Clinical response in dogs with acute hemorrhagic diarrhea syndrome following randomized probiotic treatment or fecal microbiota transplant

Abstract

Probiotics and fecal microbiota transplants (FMTs) are two microbiome-targeted therapies that have been investigated for use in gastrointestinal diseases associated with dysbiosis. The aim of this study was to compare the effects of an oral multi-strain probiotic and enema-administered FMTs on clinical signs and serum lipopolysaccharide in dogs with acute hemorrhagic diarrhea syndrome (AHDS). A total of 18 client-owned dogs with a diagnosis of AHDS were enrolled in a randomized, blinded study at the time of hospital admission. The dogs were randomized into two groups: the probiotic group received a daily oral probiotic (200 × 109 CFU/10kg q 24 h) for 14 days and a single sham enema; the FMT group received a single FMT via retention enema (10 mL/kg) and placebo oral capsule for 14 days. All dogs received concurrent standard-of-care therapy, including intravenous fluids and anti-emetics; no dogs received antimicrobials. The fecal score, disease severity scores, and serum lipopolysaccharide were measured on days 0, 3, and 14. Fourteen of eighteen enrolled dogs completed the study (n = 9 probiotics; n = 5 FMT). Lipopolysaccharide decreased on days 3 and 14 from baseline and correlated with fecal and disease severity scores. There was no difference in the duration or severity of clinical signs in dogs with AHDS following an enema-administered FMT compared to probiotic treatment. Further evaluation of serum lipopolysaccharide as a marker of disease severity and recovery is warranted.

Safety profile and effects on the peripheral immune response of fecal microbiota transplantation in clinically healthy dogs

“…15,35 In veterinary medicine, FMT also is being explored in many diseases, such as parvoviral enteritis, chronic enteropathies, acute hemorrhagic diarrhea syndrome, and atopic dermatitis. 23,24,27,40,57,58 With the increase in veterinary use, concerns over the lack of data on the short-and longterm safety of FMT have been raised. In companion animal veterinary medicine, few published studies on FMT are available, and safety has not been thoroughly investigated.…”

“…In human medicine, FMT is a promising adjunctive treatment modality for recurrent CDI and is used as exploratory treatment in multiple diseases, including IBD and metabolic syndrome 15,35 . In veterinary medicine, FMT also is being explored in many diseases, such as parvoviral enteritis, chronic enteropathies, acute hemorrhagic diarrhea syndrome, and atopic dermatitis 23,24,27,40,57,58 . With the increase in veterinary use, concerns over the lack of data on the short‐ and long‐term safety of FMT have been raised.…”

Plasma proteome signature of canine acute haemorrhagic diarrhoea syndrome (AHDS)

“…Some strains of Clostridium perfringens , a bacterium that is an ordinary member of the canine microbiome, produce the pore-forming toxins NetE and NetF, which are commonly discussed in the literature as a major cause of gastrointestinal epithelial necrosis leading to AHDS [ 9 ]. As the incidence of AHDS is next to parasitic diseases and alimentary indiscretion probably the highest among acute gastrointestinal diseases in dogs, understanding the underlying aetiology and pathophysiology, identifying predisposing factors and developing effective management strategies are critical in mitigating the impact of this syndrome on canine health [ 10 ].…”

Microbiome Responses to Oral Fecal Microbiota Transplantation in a Cohort of Domestic Dogs

“…FMTs involve the transfer of fresh or freeze-dried fecal material from a healthy donor into the gastrointestinal tract of a recipient in the form of endoscopies, rectal enemas, or oral capsules [ 12 , 13 ]. In dogs, fecal microbiota transplants have been effective at resolving clinical signs in individuals with acute (hemorrhagic) diarrhea [ 14 , 15 ], parvovirus-associated diarrhea [ 16 ], Clostridium perfringens -associated diarrhea [ 17 ], antibiotic-responsive or non-responsive enteropathy [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ], and canine atopic dermatitis [ 24 , 25 ]. Fecal transplants aim to restore the gut microbiome by increasing microbiome diversity, repopulating numbers of beneficial bacteria and their metabolites, or reducing the abundances of potential pathogens.…”