Probiotics are common in today’s horse industry and human health. \u00a0They are heavily marketed for supporting gastrointestinal health on many levels.\u00a0 Are they truly beneficial to the horse, or is it all hype? There are many types of probiotics promoted in various products, but unfortunately, they are all lumped together and promoted as being beneficial, which can further muddy the waters.\u00a0 Then, there are prebiotics, which do not gain as much attention in the marketplace or world of equine health.\u00a0 So how do you know if you need to use them in your horse and if so, which ones are most beneficial? The answer to this question lies not only within research but also through clinical experience. \u00a0<\/p>\n
To open the discussion, we must first apply some basic definitions:<\/p>\n
1. Probiotics:<\/strong> \u00a0Live microorganisms when administered in adequate amounts provide health benefits to the host<\/p>\n 2. Prebiotics:<\/strong> A chemical or food ingredient which can promote the growth of microorganisms, which can be anywhere including the gastrointestinal tract.<\/p>\n The two main groups or classifications of prebiotics include specific sugar molecules and fiber, which not only provide energy sources for the bacteria but can also assist in creating a more favorable environment for their growth. \u00a0Specific oligosaccharides and inulin are the two main accepted prebiotics by most authorities. \u00a0In other cases, we also have nutrients provided through various foods that may also serve as direct substrates for bacterial growth. \u00a0Natural sources of prebiotics include chicory root, artichoke, dandelion, onion, garlic, oats, apple pectin, aloe gel, and many types of fruits, including blueberries. \u00a0The use of prebiotics in the diet have been found to be beneficial in numerous human health conditions helping to reduce risk of hypertension, inflammatory bowel disease, immune related conditions and even colorectal cancer. 1\u00a0<\/sup><\/p>\n Given the findings in human medical research, which includes animal or rodent studies, it just makes sense that those benefits would transfer to the horse…and they do!<\/p>\n Probiotics are numerous and involve many different strains of bacteria, some of which have research merit, while others do not. In the equine industry, a quick search of Pubmed.gov<\/a> indicates 23 articles with the terms “horse probiotics” ranging from 1997-2014. \u00a0This number of articles is not high as compared to the human search equivalent which yielded over 8500 articles. \u00a0In actuality, much of the supporting research regarding probiotic usage is geared towards humans and not so much towards horses or even pets. \u00a0Given this, the use of probiotis in horses specifically is more extrapolated from human data.<\/strong><\/p>\n Probiotic usage has been shown to alter populations of bacterial populations within the gastrointestinal tract, with research studies showing increased populations of Lactobacillus<\/em> or Bifidobacteria<\/em>, which are commonly used in probiotics. In reality, the increased level of those specific bacteria actually equates to altered populations and not necessarily improved ‘bacterial balance’ as proposed by probiotic supplement manufacturers. \u00a0There is actually little to no scientific data which demonstrates what a healthy bacterial population should be, so given the changes in these levels due to probiotic usage, we are actually uncertain as to what this really means. \u00a0Evaluating the studies that exist, probiotic usage may actually promote a change back towards a positive balance when a challenge is presented to the body, such as antibiotic usage or other stressful event, but in regards to supporting overall bacterial balance back towards normal, it is uncertain. \u00a0When it comes to specific species of probiotics, we have to keep in mind that there are many strains within that species and just because one study shows one strain to be effective or beneficial at one dose, does not mean that other strains of that same species will as well.1<\/sup><\/p>\n The horse’s intestinal tract is home to an abundance of diverse bacterial, fungal and protozoal species.<\/strong> \u00a0It is true that often a single pathogen such as Clostridium<\/em> or Salmonella<\/em> species can create upset and clinical disease, but in fact, most clinical health problems are actually associated with an imbalance or dysbiosis overall. This dysbiosis in horses has been connected with a range of clinical problems from colitis to grass sickness, metabolic problems and laminitis. \u00a0It has been noted that the bacterial flora for each horse is unique and can vary, but often there are predominant species that are present including Firmicutes<\/em>, Bacteriodetes<\/em>, Proteobacteria<\/em>, Verrucomicrobia<\/em>, Actinobacteria<\/em> and Spirochaetes<\/em>. It is interesting to note that some species will change in their populations between healthy and diseased horses, for instance Clostridial<\/em> species, which tends to be more prevalent in healthy versus diseased patients, which indicates a level of importance of this species for overall health.