Symptoms and Identification Secondary SIBO can affect any dog, depending on the underlying cause. But idiopathic SIBO tends to affect relatively young dogs. Diarrhea and flatulence (gas) are the most common signs of SIBO. Chronic, intermittent diarrhea is most typical, with many dogs also suffering weight loss, stunted growth, and/or generalized failure to grow or gain weight. Some dogs may appear inordinately hungry and may even eat their stools or other indigestible items. SIBO is identified by noting small bowel diarrhea (characterized by limited straining and large volumes) and finding large numbers of bacteria in the fecal material. Diagnosis is aimed primarily at ruling out other potential causes of bacterial overgrowth and diarrhea. Because these are numerous, the process usually involves X-rays, serial fecal examination (not cultures, which are notoriously unreliable), and sometimes endoscopy to test the upper part of the small intestine for high bacteria counts. Blood tests that reveal high folate levels and decreased cobalamine may also be indicative of the process. That’s because folate is synthesized by the bacteria, and cobalamine is bound by them. However, these tests may be inconclusive.
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Small intestinal bacterial overgrowth develops when the bacteria that are already present in the intestinal tract are given the opportunity to use the undigested material passing through the intestine as fuel to grow and thrive. The food that isn’t being absorbed by the animal is being “eaten” by the bacteria, which leads to a population explosion.
One such potential problem in animals with EPI is a condition called small intestinal bacterial overgrowth (SIBO). It is commonly seen in dogs with EPI and can complicate treatment unless it is recognized and brought under control. Cats are more often afflicted with irritable bowl disease than SIBO.
Prebiotics, such as fructo-oligosaccharides or FOS, will stimulate healing in the gut and encourage the growth of beneficial intestinal bacteria. Feeding of probiotics and prebiotics should be done several hours before or after the administration of antibiotics, since they could be destroyed by the medication.
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Those animals that don’t respond as they should to enzyme replacement therapy for EPI should have their blood levels of vitamin B12 evaluated. If necessary, B12 should be given by injection to supplement any deficiencies.
Why Antibiotics Don’t Work For SIBO
So, after reading the paragraph above, you won’t be surprised to learn that the way many vets treat SIBO is with antibiotics. And they’re not even very effective. One problem is that antibiotics need to be given for a long time to get rid of SIBO. And even then, it often comes back.
The main antibiotic vets use for SIBO symptoms is oxytetracycline, which is often used for respiratory infections or tick-borne diseases. But oxytetracycline can damage the kidneys, affect bone and tooth development … and cause intestinal problems.
Your vet may also prescribe a drug likeMetronidazole (flagyl) or Tylosin/Tylan. These are antibiotics that treat diarrhea. Vets often use them long-term for chronic diarrhea … or SIBO. Even with short term use, these drugs have known side effects … including, ironically, chronic diarrhea! But giving them long term is especially foolish. Here are a few reasons why.
Make a rule that you’ll only use antibiotics when nothing else will do. Save antibiotics to save your dog’s life … not to manage chronic health issues. For SIBO there are better, safe options. So how can you recognize SIBO and treat it naturally and safely?
Holistic veterinarian Dr Odette Suter observes most dogs, cats and humans these days have some degree of SIBO. Like other gut health issues this starts with a poor microbiome transferred from mom. Then they get a poor diet and toxic environment, plus damage from deworming, antibiotics, vaccines and stress.
This creates an overgrowth of some bacteria, and “undergrowth” of others … usually combined with lack of microbe diversity. So Dr Suter views SIBO as part of a general microbial imbalance in the entire GI tract. The dog’s symptoms will usually allow her to diagnose the problem. However, she does do some microbiome testing for more specifics on how “off” the microbiome is … and that allows her to customize treatment.
Dr Dee Blanco takes a similar approach. She doesn’t view SIBO as a separate diagnosis in dogs like it is in humans. In part, shorter small intestines in dogs may be less prone to invasion by pathogenic bacteria. Dogs’ high hydrochloric acid may also help reduce SIBO risk.
To Dr Blanco, small intestinal bacteria are part of the overall gut health picture. They can lead to inflammation and leaky gut … but may not cause the “human” SIBO symptoms of GERD or burping. And Dr Blanco agrees diagnosis is difficult. She jokingly commented, “I haven’t been able to get one dog to blow ito the bag to test their methane levels. Try as I might!”
This broader approach makes sense to holistic veterinarians. They treat the “whole patient” … not just one “disease” or set of symptoms. And because they’re not using antibiotics, they don’t have to pin down a specific disease as the culprit. Holistic treatment options for SIBO are safe! So the good news is … if you suspect SIBO in your dog, you can do several things at home to manage it.