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The term ‘gastrointestinal microbiota’ refers to the complex population of microorganisms in the gastrointestinal tract. This includes bacteria, fungi, viruses, parasites and yeasts, however bacteria are the most common focus in research. It is the most extremely diverse microbial population in dogs, cats and in humans alike.
Each region of the gastrointestinal tract has a varying microenvironment with different conditions e.g. pH levels, contraction frequency, oxygen levels and nutrient availability. As a result, there are dominant populations along different regions of the gastrointestinal tract.
In cats and dogs, the gastrointestinal tract is colonised by microorganisms at birth and the make-up of the microbiome also influences the development of the puppies and kittens immune systems.
Once established, the microbiome contributes to digestion of food and absorption of nutrients and is linked to diseases such as colitis (inflammation of the colon), inflammatory bowel disease, clostridial infections and acute or chronic diarrhoea.
Fascinating studies have also recently demonstrated that the gastrointestinal microbiome influences many other organs and can exert effects on the neurological system including altering behaviour and mental health and, although the limits are far from uncovered at this time, the importance of the microbiome is widely recognised as vital for health.
Faecal microbiota transplantation, or FMT for short, is the technique by which we can transfer processed faecal microorganisms from a healthy screened donor into the gastrointestinal tract of a diseased patient in order to try and re-establish an unbalanced microbiome, usually as the result of a disease process or from use of antibiotics.
Figure 1. The diagram above shows a microscopic view of the intestinal wall. This shows how the donated gut flora re-establish the normal microbial flora over time by outcompeting the pathogenic bacteria.
Different conditions exert different influences on the microbiome and one such influence is the use of antibiotics. Antibiotics are so helpful in dealing with infections elsewhere in the body, however, these antibiotics do not differentiate between types of bacteria and can significantly alter the microbiome, often permanently.
This is where the concept of FMT comes in. As mentioned earlier, healthy donors, screened for disease, are used to donate processed faeces containing their unique microbiome, which is transferred into the gastrointestinal tract of the patient.
We have successfully treated many patients with this technique here at Bridge and below is a case to highlight the significant impact this can have when used. Studies have shown that FMT-treated dogs and cats have longer positive outcomes from this therapy when compared to antibiotic use which is great news for the responsible use of antibiotics and avoiding their use wherever possible.
Max, a handsome and loveable 2 year old Male Border Collie, presented to our Internal Medicine team with a history of significant chronic diarrhoea. His owner reported that he had not passed a normal stool since he was just 11 weeks of age. The diarrhoea responded rapidly to metronidazole antibiotic, but would sadly relapse immediately on stopping. He had been on metronidazole for a significant period before presenting for assessment and he had lost a significant amount of weight. We were concerned that his microbiome would have been highly unbalanced given this history and presentation.
As a further issue, he also suffered from a condition called protein-losing enteropathy which is a condition in which excessive amounts of protein are lost from the gastrointestinal tract and, in the UK, can be more commonly associated with inflammatory bowel disease, lymphangiectasia (dilated lymphatics) and a cancer called lymphoma. This can cause problems ranging from fluid retention and oedema to fatal thromboembolic disease due to loss of anticoagulant factors in the blood.
Max before his FMT treatment at Bridge Referrals
Max underwent a thorough investigation and in order to address the suspected dysbiosis given his long term condition, he underwent an FMT procedure with rapid results that were largely unexpected. Max’s owners were instructed to stop his antibiotics for 2 weeks prior to his procedure and a few days after his procedure, Max came in for a check up. His owner was delighted with his response and he was defecating normally without the help of antibiotics and his blood proteins were rapidly correcting.
He had gained weight and was so full of energy it was fantastic to see him back to behaving like the young dog he is. He really is a star patient and still loves coming in to see the team for rechecks, often trying his hardest to lick the face of whichever staff member crosses his path! Max has recently been booked in for flyball classes at Kirkley Hall because he is so fast and is just obsessed with chasing balls, his owner also reported that he can walk 6-8 miles at a time and still has energy afterwards!
The handsome Max after his FMT treatment! Such a happy boy and full of life!
Max is one of many patients here that has benefitted from this technique and, as research further increases in this field, the technique will be adapted over time to maximise the benefit to our patients.
If you have any questions about FMT or you think your pet might benefit from this, get in touch with your veterinary surgeon regarding referral to us .
