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Probiotic use in small animals, part two

Jugan MC, Rudinsky AJ, et al. Use of probiotics in small animal veterinary medicine. J Am Vet Med Assoc. 2017 Mar 1;250(5):519-528.

Part one of this paper about probiotic use in small animals discussed general considerations regarding the nature of probiotics and similar products such as prebiotics and synbiotics. The following is Part Two which discusses the evidence for use of probiotics in different health situations.

Evidence for use of probiotics in healthy cats: In vivo studies have been conducted on the use in healthy small animals. While these studies of healthy animals often provide apparently positive effects of probiotics, their implication for disease states is unknown. One significant point noted is that no study has found major negative effects of probiotics administered to healthy animals which suggests probiotics are relatively safe to use.  It is also noted that in these in vivo studies, there are changes noted in characterization of bacteria often considered as pathogens. The authors comment that these microorganisms are present in healthy animals. Therefore, just because a presumed pathogenic organism is present, this does not mean the organism is causing clinical disease. Attempts to treat animals in these situations might well be ill-advised. Also, in testing for viability of organisms in feces, the presence of nonviable organisms does not imply lack of effect so one cannot necessarily extrapolate data from healthy patients to a clinical setting.

Evidence for use of probiotics in cat with gastrointestinal tract (GIT) illness:

(Acute enteropathy)- For cats, it was noted that administration of E faecium SF68 to shelter cats demonstrated a lower percentage of cats with diarrhea for > 2 days versus the percentage of cats administered a placebo. Overall, the authors state that studies of small animals with acute diarrhea provide weak evidence for the exclusive use of probiotics. Yet, the studies do provide considerable evidence for the prevention of stress-induced diarrhea (likely caused by housing in shelters, significant physical exercise, or antimicrobial administration). Evidence based medicine is lacking for using probiotics in cats with naturally occurring acute diarrhea.

(Chronic enteropathy)- In this situation, it was stated that with client-owned cats with undefined (> 3 weeks duration) diarrhea, fecal firmness did increase in almost 72% of the cats given a synbiotic product when the synbiotic capsule was opened and mixed with the food. Due to a number of limitations related to studies of sick pets, comparisons regarding probiotics and their use in animals with chronic GIT illness are inadequate. However, as with healthy animals, no adverse effects were reported with probiotic administration.

Evidence of use of probiotics in kittens:  In one study of an acute outbreak of diarrhea in kittens, only 9.5% of kittens that received E faecium SF68 required other medical treatment, compared to 60% of the control kittens that did not receive the probiotic. There was also more rapid resolution of signs in kittens that received the probiotic compared to those kittens that did not. There were still concerns that there were similar limitations to the studies available in kittens as in adult cats. The authors state that it is important to remember that there are significant species differences in the response to probiotics and probiotics are likely to have different effects in immature animals than in adult animals due to transitions in the GIT microorganisms during development.

The evidence for probiotic use in non-GIT illness (atopic dermatitis, genitourinary tract infection, respiratory tract disease) is limited to a few studies with limited numbers of animals.

In the long run, results were variable among studies and some studies indicated no effect of probiotics. Since there were no substantial adverse effects noted in any of the studies after probiotic administration, this suggests the relative safety of their use over a short period. Further consistent microbiome and metabolome assessment will better assist our understanding of the mechanisms of response and GIT influences in GIT and non-GIT diseases. Part Two. (VT)

See also:
Sauter SN, Blum JW. Probiotics in veterinary medicine. Schweiz Arch Tierheikd. 2003 Nov; 145(11):507-514, 516-518.