Prebiotics, probiotics and faecal transplants in cats: where are we now?

Chronic gastrointestinal signs in cats can be a frustrating problem, especially as there is little evidence for best diagnostic or therapeutic approaches specific to cats, which are mostly extrapolated from dogs. There is often an additional concern that insidious infectious agents have been missed, or that chronic intestinal inflammation could transition to a neoplasm. Empirical use of antimicrobials is problematic both from a global health perspective and due to the mounting evidence of the disruptive effect of commonly used antibiotics on the feline intestinal microbiota. Antibiotic-induced dysbiosis is inevitable and recovery of the microbiota after cessation of antibiotic treatment cannot be expected in all cats. Due to an increasing awareness of these challenges amongst veterinary professionals, “novel” or “alternative” treatment approaches focusing on manipulation and improvement of the intestinal microbiota are sought after. This includes the use of prebiotics, probiotics or synbiotics, dietary interventions inducing production of beneficial postbiotics as well as faecal microbiota transplantation (FMT). This article explores the evidence for the use of these potential treatments, the concept of dysbiosis, and details novel discoveries in the context of the feline microbiota.