Microbiome-Centric Interventions for Pet Health Conditions

Microbiome-Centric Approach to Diarrhea

The gut microbiome plays critical roles in digestion, nutrient absorption, and host health.

Maintaining or restoring the health of the gut microbiome can help prevent and manage many gastrointestinal disorders.

Putting microbiome science into practice for gastrointestinal health

Probiotics can mitigate antimicrobial effects on the gut microbiome

The science

Antibiotics such as metronidazole and amoxicillin-clavulanate alter the microbiome, and these changes may persist after discontinuation of the antibiotics.^1,2

The administration of the probiotic strain E. faecium SF68 in combination with a therapeutic diet specifically formulated for intestinal disorders improved diarrhea after 14 days in dogs with clinical signs consistent with small intestinal bacterial overgrowth or antibiotic-responsive diarrhea, compared to the therapeutic diet alone.⁵

The probiotic strain Enterococcus faecium SF68 is unaffected by metronidazole, an antibiotic commonly used to treat dogs with diarrhea.⁶

Supplementation with E. faecium SF68 during the administration of amoxicillin-clavulanate to cats resulted in fewer cats developing severe diarrhea, improved fecal consistency, and lower total diarrhea score compared to cats administered a placebo.²

Use of a synbiotic (Enterococcus faecium SF68 and psyllium) reduces the severity of diarrhea and may decrease time to resolution for feline diarrhea associated with the administration of amoxicillin-clavulanate.⁷

Putting the science into practice

Antibiotics such as metronidazole and amoxicillin-clavulanate can have long-lasting, negative impacts on the microbiome, and their use should be avoided unless necessary and with the principles of antimicrobial stewardship in mind.^3,4

For dogs with clinical signs consistent with antibiotic-responsive diarrhea or small intestinal bacterial overgrowth, the probiotic E. faecium SF68 combined with a therapeutic diet improves diarrhea without the administration of antibiotics. Consider trying this approach before administering antimicrobials to these cases.

Metronidazole does not inactivate the probiotic E. faecium SF68, making the probiotic suitable for co-administration. When administering amoxicillin-clavulanate to cats, the administration of E. faecium SF68 or a synbiotic (E. faecium SF68 and psyllium) helps mitigate diarrhea.

Probiotic can reduce flatulence

The science

Supplementation of dogs’ diets with E. faecium SF68 significantly reduced the number of flatus events/emissions and the maximum amount of hydrogen sulfide released.⁸

Putting the science into practice

When a client complains about their dog’s flatulence, consider administering a course of E. faecium SF68 to reduce frequency and malodor.

Probiotic can reduce diarrhea in kittens

The science

Supplementation with the probiotic strain E. faecium SF68 was associated with lower incidence and duration of naturally occurring diarrhea, higher serum IgA antibody levels in kittens.⁹

Putting the science into practice

Administering the probiotic E. faecium SF68 can reduce diarrhea in kittens.

Prebiotics enhance gut health

The science

The inclusion of chicory in dogs’ diets increased Bifidobacterium species and improved digestibility of the diet. The response was variable, with some dogs responding within 7 days but others requiring 21 days.¹⁰

Dogs fed chicory or fructooligosaccharides (FOS) had significantly more fecal Bifidobacteria, fewer fecal Clostridia, and increased levels of beneficial short-chain fatty acids.¹¹

Supplementing senior dogs’ diets with prebiotics (inulin, mannan-oligosaccharide alone or in combination) improved fecal scores and produced beneficial shifts in the microbiome.¹²

Putting the science into practice

Prebiotics (such as inulin and fructooligosaccharide) can improve microbiome balance and food digestibility and increase the production of beneficial short-chain fatty acids. Allow at least 3 weeks to determine efficacy of the dietary change.

