PRE AND PROBIOTICS PRACTICAL APPLICATIONS FOR VNS IN PRACTICE

Transcription

1 Vet Times The website for the veterinary profession PRE AND PROBIOTICS PRACTICAL APPLICATIONS FOR VNS IN PRACTICE Author : Linda Matthewman, Karin Allenspach Categories : RVNs Date : January 1, 2013 Linda Matthewman BVSc, CertSAM, MPhil, MRCVS, and Karin Allenspach DrMedVet, FVH Dip, ECVIM-CA, PhD, FHEA, MRCVS, consider the evidence surrounding the perceived gastrointestinal benefits of using prebiotics and probiotics in patient PROBIOTICS are usually defined as products that contain viable, non-pathogenic microorganisms (bacteria or yeasts), which are able to confer health benefits to the host. Prebiotics are short or long-chain oligosaccharides (starch-like or fibre-like molecules). They cannot be digested by mammalian digestive enzymes, but are fermented in the colon by microorganisms. These products of fermentation, like short-chain fatty acids, are essential nutrients for colon epithelial cells and, therefore, for host health. They also provide an energy source for the bacteria and are thought to increase the numbers of beneficial bacteria. Synbiotics are a mixture of beneficial bacteria and prebiotics, such as fructooligosaccharide (FOS), which provide both the microorganisms and a substrate for them to work on 1. There are 10 times as many microorganisms living on the skin, and in the respiratory, gastrointestinal and reproductive tracts, as there are body cells. These are commensal microorganisms and, collectively, are called the microbiota. For the most part, the host lives in symbiosis with its microbiota. Neonatal animals, birds and reptiles are sterile when they are born or hatch, but are inoculated at birth with the microbiota of their mothers and the environment. This is crucial because the 1 / 6

2 microbiota has several very important functions; it helps with development of the immature immune system, it colonises the host and it prevents invasion by other pathogenic microorganisms. In the gut, it helps with the digestion of food and it provides other nutrients, like B vitamins for example, biotin and folic acid. Thus, this is a mutually beneficial relationship and the microorganisms confer many benefits on the host. Much research has shown the benefits of having a healthy microbiota and how the microbiota changes in obesity, in diseases such as diabetes mellitus and in diseases with an inflammatory basis including allergies and inflammatory bowel disease (IBD). When disease occurs, the balance of the microorganisms can be upset (dysbiosis), especially when antibiotics are used as a treatment. Probiotics and synbiotics are used to try to resolve the dysbiosis and return the microbiota back to health. Over the lifespan of the host, the microbiota evolves and changes because it is affected by diet, age and disease 1. Probiotics are considered to be dietary supplements and prebiotics are a functional food. Therefore, they are not subject to the same strict licensing as drugs. This means various formulations may vary considerably in quality and efficacy. Perhaps the most important thing to bear in mind when recommending the use of a probiotic or synbiotic supplement, is whether there is any solid, scientific evidence to show the product works. Can we be sure the product contains the appropriate number of microorganisms for the animal that it claims to treat? It is considered a probiotic supplement should deliver at least colony forming units (CFU)/dose of product. It is very important to use only veterinary products from recognised sources when dispensing these formulations. Adverse effects caused by taking probiotics and prebiotics are very rare and a study that fed probiotics to growing puppies found the formulation was well tolerated with no safety concerns 2. The most commonly reported of these very rare side effects is flatulence, which usually only happens for a brief period during adjustment to the formulation. Probiotics and synbiotics are considered safe, but there is one exception that requires careful consideration and this is in animals that are immunosuppressed. Since probiotics contain live organisms, they must be used with caution in very ill and immunosuppressed patients. When recommending the use of a probiotic or symbiotic, always use a tested veterinary product, tell the owner about the possibility of transient flatulence and remind them to wash their hands after they have administered the supplement. A list of probiotic and symbiotic formulations available in the UK is in Table 1. Use of pre and probiotics in patients All species of animals have their own microbiota and because it is such an important part of the animal, keeping the microbiota healthy is critically important. With that in mind, any of the veterinary species could be treated with probiotics when they are unwell however, there are two 2 / 6

3 issues. The first is there is not a lot of published evidence in all species that probiotics are effective. The second is that different species have different flora, so a probiotic for a dog would not be appropriate for a rabbit, for example. The following deals with the use of probiotics where there is scientific evidence for their use. Acute diarrhoea in dogs and cats Stress is an important cause of diarrhoea in puppies and kittens around the time of rehoming, and dietary supplementation with probiotics has been shown to be beneficial when given to puppies and kittens suffering from stress-induced diarrhoea 3. Other possible sources of stress where supplementation with probiotics has been shown to be beneficial are kennelling, housing in an animal shelter and extreme exercise, such as racing sled dogs 4. Dogs and cats given probiotics had less severe disease and recovered more quickly than those not given probiotics. Also, probiotics have been shown to help when used to treat diarrhoea of infectious or dietary cause 5. There are a number of possible reasons : the probiotic bacteria may stimulate the immune response and may prevent the adherence of other pathogenic bacteria; they may also reduce shedding of pathogenic bacteria into the environment in the diarrhoeic faeces; and the beneficial bacteria probably have anti-inflammatory effects and they produce short chain fatty acids that nourish enterocytes and repair the intestinal mucosa 1. Immune stimulation in dogs and cats The microbiota is crucial for the development of a strong immune system while the animal is growing and maturing. Giving probiotics to beagle puppies from weaning to maturity was shown to enhance specific immune functions and they mounted a stronger immune response to vaccination against the distemper virus than puppies that did not receive probiotics 6. Also, giving probiotics to beagle puppies, which are genetically predisposed to developing atopic dermatitis, was shown to reduce their risk of developing the disease 7. Over the life of the animal, the microbiota continues to stimulate and interact with the immune system and further studies have shown that supplementation with probiotics in adult cats and dogs continued to have beneficial systemic and immunomodulatory effects on these species 8, 9. Maturity and old age 3 / 6

