Author: Artem Cheprasov, DVM

Last Medical Update & Review: May 27th, 2019


Diseases, Disorders, & Scenarios
Probiotics, Prebiotics, Synbiotics, & Related Treatments
Pages of Easy to Understand—Scientific—Info
Clinical, Medical, & Scientific Research Articles

Millions of articles and studies are published every year. Healthonym identifies the most important research and inputs the latest evidence-based information into this guide on a regular basis.

100% of the information in this guide comes from published, peer-reviewed, medical and scientific articles.

This guide does not contain ads, sponsored content, nor product placements; and none of the authors have any conflicts of interest.

While you might spot the names of products in this guide, they’re there for your reference and convenience only. They are not paid placements and Healthonym makes no profit from their mention nor sale. Most importantly, Healthonym does not endorse any products in this guide and does not vouch for their quality nor efficacy.






























The quality of evidence hierarchy below applies solely to this guide on probiotics for dog. It isn’t a judgement on a study or researcher’s work per se.

For example, a test tube study may be conducted extremely well and may provide very important scientific findings. However, Healthonym labels test tube studies as providing poor quality evidence with respect to clinically applicable information.

Similarly, an observational study may be excellent. However, due to the intrinsic biases in such studies, they are labeled as providing good, not high, quality evidence.


Very high quality evidence comes from one of the best available forms of scientific and medical research. In other words, this evidence comes from at least one of the following:

  • A systematic review and/or meta-analysis of high and/or good quality studies.
  • In select cases, a single study (observational or trial) that provides overwhelming evidence in light of the fact that a more rigorous study design is unlikely for ethical reasons.


High quality evidence comes from the results of at least one double-masked (“blinded”) randomized controlled trial (RCT).


Information based on good quality evidence is supported by an observational study or a clinical trial missing one or more of the following: randomization, control, or double-masking (“blinding”). Further research is definitely warranted.


Information based on fair quality evidence comes from clinical case series or clinical case reports.


This is evidence that comes from test tube studies or research conducted on a different species of animal than the one in question.


In research, “blinding” is also known as “masking”.

This refers to a situation where a group of people involved in a clinical trial don’t know which patient got which treatment (or placebo). So, they are “blind” to which patient got what.

Which groups of people may be blinded to treatment in research?

1. The patients. This is obviously human patients in human research. In veterinary research, it’s often assumed that dogs who are patients don’t need to be blinded to treatment. Yet this assumption has not been proven and may be incorrect. For example, a tablet whose taste is extremely bitter compared to a placebo may, in theory, lead to stress or vomiting. This lack of blinding to taste may influence study results.

2. Caregivers. This could be any person, paid or unpaid, who provides direct care to the patient in a healthcare or home setting. In veterinary research, examples include: veterinarians, pet owners, and scientists working with laboratory animals.

3. Data collectors.

4. Assessors of outcomes. This is the people who judge whether a patient has had an outcome of interest or not.

5. Data analysts.

Given all of that, you may have heard of the term “double-blind”.

The term “double-blind” is also known as “double-masked”. In human research, it’s often assumed that this refers to a situation where physicians and patients are blind to treatment. In veterinary research, it’s often assumed this refers to veterinarians and pet owners.

In actuality, there is no standardized definition for “double-blind”. Unless a study’s authors explicitly mention which groups were blinded to treatment, this term is highly ambiguous and means little.

Research has shown that “double-blind” can mean any of the following:

A. The underlying assumption: patients and doctors were blinded. Or, in veterinary research: pet owners and veterinarians were blinded. Unless the researchers mention this in their paper, however, you can’t be sure if that’s the case.

B. That any two of the five main groups of research participants were blinded. But, which ones? Unless the researchers detail this in their paper, you can’t be sure either.

C. As a catch all phrase that all of the five groups of research participants were blinded.

With respect to this guide only, Healthonym currently classifies any type of double-blind study as a high quality study. Where applicable, each study’s definition of this term is made explicit in the Notes tab for those who want more information.


Much has been said about the state of research on probiotics for dogs as well as people. There are plenty of proponents and detractors of probiotics in general as well.

Regardless, the research on probiotics for dogs is definitely in its infancy and will continue to be so for the foreseeable future.

