NutriGest - R X Vitamins

NutriGest - R X Vitamins

NutriGest - R X Vitamins


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USES:<br />



Robert J. Silver DVM, MS, CVA<br />

Rx <strong>Vitamins</strong> for Pets Formulator and Chief Medical Officer<br />

<strong>NutriGest</strong><br />

As a dietary supplement to aid in the treatment of:<br />

Acute and chronic diarrhea<br />

Chronic intestinal infections/Intestinal Dysbiosis<br />

Inflammatory Bowel disease(s)<br />

Chemotherapy-associated gastrointestinal side-effects<br />

With antibiotic administration to promote bowel recolonization<br />


1) Provide nutritional support for repair of damaged intestinal mucosa<br />

2) Provide substantial counts of colony forming units of beneficial bacteria to reinoculate<br />

bowel microflora<br />

3) Support normal function of bowel<br />

4) Gently eliminate pathogenic micro-organisms from bowel microfloral ecology<br />

5) Provide nutritional co-factors to improve digestive function<br />

6) Provide botanical and nutraceutical support to reduce heightened<br />

inflammatory response in the bowel<br />

INGREDIENT LIST (2 capsules or ½ teaspoon of powder provides):<br />

1. Probiotic Cultures: (L-Acidophilus (85%); L-Thermophilus (1.7%); L-Plantarum (1.7%)<br />

Bifidobacterium Bifidum (5%); Bifidobacterium Longum (5%); B-Coagulans<br />

(1.7%)……………………………………………………500 million viable cells<br />

2. L- Glutamine (free form amino acid)..........................................……...200 mg.<br />

3. Cats Claw (Uncaria tomentosa) (standardized to 3% oxindole<br />

alkaloids)...........................................…………………………150 mg.<br />

4. N-acetyl D glucosamine..........................................................………....150 mg.<br />

5. Calcium pantothenate…..........................................................…………100 mg.<br />

6. Ginger root extract(standardized Zingiber officinale supplying 4% volatile<br />

oils)....................................................…………….....…………50 mg.<br />

7. Fructooligosaccharide..............................................................………….50 mg.<br />

8. Oregon Grape Root (Mahonia repens)...........................................…......50 mg.<br />

9. Garlic (Allium sativum) (standardized to 1% total allicin potential)...…..25 mg.<br />

10. Psyllium Seed (Plantago ovata)....................................…...............….....25 mg.<br />

11. Aloe Extract (emoden free)........................................................…….......25 mg.<br />

12. DGL (deglycerrhized licorice)......................................................……....25 mg.<br />

13. Folic Acid.............................................................................…………...50 mcg.<br />

14. Vitamin A (retinol)..........................………………….............…………100 IU.<br />



Probiotic cultures: Intestinal microflora play a significant role in the maintenance<br />

and health of the gastrointestinal tract (Shahani, 1980). Studies<br />

demonstrate that certain strains of intestinal microflora beneficially<br />

influence the host immune response. (Perdigon, 1988) Probiotic cultures<br />

are an exogenous source of these beneficial bacteria which can recolonize<br />

the bowel and improve intestinal microfloral ecology. Other studies have<br />

demonstrated that beneficial bacteria also exert an “antibiotic” effect upon<br />

pathogenic intestinal microflora such as Pseudomonas spp., E. coli, and<br />

the agents causing “traveler’s diarrhea” in humans. (Price, 1970)<br />

(Clements, 1981) (Warram, 1978)<br />

Lactobacillus acidophilus has been shown to inhibit the following bacteria<br />

(Murray, 1996):<br />

Bacillus subtilis<br />

B. cereus<br />

B. stearothermophilus Candida albicans<br />

Escherichia coli<br />

Clostridum perfringens<br />

L. bulgaricus Klebsiella pneumonia<br />

Lactobacillus helveticus<br />

L. fermenti<br />

L. leichmannii L. lactis<br />

Proteus vulgaris<br />

L. plantarum<br />

Pseudomonas aeruginosa P. fluorescens<br />

Salmonella typhosa<br />

S. schottmuelleri<br />

Shigella dysenteriae<br />

S. paradysenteriae<br />

Sarcina lutea<br />

Serratia marcescens<br />

Stapholococcus aureus<br />

Streptococcus faecalis<br />

S. lactis Vibrio comma<br />

Reinoculation of the bowel with active cultures of beneficial intestinal<br />

microflora will help to restore healthy digestion if administered both<br />

during and after a course of antibiotic therapy. Oral administration of l.<br />

acidophilus concurrent with antibiotic therapy has been demonstrated to<br />

help maintain normal levels of beneficial intestinal bacteria. (Zoppi, 1982)<br />

