Repeated fecal microbiota transplantation in dogs with chronic enteropathy can decrease disease activity and...

Area of Science:

• Veterinary Medicine
• Gastroenterology
• Microbiome Research

Background:

• Chronic enteropathy (CE) in dogs is a challenging condition often requiring advanced therapeutic strategies.
• Refractory CE cases present a significant clinical need for novel treatment options.
• Fecal microbiota transplantation (FMT) is emerging as a potential therapy for gastrointestinal disorders by modulating the gut microbiome.

Purpose of the Study:

• To evaluate the efficacy of repeated fecal microbiota transplantation (FMT) as an adjunctive treatment for dogs with refractory chronic enteropathy (CE).
• To assess clinical outcomes and fecal parameters, including dysbiosis index, bile acids, and calprotectin, following FMT.
• To identify predictors of response to repeated FMT in dogs with CE.

Main Methods:

• A prospective longitudinal observational study involving 39 dogs with refractory CE.
• Dogs received 2 to 3 rectal FMTs over one month.
• Clinical assessments using the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) and fecal analyses were performed over a 6-month period.

Main Results:

• Twenty-eight of 39 dogs (71.8%) responded to FMT, with 13 achieving corticosteroid tapering.
• Long-lasting responders (LLRs) had significantly lower baseline dysbiosis index and higher percentages of secondary unconjugated fecal bile acids compared to non-responders.
• Dysbiosis index decreased significantly in LLRs after FMT, while clinical improvement was sustained for 6 months in this group.

Conclusions:

• Repeated FMT serves as an effective adjunctive treatment for refractory CE in dogs, especially those with minimal or moderate dysbiosis.
• Pre-existing marked dysbiosis and bile acid dysmetabolism may be associated with poor or transient responses to FMT.
• Further investigation into optimizing FMT protocols, potentially including repeated administrations, is warranted for non-responsive cases.