Fecal Microbiota Transplantation as Adjunct Treatment in Dogs with Refractory CE: A Prospective Study

Abstract:

Background: Fecal microbiota transplantation (FMT) is promising as adjunct therapy in dogs with chronic enteropathies (CE), but prospective longitudinal studies are lacking.

Objectives: Report fecal and clinical parameters in dogs with refractory CE treated with FMT Animals: 41 dogs with refractory CE

Methods: Prospective observational study. CE dogs were treated with rectal FMT as adjunct therapy on 2-3 occasions. Fecal samples were collected and canine inflammatory bowel disease activity index (CIBDAI) was calculated for 3 months after inclusion. A positive response to FMT was defined as a decrease of CIBDAI 28-35 days after inclusion, without changes to treatment or diet, or being able to decrease concurrent medication. Dysbiosis index (DI) was used for fecal microbiota assessment.

Results: 29/41 dogs responded to FMT, of which 8 dogs had a response lasting < 30 days post FMT. Corticosteroids could be tapered in 14 dogs. Baseline CIBDAI (median (range)) was 5 (2-13) in responders, which decreased to 2 (1-5) 28-35 days after inclusion, without further increase at day 88-95 (p < .001, mixed-effect analysis with multiple comparisons). Baseline CIBDAI in non-responders was 5.5 (2-9) (p = .42 versus responders, Mann-Whitney test) without improvement at follow-up (p = .67, paired t-test). Good responders had lower DI at inclusion (0.1 (-7 to 8.7)) versus non- and short-lasting responders (4.2 (-4.6 to 8.6) p = .04, unpaired t-test). Conclusions and clinical importance: FMT can be effective and potentially corticoid sparing adjunct treatment in refractory CE dogs. Dogs with severe dysbiosis may respond less favorably to FMT.