As well, there is an overall lack of very rigorous, highly-detailed, published clinical trial data on probiotics for dogs. Clinicians are often left with only a few studies on which to rely on. Many of them are observational in nature or have questionable methodologies.

Even many clinical trials are missing controls, randomization, or blinding.

To address this issue, Healthonym relies on an easy-to-use hierarchy of evidence described above.

Much like the GRADE framework, Healthonym’s method is a transparent and reproducible way to classify the evidence surrounding probiotics for dogs.

Like the GRADE framework used throughout human medicine, Healthonym’s hierarchy is not perfect. Moreover, one can make a very good case for the notion that most scientific findings are false.

However, this does not relieve us from the necessary duty of systematically, reproducibly, and transparently classifying the available evidence and working with that to the best of our ability.

This is precisely what Healthonym has done in this guide on probiotics for dogs.


What is Dysbiosis?

The term dysbiosis refers to an unhealthy or abnormal state of microorganisms within a particular area.

Example: intestinal dysbiosis. This refers to a state where there is an unhealthy or abnormal number, or combination, of microbes in the gut.

Dysbiosis is a word that comes from dys-, meaning bad or abnormal, and –biosis (which refers to life).

Dysbiosis is the opposite of normobiosis. Normobiosis is when the number and combination of microorganisms in a particular area is healthy.

What is a Microbe?

Microbe = microorganism = microscopic organism.

A microbe is a form of life so small, it cannot be seen with the naked eye. Microorganisms (microscopic organisms) include bacteria, viruses, fungi (like yeasts), and many parasites.

What is the Microbiome?

There isn’t a standardized definition of microbiome. Some people use the term “microbiome” and “microbiota” synonymously. Albeit they aren’t the same thing.

Very broadly, the term microbiome can be broken down into micro- and -biome. Micro- denotes something microscopic, or extremely small. While –biome refers to a distinct system composed of numerous factors:

  • A particular environment or region. For instance: the intestinal tract (gut).
  • The organisms that live in that region. For example: bacteria.
  • The interactions between the above.

More simply, microbiome is a word that refers to a microscopic ecosystem of sorts.

However, scientists often use “microbiome” in an even more specific manner. They define microbiome as a community of microbes and, namely, all of their genetic material.

Example: intestinal microbiome. This refers to all of the microbial genetic material that is found in the gut. And, by extension, the microorganisms that give rise to this genetic material.

What is Microbiota?

Microbiota is a term that comes to us from micro- and -biota. Micro- implies that something is so small, it cannot be seen with the naked eye. –Biota is a term that refers to all of the organisms of a particular region.

In other words, microbiota is literally defined as a collection or community of extremely small organisms that live on, or in, a particular part of the body.

These microscopic organisms include bacteria, viruses, fungi, and protozoa. They can be helpful, neutral, or harmful to us.

They live on our skin, in our airways, digestive system, and many other places throughout our body.

Example: “intestinal microbiota”. Here, we’re referring to the entire collection of microorganisms that live in the intestinal tract (the gut).

Microbiota vs. microflora

The terms “microflora” or simply “flora”, refer to the same thing as microbiota. However, the suffix of –flora refers to plants, not microscopic organisms. As a result, many believe it’s more appropriate to use microbiota instead of “microflora” or “flora”.

What is Microflora?

Microflora is the shortened form of “microscopic flora”. “Microscopic flora” refers to a collection of microscopic organisms living in or on our body.

The term “microflora” is often used to denote “gut flora”; although they’re not the same exact things.

See the newer and synonymous term for microflora, called “microbiota”, for additional details on what microflora refers to.

What are Postbiotics?

Postbiotics are products made by microbes; ones that have an effect on our body.

These substances are produced as a result of microbial life-sustaining processes. As a result, they are called metabolic products.

For instance, some bacteria in our gut produce toxins as a result of the chemical reactions they use to stay alive. These types of postbiotics, the toxins, can harm our intestinal tract.

Not all postbiotics are harmful. For example butyrate, a postbiotic (product) of some gut bacteria, may help decrease inflammation.

What are Prebiotics?

Prebiotics are particles of food that help friendly microbes (probiotics) thrive. Often, prebiotics are substances that we normally can’t digest. For example, some types of fiber (complex carbohydrates) are prebiotics.

