Probiotics: Are they the Free Ride to improved Gut health?

I was recently up at Lake Gaston visiting some friends over the weekend.  Sunday morning ham biscuits are a special treat at a lakeside eatery, so my friend took the Jet Ski  for lakeside delivery to the guests. Much to my surprise his dogs love to ride the Jet Ski.

Riding the wave of natural health supplements are pre- and probiotics. There are millions of bacteria that happily live in  harmony within the intestines of normal, healthy animals. They  aide in the digestion of food and help maintain proper metabolism while supporting healthy  immune systems.  Research has shifted from focusing exclusively on illnesses created by bad bacteria to how good bacteria may benefit the body. As a result, many veterinarians prescribe supplements containing friendly bacteria probiotics or fiber-laden prebiotics to alleviate GI upset such as diarrhea, vomiting, gas, and bloating. The question remains are they superhero supplements or a free ride on other factors?

I AM CONFUSED, AS TO THE MEANING OF PREBIOTICS?

These are non-digestible, fibers that are fermented by intestinal bacteria that selectively provide carbohydrate energy for beneficial bacteria in the gut.   Examples include chicory, beet pulp, and fructooligosaccharide (FOS). FOS occurs in fruits and vegetables such as bananas, onions, garlic, leeks, chicory root, asparagus, wheat, barley, tomatoes, and Jerusalem artichoke.

HOW ARE BACTERIAL PROBIOTICS UTILIZED? 

 When ingested, these living microorganisms replenish beneficial bacteria in your pet's intestinal tract and enhance digestive function. According to the hype, these bacterial products can improve the immune system, improve gastrointestinal function, and do any number of other things just short of walking your dog! After being consumed, it is theorized they help to support production of important vitamins B and K, aide in producing folic acid and biotin, promote mineral absorption,  and provide a defense from stress in debilitated or shelter animals. In addition, there are claims of improved oral health, less gas, and a counter balance to the side effects of antibiotic therapy. They also claim to give balance to bad bacteria overgrowth in the gut (dysbiosis). Claims of less shedding  and a better coat are mentioned as well. 

WHY IS THE INTESTINAL TRACT SO HYPED CURRENTLY IN ITS ROLE OF BODY DEFENSE?

The intestines are seen as the largest guardian against bad diseases since most infections enter the body through the gut. It is speculated that probiotics are a positive influence on that protective mechanism.

WHAT ARE SOME OF THE CHALLENGES OF PROBIOTIC MANUFACTURERS?

Survivability of the  probiotics bacterial products is a huge concern as many are lost during storage. The next concern is making sure they are not inactivated by stomach acid before they can colonize the small intestine (addressed by encapsulation and a large variety of bacteria in the capsule). Usage may be short term or long term depending on the natural gut bacteria adaption to overcoming the issues.

ARE THEY REGULATED?

NO, nutraceuticals face no significant scrutiny by the FDA.

WHAT ARE THE CURRENT PRODUCTS RECOMMENDED BY VETERINARIANS?

NUTRAMAX PROVIABLE-DC®

Ingredients: Contains active cultures of Bifidobacterium bifidum, Enterococcus faecium, Enterococcus thermophiles, Lactobacillus acidophilus, Lactobacillus bulgaricus, Lactobacillus casei and Lactobacillus plantarum. Also contains prebiotics, which are complex carbohydrates (such as fructooligosaccharide) that help improve function of the large intestine. Open a capsule and sprinkle on slightly moistened food daily or administer the capsule directly. They are hypoallergenic. My dog Taco Belle takes one a day.

 PURINA FORTIFLORA®

Ingredients: The main type of beneficial bacteria present is called Enterococcus faecium SF68. Other beneficial ingredients include vitamin E, vitamin C, brewer’s yeast, beta-Carotene and minerals. Fortiflora is given by mouth once a day.

VETRI-SCIENCE VETRI MEGA PROBIOTIC® 

Ingredients: Contains active cultures of Bifidobacterium bifidum, Enterococcus faecium, Lactobacillus brevis, Lactobacillus acidophilus, Bifidobacterium longum, Lactobacillus casei and Lactobacillus plantarum. Also contains a prebiotic called fructooligosaccharide that helps improve function of the large intestine.

