Protexin Veterinary Synbiotic D-C Daily probiotic and prebiotic capsules for dogs and cats (Pack of 1, 50 Capsules)

Product Information

Sommacal, H. M., Bersch, V. P., Vitola, S. P. & Osvaldt, A. B. Perioperative synbiotics decrease postoperative complications in periampullary neoplasms: a randomized, double-blind clinical trial. Nutr. Cancer 67, 457–462 (2015).

No governing agency oversees the label claims on probiotics. Products are most likely to be of good quality if they were produced by a reputable manufacturer and underwent clinical study. Can dogs be used as a model for studying human disease? We have a collaboration with pediatric oncologists evaluating if canine sarcoma can be used as a model for pediatric human sarcoma.Farid, R., Ahanchian, H., Jabbari, F. & Moghiman, T. Effect of a new synbiotic mixture on atopic dermatitis in children: a randomized-controlled trial. Iran. J. Pediatr. 21, 225–230 (2011). Childs, C. E. et al. Xylo-oligosaccharides alone or in synbiotic combination with Bifidobacterium animalis subsp. lactis induce bifidogenesis and modulate markers of immune function in healthy adults: a double-blind, placebo-controlled, randomised, factorial cross-over study. Br. J. Nutr. 111, 1945–1956 (2014). In a hypothetical study, an established prebiotic substrate (for example, GOS or inulin) at the dose shown to be both selectively utilized and have a health benefit (primary outcome showing improved probably of response) is combined with an established probiotic at the dose shown to have a health benefit in the same target host. This combination product is tested and shown to confer a health benefit compared with the control (not necessarily the same benefit as previously tested for the probiotic and prebiotic). This product would meet our definition of a complementary synbiotic. Hadi, A., Alizadeh, K., Hajianfar, H., Mohammadi, H. & Miraghajani, M. Efficacy of synbiotic supplementation in obesity treatment: a systematic review and meta-analysis of clinical trials. Crit. Rev. Food Sci. Nutr. 60, 584–596 (2020).

Food and Agriculture Organization of the United Nations/World Health Organization. Guidelines for the Evaluation of Probiotics in Food. who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf. Accessed May 2020. Anderson, A. D., McNaught, C. E., Jain, P. K. & MacFie, J. Randomised clinical trial of synbiotic therapy in elective surgical patients. Gut 53, 241–245 (2004).

Specification

Nabhani, Z., Hezaveh, S. J. G., Razmpoosh, E., Asghari-Jafarabadi, M. & Gargari, B. P. The effects of synbiotic supplementation on insulin resistance/sensitivity, lipid profile and total antioxidant capacity in women with gestational diabetes mellitus: a randomized double blind placebo controlled clinical trial. Diabetes Res. Clin. Pract. 138, 149–157 (2018). Moher, D. et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Int. J. Surg. 10, 28–55 (2012). Dysbiosis index vs. next generation sequencing vs. metabolomics or immune system profiling. Is the ideal test a stool test, a serum biomarker, or a combination of tests?