Prebiotics aim to improve the health of probiotics and, by extension, the health of the person taking them.

For the technically inclined, prebiotics can be defined as fermentable ingredients that change the composition or the activity of microbes in the body in a way that benefits the health of the person taking them.

What are Probiotics?

Very generally speaking, probiotics are microscopic organisms (microbes) that are beneficial to our health. These microorganisms are mainly bacteria and fungi (like yeast).

The term “probiotic” is also commonly used to refer to a food or supplement that contains such organisms.

For the more technically inclined: probiotics are natural or genetically modified microbes. These microbes must be able to make it past stomach acid and bile alive. Additionally, these microbes must produce substances that increase the concentration of other helpful microorganisms in the colon and improve the health of the person (or animal) taking these probiotics.

Literally speaking, probiotics can be translated from Greek as “for life”.

What are Synbiotics?

Synbiotics are beneficial combinations of probiotics (friendly microscopic organisms) and prebiotics (the food that nurtures those organisms).

Practically speaking, a synbiotic (probiotic + prebiotic) is often designed to be more effective than either the probiotic or prebiotic alone.

The term synbiotics comes from syn-, which denotes “union”. Synbiotics also contains the suffix –biotics, which refers to life.

So a synbiotic is a synergistic union of things (probiotics and prebiotics) that contains life and enhance the life therein.




Inside of your dog’s gut are trillions of bacteria, fungi, viruses, archaea, and protozoa.

For a long time, these microorganisms were ignored. Few bothered to consider the impact their number or diversity might have on your dog’s health.

It wasn’t until the last 2-3 decades or so that researchers started paying serious attention to them. Paying attention to the fact that they play an important role in canine health and disease.

In the ensuing years of research, two things have become abundantly clear.

First, we have a lot to learn about exactly how one or a collection of microbes influences canine health. At the same time, we have a lot to learn about which probiotics for dogs are truly helpful (or not).

This is where double-masked, randomized, and controlled clinical trials are imperative. They help us answer these questions with conviction.

Second, we now know there is no standardized “good” or “bad” collection of microbes in dogs.

That’s because many factors can influence exactly what makes an (un)healthy collection of gut microbes for any particular dog.

These factors include the following:

  • A dog’s unique genetics
  • The dog’s specific diet
  • What (if any) disease they may have
  • Any medication they may be taking
  • The dog’s age
  • The dog’s weight
  • The place they call home (their environment)

Here’s an example. We know that dogs with certain conditions benefit from animal protein-free diets. These diets improve the health of their intestinal microbiota.

But will these diets work for all dogs? Of course not. That’s because all of the factors above will influence whether a particular diet will help one dog, but not another.

By now, one thing is clear: there’s much to learn about probiotics made for dogs. There’s a lot to learn about how they work and when.

But this is brilliant precisely because we have so many exciting things to discover!

So, the rest of this article is dedicated to one thing. To exploring the amazing potentials these probiotics have for dogs in the coming years.

We also go over the many pitfalls this field has at the moment. It’s really important to be aware of them.

In either case, we do so with a primary focus on canine-related research. However, many insights from human studies, and that of other animals, will be used as well.


Although the research on the canine microbiome and probiotics for dogs has only just begun, we’ve learned a lot in the meantime.

Here’s a cool fact. Researchers know that a dog’s intestinal microbes are no longer like their ancestors (wolves). Why not? It’s because dogs have adapted to a human-like diet. Wolves have not.

Here’s another interesting tidbit. Most of the microorganisms in your dog’s digestive tract are bacterial in nature. In fact, they mainly come from four major phyla (big groups of bacteria):

  • Bacteroidetes
  • Firmicutes
  • Proteobacteria
  • Actinobacteria

And some of them may play a role in causing everything from GDV to digestive disorders.

As a case in point, researchers have learned that dogs with some intestinal disorders have decreases in two types of bacteria:

  • Faecalibacterium
  • Fusobacteria

These decreases may be harmful to your dog. That’s because these bacteria produce short-chain fatty acids (SCFAs). These are substances that improve canine digestive health.

Actually, this is exactly one reason why we give probiotics made for dogs with digestive disorders. We want these probiotics to make lots of helpful SCFAs.