An L. acidophilus strain fed to experimental animals helped to reduce the<br />

development of antibiotic resistant strains of pathogenic bacteria. (Gotz,<br />

1979)<br />

With a long history of usage as a dietary supplement for both humans and<br />

livestock, probiotics have been observed and reported to provide health<br />

benefits for cancer victims, and other patients who have immune systems<br />

weakened by viruses, medications or environmental toxins.<br />

l-Glutamine<br />

This free form amino acid has been used with a high degree of success in<br />

human medicine in the treatment of severe trauma and burns, drug and<br />


alcohol withdrawal, and restoring intestinal mucosal integrity. Glutamine<br />

has been found to promote intercellular hydration, which in turn triggers<br />

anabolic (tissue building-healing and repairing) activity. (Pasquale, 1998).<br />

Glutamine is known to benefit a number of tissues, including: GI mucosal<br />

cells, hepatocytes, monocytes (macrophage), T and B lymphocytes,<br />

pancreatic exocrine cells, kidney tubular cells, fibrocytes, and myocytes. L<br />

glutamine is of benefit for the anabolic metabolism in any living cell.<br />

Glutamine is considered to be a conditionally essential amino acid<br />

(Grimble, 1993). Glutamine is a conditional nutrient when its<br />

supplementation in a diet resolves symptoms associated with a dietary<br />

deficiency l glutamine. This conditional status occurs when the body’s<br />

production of glutamine is at an insufficient rate to keep up with the tissue<br />

demands.<br />

A variety of conditions and circumstances can increase the tissue demands<br />

for l glutamine. Glutamine is necessary for maintenance of the structural<br />

and functional integrity of the mucosal lining of the small intestine.<br />

(Nappert, 1999) Other studies have demonstrated that dietary<br />

supplementation with glutamine promotes the repair of damaged and<br />

“leaky” intestinal mucosal lining. (Fox, 1988) These studies, in<br />

combination with the observed clinical benefits of glutamine<br />

supplementation support the use of enteral glutamine supplementation in<br />

patients with intestinal dysbiosis as well as inflammatory bowel disease.<br />

Clinical applications of high dose glutamine therapy for chemotherapy<br />

patients has provided substantial benefits for patients undergoing<br />

potentially enterotoxic cancer therapies. Fewer gastrointestinal side<br />

effects, improved activity levels and improved appetance were noted in<br />

these patients. (Silver, 1998)<br />

Cat’s Claw (Uncaria tomentosa)<br />

This botanical compound is derived from the bark of the root of a large<br />

woody vine that grows in the South American rainforest. It contains over<br />

50 active constituents, including five oxindole alkaloids. In traditional<br />

use, Cat’s Claw is prescribed for a variety of conditions characterized by<br />

inflammation, immune system defects. or infection, such as: Skin<br />

problems, poor hair growth, rheumatism, female contraceptive, gastric<br />

ulcers, dysentery, pediatric gastroenteritis, diabetes, fevers, abscesses,<br />

chemotherapy side-effects, hemorrhage, and urinary tract infections.<br />

(Jones, 1995)<br />

In a study of the effects of Cat’s Claw published by Humberto Ruiz,<br />

Professor Emeritus of Veterinary Medicine at the University Mayor de San<br />

Marcos, Lima, Peru, studies performed on 135 dogs and 53 cats carried out<br />

over the course of four years, found Cat’s Claw to be effective in the<br />

treatment of arthritis, hip dysplasia, feline immunodeficiency viral<br />

infections, and intervertebral disc disease (Ruiz, 1995) In this study,<br />

patients were given capsules of pulverized bark, containing 250-300 mg<br />


per capsule. The dosage used by Ruiz was 250 mg/10 kg of body weight<br />

divided BID.<br />

Dr. Ruiz reports that cat’s claw is effective as an adjunctive therapy in the<br />

treatment of parvovirus enteritis and inflammatory conditions of the<br />

stomach, as well improve immune system function when faced with feline<br />

immuno-deficiency virus (Jones, 1995) and feline leukemia virus<br />

infections. Cat’s claw repeatedly demonstrated an ability to improve<br />

immune system function with out any sign of toxicity or adverse sideeffects.<br />

