Fecal microbiota transplant for treatment of diarrhea in adult hospitalized horses – 111 cases (2013 – 2018)

Abstract

Background: Fecal microbiota transplant (FMT) is increasingly administered as part of the treatment of colitis in horses, yet there are little data as to effectiveness. Aim: Retrospective evaluation of the effects of FMT on discharge status, fecal consistency, length of hospitalization and improvement in clinical signs in horses hospitalized for diarrhea. Methods: Retrospective case-control study. Medical records of adult horses (>1 year old) that received at least one transfaunation treatment (2013-2018) in two referral hospitals were identified through a medical records database search. Medical records of contemporary adult horses with diarrhea that did not receive FMT at the same study centers were used as controls. Results: Control horses had statistically significant shorter hospitalization (7 [1-21]) as compared to the transfaunation group (12 [3-31]) (P=0.0006). There were no significant differences between groups in number of days to improvement of feces (P=0.38), or in days to normalization of fecal consistency (P=0.43), respiratory rate (P=0.42), heart rate (P=0.27), body temperature (P=0.12), peripheral white blood cell count (P=0.37), improvement in appetite (P=0.81) or attitude (P=0.06). There was also no significant difference in survival to discharge (transfaunation 28/37, 75.7%; control 56/74, 75.7%, P=1.0). Conclusions: There were no significant advantages of performing fecal microbiota transplant in horses with diarrhea in this retrospective study. This highlights the need for prospective, randomized studies to evaluate the efficacy of FMT, as well as different formulations, in horses with colitis before this can become standard practice.

Carbonate buffer mixture and fecal microbiota transplantation hold promising therapeutic effects on oligofructose-induced diarrhea in horses

“…However, it is worth noting that this particular study utilized a relatively small amount of stool (500 g) for the transplantation, which may not have been sufficient to induce significant changes in the gastrointestinal tract of the horse. Additionally, a study involving 111 horses reported no effectiveness of FMT in their cohort ( 22 ). However, it is important to acknowledge that in this study, the authors failed to exclude horses treated with antimicrobials from the statistical analysis when evaluating the efficacy of FMT.…”

“…However, it is important to note that these studies were not case-controlled and involved horses from various locations with differing health statuses serving as controls. Conversely, other studies have demonstrated no discernible impact of FMT on gastrointestinal issues in horses (19)(20)(21)(22). Consequently, it is crucial to approach these findings with caution and acknowledge the necessity for further research to enhance the efficacy of FMT in equine care.…”

Current Understanding of Equine Gut Dysbiosis and Microbiota Manipulation Techniques: Comparison with Current Knowledge in Other Species

“…A decrease in the symptom’s severity was reported, but horses were evaluated by their owners non-blinded, which might have introduced bias to their evaluation. Quattrini et al performed a retrospective study using records from 111 cases of colitis from two equine hospitals [ 177 ]. Non-treated horses had significantly shorter hospitalization times than the group receiving FMT, and there were no statistical differences in time to normalize fecal consistency, clinical parameters, or mortality.…”