Furthermore, scientists discovered that 6 other types of bacteria are commonly altered in dogs with many intestinal disorders.

These include Blautia, Escherichia coli, Streptococcus, Clostridium hiranonis, and Turicibacter.

These insights help us distinguish dogs with normobiosis vs. dysbiosis. Normobiosis refers to healthy collections of microbes. Dysbiosis refers to unhealthy combinations of microbes.

Discoveries like these can help us diagnose dogs with all sorts of disorders. Furthermore, they help us understand how we can use probiotics for our dogs in order to treat disease.

Probiotics that re-establish a healthy balance between these and other microscopic organisms in the dog’s gut. A balance that, in turn, would help to treat or prevent disease.


Beyond the gut, there’s another tantalizing way we may end up using probiotics created for dogs in the future.

It has to do with smell. Yes, the way dogs smell the world around them. But also the way your dog smells.

There are plenty of reasons for why a dog may smell, of course. They range from bad breath (halitosis) as a result of dental disease to various skin disorders. Flatulence is another possibility.

Sometimes, however, a dog smells because they, like people, have natural body odors even when completely healthy.

It’s possible that we’ll use probiotics created specifically for dogs in order to get rid of this unpleasant odor.

This possibility stems from a recent discovery. Researchers found that certain types of skin bacteria may be more likely to cause malodor in dogs.

They include Psychrobacter and Pseudomonas.

Simultaneously, dogs with malodorous skin have a reduction in the bacterial diversity of their skin.

As with many newer human skin healthcare products, scientists may one day develop topical creams with probiotics designed for dogs.

These creams may get rid of the smell-inducing bacteria. Or, they might establish a healthy balance to the skin’s bacteria.

Either way, the smell will hopefully disappear.

There’s something even more interesting, though. Topical creams with probiotics for our dogs make sense.

But did you know that oral probiotics may be helpful for the dog’s the skin as well?

Scientists know that probiotics make products called postbiotics. Using the bloodstream, these postbiotics can travel from the intestines and to the skin in order to alter the bacteria therein.

All of this implies that we may develop unique probiotics for dogs in order to treat all sorts of skin disorders, not just body odor!


Beyond their potential effects on the skin, probiotics may be useful for your dog’s kidney health as well.

Probiotics like Lactobacilli are helpful microbes. That means they help the dog and we’d want to increase their number in our dogs as a result.

That’s because they can minimize the number of harmful bacteria found in the dog’s digestive system. As the number of harmful bacteria decrease, the toxic postbiotics they produce decrease in number as well.

Examples of toxic postbiotics produced by gut bacteria include N-Oxide, p-cresyl-sulfate, and indoxyl-sulfate. Their increases are associated with a decline in kidney function.

One answer to this problem is obvious. Just give probiotics made for dogs with kidney disease. Theoretically, this would decrease the number of harmful bacteria producing toxic postbiotics.

But there’s another way.

We can also increase the number of helpful bacteria in the dog’s digestive tract via dietary changes alone. The dietary changes may lead to a reduction in harmful bacteria or toxic postbiotics as well.

For instance, research has shown than low-protein diets are associated with a reduction of p-cresyl-sulfate. If you recall, this is one of the toxic postbiotics that harm the kidneys.

So, we can feed a low protein diet. But we can also increase the number of fruits and vegetables in the diet.

Fruits and vegetables are full of prebiotics. Prebiotics are healthy sources of food that probiotics use for chemical reactions that help your dog.

Fiber-full diets such as these are linked to the production of helpful postbiotics. They’re also known to improved kidney function as well.

So while probiotics tailored for dogs with kidney disease can be helpful, they’re only one potential way to naturally improve kidney health.


Like kidney disease, infections of the lower urinary tract are a constant source of worry. In other words: UTIs are a big deal for many dog owners.

For the longest time, scientists believed that the canine urinary bladder is sterile. That is, there are no microorganisms found therein.

Yet new findings challenge this long-standing notion.

It’s now thought that the bladder has a unique microbiota that is largely separate from that of any intestinal (rectal) or genital microbiota.

This may partially explain why oral probiotics for dogs with UTIs have been largely unsuccessful in treating those UTIs.

