“Irregularity” is a politely inadequate euphemism for what you know as diarrhea, constipation and flatulence. In all cases, these symptoms are accompanied by changes in the animal’s gastrointestinal bacteria. That’s why “probiotics” are often recommended for these pets by way of boosting “good” gut bacteria and counteracting the bad.
But what are these probiotics anyway? And how do they work? Should you be careful with them? Are you missing out if you don’t use them?
Here’s some background:
Probiotics are as timeless as Abraham and his sour goat milk, yet these therapeutic food additives are a relatively new field of study for nutritionists.
Part of the problem has always been the mystery that is the unplumbed depth of the intestinal tract. Just as our oceans are unknown to us relative to the dark side of the moon, the lowly intestinal tract is teeming with populations of creatures that outnumber our own cells ten to one. While their populations and diversity astound us, it’s their complex biological machinations that really find us scratching our heads in amazement.
According to the proceedings from a recent veterinary conference, here’s a sampling of what they do:
“Microbes impact the maturation and maintence of the intestinal immune system, influence cell proliferation and facilitate energy salvage (eg, through conversion of nutrients to short chain fatty acids). The catalytic potential of the microbiota may contribute to (or detract from) health through production of beneficial (or detrimental) metabolites.”
If that sounds complex, that’s because it is. Let it suffice to say that bacteria aid in more than the simple digestion and absorption of foodstuffs and nutrients, respectively. Though they do that, too, of course.
OK so now that you have an inkling as to the role of intestinal bacteria, onto the explanation of therapeutic intestinal probiotics for pets. First up, here’s the current working definition of a probiotic according to the World Health Organization:
“[Probiotics are] live microorganisms which when administered in adequate amounts confer a health benefit on the host.”
The idea is that adding “good” bacteria will stimulate more “good” bacteria (the ones that are presumed to be associated with health benefits). In this way, the entire balance of the intestinal flora will be shifted toward the beneficial bacteria. Makes sense, right?
Lots of veterinarians think so, too. Many are recommending probiotics for any pet with symptoms of “bacterial imbalance” associated with unhappy symptoms of the aforementioned “irregulatity:” diarrhea, constipation, flatulence and sometimes vomiting. Sometimes the probiotics are offered on a short-term basis or short-term symptoms. For others with more chronic or chronically-intermittent symptoms, however, they may serve well as a lifetime stopgap for whatever underlying intestinal malady ails them.
They’ve been so successful (in many cases displacing the need for antibiotics and food trials) that the trend towards using probiotics in veterinary medicine is ramping up. And now that more companies are stepping forward with their own versions of probiotic supplements, the pet food reps are out in full force with their explanations and exhortations in tow to make sure all veterinarians consider their routine use. It’s a new probiotic world out there and we’re just beginning to scratch the surface of it.
Intestinal probiotics are usually formulated as oral supplements. Some come as capsules. Others as tasty chews. Still others are powdered and packaged in single-dose envelopes. Purina and Iams are big on their own products, Forti-Flora and ProStora. Indeed, I’ve used both to great effect. I’ve also used the Pet-Flora brand and found it to be equally as good. In fact, in my experience they’re all pretty much the same in terms of their efficacy.
But there’s a catch––as there always is. As the CVC proceedings (referenced above) explain,
“Probiotics and related compounds are not approved drugs and undergo no premarket approval process. As such, data supporting quality assurance, safety and efficacy for each product may not exist.”
Purina and Iams are quick to point out that theirs are safe, effective, quality controlled and subject to the same rigorous standards we’ve come to expect from their other products. They’re also the most well-distributed and safely packaged, which is why I’ll continue to use them.
Then there’s the other issue my clients have asked about: If this probiotic works, am I just masking the symptoms of a larger disease process? Do I risk killing bad bacteria arising from a chronic problem we should be addressing?
To any client who poses such intelligent questions I only have this to say: I don’t know for sure but we can always stop the probiotics and start looking for the true source of your pet’s ills. Food trials, blood tests, endoscopies, biopsies, etc. may be in order.
That’s about the time they start thanking the probiotics and administering them to their pets like communion wafers. A good thing? It’s better than a whole lot of other alternatives, I say.
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On the feline IBD list, Fortiflora is not vary popular at all. Several cats have not done well with it. The main theory is that the animal digest in it, which is pork and chicken based per communication with Purina, may not be a good option for cats with allergies to specific proteins.A small, more techy, minority that likes to do research on these things is not very wild about the use of enterococcus faecium as the probiotic of choice in Fortiflora. There are limited studies as to it's safety in animals and humans, including cases of antibiotic resistance (although this may or may not be common, and the cases we know of are not related to Fortiflora). Several months ago, a member's cat (who later died) had a raging infection. Three bacteria were found in the culture and the first one listed was enterococcus. To this day I don't think the owner ever understood the question I was asking her to ask her vet, or something got lost in the translation as the response from the vet didn't make sense based on the question that was asked. She was giving her cat antiobitics to fight this infection - if enterococcus was was one of the bacteria they were trying to fight, it didn't make sense to continue to give the cat Fortiflora. The cat had a feeding tube, but I don't know what type.
