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PROBIOTICS

We are always expressing the need to ‘condition or train-up the digestive system of the pets,’ to their custodians, with the aim to optimize their natural abilities to defend and repair their own bodies.

Creating a healthy and balanced microbiome in the digestive system is the first imperative step.

One of the definitions by the World Health Organization for “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host” is Probiotics (1) (2)

 

Lactobacillus and Bifidobacterium are significant genera in this context because they are unaffected by the gastrointestinal acidic environment and readily form colonies by attaching to the intestinal tract (3) when fed orally. 

 

There are only limited published, peer-reviewed, controlled clinical trials or reports on probiotic uses on either diseased or healthy pet cats and pet dogs (4).

 

The studies done in humans and other mammals have amassed evidence to link a balanced and stable gut microbiome to a range of physiologic processes that are vital to host health, including energy homeostasis, metabolism, gut epithelial health, immunologic activity, and neurobehavioral development (4).

Any changes or dysbiosis to these gut microbiomes can result in diseases or medical conditions like inflammatory bowel disease, asthma, obesity, metabolic syndrome, cardiovascular disease, immune‐mediated conditions, and neuro-developmental issues (4).

 

Most discussed benefits and narratives about probiotic uses are extrapolated from these studies on human health, laboratory animals, and production animals. It is essential to understand that the effects of all mentioned probiotics can vary from animal to animal (1).

 

To expound on this point, we can consider the domestic short hair pet cats. Being obligate carnivores that need a protein-rich diet, their gut microbiota, logically, should constitute a very different composition of microorganisms, compared with those of omnivorous humans and many other mammals (4).

 

Therefore, the true impact and benefits on the immune system after and during probiotic therapy are dependent on an individual's overall health condition, the specific strain of probiotics, and the dosage or concentration used (1).

LACTOBACILLUS

Lactobacillus is a well-known beneficial bacterium genus that can be found in various parts of the body, especially in the digestive system.

 

Many Lactobacillus species contribute to the overall health of the host by maintaining a healthy and slightly acidic pH level, consequently, a balanced yet diverse, beneficial gut microbiome in the digestive system when fed correctly. It can help to prevent the overgrowth of harmful bacteria or alleviate certain digestive issues, such as bloating, flatulence, and diarrhea (5, 22).

 

They can assist in the digestion of food by breaking down complex carbohydrates (a common ingredient in pet food) and producing enzymes that aid in nutrient absorption (21).

 

Some strains, like Lacticaseibacillus rhamnosus and Lacticaseibacillus paracasei (formerly known as Lactobacillus rhamnosus and Lactobacillus paracasei respectively)  (2), are believed to support the immune system and help prevent infections (5, 6). They can enhance the body's immune responses and modulate inflammation, making it more effective in defending against common gastrointestinal infections and even respiratory infections. Other studies picked up potential antiviral properties in Lacticaseibacillus casei (formerly known as Lactobacillus casei) as well (2,7,6,22).

One of the most familiar strains is none other than Lactobacillus acidophilus. It potentially inhibits the growth of pathogenic microorganisms and reduces the production of enzymes by them, it may also inhibit the catalysing of the conversion of carcinogenic precursors to carcinogens like reductase, nitro reductase, and β-glucosidase (8).

BIFIDOBACTERIUM

Bifidobacterium is another genus of beneficial microorganisms with 48 recognized species (9,10) that inhabit the intestinal tract of a wide range of animals (9), primarily residing in the colon (5, (10).

 

It has also been shown in studies that bifidobacterium and other butyrate-producing colon bacteria are negatively correlated with disorders such as inflammatory bowel disease and colorectal cancer (11).

 

Species, like Bifidobacterium longum, Bifidobacterium adolescentis, mainly aid in the fermentation and breakdown of dietary fibre (which are also found in pet food) and other complex carbohydrates (12), producing short-chain fatty acids (SCFAs) and helps to extract energy from otherwise indigestible compounds (9,10) in the food.

Others, like Bifidobacterium bifidum adhere to the intestinal lining, directly competing with harmful bacteria for resources, helping to keep the microbiota in balance and preventing the overgrowth of pathogenic microorganisms physically through colonisation of the intestinal linings (9). They also help maintain the integrity of the intestinal barrier, which is crucial in preventing and defending the entry of harmful substances produced by these pathogenic microorganisms into the bloodstream (13,22).

 

While others, like Bifidobacterium animalis subsp. Lactis, are known for their role in promoting regular bowel movements and preventing constipation by softening the stool (10,13).