See, oral probiotics change the intestinal (rectal) and vaginal microbiota. Such changes are supposed to protect the nearby lower urinary tract from infection.

Some studies in women have shown this to be the case.

But similar studies in dogs have found that oral probiotics do not protect female dogs from UTIs. At least not with the probiotics studied thus far.

This may be because these probiotics are trying to alter the wrong microbiota in the wrong way. Should probiotics be designed to target the newly discovered microbes in the dog’s bladder instead?

This presents a great opportunity for further research. And a big opportunity for the development of probiotics for dogs with urinary tract infections.


Another area of deep research is the way by which probiotics interact with your dog’s immune system.

We know that gut microbes can act as a biological defense system. This defense system protects your dog against harmful microbes. This means the immune system has less to worry about when these microscopic defenders are healthy. Or, if we prop them up with probiotics designed for our dogs.

We also know that probiotics and other gut microbes play a role in helping the immune system mature. A healthy, mature, immune system does a good job of protecting your dog from disease.

Yet what’s been discovered is that probiotics can actually boost an animal’s immune system as well.

For many dogs, supplementation with probiotics can increase the number of something called antibodies. Antibodies are protein molecules that help destroy harmful microbes.

In the future, these findings may have major implications in treating dogs with unhealthy immune systems.


Microbes may also play an important role in heart disease in dogs. This is another critical area of research with respect to using probiotics for dogs.

In dogs, the most common form of heart disease is degenerative mitral valve disease (DMVD).

Research in dogs, rodents, and people has shown that a molecule known as trimethylamine N-oxide (TMAO) may play a role in heart disease. If not causing heart disease then, at the very least, its detection.

Here’s the thought process on this.

Intestinal microbes use dietary nutrients, like L-carnitine and choline, to produce a compound called trimethylamine. This is then converted into TMAO in the liver.

Increases in TMAO have been tied to the severity of cardiovascular disease in people.

In fact, the concentrations of TMAO in the blood are a good predictor of death as a result of heart disease. Heart disease like coronary artery disease and congestive heart failure (CHF).

Researchers found that dogs with DMVD or CHF have increases in TMAO as well.

So if TMAO causes cardiovascular disease in dogs, it would be critical to develop probiotics for dogs that decrease the amount of this harmful substance.

These probiotics would alter the amount or diversity of bacteria producing trimethylamine.


One other important field of research is the use of probiotics for dogs with cancer. This is a promising subfield with a lot left to learn.

What we do know, or suspect, is that the dog’s intestinal microbes play a role in the development of cancer. Specifically: colorectal cancer and lymphosarcoma.

As a case in point, research in people has shown that bacteria like Helicobacter pylori, Escherichia coli, and Streptococcus gallolyticus, may all have pro-cancer properties.

Research has also shown that dogs with intestinal cancer may have unhealthy changes in their intestinal tract. For instance, healthy bacteria like Clostridiales, may be rarer in dogs with colorectal cancer.

Critically, it’s assumed that combinations of harmful microbes (not just one) contribute to the formation of cancer in dogs.

In the same breath, it would make sense that only a diverse combination of probiotics for dogs would help in the prevention of cancer as well.


Likewise, it’s not a far stretch to suspect that oral probiotics can help prevent dental disease.

There are plenty of oral-health probiotics out on the market for humans for just such a purpose. Albeit, their efficacy is questionable.

Nevertheless, scientists know that various microbes contribute to dental disease in dogs. What’s more, even dental cleanings can only do so much to control these disorders.

For example, one study found that—by 5 weeks after cleaning—a dog’s oral microbiota was restored to pre-cleaning levels.

This finding presents a gaping opportunity to develop probiotics for dogs with dental disease. Probiotics that can be taken in between visits to the veterinarian in order to sustain oral health and even prevent disease.


As with most of the things we’ve gone over so far, it won’t surprise you that dogs with ear infections have different collections of microbes in their ear canal as compared to healthy dogs.

Some studies in children have shown promising results in the use of oral probiotics for the prevention of ear infections.

But in dogs, ear infections are often tied to allergic skin disease. So any effort on the development of probiotics for dogs with ear infections will have to consider this more complex facet of canine health.