Proviable by Nutramax has gained a little attention on the list. Some use human grade probiotics, and others use products designed for pets but not veterinary products.
Jenny July 6th, 2009 02:08:18 PM
Dr. Patty, there's an old wive's tale passed around bulldog owners that a few tablespoons of plain yogurt in the dog's food prevents the digestive problems and flatulence so common to the breed.
Can you please shed some light on this - would it work, and how do the benefits compare to these brand probiotics?
Courtney July 6th, 2009 02:35:03 PM
I love the picture of the cat. You always pick such good ones to go with your articles. For what it's worth to add to what you have just said about probiotics.....I have a 4 year old standard poodle female. I know she will hate me for broadcasting this, BUT...when she was a younger dog, just starting out in her therapy dog (Delta Society) and READ dog career she was one gassy girl. She could make me want to jump out of a moving van or clear a nursing home hall or a classroom! Of course the 2nd grade boys we worked with really liked it when she did that, especially if she made "the noise' along with it..you know how boys are. I have always fed this dog excellent food (Innova) and supplemented with grated carrots, squash, sardines, canned salmon and those kind of things. She never got commercial dogs treats like pupperoni or the like, it was always apple slices or bits of cooked chicken. Forget the raw diet.....that was a total disaster! But figuring that maybe she had some kind of intestinal imbalance I started giving this dog plain yogurt or some plain kefir (couple tablespoons) on her morning feeding every day. That has been well over a year ago. The problem seems to be totally under control (well with the exception of an occasional little toot, but its normally minue the "perfume". I also have a 5 month old pygmy goat and a 6 month old nigerian dwarf. After I got each of those little guys I had some coccidia problems and the pygmy would worry me to death with looking bloated and scaring me to death that he had a rumen imbalance. I have heard that you don't raise goats...you raise rumens...and I believe that from my first experience with raising pet goats in confinement. I have had much much less trouble with them since I have made it an evening ritual to mix B vitamins with a tablespoon full of plain yogurt and give this to them. I felt like maybe they can use the good bugs to balance out the rumen bacteria while they are resting overnite. But I have no idea if this is actually whats going on, or if they are just older and the rumen is more functional now. Thank you for all your effort with your immensely informative and extremely entertaining posts! I don't know how you have the time to keep it up but THANK YOU
Arriss July 6th, 2009 03:13:28 PM
Arriss: Ah, yes, the goats. I do raise rumens (and ruminants). My contribution to global climate change is astounding when I feed too much grain. Kept at a minimum and kept on lots of basic forage, instead, they do great. No bloated rumens. Green is good. ;-)
Dr. Patty Khuly July 6th, 2009 04:30:07 PM
Courtney: Plain yogurt contains Lactobacillus acidophilus cultures, a probiotic widely regarded to be among the most beneficial for the intestinal flora. Yes, it can be helpful, especially if you use Activia or other brands that have extra cultures.
As Jenny intimates, however, the mix of different kinds of bacteria found in the probiotic supplements veterinarians recommend is varied and aimed at an individual species' bacterial makeup. That's why we tend to prefer to use these instead of just plain yogurt. But if yogurt works...do it!
Dr. Patty Khuly July 6th, 2009 05:07:22 PM
As for cats and yogurt, some like my kitty are very lactose intolerant. Not that you mentioned cats!
Jenny July 6th, 2009 05:52:06 PM
Jenny: Not that I mentioned dogs, either. ;-) I was trying to be very species neutral in this post since intestinal probiotics work well for both cats and dogs.
Dr. Patty Khuly July 7th, 2009 10:04:18 AM
My kitty is on Prozyme, after an acute bout of pancreatitis left her with watery stool. It helped from the first dose.
alh July 7th, 2009 12:28:58 PM
I've got a picky, technical question about "probiotics". How do these organisms survive the stomach acids in enough quantity to actually reach the intestines?
Heather in Miami July 7th, 2009 09:50:55 PM
Heather: The stomach acids are great for continuing the digestion process that begins in the mouth, but they're nowhere near strong enough to kill most bacteria as they make their way past over a short period of time. If they were, they'd probably kill the lining of the stomach, too.
Dr. Patty Khuly July 8th, 2009 08:28:11 AM
Courtney -
I have bullies and have used yogurt before. It really didn't make a difference for mine (but i still give it as an occasional treat since they like it).