 

There are even species, like Bifidobacterium breve, that research has found may possibly trigger tumour apoptosis and inhibit tumour growth in mice by the recruitment of intestinal defense cells, like Interleukin 12 and T cells that can enhance antitumor effect (14, 21).

SACCHAROMYCES BOULARDII

Saccharomyces boulardii, a non-pathogenic yeast, has been used worldwide for several decades to modulate against intestinal injury and inflammation (15).

 

This yeast was seen to alleviate the clinical signs of several diarrhea diseases, including pediatric diarrhea, antibiotic-associated diarrhea, acute diarrhea, traveler’s diarrhea caused by bacterial, viral or parasites, and enteral nutrition-related diarrhea (16, 17, 18).

 

Current data indicate that the benefits of Saccharomyces boulardii are not reliant on colonization of the digestive system, differentiating its mode of action from other widely used bacterial probiotics such as Lactobacillus and Bifidobacterium (15). It grows well at normal human body temperature (37°C) and is resistant to some antibiotics (16). However, these benefits also appear to be transient, lasting not more than 5 days after discontinuation (19).

 

Studies on non-diseased laboratory mice have shown that the administration of Saccharomyces boulardii during antibiotic treatment (Amoxicillin-clavulanate, 150 mg/kg) and another 1 to 2 weeks beyond the end of antibiotic treatment was able to maintain a high level of beneficial, commensal bacteria, promoting an efficient return to eubiosis for the gut system (19).

However, there is currently not enough scientific research done on the use of yeast-based probiotics on cats (obligate carnivores) and any other carnivorous animals’ digestive systems. A small number of studies and anecdotal reports on its pet use and carnivore-related digestive condition can be found but scientific literature and evidence is still lacking (20, 21).

GOOD PRACTICE STANDARD

Before you dash out to the shop to grab a probiotic for your pets, be aware that there are many, many products in the market carrying the label ‘probiotic’. 

The misuse of the term ‘probiotic’ (in the pet and human industries) has also become a major issue, with many products exploiting the term without meeting the established requisite criteria (1,2)

For example, some manufacturers of products containing some level of live microbes, that is not well-defined in terms of strain composition, stability, and ability to provide substantiable host benefits, will misleadingly label their products as ‘probiotics’. (1,2)

On the contrary, they are at best ‘items that contain live and active cultures’, without established true probiotic activities or benefits. (1)

The International Scientific Association for Probiotics and Prebiotics (ISAPP) gathered an expert panel in October 2013 to clarify and deliberate about a more precise definition of the term ‘probiotic’ to help steer clinicians and consumers to differentiate the diverse products on the market. (1)

World Gastroenterology Organisation (WGO) and (ISAPP) unequivocally recommend that the term ‘probiotic’ be used only on products that deliver live microorganisms with a suitable viable count of well-defined strains with a reasonable expectation of delivering stated benefits for the wellbeing of the host, backed by peer-reviewed studies. (1,2)

The goal to standardised and create accountability is difficult to achieve because of the vast differences in restrictions and requirements on product labels according to regulatory agencies of different countries(1)

The development of an internationally accepted and endorsed product-labeling guideline that communicates the information known about the probiotics being sold would be most useful for consumers (including pet custodians) and health-care providers (including veterinarians). 

For example, from a scientific perspective, WGO recommends that the labels for probiotics should include the following (2):

 

  1. Name of probiotic including Genus, species, subspecies, identification, with nomenclature consistent with current scientifically recognized names

  2. Strain designation

  3. Viable count of each strain at the end of shelf-lif

  4. Recommended storage conditions

  5. Recommended dose

  6. An accurate description of the physiological effect/ benefits

  7. Contact information of manufacturers

 

This narrative should be seriously deliberated and considered for future use in all probiotic products in Singapore (whether for human or animal consumption) to encourage better accountability to consumers at large. 

CONCLUSION

The strains of probiotics discussed represent a core group of well-studied and safe species likely to impart some general benefits for the host as extrapolated from human studies (2)

However, there are some reports of sepsis from bacterial probiotics and fungemia in human patients. 

Although these reports are uncommon and usually associated with human patients with central access catheters in intensive care (15,16) , we caution you to consult your appointed veterinarian before embarking your pet on probiotic therapy, whether the intention is to condition the digestive system during the healthy phase of life, or for recuperation from a diseased phase of life.

Author Contributions

Dr. Denise Ng BSC BVMS

 

Conflict of interest

The author declares that there is no conflict of interest.