This guide includes a lot of information on probiotics for dogs with allergies. The treatment options outlined therein may play an important part in treating ear infections as well.


As any owner with a dog who gets chronic ear infections knows, they’re hard to treat.

Yet the greatest challenge in utilizing probiotics for dogs may lie with the central nervous system. The central nervous system includes the brain and spinal cord.

Scientists know that germ-free mice are resistant to some nervous system disorders, like encephalomyelitis. This is where the brain and spinal cord become inflamed.

These results tell us that there is a connection between the microorganisms in the gut and brain disease.

Recently, researchers have found something very similar in dogs with meningoencephalomyelitis (ME). This is a condition where the brain, spinal cord, and their surrounding layers are inflamed.

Dogs with ME have lower amounts of certain bacteria (Prevotellaceae) in their digestive tract.

Once again, this points to a connection between gut and brain health researchers have long suspected of in a lot of other studies.

By extension, this means we may one day rely on probiotics for dogs in order to prevent, or treat, various nervous system disorders.

The potentials here are primarily two-fold.

In this particular case, we may develop and administer Prevotellaceae. Or, we may give probiotics that increase the amounts of Prevotellaceae indirectly in our dogs instead.


Most of the discussion so far has focused on the exciting potential probiotics may have for various body systems. But we’ve left out something important.

We haven’t addressed the way medications may affect a dog’s intestinal microbiota. It’s obvious that antibiotics will alter a dog’s intestinal microbes.

But what about the scores of other medications out there? Very little information is available about their effects.

One study found that omeprazole alters the canine intestinal microbiota. Omeprazole (Prilosec) is a drug that minimizes the secretion of stomach acid.

Clearly, if antibiotics and omeprazole alter your dog’s microbes, other drugs may do so as well.

But almost nothing is known about the way these other drugs alter the microbes in a dog’s intestinal tract. It’s entirely possible that, in the future, we’ll give probiotics to dogs as supplements. Supplements that minimize the effects drugs have on your dog’s intestinal microbes.


That last sentence had a small implication. The implication that probiotics are always helpful.

By definition, probiotics are helpful microorganisms.

However, as with any substance you give to your dog, probiotics may have side effects. They should always be used with care.

For instance, some probiotics created for dogs are associated with reductions in vitamin levels. That may not be very good!

Even more critically, it may be important to avoid giving probiotics to dogs with severe intestinal diseases. Doing so may predispose to secondary infections.

While research on probiotics for dogs often claims a lack of side effects, there may be a reason for this.

It’s not that probiotics have no bad side effects. It’s that many of these studies are conducted on healthy dogs. Or they have serious biases. Or, further still, they may be too short to make practical sense of.

We need a lot more evidence, better evidence, to claim that probiotics are always helpful.


One other issue in research on probiotics for dogs is a lack of availability. In other words, many studies find that a probiotic has a beneficial effect. But you can’t buy that same probiotic!

A great example of this is some strains of Lactobacillus murinus.

Helpful probiotics such as these are often commercially unavailable. Or, they must be bought from research laboratories.

It goes without saying, both scenarios pose a problem for the clinician and pet owner.

So there are many beneficial probiotic therapies out there that we aren’t using due to commercial reasons.

Herein lies an opportunity for business-minded individuals. Take advantage of this gap between research, clinic, and market. And help dogs in the process.


Yet even in cases where commercial probiotics are available, there can be another problem. Many studies on probiotics for dogs use proprietary strains.

On the one hand, research indicates that probiotic strains specific to the canine digestive system are more helpful than strains from other animals, like cattle.

At the same time, though, many of these studies fail to compare their specific strains to active controls. Active controls that consist of more commonly available probiotics of the same genus and species.

This means we can’t be sure if these proprietary strains are truly better than more commonly available ones. These common strains are often cheaper to boot.

In this guide, we’ve always listed the genus, species, and strain (if available) of the probiotics used during research. We’ve also listed products that contain these exact strains (if available and applicable).

However, unless proven by a clinical trial, it’s hard to say whether or not one should worry about getting a specific strain. Or, if a clinician can simply turn to an off-the-shelf strain of the same genus and species with the expectation of it having the same effect.

This is another area of research on probiotics for dogs that has lots of potential and need.


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