4 As dogs and cats age, the microbiota changes as a result of diet, disease and other factors, and maintaining a healthy microbiota may help to support the immune system and maintain health. Preliminary studies in cats have shown supplementation with a probiotic reduced azotaemia in cats with chronic kidney disease 1. Rabbits and other small mammals Rodents need the microbiota in their gastrointestinal tracts to help them digest indigestible carbohydrates, such as cellulose, in their diets. Rabbits fed probiotics in their feed had less mortality and better growth than rabbits not fed probiotics 10. A number of recovery formulas are available that incorporate probiotics and prebiotics, which may help to resolve the dysbiosis associated with stress and disease in small rodents and return their microbiota to health. These formulas are not tailor-made to the species and no scientific evidence is available that they work, but they may help. Reptiles Success with the use of probiotics in reptiles is mostly anecdotal, but many herpetologists recommend using them. One unpublished study showed supplementing the food with a probiotic preparation greatly reduced the amount of salmonella bacteria in the faeces and reduced shedding of the bacteria into the environment 11. Salmonellosis is a problem in captive reptiles. Birds and poultry In poultry production, strong evidence shows treating chicks with probiotic preparations enhances their immune systems and reduces colonisation by a number of diarrhoea-causing organisms 1, 12. With that in mind, there may be a benefit to supplementing caged birds and garden poultry with probiotics, but no studies exist to support this. Antibiotic therapy One area where probiotics may be useful is during treatment with antibiotics. Broad spectrum antibiotics have a devastating effect on the microbiota and, in some cases, this is evident when the animal develops diarrhoea. Giving probiotics at the same time as treating with antibiotics may have a protective effect and maintain some of the functions of the microbiota during the treatment, although the probiotic bacteria will also be affected by the antibiotic and it may be necessary to continue giving the probiotic after the antibiotic treatment has finished. Studies in people have shown that taking probiotics while being treated with antibiotics was associated with less antibioticassociated diarrhoea 13. Conclusion 4 / 6

5 It is clear great potential benefits are associated with the use of probiotics in veterinary species and they have been shown to enhance the immune function in several species, both pets and farm animals. Probiotics certainly have a role in treating animals with gastrointestinal disease and probably confer benefit during treatment with antibiotics, but they should be used with caution in severely ill and immunosuppressed patients. It is important to remember probiotic and synbiotic preparations are considered to be supplements and are not subject to strict licensing. As a result, the quality of products can vary, so only those with clear evidence of efficacy should be offered to patients. 1. Wynn S G (2009). Probiotics in veterinary practice, J Am Vet Med Assoc 234 (5): Kelley, R L, Park J S, O Mahony L et al (2010). Safety and tolerance of dietary supplementation with a canine-derived probiotic (Bifidobacterium animalis strain AHC7) fed to growing dogs, Vet Ther 11: Bybee S N, Scorza A V and Lappin M R (2011). 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): Gore A M and Reynolds A (2012). Effects of Enterococcus faecium SF68 on stress diarrhoea, 2012 Proceedings, ACVIM Congress. 5. Herstad H K, Nesheim B B, L Abée-Lund et al (2010). Effects of a probiotic intervention in acute canine gastroenteritis a controlled clinical trial, J Small Anim Pract 51 (1): Benyacoub J, Czarnecki-Maulden G L, Cavadini C et al (2003). Supplementation of food with Enterococcus faecium (SF68) stimulates immune functions in young dogs, J Nutr 133: 1,158-1, Marsella R, Santoro D and Ahrens K (2012). Early exposure to probiotics in a canine model of atopic dermatitis has long-term clinical and immunological effects, Vet Immunol Immunopathol 15; 146 (2): Marshall-Jones Z V, Baillon M L, Croft J et al (2006). Effects of Lactobacillus acidophilus DSM13241 as a probiotic in healthy adult cats, Am J Vet Res 67 (6): 1,005-1, Baillon M L, Marshal-Jones Z V and Butterwick R F (2004). Effects of probiotic Lactobacillus acidophilus strain DSM13241 in healthy adult dogs, Am J Vet Res 65 (3): Kritas S K, Petridou E I, Fortomaris P et al (2008). The effect of probiotics on microbiology, health and performance of fattening rabbits, Asian-Aust J Anim Sci 21 (9): 1,312-1, Chen C Y, Tsen H Y, Lin C L et al (2012). Oral administration of a combination of select lactic acid bacteria strains to reduce the Salmonella invasion and inflammation of broiler chicks, Poult Sci 91 (9): 2,139-2, Hempel S, Newberry S J, Maher A R et al (2012). Probiotics for the prevention and treatment of antibiotic-associated diarrhoea: a systematic review and meta-analysis, JAMA 5 / 6

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