Probiotic enhances microbiome balance

The science

Dogs fed a dry diet supplemented with the probiotic Bacillus coagulans GBI-30 6086 (BC30) increased fecal microbial diversity and richness compared to placebo-fed dogs, and maintained a negative dysbiosis index consistent with a healthy microbiome.¹³

Cats fed a dry diet supplemented with the probiotic Bacillus coagulans GBI-30 6086 (BC30) showed increased fecal microbial diversity consistent with a balanced fecal microbiome.¹³

Putting the science into practice

Dry diets supplemented with the heat-stabile probiotic Bacillus coagulans GBI-30 6086 (BC30) can improve microbial balance in the gut microbiome.

Probiotic and synbiotic address diarrhea in adult dogs and cats

The science

The administration of E. faecium SF68 suggested an enhanced treatment effect compared to metronidazole alone. Dogs on dual therapy had significantly greater percentages of days with normal stool; a numerically higher percentage of dogs with normal stool on Day 7; and numerically lower diarrhea severity scores on Days 5-7.⁶

Use of a synbiotic resulted in a presumed beneficial effect on the dogs’ microbiome and a decrease in the prevalence of diarrhea in training sled dogs. Fewer days of diarrhea were observed when a presumed contagious outbreak of diarrhea was observed in the dogs supplemented with the synbiotic during Week 5 of treatment, further suggesting a beneficial effect.¹⁴

Shelter cats supplemented with E. faecium SF68 had fewer episodes of diarrhea of 2 or more days’ duration when compared to placebo-fed cats.¹⁵

Putting the science into practice

When metronidazole is administered, providing the probiotic E. faecium SF68 can enhance the treatment effect.

Synbiotics may reduce the prevalence and duration of diarrhea – including contagious diarrhea – in dogs.

The probiotic E. faecium SF68 can reduce the duration of diarrhea in cats.

Probiotic safe for use in dogs with liver disease

The science

Short-term administration of the probiotic strain E. faecium SF68 did not alter the levels of two primary liver enzymes and did not produce clinically relevant changes in cholesterol or triglyceride concentrations. This indicates the probiotic would not affect levels of these enzymes when administered to dogs with liver disease, and may be the probiotic of choice in dogs with liver disease.¹⁶

Putting the science into practice

The probiotic E. faecium SF68 does not alter liver enzymes, cholesterol or triglycerides, making it safe for use in dogs with liver disease.

Probiotics offer benefits for shelter medicine

The science

The administration of E. faecium SF68 suggested an enhanced treatment effect compared to metronidazole alone. Shelter dogs on dual therapy had significantly greater percentages of days with normal stool; a numerically higher percentage of dogs with normal stool on Day 7; and numerically lower diarrhea severity scores on Days 5-7.⁶

Shelter cats supplemented with E. faecium SF68 had fewer episodes of diarrhea of 2 or more days’ duration when compared to placebo-fed cats. The percentage of cats with diarrhea was significantly lower in the SF68 group compared to the placebo group (7.7% vs 20.7%, respectively). Decreasing the prevalence of diarrhea could indirectly save shelters time and money, as well as improve animal welfare and likelihood of finding a home.¹⁵

Shelter cats supplemented with the probiotic Bacillus coagulans GBI-30 6086 (BC30) showed a significant decrease in diarrhea and an improvement in fecal scores.¹³

Putting the science into practice

Administration of the probiotic E. faecium SF68 can reduce the prevalence and duration of diarrhea in shelters. Decreasing the prevalence of diarrhea and shortening treatment times could indirectly save shelters time and money, as well as improve animal welfare and likelihood of finding a home.