But i do have some bully friends that have done well with the yogurt.
Do the Iams and Purina probiotics only come from a vet? or are they something i could order offline or find at Petsmart?
Sarah July 9th, 2009 12:04:54 PM
Dr K -
I am a fourth year vet student in clinical rotations, and I recently had a client who threw a hissy fit after I informed her that we'd be sending her cat home on cephalexin (after orthopedic surgery, with an implant! as is often our policy). She remarked that she'd be loading up on probiotics, implying that the abx we were giving were doing far more harm on the GI system than good in protecting infection. To be honest, I thought she sounded kind of silly/over-reactive ("Just take the stupid pills, lady!")... but I'm wondering if I'm the one being ignorant - especially as I can't sympathize with having GI issues after a long course of antibiotics! Do you think that probiotics should become a standard of care for our patients going on antibiotics? I personally think giving the probiotics at the same time as abx seems to defeat the purpose but that giving instructions to "give abx for ___ days and then give probiotics" would raise issues of compliance, and so on. Thoughts?
Meagan July 9th, 2009 06:58:57 PM
Dr K-
First off, I want to say I love reading your posts. They are insightful and humorous (and I love your dry humor, too).
I have a 9mos old pup that has chronic GI problems. I've spent the first 8 months of his life fighting off various protozoans he would pick up somehow (I still don't know how, we never went to places that are usual culprits, but that's for another post) and now we have a bacterial enteritis diagnosis. We are doing 10 days of Flagyl. I guess I'm digressing again. My point is, there was actually a whole month we didn't go to the vet with nasty diarrhea, thanks to probiotics I've been supplementing his food with, and when it didn't "work" (for lack of a better word) I knew we had a problem.
The only thing I can determine is that when I've taken him to a doggie day camp (to burn off energy & socialization), he develops diarrhea almost the next day. As far as I know, they do not give him any types of treats up there and treats at home are few and far between. If they do get treats, it's from Old Mother Hubbard or similar and not Pupperoni, Beggin Strips...etc...etc....His food is fine, nothing special or recent changes to note.
Is it possible that he (again, lack of better words) has "too" much fun up there and that gets his apparent delicate GI tract off balance and thus, causes the bacterial enteritis?
But also, I've noticed, otherwise, the enzyme and probiotic supplement I add to his food as been a godsend to help my poor boy digest his food. Plus, it seems that since he's able to better digest his food, he doesn't seem as itchy as before I started. I too, worry, that I'm covering up a greater problem, but until I can figure it out, I'll do whatever I need to do. :)
Stacey July 14th, 2009 12:53:05 AM
Dear Dr. K
One of my GSPs ingested some awful thing in the woods (carrion of some kind), and developed severe dysentery which. The vet put him on a course of meta.... (some antibiotic). He is also Giardia positive (I adopted him through rescue).
After a week without improvement and two more veterinary visits (ugh!!), his rich liver-colored markings became orange-tinged. It was clear to me he was becoming nutritionally compromised. I searched online and determined he developed 'leaky gut synrome' from the course of antibiotics. I immediately supplimented his diet with yogurt and tablet probiotics and within a few days his beautiful liver spots became orange-tinged and his stools became formed.
Currently, I go through four quarts of organic yogurt consumed by all four dogs! It's part of their daily ritual :)
Lisa H. July 17th, 2009 09:17:41 AM
My 13 year old cat has been fighting constipation for 2 years now. He spent the last 3 days in ICU getting enemas......and he still didn't poop. He has been home for a day and there is still no poop. Needless to say he stopped eating about a week ago. We are keeping a close eye on him to make sure there are no further complications. This is the worse he has been due to the constipation. But, we have been dealing with this for 2 years now.....about twice a month he gets backed up enough to vomit for a day or two and then we would give him the lactulose (sp??) and he would improve. We started to give the lactulose twice a week to prevent the constipation and it seems to work most of the time. This is the current treatment our vet would like to use. My question: What probiotic would you recomend we try to get him some long deserved reliefe? We are willing to try anything. I have the same question in to my vet but figured you seem to know a bit about this and may have some insight.
Sue July 23rd, 2009 04:05:41 PM
Yogurt actually contains very small amounts of lactose compared to other dairy products such as milk. The live bacterial cultures in the yogurt also produce lactase which helps to digest the lactose. Most lactose intolerant people, and my two cats , can eat yogurt without any problems. Plain greek yogurt is best, in my opinion, because it doesn't contain thickening agents or coloring. I think plain yogurt is a great dietary supplement for people, dogs and cats!
Debbie August 12th, 2009 07:32:23 PM
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