Dosage of S.Boulardii for diarrhea

My civvie, Budge, has been having intermittent diarrhea after taking anti-biotics (augmentin) for a UTI. I read here that I should try S. Boulardii to resolve the diarrhea.

I wanted to confirm the dosage since what we get here is different from what we get in the US. I've read what FFL and IBK Kitties and posts here say but wanted to confirm the dosage in terms of bn CFU.

The capsules we get here are 2.5bn CFU each.
And they also contain : Lactobacillus Acidophilus + Lactobacillus Rhamnosus + Bifidobacterium Longum. Is that an issue?

 

A few years ago I copied this from a website linked by a member when I asked the same question. This is for a 5 billion CFU, so since yours is half that strength, perhaps double it, but I’ll tag @Marje and Gracie for that info.

Traditional dosing for therapeutic treatment of diarrhea in adult cats as provided by U.C. Davis is one-half of a 250mg capsule (5 billion CFU) given twice daily. Treatment for kittens is half of the adult dose. It can be given with food; it does not have to be. This is usually sufficient for loose stools of normal frequency. For the “emergency stop diarrhea” approach, we find more frequent dosing of smaller amounts of the probiotic, providing a higher total CFU the first day or two, resolves diarrhea much more quickly.

Emergency stop for adult cats (defined here as 9 months of age and older):

Give one-quarter of the 250mg / 5 billion CFU capsule every two hours or so. Many cats accept it when mixed into finely ground poached chicken breast / turkey breast / pork loin or meat-only baby food. (Beech Nut, Goya, and Gerber list “meat” and broth or gravy as ingredients. These are fine, they are referring to the water used to cook the meat, and they contain no spices). If your cat does not like the taste of the probiotic, you can syringe after mixing with water. If you are not experienced syringing liquids into your cat, you can use empty #3 gel capsules. Simply fill 10 to 20 of these by transferring the S boulardii from the larger capsules into the smaller ones. These are a size easy to pill your cat. Pill your cat with one #3 capsule filled with S boulardii every two hours or so. For pilling instructions, see How to Pill (Your Cat).

This frequent dosing method usually stops diarrhea within 24 – 48 hours, other than when diarrhea is caused by another disease that requires treatment (low B12, exocrine pancreatic insufficiency, hyperthyroidism, as examples). This “loading dose” can be continued for longer if necessary, up to three to four days – but if you do not see substantial improvement in the diarrhea on day 3, it is best to follow-up with your veterinarian. It is NOT necessary to use this approach, it can be given at “therapeutic” doses as discussed above twice a day (and doubled if you see improvement in stool but diarrhea or soft cow patty stools have not resolved).

When the diarrhea has substantially resolved with use of the emergency stop treatment protocol, begin use of S. boulardii at the therapeutic dose level (2.5 billion CFU twice daily) and continue for at least one week. If stools soften, resume use of S. boulardii at the therapeutic dose as needed. Given its role in improving performance of bacterial probiotics and its anti-inflammatory properties, the use of S boulardii at maintenance levels (anywhere from 500 million CFU to a total of 2.5 billion CFU daily) can be continued indefinitely along with a bacterial probiotic. It confers many health and GI protective benefits, and we use it along with bacterial strains in all of our cats, all the time.

 

Maybe a dumb question but how do you only do half a capsule?

 

Open the capsule and sprinkle half the contents into a little food and mix it through, or mix it with water to give via syringe. You could also try mixing it with a little broth to see if the cat might take it that way.


Mogs
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But how do you know it's half? Knowing me, it'd be almost the full pill! Also, is there a flavor? My cat is so picky; he can tell something is up with his food.

 

One option would be to get a cheap and cheerful electronic pocket jeweller's scale (less than a tenner on Amazon or eBay).

- Weigh full capsule and note the value.
- Empty the capsule.
- Weigh the empty capsule.
- Deduct weight of empty capsule from weight of full capsule to give you the weight of the capsule contents.
- Divide weight of capsule contents by two to give you the regular dose weight. Keep a note of this weight for reference when measuring future doses.
- When using a new capsule, use the jeweller's scale to weigh out the correct amount for the first dose.
- What's left in the capsule will automatically be half the original contents so no need to measure second dose.

Or you could eyeball it.


Mogs
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I guess I'll be eyeballing it!

 

As luck would have it, at the moment I'm trialling S boulardii for the first time with my civvie, Lúnasa (aka the Noodle). (She's got antibiotic-induced diarrhoea at the moment.) I normally use well-diluted cat soup to give supplements. I gave her the first tiny dose of S boulardii yesterday (about 1/8 capsule). Normally she monsters the diluted soup but she was hesitant with the serving containing the probiotic. Based on that I'd deduce that it does have a taste to it. I got round it by adding more of the undiluted cat soup so perhaps it's possible to mask the taste somewhat. That said, cats...


