From the time Ana was young, she had intestinal problems. When she was only 5 months old, she suffered severe vomiting and diarrhea and wouldn’t eat or drink. Instead she tried to eat non-food items such as toys, cords and paint on the wall.
“We thought she was going to die. When she should have been gaining about 6 pounds, she lost about 6 pounds,” says Ana’s owner, Tracy Weber of Seattle.
To help Ana thrive, Weber cooked special meals for the German shepherd puppy and tried different proteins and supplements. Nothing worked.
“When I called the vet and said, ‘What do we try next?’ she suggested a fecal transplant.”
The gastrointestinal tract houses a complex collection of microorganisms known as the microbiome. They play a crucial role in health – not just of the gut, but of the entire body, including regulating the immune system. Microbiome population is affected by factors such as diet, antibiotics and gastrointestinal disease, and healthy animals have a highly individual microbiota.
Weber didn’t know much about fecal microbiota transplants (FMT), and she didn’t like the idea of implanting another dog’s poop into her dog’s gastrointestinal tract. But the more she researched it, the more she thought it would be worth a shot.
Fecal transplants are a rare instance of a treatment used first in humans and then in dogs and cats. In humans, FMT has been successful in treating 90 to 98 percent of recurring Clostridium difficile infections, leading to normalization of the microbiome. Clinical signs resolve within one to two days. For inflammatory bowel disease, though, the success rate is much lower, only 25 to 30 percent.
Nicknamed “re-poopulation,” FMT involves transplanting fecal material from a known healthy dog with good digestion, no parasites and no treatment with antibiotics for at least the previous three months. The process begins by blending the feces and separating out the solids. What remains is a soupy mixture of probiotic and fecal material that, for Ana, was administered as an enema into the colon. Another protocol involves inserting the material into the gut through a nasogastric tube, and one company offers an oral fecal transplant capsule.
Ana did not need to be sedated during the procedure. Afterward, she had to remain crated for six hours to give the microbes time to settle in to their new environment. Patients may be given loperamide (Imodium) to reduce the likelihood of a bowel movement.
It took several weeks before Weber saw improvement in Ana’s appetite and chronic diarrhea, but the pica – the tendency to eat non-food items – disappeared the same day as the fecal transplant. The transplant was repeated when the pica reappeared.
The number of fecal transplants required varies in both dogs and humans, probably depending on how difficult it is for gut microbes to stay alive in a specific digestive tract. In his lecture on the intestinal microbiome at the 2018 Veterinary Meeting and Expo, Texas A&M University veterinary microbiologist Jan S. Suchodolski says that in some patients, fecal transplants are repeated up to three times every three to four weeks. The procedure decreased the imbalance of microorganisms (known as dysbiosis) in most dogs, although a subset had no improvement.
“I have colleagues who say 70 percent of patients get better, and I have colleagues who say zero percent get better,” Dr. Suchodolski said.
Of Ana, Weber says, “In general, (the transplants) have helped, but we may do a third with a different donor dog.”
Pet Connection is produced by a team of pet-care experts headed by “The Dr. Oz Show” veterinarian Dr. Marty Becker and award-winning journalist Kim Campbell Thornton. They are affiliated with Vetstreet.com and are the authors of many best-selling pet-care books. Joining them is dog trainer and behavior consultant Mikkel Becker. Dr. Becker can be found at Facebook.com/DrMartyBecker or on Twitter at DrMartyBecker. Kim Campbell Thornton is at Facebook.com/KimCampbellThornton.