan all at once, try a slow withdrawal technique after the 45th day.  
  • Some dogs require a minimum management dose of Tylan for life. However, some can come off antibiotic use once the right diet is found.
  • When a future SID relapse happens, sometimes Tylan is not required but rather a course of Prebiotics or Prebiotics with Probiotics is enough to get the SID back under good control.
  • 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: