Saccharomyces Boulardii use for diarrhea and GI disease (incl IBD)

[ldg]

Just a collection of links for information, for TCS members and their vets.

UC Davis used S boulardii to treat a cat infected with what they thought was antibiotic-resistant clostridium difficile because the owner could not afford vancomycin. After one month, the cat tested negative for C. diff.

Madewell et al. 1999. "Clostridium difficile: A survey of fecal carriage in cats in a veterinary medical teaching hospital," J VET diagn Invest 11:50-54 The discussion of S boulardii is on p. 53. http://vdi.sagepub.com/content/11/1/50.full.pdf


Simply explained in the Biocodex FDA submission (last link), S boulardii is not digested and absorbed in the gut and does not exert its effect systemically. Instead, S boulardii acts locally in the lumen of the gut. During its passage through the intestine, S boulardii mimics the physiological effects of the digestive flora, stimulating healthy immune response and reducing inflammation.


Saccharomyces boulardii prevents enteritis from Clostridium difficile infection http://archives.focus.hms.harvard.edu/2006/091506/research_briefs.shtml


"Saccharomyces boulardii in Gastrointestinal Related Disorders," Point Institute Technical Report (2008) http://www.pointinstitute.org/wp-co...s-Boulardii-in-GI-related-disorders-paper.pdf


Saccharomyces boulardii effects on gastrointestinal diseases, (Zanello et al. 2009) http://www.horizonpress.com/cimb/v/v11/47.pdf


Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii, (Pothoulakis 2009) http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2009.04102.x/pdf


"Systematic review and meta-analysis of Saccharomyces boulardii in adult patients," (McFarland 2010) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868213/


Anti-inflammatory effects of Saccharomyces boulardii mediated by myeloid dendritic cells from patients with Crohn’s disease and ulcerative colitis, (Thomas et al. 2011) http://ajpgi.physiology.org/content/ajpgi/301/6/G1083.full.pdf


Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders, (Kelesidis & Pothoulakis 2012) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296087/pdf/10.1177_1756283X11428502.pdf


New Dietary Ingredient Notification for S boulardii (FDA submission) by Biocodex (Florastor) (includes summary table and references) http://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-rpt0301-04-vol239.pdf

 

[red top rescue]

THANK YOU!!  I'm adding this to my other info on S. boulardii

 

[oceanbreathes]

Sorry if I missed it but are there any particular brands that cats are more willing to consume?  I have the Jarrow brand(big bottle of it) and my cats are pretty resistant to taking it(no matter what I mix it into).  

 

[catpack]

I bought the Nuticology brand as it was mentioned on another forum that the Jarrow brand has an ingredient in it that is very bitter.
The Nutricolgy is being tolerated well by the cat it is intended for; though, I tried it with another cat that would not touch it (though he also turns his nose up at FortiFlora.)

 

[ldg]

I have Nutricology and the Jarrow with MOS. I cannot find studies on MOS as it is almost always combined with something else. It's one of the main ingredients in the product Entero-chronic, used for diarrhea and IBD in Europe (also available in Canada) - not available in the U.S. It CLEARLY increases the efficacy of the S boulardii, as I've seen a number of people with IBD kitties try the plain S boulardii (like Nutricology) - because their cats will eat it mixed into food - and not have it stop the diarrhea - yet when they switched to the Jarrow with the MOS, the diarrhea cleared up.

I have used S bouldardii alone to resolve coccidia in kittens: it was the Jarrow with MOS. I put it into #3 gel caps and pilled them with it. TCS member @Carolina used S boulardii (the Jarrow with the MOS) to treat C perf in her cats. We don't know if the S boulardii without the MOS would have resolved the coccidia or the C perf.

I know very few cats that will eat the Jarrow S boulardii with MOS in it. Most cats will eat the plain S boulardii. But if you can pill your cat, IMO, it's worth getting the Jarrow with the MOS, as it is more effective, especially if you're treating diarrhea or IBD with diarrhea.

Sometimes cats need a "loading dose" to stop the diarrhea, and then move to a "treatment" dose, and then after a month or so, move to a longer term maintenance dose. Some cats are able to come off the S boulardii and do great with an acidophilus/bifidus supplement after that; some need to stay on it longer term. I think the difference is how impaired the intestinal lumen is - if kitty has a lot of inflammation and a really leaky gut, it takes longer to heal.

http://www.ibdkitties.net/Probiotics.html

Many move to the probiotic Nexabiotic after the month or so of treatment. It has L acidophilus (and other lactobacillus strains), bifidobacteria, AND S boulardii. It is the only probiotic available in the U.S. that I'm aware of with all three types.

S boulardii is a yeast-based probiotic that does NOT colonize the gut. It is entirely gone from the system in 18 - 36 hours, thus it must be given 2x a day to work. As a yeast-based probiotic, it can be given as adjunct therapy WITH antibiotics, without worrying about timing of meds in relation to giving the probiotic. Antibiotics do not kill it.

S boulardii prevents unhealthy bacteria from colonizing, and helps healthy bacteria colonize, so inclusion of healthy bacteria (L acidophilus and bifidobacteria) that DO colonize, at some point, is also important.

There is a different brand in Canada that has all three types (lactobacillus, bifidobacteria, and S boulardii) : http://newrootsherbal.com/product/id/1679 But again - this is not for treatment of diarrhea, it is for maintenance once the diarrhea is under control from using S boulardii.

Of course, please discuss using any of these products with your vet.

 

[oceanbreathes]

Thank you both for the info.  I knew there was a reason why I chose the Jarrow brand(the MOS) but had forgotten.  I've had the 180 ct in my fridge since last winter, I believe.  I hope it's still effective.  I'll try pilling them; wish I had thought of that before.  I was giving it(or trying to..) to everyone after losing a cat to FIP.  I was also hoping to help one of my guys with his yeast infections(ears) and yes, I have a cat who was experiencing diarrhea recently.  I know it's a great supplement and have heard about the benefits for people for years.

 

[kittilingling]

I started my cat on Jarrow's Saccharomyces Boulardii yesterday 5/10/2015.   She has IBD and usually has diarrhea rather then constipation from the disease.  So I am hoping the Saccharomyces Boulardii can help her.  I tasted the Jarrow's Saccharomyces Boulardii with MOS.  Actually I don't think it is bitter at all.  It tastes like malt to me.  I added a capsule to about 5 ml baby food and some water and syringed to my cat.  She took it without any resistance.  My cat resists to things like pumpkin and even plain water from syringing.

 Is it okay that I give her Saccharomyces Boulardii daily to prevent her from having a diarrhea bout?  I am going to add acidophilus to the Saccharomyces Boulardii daily.  Just ordered the Vetri Mega probiotics that has ifidobacterium as well.  

 

[ldg]

It is OK.

For treating diarrhea, many use 1/2 of a five billion CFU capsule 2x a day, and up to a full capsule of it 2x a day. This often resolves the diarrhea pretty quickly in the absence of cancer or very severe inflammation with lesions.

For just preventing diarrhea (using it daily for "maintenance" rather than therapeutically trying to stop diarrhea), most use either 1/4 cap or 1/2 cap twice a day. But at that point, many add in a bacterial probiotic that contains both acidophilus and bifidobacterium. :nod:

There are two probiotic supplements in the U.S. I'm aware of that contain Lactobacillus strains, bifidobacterium AND S boulardii. These are the pet probiotics by Mecola, and the human supplement, Nexabiotic. I know a lot of people that have tried the Mercola product for pets, and I know of ONE person whose cats liked and ate it. It takes a lot of powder, apparently. I know of many successfully using Nexabiotic. The human dose recommendation is 2 caps (for a total of 30 billion CFU, of which S boulardii is a total of ... 1.5 billion? 2 billion?). Once the diarrhea is under control with the Jarrow product, many find that using one capsule of Nexabiotic, half given in the AM and half given in the PM is enough to prevent diarrhea - usually. During an IBD flare, most use the S boulardii again.

 

[ldg]

Oh - and yes, baby food is a GREAT way to deliver it! Many are finding their cats just eat it, no syringing necessary, when added to some baby food.

 

[kittilingling]

Thanks for responding promptly Laurie.  

I am not aware of the Mercola probiotics having all 3 strains like Nexabiotic.  My cat cannot have Nexabiotic as it has MCT and she has elevated ALP and ALT from budesonide she is taking daily.  We found her inflammation is absent in 4/2 ultrasound so my vet decided to taper her off budesonide.  I am giving her 0.85 mg budesonide daily now, have to taper very slowly to avoid inflammation again.  Last October it failed for being too fast.  She is easily having diarrhea from anything now, e.g., fish oil, coq10.  I want to keep using Jarrow one cap (1/2 cap twice daily) to fix her over reactive GI.  It is very scary to me currently.  She can have severe diarrhea for days from 1/64 tsp milk thistle that my vet wanted her to take for her liver.  She even got diarrhea from having Hill's z/d food in early April.  All the diarrhea does not match her lack of inflammation at all.   We are stumped by her extremely sensitive GI.  I really hope the therapeutic dose of Jarrow can correct her sensitivity.  

Since I will give her Jarrow one cap daily, I will add half a cap of Vetri mega probiotics that has both acidophilus and bifidobacterium.  Do you think this will work for her?  I am at my wit's end what I can do to help her diarrhea bouts that she has had since last October.

Lai Har 

 

[ldg]

Oh my goodness, poor baby! :rub: It's so frustrating when they are SO sensitive. We have seen S boulardii help - but it usually takes time in cases like that AND the kitties often remain sensitive - it's just that over time, the reactions decrease in strength of response and duration. I really hope this works for both of you. Keep us posted - and feel free to ask more questions.

You have to scroll down to the "Label Snapshot" because S boualrdii is not discussed in the sales pitch part of the "article." But here are the ingredients in the Mercola product: http://probiotics.mercola.com/probiotics-for-pets.html

Looks very much like Nexabiotic without the MCTs and maltodextrin.

But yes, the acidophilus and bifidobacterium are both very important inclusions. :nod:

 

[kittilingling]

I ordered the Mercola probiotics from mercola.com this morning.  I like it as it is simply powder and I can control the amount easily.  Also it has more strains.  I increased the Jarrow dose to 1 cap twice daily this morning as you said it could be the max dose for therapeutic treatment.  I will be very patient with her now as she is very old and sensitive.  

If you think of anything else that would help, please let me know.  

I myself also started taking Jarrow 2 days ago.  It seems working well for my IBS gut.  

Many thanks Laurie.

Lai Har

 

[ldg]

Yes, many with IBD and, interestingly, IBS, find that S boulardii works for them. Helps convince people to try it on their cats, actually.

The main issue with the Mercola product is that I know of very few cats that will eat the stuff. So I hope you can get it into her.

When it comes to those kind of sensitivities... it is really just all about feeding a diet that is not inflammatory, and using supplements to help the gut heal.

What helped our Chumley immensely, at the recommendation of the holistic D.V.M. we found to treat him, was mixing one half teaspoon of slippery elm bark powder ( http://www.littlebigcat.com/health/slippery-elm/ ) with one teaspoon of George's Aloe Vera Juice (has to be George's, because it is distilled and contains no latex. There is a brand, Lily of the Desert, that also has distilled unflavored aloe vera juice, but they have SO many products, it can be difficult to make sure you're getting the right one), and then add in the probiotic. Mix it into a gelled up glop, and mix into food. I did this for Chumley twice a day for over a year and I didn't change up his diet at all until after that. One day he just refused to eat it. And then I tried a new food. I didn't listen to my own advice, and I didn't start small, and I didn't transition slowly - but we didn't get diarrhea OR itching OR biting at himself and pulling out fur. So I don't know when in that timeline his guts were actually healed up? But that's what worked to fix up his insides.