IAM’S PROSTORA MAX

 Ingredients: Contains a special strain of Bifidobacterium animalis that kills the disease-causing bugs salmonella and Clostridium difficile in laboratory studies.

Over-the-counter human products including culturelle or VSL#3  are suggested for clients that choose not to use the veterinary products.

Betsy T. Sigmon, DVM, Diplomate American Board of Veterinary Practitioners, Canine&Feline

Creature Comforts Animal Hospital

Cary, NC

Heart Disease: Mitral Valve Insufficiency (regurgitation) in Dogs

A very dear veterinary colleague underwent mitral valve replacement surgery this week in a rather prolonged procedure. He had his valve replaced with a pig valve rather than an artificial one for the simple reason he did not want to be on blood thinners the remainder of his life. The surgeon theorized eight to 10 years of longevity for the implanted valves. What are the options in dogs when this same valve failure?

What is the mitral valve of the heart and the association with congestive heart failure?

There are four chambers of the heart. Each one has a valve to keep blood flowing in one direction. On the left side of the heart the upper atrium is separated from the lower ventricle by the mitral valve. When this valve begins to deteriorate, blood backs up to the upper left heart (atrial) chamber causing it to gradually enlarge. Eventually this will lead to fluid accumulation in the lungs. See more at: http://www.akcchf.org/canine-health/your-dogs-health/disease-information/mitral-valve-disease.html#.dpuf

How does a veterinarian detect a valve is deteriorating and the concern?

One of the more common findings is the detection of a heart murmur (think "rap song beat") with a stethoscope. 

Are there some common factors associated with this disease?

Greater than 1/3rd of small/ toy breeds around 10 years of age or older will acquire this disease, although it is possible in any breed. The percentage rises up to 75 percent at 16 yeara of age. Cavalier King Charles Spaniels appear to have an increased risk.

Since most pet owners do not keep a stethoscope at home, are there potential signs in dogs at risk?

-coughing, especially after laying down

- sleeping more or having difficulty sleeping

- panting, difficulty breathing, and increased respiratory rate

- fainting or collapse

Does the intensity of the heart murmur correlate with the severity of the valve deterioration?

No

Once a heart valve condition is suspected, what are the next steps?

Chest radiographs (x-rays), bloodwork, blood pressure, and sound waves (echocardiogram) are recommended. These may be performed at Creature Comforts or by referral to a veterinary cardiologist.

What are the stages of heart disease with a murmur classified by veterinary cardiologists?

Stage A: murmur and no other signs- recheck every 6 to 12 months

Stage B1: radiographic changes- recheck every 3 to 9 months 

Stage B2: cough, elevated heart rate, and often an irregular heart beat- start medication and recheck within 2 weeks then every 3 to 6 months

Stage C: early onset heart failure, possible collapse adding maximum drug therapy 

Stage D: end stage heart failure, cage rest and possible oxygen therapy initially, with a guarded prognosis

Can mitral valve disease be treated in dogs?

While mitral valve disease cannot be cured there are protocols that may extend life a year or longer based on the degree of damage when treatment is initiated. These include medications, exercise, and a healthy diet.

What are these medications?

- diuretic to remove fluid from the lungs via the kidneys(ex. Furosemide )

-an angiotensin converting enzyme (ACE) inhibitor, to dilate arteries and veins increasing blood flow (ex. Enalapril or Benazepril)

-medication to lower heart rate leading to increased strength of each heart contraction (pimobendin)

Are there other condition(s) that hasten the onset of heart disease?

Severe dental disease harbors bacteria that can get to the blood stream and setting up bacterial infections of the heart valves and sudden death. It is very important that heart patients or dogs at risk maintain a healthy mouth.

Betsy Sigmon DVM, Diplomate American Board of Veterinary Practitioners, Canine & Feline

Creature Comforts Animal Hospital 

Cary, NC

Many thanks to Soho Dettelbach for sharing her New York moment.