N-acetyl D-glucosamine is necessary in the manufacture of mucin, the<br />

glycoprotein that lines the intestinal tract. One study demonstrated the<br />

increased uptake of N-acetyl D glucosamine by the intestinal mucosa in<br />

patients with inflammatory bowel disease. (Burton, 1983) Some human<br />

patients with Crohn’s disease and ulcerative colitis are “slow acetylators”<br />

and are unable to convert endogenous glucosamine sulfate to N acetyl D<br />

glucosamine, and therefore must have this nutrient supplied in their diet.<br />

This glycosaminoglycan is used as substrate in the formation of the<br />

proteoglycan ground substance that holds cells together. The ground<br />

substance is weakened by the inflammatory process. Patients with chronic<br />

inflammatory conditions can benefit from the introduction of N acetyl D<br />

glucosamine or glucosamine sulfate to their diets. (Murray, 1996)<br />

Calcium pantothenate supplies both the macromineral calcium as well as the B<br />

vitamin pantothenate (B5). Vitamin B5 is utilized in the manufacture of<br />

coenzyme A (CoA) and acyl carrier protein (ACP).Both are compounds<br />

that have essential roles in the utilization of fats and carbohydrates for<br />

energy production. Pantothenate is also used in the manufacture of<br />

adrenal hormones and the production of red blood cells. As a result of its<br />

influence on adrenal hormone production, B5’s role has been<br />

acknowledged as the anti-stress vitamin. (Fry, 1976) It has been known<br />

for over 40 years that pantothenate also plays a role in improving immune<br />

system function. (Axelrod, 1955). This vitamin in this formula addresses<br />

patient stress and the loss of appetite associated with inflammatory bowel<br />

disease and the side-effects of chemotherapy.<br />

Ginger (standardized Zingiber officinale supplying 4% volatile oils) contains over<br />

300 biologically active compounds in its volatile oil fraction. These<br />

compounds have a variety of actions, including promotion of the secretion<br />

of saliva and gastric juices, stimulation of bile flow, anti-microbial<br />

activity, intestinal anti-spasmodic activity, and improving the tone of the<br />

gastrointestinal tract as well as stimulating peristalsis of the intestines.<br />

Ginger has also been used for inappetance, dyspepsia, and as a digestive<br />

aid for hypochlorhydric gastritis. In folk medicine ginger has been used to<br />

relieve flatulence, as an expectorant, and as an astringent. (Gruenwald,<br />

1998) Clinical trials have shown ginger to be an anti-emetic equivalent in<br />

activity to diphenhydramine (Mowrey, 1982) and a motility enhancer<br />


equivalent in activity to metoclopramide. (Yamahara, 1990). Ginger has<br />

been shown to be effective in the treatment of diarrhea. (Huang, 1990)<br />

Ginger has the unique ability to improve gastric motility at the same time<br />

as it exerts anti-spasmodic effects upon the bowel.<br />

Ginger has shown itself to have potent anti-inflammatory and painrelieving<br />

activity. A number of the volatile oil fractions in ginger are<br />

potent inhibitors of prostaglandin and leukotriene synthesis. (Kiuchi,<br />

1992) Ginger has been shown to inhibit the release of substance P from<br />

nocioceptive nerve endings. (Onogi, 1992) In this formula ginger is being<br />

used both for its anti-inflammatory activity as well as for its ability to<br />

balance digestive function for patients with inflammatory conditions of the<br />

bowel and GI problems secondary to chemotherapy.<br />

Fructooligosaccharides are short chain sugar compounds that are digested not by<br />

