Effects of fecal microbiota transplantation on clinical outcomes and fecal microbiota of foals with diarrhea.
Authors: Bell Jillian, Radial Sharanne L, Cuming Rosemary S, Trope Gareth, Hughes Kristopher J
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Fecal Microbiota Transplantation in Diarrheic Foals Diarrhoea in foals frequently accompanies intestinal dysbiosis, yet evidence-based treatments targeting microbial imbalance remain limited. Bell and colleagues conducted a prospective randomised, placebo-controlled trial across three veterinary hospitals, treating 25 foals under six months of age presenting with diarrhoea and systemic inflammatory response syndrome; 19 received fecal microbiota transplantation (FMT) whilst nine received electrolyte solution daily for three days, with fecal sampling performed on days 0, 1, 2, 3 and 7. Although FMT did not significantly improve survival rates (79% versus 100% in controls) or diarrhoea resolution (68% versus 55%), foals receiving transplants demonstrated measurably lower white blood cell counts by day three (median 6.4 g/L compared to 14.3 g/L in controls, *P* = 0.04) and progressive heart rate reduction through day three, suggesting dampened systemic inflammation; microbiota analysis revealed rapid enrichment of beneficial taxa including *Akkermansia* and Prevotellaceae family members in treated foals by day one. These findings indicate FMT is a safe intervention that may modulate inflammatory markers in diarrheic foals, though larger prospective studies would be needed to establish whether these microbiotal and physiological improvements translate to clinically superior outcomes or identify which foals would benefit most from this approach.
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Practical Takeaways
- •FMT appears safe in foals with diarrhea but does not significantly improve survival or diarrhea resolution rates compared to standard electrolyte therapy
- •FMT may reduce systemic inflammation markers (lower WBC counts and heart rate) suggesting some biological benefit, though clinical outcomes were not dramatically improved
- •Consider FMT as a complementary treatment option for foal diarrhea when combined with standard management, but do not expect it to be superior to conventional fluid and electrolyte therapy alone
Key Findings
- •FMT did not improve survival rates (79% vs 100%, P=0.3) or diarrhea resolution (68% vs 55%, P=0.4) compared to control
- •FMT group showed significantly lower white blood cell count on Day 3 (6.4 g/L vs 14.3 g/L, P=0.04)
- •Heart rate decreased over time in FMT group from median 80 bpm to 64 bpm by Day 3 (P<0.001)
- •Phylum Verrucomicrobiota, genus Akkermansia, and family Prevotellaceae were enriched in FMT group on Day 1