MICROBIOME-CENTRIC APPROACH TO BRAIN HEALTH

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Belas, A., Marques, C., & Pomba, C. (2020). The gut microbiome and antimicrobial resistance in companion animals. In Duarte, A. & Lopes da Costa, L. (Eds.), Advances in Animal Health, Medicine and Production (1st ed.), pp. 233–245. Springer International Publishing
Torres-Henderson, C., Summers, S., Suchodolski, J., & Lappin, M. R. (2017). Eﬀect of Enterococcus faecium strain SF68 on gastrointestinal signs and fecal microbiome in cats administered amoxicillin-clavulanate. Topics in Companion Animal Medicine, 32(3), 104–108. doi:10.1053/j.tcam.2017.11.002
American Animal Hospital Association. Judicious therapeutic use of antimicrobials in cats and dogs. https://www.aaha.org/aaha-guidelines/use-of-antimicrobials-conﬁguration/judicious-therapeutic-use-of-antimicrobials-in-cats-and-dogs/. Accessed March 26, 2021.
American Veterinary Medical Association. (2016). Antimicrobial stewardship in companion animal practice. https://www.avma.org/resources-tools/reports/antimicrobial-stewardship-companion-animal-practice-2016. Accessed March 26, 2021.
Rallis, T. S., Pardali, D., Adamama-Moraitou, K. K. & Kavarnos, I. (2016). Eﬀect of Enterococcus faecium SF68® (FortifFlora®) administration in dogs with antibiotic responsive or small intestinal bacterial overgrowth diarrhoea. Hellenic Journal of Companion Animal Medicine, 5(2), 13–16.
Fenimore, A., Groshong, L., Scorza, V. & Lapppin, M. R. (2017). Evaluation of metronidazole with and without Enterococcus faecium SF68 in shelter dogs with diarrhea. Topics in Companion Animal Medicine, 32, 100–103. doi:10.1053/j.tcam.2017.11.001
Kiene, J. A., Dobesh, K., & Lappin, M. (2020). Use of a synbiotic for treating antibiotic-induced diarrhea in cats. Journal of Veterinary Internal Medicine, 34, 2902. doi:10.1111/jvim.15904
Waldron, M., Kerr, W., Czarnecki-Maulden, G. & Davis, J. Supplementation with Enterococcus faecium SF68 reduces ﬂatulence in dogs. Presented at: International Scientiﬁc Congress of the European Society of Veterinary and Comparative Nutrition; September 2012; Bydgosczc, Poland
Czarnecki-Maulden, G. L., Cavadini, C., Lawler, D. F. & Benyacoub, J. (2007). Incidence of naturally occurring diarrhea in kittens fed Enterococcus faecium SF68. Compendium: Continuing Education for Veterinarians (Supplement), 29 (2A), 37.
Czarnecki-Maulden, G. L., & Patil, A. R. The eﬀect of trial length on canine fecal microﬂora response to chicory ingestion. Presented at: Joint Nutrition Symposium; August 2002; Antwerp, Belgium
Czarnecki-Maulden, G. L., & Russell, T. J. (2000). Eﬀect of chicory on fecal microﬂora in dogs fed soy-containing or soy-free diets. Federation of American Societies for Experimental Biology Journal, 14(4), A488.
Grieshop, C. M., Flickinger, E. A., Bruce, K. J., Patil, A. R., Czarnecki-Maulden, G. L. & Fahey, G. C. (2004). Gastrointestinal and immunological responses of senior dogs to chicory and mannan-oligosaccharides. Archives of Animal Nutrition, 58(6), 483–493.
Internal data, publication anticipated 2021 or 2022.
Gagné, J. W., Wakshlag, J. J., Simpson, K. W., Dowd, S. E., Latchman, S., Brown, D. A.,…Fahey, G. D. (2013). Eﬀects of a synbiotic on fecal quality, short-chain fatty acid concentrations, and the microbiome of healthy sled dogs. BMC Veterinary Research, 9, 246. doi:10.1186/1746-6148-9-246
Bybee, S. N., Scorza, A. V., & Lappin, M. R. (2011). Eﬀect of the probiotic Enterococcus faecium SF68 on presence of diarrhea in cats and dogs housed in an animal shelter. Journal of Veterinary Internal Medicine, 25(4), 856–60. doi:10.1111/j.1939-1676.2011.0738.x
Lucena, R., Novales, M., Blanco, B., Hernández, E., Ginel, P. J. (2019). Eﬀect of probiotic Enterococcus faecium SF68 on liver function in healthy dogs. Journal of Veterinary Internal Medicine, 33, 2628–2634. doi:10.1111/jvim.15625