<\/p>\n Lactobacillus<\/em> species, interestingly, did not show a change in levels between healthy and diseased equine patients. However, in some studies evaluating metabolic and laminitic patients, Lactobacillus<\/em> species tended to show higher than normal levels. This is a noteworthy point as Lactobacillus species are one of the main probiotics promoted for use in horses.<\/strong>\u00a0 Here is a study<\/a><\/strong><\/span> that we conducted at Nouvelle Research on Lactobacillus overgrowth in the horse feces. Given the information that levels of this species did not change between health and disease, and may actually be more prevalent in metabolic and laminitic patients, the question has to be raised regarding whether or not supplementation is worthwhile. \u00a0Even more, one could raise the question, given the high use of the Lactobacillus<\/em> species in equine feeds and supplements, that maybe we might be contributing to a problem more so than resolving one? 2,3<\/sup><\/p>\n The bacterial species used in most probiotics in the equine industry actually make up less than 1% of the entire microbial population within the gastrointestinal tract.<\/strong> \u00a0Species including Lactobacillus<\/em>, Bifidobacteria<\/em> and Enterococci<\/em> are all common sources of probiotics for the horse, which actually make up a small percentage of overall bacteria within the hindgut. Given this low level population normally, it makes more sense to focus on those bacteria that are highly represented including Firmicutes<\/em> and even Clostridia<\/em>l species, however data is lacking.2<\/sup><\/p>\n When it comes to probiotic usage, there is much concern not only over viability of that bacteria to survive the journey to its intended location, but also whether or not that bacterial species can colonize and further develop. \u00a0This can all be dependent and variable based on the strain of the bacteria and even the host species, being human or animal. \u00a0One area of concern is antibiotic resistance, which is genetically created within the probiotic bacterial species chosen. \u00a0Obviously, if an antibiotic resistant strain is selected and colonizes the host, then this could infer potential health problems down the road. In most cases with probiotics, we are more focused on colonization above survivability, meaning we not only want them to survive but to colonize and repopulate the area. \u00a0In several equine studies, colonization has proven difficult and detection of the chosen probiotic species in the feces of horses is only present during the course of administration, which infers poor colonization and a need for long term consistent administration.2<\/sup><\/p>\n The main goal of probiotics usage is to infer health or an improved state of health upon the host.<\/strong> \u00a0The ultimate question is what strain or strains of bacteria are beneficial, at what dose and what administration frequency? \u00a0Probiotics infer their health benefits to the host by improving digestion potentially and preventing overgrowth of harmful or pathogenic bacterial strains which may infer disease. \u00a0They do this by 4 main mechanisms:2<\/sup><\/p>\n Overall, we know that bacterial balance within the digestive tract is critical for health on many levels, however, each species (human or animal) is different and evidence for success of one strain in humans does not equate to same results in horses. \u00a0This can also vary further when evaluating an adult horse as compared to a foal, as microbial populations within the gut differ. \u00a0In the case of the horse, research data is weak and lacking. \u00a0What data is available is hard to decipher regarding overall efficacy as bacterial species vary as does the research model.<\/p>\n One area that has been evaluated in horses is acute enterocolitis or diarrhea, mainly using strains of Saccharomyce<\/em>s species of yeast, which demonstrated overall no distinct difference between treated and non-treated groups in regards to outcome, diarrhea recurrence or hospitalization stay. In one clinical study, the use of specific Lactobacillus<\/em> species did reduce fecal shedding of Salmonella in clinically affected horses by 65% compared to 25% in the non-treatment group. \u00a0When stepping back and evaluating gastrointestinal disease, especially diarrhea, we come to realize that many bacterial populations are potentiall impacted and the success through supplementing one specific species is unlikely to yield significant