 

[kittilingling]

Hi Laurie.  I have to syringe feed my cat all the supplements because she will not touch the food with anything other than a phosphorus binder added.  Also I want her to have most of the supplements by syringing them to her as she seldom cleans her bowl.  I don’t know how the Mercola probiotic tastes.  I will taste it to find out.  I plan to syringe her the Mercola probiotic. 

Yes SEB is very good for the IBD GI.  I have been giving it to her daily since summer 2013.  But only when she had diarrhea, then I would give her more than ¼ tsp daily.  I will increase it from ¼ to ½ tsp daily per your experience.  It is also anti acid and anti nausea.  So I can give less anti acid and anti nausea meds if I use more SEB. 

I have a question for you.  I am now giving my cat one capsule of Jarrow’s s. boulaudii twice daily, that is 10 billion daily (5 billion each capsule).  For cats, the therapeutic dose of the Mercola probiotic is 1 scoop daily, that is about 19.3 billion.  If I give my cat two capsules Jarrow and 1 scoop Mercola, that will add up to 29.3 billion.  Is 29.3 billion probiotics too much for her daily? 

Many thanks for all your advice.

Lai Har

 

[mphscat]

And would S. Boulardii be something to use on cats that have hairball issues but NOA diarrhea? Right now i'm using digestive enzymes + Proviable but should i consider S. Boulardii in addition to this? Or instead?

 

[ldg]

kittilingling so sorry I haven't been on to answer your question. Here's the thing with probiotics. Stomach acid kills some? most? of them, unless they are enteric coated. Further, the effective doses of (human) bacterial probiotics in cats ranges from 100 million to 400 billion, according to a review of their use at the Western Vet Conference in 2013. So "effective dose" and "too much" are so very, very individual. It's always best to start small, and work up to an effective dose rather than a recommended dose, IMO. If one needs more than the described recommended daily amount, best to contact the manufacturer to ask if there may be detrimental health effects if using more than recommended.

I know this isn't a straightforward answer, but I hope it helps.

 

[ldg]

And would S. Boulardii be something to use on cats that have hairball issues but NOA diarrhea? Right now i'm using digestive enzymes + Proviable but should i consider S. Boulardii in addition to this? Or instead?

Sorry, been a while, and I'm just catching up! That's a fascinating question. If it were to help, it would be due to its impact on inflammation. Hairballs are a result of some type of impaired GI motility, otherwise hair is moved through the digestive tract. The primary causes of hairballs are free-feeding (no chance for hunger pangs that cause the strong peristaltic waves that trigger emptying indigestible material from the stomach - OR - Inflammation somewhere in the system prevents proper gastric emptying. So the methods for treating hairballs include reducing inflammation and improving motility. S boulardii would address the inflammation. So it's possible it could help!

I wouldn't use it in place of the enzymes and bacterial probiotics, rather in addition to them.

Of course, when it comes to hairballs, avoidance of hair ingestion is the best way to prevent them. This year I got Tuxie's tummy shaved. No more hairballs. I don't think lion cuts are necessary. The tummy.is easiest for a cat to access, so shaving just the belly sure does seem to work - for us.

 

[kittilingling]

Many thanks Laurie.  I thought about it and limited my cat Kitti's daily probiotics to about 17 billion.  I include other strains to go with the Jarrow to build up her GI flora and it seems working well.  I also give her slippery elm bark and marshmallow root daily and they help her GI, acid and nausea.  She eats well for a cat with her age and conditions.  

Lai Har

 

[ldg]

Oh excellent! I'm so glad you've found a good mix of supplements and amounts that work!

 

[mphscat]

Thanks, Laurie, for your answer about the S. Boulardii.  I may integrate that in to the mix that I have in addition to, not instead of, the other probiotics that I use. 

Thanks again for getting back to me!!!!!!!