Mogs
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I had a funny suspicion...




Mogs
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thats what we did.

 

That's what I'm worried about. The probiotic my vet gives is 1/day and he doesn't notice the taste at all. In fact, I barely have to mix it in the with the food. For this reason alone I'm thinking of sticking with their probiotic but it is pricier. Of course. So I'm not sure if I should switch to S. Boulardii or what.

Sorry for hijacking this thread!

 

I eyeball it but I take a sharpie and make a mark on the half (I actually do 1/4 so I divide the capsule up in four with the sharpie) then I empty the contents up to the mark so I know I’ve got as close as possible to the right amount

 

There’s a better option see my reply below.

 

Interesting! I might have to try that.

 

Minnie wouldn’t eat it until I started mixing it with baby food. For some reason the smell of the pure meat from the baby food masks the probiotic. I actually give her 2 and she dislikes both but eats it up with a little bit of Gerber mixed in!

 

I haven't tried the S. Boulardii at all yet because I'm worried that he won't it since he can smell or taste any weird additive. I'm not sure if he would like baby food but these are all great ideas!

 

I was having a really hard time getting her to eat it mixed with her regular food. I think this feels like a treat for her now

 

Haha of course! Cats, man. So weird.

 

1 capsule is how many billion CFU of S. Boulardii? You give 1/4th of a capsule twice a day?

 

I think the standard is 1/2 a capsule twice a day.

 

Depends on how anal retentive one is!

(You'd never for a minute think I had a background in engineering... )


Mogs
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I think you might need to check the formulation for different products, Bhooma.


Mogs
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The thing is I am not in the US, so I don't know what dosage 1 capsule is in the US and it may or may not be the same.

 

Most of the S. boulardi in the states is 5b CFU per capsule so the therapeutic and emergency stop instructions are based on that; if you are doing therapeutic dosing, that would be 2.5b CFU twice a day. It’s ok if you’ve got other probiotics in with it as long as you make sure that however much S. boulardi is in the capsule, you are able to give 5b CFU a day.

It might be hard for you to get it there but I’ve been giving S.boulardi with MOS. It’s even a step better than the “plain” without MOS. I give a maintenance dose to Tobey twice a day just because he had coccidia as a baby which “can” potentially predispose a cat to IBD later in life. He likes the taste...it’s kind of yeasty and so the odor also doesn’t bother him.

 

Thanks Marje. Just what I was looking for. The capsule here is 2.5bn CFU.

 

Let me rephrase I meant better option than eye balling and a half way solution between the 2

 

I think most members here do 1/4 twice a day FYI. That’s what was recommended to me when I stated and it has worked so far. not sure how many billion but I’ll look at the bottle. I’d think it varies from brand to brand...?

 

Simiplified basic S. boulardii dosing from ibdkitties.net:

Therapeutic Dose: 2.5 billiion CFU twice a day - hold for 1 week to 1 month after resolution of problem clinical signs, then titrate down to maintenance dose.

Maintenance Dose: 1.25 billion CFU twice a day. If problem clinical signs worsen again, return to to therapeutic dose.

(Not including diarrhoea emergency stop dosing protocol here; already covered very well in Sharon's earlier post.)

Notes:

* If required, dose can be started very low and gradually titrated up to therapeutic level.

* S. boulardii is not a suitable supplement for cats with yeast sensitivities.

* S. boulardii will not be effective if a cat is deficient in B12.


Mogs
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Okay so bottom line is therapeutic dose is 2.5 billion CFU (usually half a pill depending on pill) twice a day. Maintenance dose 1.25 billion CFU (1/4 pill) twice a day. Geez, a quarter pill!!!! However do you measure that? I just know I'd be giving like half or more!! It makes me want to stick with what the vet is giving for fear I'd mess it up!

 

It’s a capsule so you pre-mark it with a pen or sharpie. It’s not that complicated I promise

 

Mine is 5B potency btw

 

You GO Ale!

 

Just call me Metro MacGyver

 

I loved MacGyver. I don't care how cheesy it was.


Mogs
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Oh they're clear!!! How nice!

 

Oh I see you thought you wouldn’t be able to see the contents. Now I get huge concern. Yes, clear both her probiotics are thankfully

 

Exactly - I had no idea they were clear so I didn't get how people were doing it. That's great that both are clear. Thanks for all the info!

 

Me too!!

 

A picture is indeed worth 1,000 words isn’t it?

