- What is a fecal transplant?
A fecal transplant (also known as fecal microbiota transplantation, fecal transfaunation, or fecal bacteriotherapy) is the introduction of fecal matter, obtained from a selected healthy individual, into a patient diagnosed with a gut dysbiosis. It is important to realize that more than just bacteria are being transplanted; viruses, parasites, fungi, and food antigens can be transferred as well. The procedure has gained popularity in humans, and is becoming more and more popular in veterinary patients, with ongoing studies being performed in animal health.
2. What does a fecal transplant treat?
In veterinary patients, a range of conditions has been treated with fecal transplantation, including ulcerative colitis, irritable bowel syndrome, chronic non-responsive diarrheas, recurrent urinary tract infections, and restoration of normal flora maturation in pediatric patients following antibiotics.
3. Are there studies available?
Ongoing research is being performed to identify conditions that benefit from fecal transplantation. Studies and case reports from 2009 to the present show some success with treating conditions mentioned above, but larger studies are still lacking at this time (November 2023).
4. How are donors selected and screened?
The Royal Treatment Veterinary Center uses two distinct sources of fecal material from donors. The primary resource is from directly screened and evaluated animals, mainly staff-owned. The donors are screened for infectious bacterial, viral, and parasitic diseases, and opportunistic pathogens that can be carried by an asymptomatic patient. The donors are maintained at a healthy weight, are healthy adults, have not used systemic antibiotics in at least 6 months, are raw-fed, and receive supplemental care to maintain a healthy, diverse gut biome (e.g. probiotics, fiber, etc.). Screening is re-performed every 6 months, in addition to routine annual care and exams.
The secondary source of donor fecal material is from AnimalBiome. If a canine or feline patient is unable to have a fecal transplant performed in-clinic we recommend the oral fecal transplant capsules from raw-fed donors. We also utilize freeze-fried fecal material from AnimalBiome’s feline donors for our in-clinic procedures with feline patients.
5. How is an in-clinic transplant performed?
In dogs, the current recommendation is to administer fecal solution as an enema. The patient should be fasted overnight from food, but water may continue to be offered. At the beginning of the procedure a weight based warm water and lube enema is administered to ensure an optimal clean surface in the gastrointestinal tract, and after administration the patient is given an opportunity to defecate.
Then the fecal solution is administered rectally using a large-bore, flexible, red rubber catheter that is a size appropriate for the patient. The weight based volume of solution is administered slowly to ensure maximum retention. Sedation is not used, and if any signs of discomfort are noted, the administration is paused. If signs of discomfort resolve within a short period of time, the infusion is continued. Once the infusion is completed, patients are kept in an upright position (standing, sitting, laying sternal) for 15 minutes to ensure minimum retention. After the initial retention period, patients are discharged and strongly encouraged to avoid bathroom triggers for an additional 45 minutes to achieve maximum transplant benefit. Food and water may be offered immediately after the infusion is complete. Some patients with chronic gastrointestinal disease may require more than one treatment if symptoms fail to resolve.
6. Are there other transplant options?
Oral administration is available using capsules that are specially prepared to ensure contents of the capsule reach the intended treatment area within the gastrointestinal tract. These capsules are available from AnimalBiome. Whether oral administration is more or less effective in dogs and cats is still unknown, and is only strongly considered when rectal administration is not feasible.
7. Are fecal transplants safe?
Fecal transplantation is considered very safe in human medicine, and the FDA treats human feces as a regulated drug, but this does not currently apply to veterinary feces and patients. Minimizing risk is currently focused on donor screening and maintenance.
If you have additional questions or concerns about fecal transplantation options, please call 773-267-9966 or email royalvet@rtvc.us.