mammals, but by the beneficial bacteria that colonize the bowel. Human<br />

studies have shown that FOS increases colonization by Bifidobacterium<br />

spp and Lactobacillus spp, at the same time as it reduces colonization by<br />

pathogenic species of bacteria. Other benefits noted by researchers include<br />

the increased production of beneficial short-chain fatty acids such as<br />

butyrate. (Gibson, 1995) These short chain fatty acids are dietary<br />

metabolism factors which benefit human patients with small bowel<br />

bacterial overgrowth syndrome. (Hoverstad, 1985) The<br />

fructooligosaccharide content of this formula is designed to assist in reestablishing<br />

healthy bowel micro-floral ecology.<br />

Oregon Grape Root (Mahonia repens AKA Berberis aquifolium) is a berberinecontaining<br />

herb that has natural antibiotic properties. Berberine hcl is an<br />

alkaloid present in a number of herbs, including goldenseal (Hydrastis<br />

canadensis), goldenthread (Coptis chinensis), and barberry (Berberis<br />

vulgaris). Its antibiotic spectrum of activity is directed primarily toward<br />

the population of pathogenic bacteria that can colonize the bowel as a<br />

result of chronic gastrointestinal disease, following anti-biotic therapy,<br />

food poisoning and chemotherapy. (Gupte, 1975) Oregon grape root also<br />

exerts a beneficial effect on the secretory capacity of the mucosal cells<br />

lining the bowel, (Tai, 1981) as well as affecting the ability of pathogenic<br />

bacteria to adhere to the intestinal mucosal cells. (Sun, 1988). In this<br />

formula, the oregon grape root is being used to reestablish a healthy bowel<br />

ecology.<br />

Garlic (Allium sativum) (standardized to 1% total allicin potential) has a long<br />

history of well-documented effects, including anti-microbial, anthelmintic,<br />

anti-fungal, anti-viral, and anti-inflammatory. (Hughes, 1991) All of these<br />

health benefits of garlic are advantageous to its use in this formulation.<br />

Psyllium Seed (Plantago ovata) is a hydrophilic demulcent herb that supplies<br />

soluble and insoluble fiber to the bowel, thus supporting the growth of the<br />


eneficial bacteria. Its demulcent and hydrophilic actions help to control<br />

the symptoms of diarrhea.<br />

Aloe Extract (emoden free) provides anti-inflammatory and wound healing<br />

activity in this formula. The removal of the anthraquinones from the<br />

whole aloe leaf in this emoden-free aloe vera extract have eliminated the<br />

cathartic properties of aloe without disturbing this plant’s ability to reduce<br />

inflammation and promote the healing of disturbed tissues. Aloe has been<br />

shown to stimulate fibroblast and connective tissue formation.<br />

(Davis,1987) Aloe has demonstrated benefit to gastrointestinal function in<br />

a human study. (Bland, 1985) Aloe vera has been shown to improve both<br />

cancer patient and HIV clinical outcomes (Harris, 1991), (Singer, 1993).<br />

Aloe’s ability to soothe irritated tissues is its primary function in this<br />

formulation.<br />

DGL (deglycyrrhized licorice) is a special extract of licorice root (Glycyrrhiza<br />

glabra) that is used in the treatment of peptic and oral ulcers in humans. It<br />

is manufactured by removing the glycyrrhizinic acid fraction of the whole<br />

plant extract. The active components of DGL are primarily flavonoids.<br />

Animal studies have demonstrated the substantial protection this<br />

compound provides following chemically induced ulcer formation.<br />

(Yamamoto, 1992) In a placebo-controlled study, DGL was compared to<br />

Tagamet for their relative ulcer healing properties as measured by<br />

reduction in ulcer size. Both DGL and Tagamet were equivalent in their<br />

ulcer healing activity. (Morgan, 1985)<br />

Folic acid functions together with vitamin B12 in many bodily processes. Folic<br />

acid is critical for DNA synthesis. Folic acid is found in copious amounts<br />

in fresh green leafy vegetables and whole grains. Rapidly dividing cells in<br />

