Fecal Microbiota Transplant in Dogs

Fecal microbiota transplantation, FMT, is used to treat gastrointestinal disorders, especially Clostridium difficile (“C. diff”) infections in the gut. The procedure of fecal transplantation involves taking fecal matter from a healthy donor individual and introducing it into the gastrointestinal tract of an animal experiencing gastrointestinal infection or disorder to replenish healthy microbial organisms in the intestines. This procedure has been practiced successfully in humans, and is beginning to be more commonly practiced in veterinary medicine with small animals including dogs. 

Your dog's gastrointestinal system contains naturally occurring microbes and flora that aid in digestion and healthy gastrointestinal functioning. When these microbes and gastrointestinal flora become overwhelmed by overgrowths of harmful bacteria, or due to changes in the chemical composition of the gastrointestinal system, the healthy bacteria in the system can become compromised, killed, or suppressed. Introducing healthy bacteria from a donor individual by means of introducing fecal material from that individual into the sick dog can replenish the healthy bacteria in the gastrointestinal system of the dog experiencing illness, resulting in a return to health and normal functioning. Fecal material from a donor dog can be introduced orally in capsules or can be introduced into the GI tract by endoscopy of colonoscopy into the disordered animal's gastrointestinal tract with a solution of blended fecal material being introduced via the gastrointestinal tube. FMT should be conducted with the recommendation of, and under the supervision of, a veterinarian after a thorough examination to ensure that the GI disorder is correctly identified and will benefit from FMT treatment.

Fecal microbiota transplantation involves the transplantation of fecal matter from a donor which has been blended and mixed with saline or another solution and introduced to the disordered dog by colonoscopy, endoscopy, or by the use of orally administered capsules.

Appropriate donor dogs can be of any size as long as sufficient feces for transplantation is provided. Dogs that have a history of gastrointestinal disease, have been administered antibiotics, have immune system disorders including allergies, or have been subject to viral bacterial, fungal, or parasitical infections should not be considered as fecal donors. Some veterinary hospitals keep a population of healthy donors available for FMT purposes.

Fecal material collected from approved donors is mixed with saline, or another sterile solution, and the solution may be filtered to remove particles.

The fecal solution may be introduced orally in capsules or via a gastrointestinal tube into the gastrointestinal system of the diseased animal, either through endoscopy or colonoscopy, which involves a gastrointestinal tube being inserted via the esophagus or rectum to reach the GI tract. Capsules administered or oral gastrointestinal tube administration will take several hours to break down and for fecal matter to reach the small intestine. In urgent cases, direct introduction by rectal administration will provide a faster method of exposure for the intestine. 

Prior to the FMT procedure, administration of medication that slows intestinal motility may be administered to allow for introduced fecal matter to progress more slowly through the gastrointestinal system, giving it more time to be absorbed into the GI environment. Some dogs can be administered FMT with only sedation, but if treatment proves difficult, general anesthetic may be required. In some cases enemas may be used to remove feces from the diseased animal prior to FMT, maximizing the ability of rectally introduced fecal matter to become absorbed into the disordered dog’s system.

Although this treatment has been successful in treating bacterial infections in humans, its use in small animals has not been well documented. As the principles of replacing compromised gut bacteria in dogs is similar to that as it is in humans, it is inferred that FMT treatment could also be very effective in dogs for treating gastrointestinal infections where natural gut flora has become overwhelmed. FMT, used in combination with medical treatment for compromised immune systems, may be most beneficial.

Effects may be temporary and FMT may need to be repeated if introduced fecal material is not effectively absorbed into the recipient dog's gastrointestinal system, or if healthy bacteria introduced is killed off, or overwhelmed by existing medical conditions. An understanding of why this occurs and how often FMT treatment should be attempted has not been established.

Although side effects have been noted from FMT in most animals, it will be important to observe your dog following treatment for any signs of a deteriorating condition that may indicate that an infectious disease or disorder has been passed by donor fecal material. A diet free from carbohydrates and other food additives may be beneficial while your dog is recovering from having a gastrointestinal disorder treated. The use of antibiotics for gastrointestinal infections should be guided by your veterinarian, as some antibiotics can interfere with naturally-occurring gut microbes and flora and impede recovery. 

The cost of FMT varies depending on the method by which fecal matter is provided to the recipient dog. Extensive tests will be required to rule out other disease or disorder of the gastrointestinal tract. These tests, along with medications, sedation, and donor fecal matter and administration, along with veterinary consultation can cost from $500 to $1,500.

It is possible to pass infectious diseases and parasites with fecal material from a donor animal. Rigorous screening of donors will limit this likelihood. 

Few guidelines exist to govern the harvesting of donor fecal material and the administration of FMT in veterinary medicine for small animals. Clinical studies are limited in small animals and FMT effectiveness and considerations are not well understood nor is the treatment widely available for dogs.

A diet rich in protein and limited in additives and carbohydrates that are not beneficial to your dog's immune system, and naturally occurring gut flora, may prevent gastrointestinal disorders resulting in damage to “good” bacteria. Treatment of gastrointestinal disorders at the earliest opportunity to prevent infections from becoming expensive and damaging your dog's gastrointestinal system and associated microflora is recommended.