 

A few others use the Jarrow brand too. You can get it on Amazon btw

 

@April & Quincy -

A quick update on the Noodle's S. boulardii trial. I've started giving her the probiotic mixed into 1 tsp of her cat soup plus 1 tsp of water. She is now taking it readily so it appears that she can't taste it as much when mixed with something that has a bit more flavour. It might be worth trying to mix the SB well into a small bit of food to see if Quincy will take it for you that way, like he does with the current probiotic.


Mogs
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@Marje and Gracie @Critter Mom , I had a couple of follow-up questions:

(a) Can S Boulardii cause constipation? Budge had antibiotic induced diarrhea till 48 hours back and I started SB at the therapeutic dose of 2.5bn CFU twice a day. She hasn't gone at all in 2.5 days. Should I stop giving it to her?

(b) Is there a reason dosing is twice a day - can one give it only once a day?

Thanks

 

Hi Bhooma,

Can't answer Q(a) because I've only just started trialling SB and I'm only slowly working up to the therapeutic dose (the Noodle still has the diarrhoea).

WRT Q(b), I guess that the twice a day dosing is intended to keep an adequate amount of SB in the gut at a given time (assuming that some will be excreted over each 12hr period).

Marje has more experience of using SB so hopefully she should be able to give you better info.


Mogs
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Minnie is down to once a day now. It still works great

 

Yes, that's what I do with his current probiotic so that's what I would do with the S. boulardii too. I'm just worried I'll buy it and it'll be pointless because he won't eat it. Thanks!

 

The one I give Quincy from the vet says 5 billion CFU on it and I only give it once a day and it works great so I too am unsure why I'd have to divide it in half and give twice a day...? It seems that the once a day works just fine?

 

I’ve not had it do that...Tobey gets the maintenance dose twice a day and he’s never been constipated by it. I give it to him to maintain his intestinal health even though he’s only had diarrhea twice in ten years. I’m assuming you can give it once a day without issues.

 

Been thinking about this in general.

If the diarrhoea's been bad but the SB is now helping Budge's digestive system, then GI transit time is likely to reduce to normal level. Because so much waste matter has been expelled from the body recently there might be a delay before the bowels fill up enough to trigger evacuation of better-formed stool.

I had a look back at my Lúnasa's records from her previous bout of diarrhoea, and after the treatment she received for it stopped the diarrhoea there was a delay of 72.5 hours before she next produced a (formed) bowel motion. If she hadn't gone that day I would have taken her to the vets for an examination.


Mogs
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Mogs, I was thinking the same thing!
The good news is that there was some action tonight. And it was well formed. So all is well!

I think I'll reduce to the maintenance dose and see how she does on that.

Thanks for thinking about this

 

Woot! Good poop dance!





Mogs
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If you buy it from Amazon, they’ll refund your money

 

Apologies for bumping up an old thread. I had a follow-up question and wondered whether to start a new thread...

Does S. Boulardii change the colour of poop? Budge's poop used to be a dark brown colour but is now a yellowish/light brown. Is that normal?

It is still on the softer side (the last bit that comes out a little runny). She is now on the therapeutic dose of 1.25bn CFU twice a day. Should I go back up to 2.5bn twice a day form a few days to see if it hardens?

 

Yellowish/light brown poop has moved through the gut faster than the darker stuff.

Can't give you any practical tips on dosing, Bhooma. I had to abandon the SB trial for Lúnasa because it made her poops worse (looser, more yellowish). ibdkitties.net recommend that if the stool disimproves after commencement of treatment with SB to stop for 3 days and then restart treatment at a very small dose and work back up to therapeutic levels.

BTW the 2.5bn CFU BID dose is therapeutic level, 1.25bn CFU BID is maintenance level.


Mogs
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I don’t see that in my cats. I would increase if she has runny poo. Yellowish brown poo can be an indication of issues if it becomes the norm.

 

Sorry Mogs, I meant to write maintenance dose of 1.25bn BID but wrote therapeutic instead! Was past midnight for me!

Marje, the yellow brown poo has started after I put her on S. Boulardii. Earlier it was runny but dark (post the antibiotics). Wondering if it is the other components of the probiotic - Lactobacillus Acidophilus + Lactobacillus Rhamnosus + Bifidobacterium Longum that could be causing an issue?

Also, while the poo is soft, she is going only once in a couple of days or so. So it's not like she has diarrhea/loose motions.

 

I’m just not sure. My S. boulardi doesn’t have anything else in it but my cats also get a second probiotic that has those strains and others.

 

Let me try stopping and see what happens....

 

I'd really appreciate it if you could let us know how things go, Bhooma.


Mogs
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Mogs, stopping the S. Boulardii seems to have worked for Budge. And quickly! Poop is back to a darker colour and consistency is also firmer.