Probiotics vs. prebiotics vs. synbiotics  

Acute diarrhea, chronic enteropathies, and gastroenteritis are common conditions in small animal clinical practice. Because they affect the gastrointestinal system, they often require the use of products that can help restore the intestinal microbiota. 
 

Among these, the prescription of probiotics, prebiotics, or synbiotics is common, but there are still many doubts regarding the difference between these three alternatives, which have a similar purpose but are not the same. 

According to Larissa Nonato, a veterinary doctor specializing in Gastroenterology, Intensive Care and Emergencies, a member of the FeroGastro Team and director of the Brazilian Association of Animal Gastroenterology (ABRAGA), these products have various indications. 
 

'They are recommended for maintaining the animal's well-being. They can be used as adjuvant therapies in cases of diarrhea (gastroenteritis), dietary changes (intestinal adaptation), and other immune system stimulation in any chronic disease. Furthermore, there is recent evidence of probiotics having a positive effect in the treatment of oral disease, pruritus, seizures, and other conditions that, at first glance, are far removed from the intestines,' he reports. 
 

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Furthermore, Larissa comments that in recent years studies of the gut microbiota have improved considerably. Therefore, it is now possible to understand the particularities of the microbiota of dogs and cats, as well as the differences between puppies and adults. As a result, products designed to support its proper functioning are being improved.

The differences in practice  

It's not difficult to understand the function of probiotics, prebiotics, and synbiotics. The expert clarifies that probiotics contain bacteria considered desirable for the gut microbiota, and these microorganisms are responsible for regulating immunity and the overall health of the intestines.
 

Probiotics began to be given to animals in the early 1970s with Lactobacillus acidophilus. They are most commonly and efficiently used during stressful times, such as the weaning period, during changes in diet, in cases of colostrum intake failure, and after antibiotic treatments, for example. 
 

"Prebiotics, on the other hand, are elements that nourish and feed the microbiota. In other words, they provide substrate for the microbiota present in the intestines. They are generally composed of low-calorie sugars," he says.
 

Basically, prebiotics exert an osmotic effect in the gastrointestinal tract, while not being fermented. The most commonly used in animals are mannan-oligosaccharides (MOS), fructooligosaccharides (FOS), and galactooligosaccharides (GOS). 
 

On the other hand, synbiotics are products that contain both probiotics and prebiotics in the same formulation, and are considered more complete.
 

'Generally, the same patient can receive a prebiotic, a probiotic, or a synbiotic. Which alternative to choose depends on the animal's needs and the ease of handling,' says Nonato.  
 

Furthermore, the use of prebiotics in combination with probiotics presents superior beneficial effects compared to antibiotic growth promoters. Among the main reasons for this are the fact that they are not metabolized or absorbed during passage through the upper digestive tract, they serve as a substrate for one or more beneficial intestinal bacteria, and they have the ability to alter the intestinal microbiota in a favorable way.

How to prescribe

According to the expert, a major advantage of these solutions is that they can be used from the weaning stage of dogs and cats, as after this period the animals will have a more defined intestinal microbiota.
 

Regarding contraindications, to date there is no scientific evidence that advises against their use. However, there is greater confirmation of the therapeutic efficacy of prebiotics compared to probiotics.
 

Regarding the presentations, since there are now options in powder, paste, and tablet form, Larissa says there are no recommendations as to which is best. 
 

"The most traditional and studied products in human health are those in powder or capsule form. However, in veterinary medicine, the most popular presentation is oral paste, which facilitates administration at home due to its greater palatability," he says. 
 

Another important point is that there is no evidence indicating a best time or the need for fasting for probiotics, prebiotics, and synbiotics to be more effective.
 

"The studies are heterogeneous and the results vary. Therefore, it is up to the veterinarian to determine the time to administer the product. However, it is believed that the nighttime period, especially after a meal, is the most suitable time for the probiotics to remain longer in the gastrointestinal tract (oro-fecal). However, all of this is just a theory," he concludes.

Source: Cães e Gatos