results.2<\/sup><\/p>\n The probiotic species, Saccharomyces<\/em>, has demonstrated some clinical results in regards to improved cellulose digestion and even stabilization of the microflora in the horse when challenged with stress.3<\/sup><\/p>\n The bacterial population of the digestive tract within the horse is a complex entity, involved potentially in many facets of health and even lameness. Disturbances or dysbiosis has been demonstrated in a variety of conditions ranging from colitis to metabolic syndrome, which helps us to see what drastic changes can infer regarding health. \u00a0Equine probiotics currently on the market promote the use of Lactobacillus<\/em> and other species, which are often noted to be of low levels normally in the healthy horse. In actuality, most strains of bacteria used in equine probiotics have little research data to support their use and more often are extrapolated from human research. \u00a0The problem here is that there are variables from human to animals, and thus, the data is not completely reliable, no to mention that most cases of dysbiosis involved many bacterial species, not just one.<\/strong><\/p>\n When it comes to probiotic usage in my personal patients, I have not found significant value in regards to bacterial based formulas. The one probiotic that we have used and still use, is Saccharomyces cerevisiae<\/em><\/a> which is yeast based and commonly associated with Brewer’s yeast. We have used Saccharomyces<\/em> in cases of overall poor digestion, hindgut concerns and even cases of poor hoof condition with good results as research does indicate its use improves cellulose digestion. In most of other cases, we were using the bacterial based probiotic formulas to help counter gastrointestinal disturbances including diarrhea, either as a primary problem or post antibiotic therapy.<\/p>\n Again, in our patients, there was often no difference in patient outcome between those that received the probiotics and those that did not, other than cost to the owner. \u00a0I do believe that bacterial dysbiosis exists, but that the current approach to therapy or resolution to the problem is not effective.<\/strong> \u00a0Could this be due to improper bacterial strains used, dose used or even therapy frequency…it is uncertain. \u00a0The one therapy that does seem to work in many patients, is fecal transfunation, which is the transfer of fecal contents by nasogastric tube from a healthy horse to a clinically ill patient. This type of therapy has been utilized for decades, not only in horses but in cattle and even humans. \u00a0I believe that the main reason for efficacy is the supplying of a more broad spectrum species of bacteria, more so than relying on just one or two strains, believing that they will remedy the situation.<\/p>\n Bacterial dysbiosis is complex in regards to how and why it happens. \u00a0It is something that is difficult to completely measure and compare from one patient to the next. \u00a0Horses in today’s society do have a high prevalence of ulcers and hindgut concerns, which can impart gastrointestinal symptoms such as diarrhea or may actually related to clinical problems outside of the GI tract including metabolic problems and laminitis. \u00a0I think that the first thing in these patients is to admit that there is a problem in this region, either through clinical testing or personal experience. \u00a0Once we admit there is a problem, then instead of trying to supplement with a probiotic, maybe we need to dig deeper and discover why the bacterial population may be out of balance.<\/strong> \u00a0Is there stress that needs to be controlled, which may influencing the problem or is there a dietary relation in which may be promoting certain strains to proliferate while impairing others? \u00a0I believe that if we step back and really dig deep, the results can be much better for the patient if we look for causes and resolve them to the best of our ability, rather than rely on unsubstantiated probiotics.\u00a0 One area of concern is leaky gut<\/strong><\/span><\/a> <\/span>in the horse and how this influences health and soundness. Given the high use of certain bacterial strains in the equine industry, not just present in probiotic supplements, but also in hoof supplements, stomach supplements and even feeds…we may be potentially overdosing on bacterial populations that really only represent a small percentage in the normal equine gut, which then may actually contribute to bacterial overgrowth or dysbiosis.<\/p>\n I have reviewed the research on probiotics and their usage, as well as our personal clinical experience.\u00a0 Bottom line is that I believe the jury is still out and the heavy overuse of the probiotics in the horse may be contributing to more health ailments.\u00a0 One thing is for sure, they certainly are not helping the current epidemic of metabolic related ailments in the horse, or in the person.