QUARTERLY BEAT / JULY 2024
FECAL MICROBIOTA TRANSPLANTATION (FMT) HOW, WHEN, AND WHY?
DR. LINDA TORESSON
PHD
In this VETgirl Webinar, “Fecal Microbiota Transplantation (FMT) - How, When and Why?” on April 24, 2024, Dr. Linda Toresson, PhD reviews all you need to know about fecal microbiota transplantation! If you’re about to treat a chronic IBD or even a parvovirus patient, tune in to learn more! In case you missed the webinar, watch it again HERE or read the cliff notes below!
Faecal microbiota transplantation (FMT) is a technique used to transfer faeces from a healthy donor to a recipient with a disease to restore the intestinal microbiota and metabolome and decrease disease activity. The treatment was mentioned in a Chinese textbook of emergency medicine by Ge Hong in 320 A.D but has very rarely been used in conventional medicine until the last two decades. In people, FMT is superior to antibiotics in recurrent Clostridiodes difficile (rCDI) infection. 1 There is also evidence from several randomized controlled trials (RCTs) that FMT can decrease disease activity and induce remission in people with inflammatory bowel disease (IBD). 1 It has been shown that both the microbial composition of the donor stool and that of the recipient are important for a successful outcome. 2 Patients responding to FMT had increased faecal microbial diversity both before and after FMT compared to non-responders. Gastrointestinal (GI) disorders are by far the most common reasons to perform FMT in people, but multiple research studies have been performed using FMT for other indications, including hepatic disorders, metabolic syndrome, treatment of antibiotic-resistant microbes, neuropsychiatric disorders, obesity, and others. 3 The transplant can be administered rectally as a retention enema, orally as lyophilized faeces in capsules, or deposited in the duodenum or colon using an endoscope. The route of administration does not appear to affect the outcome in people. Likewise, fresh or thawed frozen faeces are equally effective in people with rCDI. 4
Guidelines on FMT from The Companion Animal Fecal Bank Consortium, an international group of experts, will be published later in 2024.
FMT IN DOGS WITH GASTROINTESTINAL DISORDERS Several case reports, case series, and studies have been published on the use of FMT in dogs. An RCT in puppies with parvovirus showed a beneficial effect of FMT. 5 Sixty-six puppies with parvovirus were treated with FMT and standard treatment or standard treatment alone. The puppies were treated with one FMT every other day until recovery (median 1.8 FMTs). A significantly reduced time to recovery and hospitalization time was seen in the FMT group. Survival was also higher in the FMT group versus the other group (79% versus 64%), although this difference was not statistically significant. In a study of 18 dogs with acute diarrhoea, dogs were treated with metronidazole or one single FMT for seven days. 6 At day 7, the faecal scores were similar in both groups. At day 28, the dogs treated with FMT had significantly improved faecal scores versus the metronidazole-treated group. The dogs in the metronidazole group had significant dysbiosis at day 28, compared to dogs treated with FMT and healthy dogs. In a study of 8 dogs with acute hemorrhagic diarrhoea syndrome (AHDS), there was no difference between FMT, placebo, or probiotics. 7 However, the amount of dogs was very small
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