 

Funding

The author received no specific grant from any funding agency in the public, commercial or not-for-profit sectors for the preparation of this review article.

Attribution:

1. Colin Hill, Francisco Guarner, Gregor Reid, Glenn R. Gibson, Daniel J. Merenstein, Bruno Pot, Lorenzo Morelli, Roberto Berni Canani, Harry J. Flint, Seppo Salminen, Philip C. Calder and Mary Ellen Sanders. (2014 AUG). The International Scientific Association for Probiotic and Prebiotic consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology & Hepatology, 11:506-514. Macmillan Publishers. Accessed 27 Oct 2023.

2. Francisco Guarner (Chair, Spain), Mary Ellen Sanders (Co-Chair, USA), Hania Szajewska (Co-Chair, Poland), Henry Cohen (Uruguay), Rami Eliakim (Israel), Claudia Herrera (Guatemala), Tarkan Karakan (Turkey), Dan Merenstein (USA), Alejandro Piscoya (Peru), Balakrishnan Ramakrishna (India), Seppo Salminen (Finland). (Feb 2023). World Gastroenterology Organisation Practice Guideline: Probiotics and Prebiotics. Accessed 28 Oct 2023.

3. Yae Jin Choi, Seon-Hee Shin, Hea Soon Shin. (2022 Sep 28). Immunomodulatory Effects of Bifidobacterium spp. and Use of Bifidobacterium breve and Bifidobacterium longum on Acute Diarrhea in Children. J Microbiol Biotechnol, 32(9): 1186–1194. Korean Society for Microbiology and Biotechnology. Accessed 25 Oct 2023.

4. P.C. Barko, M.A. McMichael, K.S. Swanson, and D.A. Williams. (2017 Nov 24). The Gastrointestinal Microbiome: A Review. J Vet Intern Med. 32(1): 9–25. Philadelphia: J.B. Lippincott Co. Accessed 28 Oct 2023.

5. Anastasia N. Vlasova, Sukumar Kandasamy, Kuldeep S. Chattha, Gireesh Rajashekara, and Linda J. Saif. (2016 Jan 14). Comparison of probiotic lactobacilli and bifidobacteria effects, immune responses and rotavirus vaccines and infection in different host species. Vet Immunology and Immunopathology, 172,72-84. Amsterdam: Elsevier Scientific. Accessed 26 Oct 2023.

6. Daragh Hill, Ivan Sugrue, Conor Tobin2, Colin Hill, Catherine Stanton, R. Paul Ross. (2018 Sept 28). The Lactobacillus casei Group: History and Health Related Applications. Frontiers in Microbiology, 9. Ireland. Accessed 28 Oct 2023.

7. Karem Prunella Fernandez-Duarte, Nury Nathalia Olaya-Galán, Sandra Patricia Salas-Cárdenas, Jazmin Lopez-Rozo, and Maria Fernanda Gutierrez-Fernandez. (2017 Apr 21). Bifidobacterium adolescentis (DSM 20083) and Lactobacillus casei (Lafti L26-DSL): Probiotics Able to Block the In Vitro Adherence of Rotavirus in MA104 Cells. Probiotics Antimicrobial Proteins. (1): 56–63. United States, New York: Springer. Accessed 27 Oct 2023.

8. Huijuan Gao, Xin Li, Xiatian Chen, Deng Hai,2 Chuang Wei, Lei Zhang. (2022 Aug 30). The Functional Roles of Lactobacillus acidophilus in Different Physiological and Pathological Processes. J Microbiol Biotechnol, 32(10): 1226–1233. Seoul: Korean Society for Applied Microbiology. Accessed 27 Oct 2023.

9. Giulia Alessandri, Douwe van Sinderen, and Marco Ventura. (2021 Mar 9). The genus bifidobacterium: From genomics to functionality of an important component of the mammalian gut microbiota running title: Bifidobacterial adaptation to and interaction with the host. Computational and structural biotechnology journal, 19,1472-1487. SWEDEN: Research Network of Computational and Structural Biotechnology. Accessed 25 Oct 2023.

10. Jing Cheng, Arja Laitila and Arthur C. Ouwehand. (2021 Dec 14). Bifodobacterium. Frontiers in Nutrition. 8:790561. Lausanne, Switzerland: Frontiers Media S. A. Accessed 26 Oct 2023

11. Audrey Rivière, Marija Selak, David Lantin, Frédéric Leroy, and Luc De Vuyst.(2016 Jun 28). Bifidobacteria and Butyrate-Producing Colon Bacteria: Importance and Strategies for Their Stimulation in the Human Gut. Frontiers in Microbiology, 172,72-84. Switzerland Lausanne: Frontier Research Foundation. Accessed 26 Oct 2023.