Rogha, M., Esfahani, M. Z. & Zargarzadeh, A. H. The efficacy of a synbiotic containing Bacillus coagulans in treatment of irritable bowel syndrome: a randomized placebo-controlled trial. Gastroenterol. Hepatol. Bed Bench 7, 156–163 (2014). D’Angelo S, Fracassi F, Bresciani F, et al. Effect of Saccharomyces boulardii in dog with chronic enteropathies: double-blinded, placebo-controlled study. Vet Rec 2018;182(9):258. The qualifier ‘established’ refers to a probiotic or prebiotic that meets the requirements of the globally accepted definitions from International Scientific Association for Probiotics and Prebiotics consensus 12, 13. Studies are done in the target host. Malaguarnera, M. et al. Bifidobacterium longum with fructo-oligosaccharides in patients with non alcoholic steatohepatitis. Dig. Dis. Sci. 57, 545–553 (2012). A patient with intestinal dysbiosis can have decreased appetite, diarrhea, vomiting, or a variety of other clinical signs. They can also be asymptomatic. One thing to remember is that in patients that are symptomatic with intestinal dysbiosis, often there is concurrent gastrointestinal disease (IBD, diet responsive enteropathy or other disease). For diagnosis currently there is an available stool test provided by the Texas A&M GI Laboratory called the dysbiosis index. This fecal test evaluates 16s rRNA sequencing of bacteria. In a study published in 2017 1, they validated the test using samples from 95 healthy dogs as the normal population and 106 dogs with chronic enteropathy as the population with disease. A negative index indicates normal microbiota and a positive index indicates dysbiosis. The results are equivocal if the value is between 0 and 2. Future studies are recommended to look at evaluation of next generation DNA and RNA sequencing to evaluate the full genome of the intestinal microbiota. We suspect that what may be more valuable than assessing which bacteria are present would be using metabolomics or immune system profiling to assess the function of normal microbiota and function in patients with dysbiosis. We currently have studies underway to investigate this. How Do We Treat Intestinal Dysbiosis in Dogs?Studies on a synergistic synbiotic that compare the synbiotic to the control can provide supportive evidence but do not constitute the primary evidence needed to confirm a synergistic synbiotic. Instead, a study including the combination, the substrate alone, the live microorganisms alone and a control should be conducted. Using an appropriate statistical model, the aim is to demonstrate that the combined effect is better than the estimated effects of each component separately. Evidence of selective utilization of the substrate by the co-administered live microorganism must be obtained from the same trial demonstrating the health benefit. Trials for complementary synbiotics David, L. A. et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature 505, 559–563 (2014). Nikbakht, E. et al. Effect of probiotics and synbiotics on blood glucose: a systematic review and meta-analysis of controlled trials. Eur. J. Nutr. 57, 95–106 (2018).

Stokes JE, Price JM, Whittemore JC. Randomized, controlled, crossover trial of prevention of clindamycin-induced gastrointestinal signs using a synbiotic in healthy research cats. J Vet Intern Med 2017;31(5):1406-1413. Hadi, A., Mohammadi, H., Miraghajani, M. & Ghaedi, E. Efficacy of synbiotic supplementation in patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis of clinical trials: Synbiotic supplementation and NAFLD. Crit. Rev. Food Sci. Nutr. 59, 2494–2505 (2019). Nixon SL, Rose L, Muller AT. Efficacy of an orally administered anti-diarrheal probiotic paste (Pro-Kolin Advanced) in dogs with acute diarrhea: a randomized, placebo-controlled, double-blinded clinical study. J Vet Intern Med 2019;33(3):1286-1294.

Regulatory statutes will differ with regard to geographical regions, regulatory categories, types of allowable claims and premarket approval. Furthermore, different standards exist for manufacturing, efficacy and safety depending on geographical region and product category. The term synbiotic does not stipulate a regulatory category, so (simply stated), regulatory requirements for a synbiotic would need to meet those that apply to the category (for example, drug, food or supplement) of the marketed product. Eslamparast, T. et al. Effects of synbiotic supplementation on insulin resistance in subjects with the metabolic syndrome: a randomised, double-blind, placebo-controlled pilot study. Br. J. Nutr. 112, 438–445 (2014). Maldonado-Gomez, M. X. et al. Stable engraftment of Bifidobacterium longum AH1206 in the human gut depends on individualized features of the resident microbiome. Cell Host Microbe 20, 515–526 (2016). Dethlefsen, L. & Relman, D. A. Incomplete recovery and individualized responses of the human distal gut microbiota to repeated antibiotic perturbation. Proc. Natl Acad. Sci. USA 108, 4554–4561 (2011). Probiotics: (180 million CFU/g) Lactobacillus acidophilus, L.casei, L. salivarius, L.plantarum, L.rhamnosus, L.brevis, Bifidobacterium bifidum, B.lactis, S. thermophilus.