<\/p>\n We have conducted over 900 fecal cultures<\/a> <\/strong><\/span>on horses to date, spanning a few year’s time.\u00a0 In most, there is an obvious dysbiosis or imbalance in the digestive microbiome, which often can be detected just by sight and smell.\u00a0 In most of these horses, the owners are overloading the animals on various supplements and often grains, which are all fortified to some extent with synthetic ingredients and additives.\u00a0 One thing that most are missing in their daily regimen is a good high quality forage, such as alfalfa or a legume mix.\u00a0 They are also lacking other whole foods, but instead are receiving vitamin-mineral supplements in their place.<\/p>\n When we take these horses and make dietary changes, including a change in forage, addition of whole foods, proper herbal choices, and eliminate all of the other things they are giving, the horses often make steady improvement on many levels.\u00a0 In repeat cultures, conducted generally less than 30 days later, the microbiome is beginning to shift back to a more balanced state.\u00a0 Given this, I have come to a few conclusions.<\/p>\n It is really that simple, but there are many facets to this creation or restoration of health.\u00a0 One has to be fully committed to changing the regimen, meaning that they alter the lifestyle and other factors additionally, as all things feed into the gut.\u00a0 It will not work if you implement a whole food regimen and forage change, but yet restrict the horse to a dry lot with no turnout or no exercise regimen.\u00a0 Things work together, period.\u00a0 So, in the end, the foods you select to feed your horse will affect their health.<\/p>\n Look at it like this.\u00a0 You desire to have a green lawn surrounding your house but nothing is growing or it is patchy and diseased.\u00a0 You could throw out various types of grass seed in hope that it will take hold, which is like seeding with a probiotic.\u00a0 In some areas, the seeds or probiotics may take root, but that new growth will not last unless it is properly nourished and that is through the prebiotic or fertilizer and lime that is placed on a lawn. You can seed all day long, or use probiotics every day, but unless you feed the gut or the lawn properly, nothing will truly take root.\u00a0 In reality, at least when it comes to the gut and digestive system, there is rarely a need to reseed it with probiotics.\u00a0 If you just stop hurting it through improper choices and instead feed it properly, the bacteria will often naturally rebalance themselves.<\/p>\n This is a complicated topic and I hope this information helps.<\/p>\n Options for whole foods and prebiotics:<\/p>\n Tom Schell, D.V.M.<\/p>\n Nouvelle Research, Inc.<\/p>\n www.nouvelleresearch.com<\/p>\n <\/p>\n References:<\/p>\n 1. Sanders, M. Probiotics; definition, sources, selection and uses. Clinical Infectious Disease; 2008; 46:S58-61<\/span><\/p>\n 2. Schoster, A et al. Probiotic use in horses; what is the evidence for their clinical efficacy? J Vet Internal Med. 2014;28:1640-1652<\/span><\/p>\n 3. Schell, T. Fecal Microflora and Dysbiosis: contribution to metabolic syndrome, inflammation and leaky gut. JAHVMA, 2015.<\/span><\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Probiotics are common in today’s equine industry and even human health. They are heavily marketed for supporting gastrointestinal health on many levels, but are they really needed and are they really beneficial? There are many types of probiotics promoted in various products, but unfortunately, they are all lumped together and promoted as being beneficial, which can further muddy the waters. So how do we know if we need to use them and if so, what types are most beneficial? The answer to this question lies not only within research but also through clinical experience. <\/p>\n","protected":false},"author":2524,"featured_media":8003,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[12],"tags":[1109,1108,208,1103,1104,207,1107,1105,204,1101,1106,1102,501,559],"class_list":["post-393","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-equine-articles","tag-colitis","tag-diarrhea","tag-equine","tag-gastrointestinal-disease","tag-hindgut","tag-horse","tag-how-to-chose","tag-lactobacillus","tag-nouvelle-research","tag-prebiotics","tag-probiotic-supplement","tag-probiotics","tag-tom-schell-d-v-m","tag-ulcers"],"yoast_head":"\nProbiotics in the Horse<\/strong><\/span><\/h3>\n
The Horse Digestive Tract and Microbiome<\/span><\/h3>\n
Probiotics; Purpose and Desires For Efficacy<\/span><\/h3>\n
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Thoughts on Probiotics and the Horse<\/strong><\/span><\/h3>\n
Prebiotics in the Horse; The True Answer??<\/span><\/h3>\n
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