12. Francesca Bottacini, Marco Ventura, Douwe van Sinderen, and Mary O'Connell Motherway (2014 Aug 29). Diversity, Ecology and intestinal function of bifidobacterial. Microbial cell factories, 13-S1-S4. London: BioMed Central. Accessed 24 Oct 2023

13. Barbora Waclawiková, Agnese Codutti, Karen Alim, and Sahar El Aidy. (2022 Jan 3). Gut microbiota-motility interregulation: insights from in vivo, ex vivo and in silico studies. Gut Microbes,14(1),1997296. Austin, Texas: Landes Bioscienc. Accessed 25 Oct 2023.

14. Qingxiang Li, Yuke Li, Yifei Wang, Le Xu, Yuxing Guo, Yixiang Wang, Lin Wang, and Chuanbin Guo. (2021 Jan 15). Oral administration of Bifidobacterium breve promotes antitumor efficacy via dendritic cells-derived interleukin 12. Oncoimmunology, 10,1:1868122. Austin, TX: Landes Bioscience. Accessed 25 Oct 2023
15. Pedro Pais, Vanda Almeida, Melike Yılmaz, and Miguel C. Teixeira. (2020 Jun 4) Saccharomyces boulardii: What Makes It Tick as Successful Probiotic? Journal of Fungi, 6(2): 78. Switzerland, Basel. Accessed 27 Oct 2023.

16. David R. Mack. (2005). Probiotics. Canadian Family Physician. 51, 11: 1455-1457. Don Mills, Ont: College of Family Physicians of Canada. Accessed 27 Oct 2023.

17. Dorota Czerucka and Patrick Rampal. (2019 May 14). Diversity of Saccharomyces boulardii CNCM I-745 mechanisms of action against intestinal infections. World J Gastroenterol; 25(18): 2188–2203. Acessed 28 Oct 2023.

18. Huan Zhou, Hui-Jing Zhang, Lin Guan, Yi-Ning Zhang, Yue Li, and Ming-Jun Sun. (2018 Oct 30). Mechanism and therapeutic effects of Saccharomyces boulardii on experimental colitis in mice. Mol Med Rep.18(6): 5652–5662. Accessed 29 Oct 2023.

19. Madeleine Spatz, Yazhou Wang, Alexia Lapiere, Gregory Da Costa, Chloé Michaudel, Camille Danne, Marie-Laure Michel, Philippe Langella, Harry Sokol, and Mathias L. Richard. (2023 Aug 4). Saccharomyces boulardii CNCM I-745 supplementation during and after antibiotic treatment positively influences the bacterial gut microbiota. Frontiers in Medicine. 10: 1087715. Lausanne, Switzerland: Frontiers Media S.A. Accessed 27 Oct 2023.

20. S.N. Bybee, A.V. Scorza, and M.R. Lappin. (2011 Jun 20). Effect of the Probiotic Enterococcus faecium SF68 on Presence of Diarrhea in Cats and Dogs Housed in an Animal Shelter. J Vet Intern Med, 25(4): 856–860. Philadelphia : J.B. Lippincott Co. Accessed 29 Oct 2023.

21. Mingrui Zhang, Ruixia Mo, Mingtan Li, Yuankai Qu, Haotian Wang, Tianyi Liu, Pan Liu, and Yi Wu. (2023 May 8). Comparison of the Effects of Enzymolysis Seaweed Powder and Saccharomyces boulardii on Intestinal Health and Microbiota Composition in Kittens.Metabolites. 13(5): 637. Swisterland, Basel. Accessed 28 Oct 2023

22. Jan S. Suchodolski, Albert E. Jergens. (2016 April 2016). Recent Advances and Understanding of Using Probiotic-Based Interventions to Restore Homeostasis of the Microbiome for the Prevention/Therapy of Bacterial Diseases. ASM Journals, Microbiology Spectrum, Vol. 4, No. 2. Accessed 29 Oct 2023. Jan S. Suchodolski, Albert E. Jergens. (2016 April 2016). Recent Advances and Understanding of Using Probiotic-Based Interventions to Restore Homeostasis of the Microbiome for the Prevention/Therapy of Bacterial Diseases. ASM Journals, Microbiology Spectrum, Vol. 4, No. 2. Accessed 29 Oct 2023.

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