a variety of tissues need adequate folic acid for maintenance of healthy<br />

tissue function. The cells of the gastrointestinal tract are especially<br />

sensitive to reductions in folic acid. In small bowel bacterial overgrowth<br />

syndrome, folic acid and vitamin B12 are not being created by the healthy<br />

bacteria species, and folic acid deficiency is one mechanism of this<br />

pathology. (Bailey, 1995)<br />

Vitamin A (retinol) plays a necessary role in the synthesis of a substantial number<br />

of glycoproteins, which provide the ground substance that holds cells<br />

together. Vitamin A deficiency adversely affects tissues with high cellular<br />

turnover rates, such as the intestinal mucosal epithelium. Inadequate<br />

Vitamin A results in hyperkeratotic tissues and reduces the semipermeable<br />

intestinal mucosal barrier. (Murray, 1996)<br />


NUTRIGEST for Dogs and Cats has been designed as a supportive clinical<br />

tool to be used as an adjunctive therapy:<br />

In the treatment of acute and chronic diarrhea<br />


To improve patient response in cases of chronic intestinal<br />

parasitiasis, including giardiasis<br />

To help recolonize the bowel following antibiotic therapy<br />

For the remediation of intestinal dysbiosis,<br />

To help improve patient response to therapies for the<br />

inflammatory bowel diseases<br />

To provide support for patients experiencing gastrointestinal<br />

side-effects from chemotherapy.<br />


DOG:<br />

½ - 1 capsules BID or 0.5-1 scoop* powder daily for 5-25 lbs.<br />

1 - 2 capsules BID or 1-1.5 scoops powder daily for 25-50 lbs.<br />

2 - 3 capsules BID or 1.5 -2 scoops powder daily for 50 – 100 lbs.<br />

CAT:<br />

½ - 1 capsule BID or 0.5-1 scoop powder daily.<br />

* 1 scoop equals ½ teaspoon<br />

NOTE:<br />

Dosing at up to three times the high range of values will increase<br />

tissue levels and improve patient response times. There is no<br />

toxicity associated with this higher dosage.<br />


Axelrod, A. E. (1955). “B vitamins and immune system function.” J. Ann New York Acad Sci 63:<br />

202.<br />

Bland, J. (1985). Effect of orally consumed Aloe vera juice on human gastrointestinal function.<br />

Natural Foods Network Newsletter. August.<br />

Burton, A. F. and Anderson F. H, (1983). “Decreased incorporation of 14C-glucosamine relative<br />

to 3H-N-acetylglucosamine in the intestinal mucosa of patients with inflammatory bowel disease.”<br />

Am J Gastroenterology 78: 19-22.<br />

Clements, M. L., Levine, M. M. et al. (1981). “Lactobacillus prophylaxis for diarrhea due to<br />

enterotoxigenic Escherichia coli.” Antimicrob Agents Chemother 20: 104-108.<br />

Davis, R. et al. (1987). “Aloe vera and wound healing.” J Am Pod Med Assoc 77: 165-169.<br />

Fox, A. D., Kripke S. A, et al. (1988). “Effect of a glutamine-supplemented enteral diet on<br />

methotrexate-induced enterocolitis.” J. Parenter Enteral Nutr 12: 325-331.<br />

Gibson, G. R. et al. (1995). “Selective stimulation of bifidobacterium in the human colon by<br />

oligofructose and inulin.” Gastroenterology 108: 975-982.<br />

Gotz, V. P., Romankiewics J.A, et al. (1979). “Prophylaxis against ampicillin-induced diarrhea<br />

with a lactobacillus preparation.” Am J Hosp Pharm 36: 754-757.<br />

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Kiuchi, F. et al (1992). “Inhibition of prostaglandin and leukotriene biosynthesis by gingerols and<br />

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Nappert, G., Zello G. A., et al. (1999). “Examination of metabolism of viscera drained by the<br />

portal vein in neonatal calves, using short-term intravenous infusions of glutamine and other<br />

nutrients.” American Journal of Veterinary Research 60(4): 437-445.<br />

Onogi, T. et. al (1992). “Capsaicin-like effect of (6)-shogoal on substance P-containing primary<br />

afferents of rats: A possible mechanism of its analgesic action.” Neuropharmacology 31: 1165-<br />

1169.<br />

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