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Journal of veterinary internal medicine2024; 38(5); 2718-2728; doi: 10.1111/jvim.17185

Effects of fecal microbiota transplantation on clinical outcomes and fecal microbiota of foals with diarrhea.

Abstract: Diarrhea in foals can be associated with disruption of the intestinal microbiota (dysbiosis). Effective management of intestinal dysbiosis in foals has not been demonstrated. Objective: Fecal microbiota transplantation (FMT) in foals with diarrhea influences the intestinal microbiota and improves clinical and clinicopathological outcomes. Methods: Twenty-five foals <6 months of age with diarrhea and systemic inflammatory response syndrome at 3 veterinary hospitals. Methods: A prospective randomized placebo-controlled cohort study. Foals in the FMT group (n = 19) or control group (n = 9) received FMT or electrolyte solution once daily for 3 days. Fecal samples were obtained on Day 0 (D0), D1, D2, D3, and D7. Within group and between group data analyses were performed for clinical, clinicopathological, and microbiota variables. Results: Treatment had no effect on survival (FMT 79%; control 100%, P = .3) or resolution of diarrhea (FMT 68%; control 55%, P = .4). On D3, the white blood cell count of the FMT group was lower than the control group (D3 FMT group median 6.4 g/L [5-8.3 g/L]; D3 control group median 14.3 g/L [6.7-18.9 g/L] P = .04). Heart rate reduced over time in the FMT group (D0 median 80 bpm [60-150 bpm]; D2 median 70 bpm [52-110 bpm] [P = .005]; and D3 median 64, [54-102 bpm] [P < .001]). Phylum Verrucomicrobiota, genus Akkermansia, and family Prevotellaceae were enriched in the FMT group on D1 (linear discriminate analysis > 4). Conclusions: In foals with diarrhea, FMT appears safe and can be associated with some clinical and microbiota changes suggestive of beneficial effect.
© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2024-09-12 PubMed ID: 39266472PubMed Central: PMC11423448DOI: 10.1111/jvim.17185Google Scholar: Lookup
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  • Journal Article

Summary

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Overview

  • This study investigated the effects of fecal microbiota transplantation (FMT) on foals under 6 months old suffering from diarrhea, focusing on clinical outcomes and changes in their intestinal microbiota.
  • The study aimed to evaluate whether FMT could improve health indicators and restore healthy gut bacteria compared to a control treatment with electrolyte solution.

Background and Purpose

  • Diarrhea in foals can lead to disruption of their intestinal microbiota, a condition called dysbiosis, which negatively impacts gut health and overall recovery.
  • Currently, effective treatments targeting microbiota restoration in foals with diarrhea are not well established.
  • The study’s objective was to determine if FMT could beneficially influence gut microbiota and clinical outcomes in diarrheic foals.

Study Design and Methods

  • Researchers conducted a prospective, randomized, placebo-controlled cohort study across three veterinary hospitals.
  • Participants consisted of 25 foals under 6 months old presenting with diarrhea and systemic inflammatory response syndrome (SIRS).
  • Foals were assigned to two groups:
    • FMT group (n=19): received fecal microbiota transplantation once daily for three days.
    • Control group (n=9): received an electrolyte solution placebo once daily for three days.
  • Fecal samples were collected from all foals on Day 0 (baseline), and Days 1, 2, 3, and 7 to analyze gut microbiota changes over time.
  • Clinical variables (e.g., white blood cell count, heart rate), clinicopathological data, and microbiota profiles were compared within groups over time and between groups.

Key Findings

  • Survival rates were not significantly different between groups: 79% in FMT group vs. 100% in controls (P=0.3).
  • Resolution of diarrhea showed no statistically significant difference: 68% in FMT group vs. 55% in controls (P=0.4).
  • By Day 3, foals in the FMT group had a significantly lower median white blood cell count compared to controls, indicating possible reduced inflammation or improved immune response:
    • FMT group median: 6.4 g/L (range 5-8.3 g/L)
    • Control group median: 14.3 g/L (range 6.7-18.9 g/L)
    • P=0.04 (significant)
  • Heart rates declined significantly over time in the FMT group, suggesting clinical improvement:
    • Day 0 median: 80 bpm (range 60-150 bpm)
    • Day 2 median: 70 bpm (range 52-110 bpm), P=0.005
    • Day 3 median: 64 bpm (range 54-102 bpm), P<0.001
  • Microbiota analysis showed enrichment of particular beneficial bacterial groups in the FMT group on Day 1:
    • Phylum Verrucomicrobiota
    • Genus Akkermansia
    • Family Prevotellaceae
    • This suggests that FMT can alter the intestinal bacterial composition toward potentially healthier profiles.

Conclusions and Implications

  • FMT was safe when used in foals with diarrhea, with no adverse survival outcomes noted.
  • While FMT did not significantly change survival rates or diarrhea resolution compared to controls, it was associated with some clinical improvements (e.g., reduced white blood cell count and heart rate) that may indicate a beneficial effect on inflammation and overall health.
  • Importantly, FMT appeared to shift the gut microbiota toward a composition featuring key beneficial bacteria, which could promote gut health and recovery.
  • These findings suggest that fecal microbiota transplantation warrants further investigation as a potential treatment for managing dysbiosis and improving clinical outcomes in foals with diarrhea.

Cite This Article

APA
Bell J, Radial SL, Cuming RS, Trope G, Hughes KJ. (2024). Effects of fecal microbiota transplantation on clinical outcomes and fecal microbiota of foals with diarrhea. J Vet Intern Med, 38(5), 2718-2728. https://doi.org/10.1111/jvim.17185

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 38
Issue: 5
Pages: 2718-2728

Researcher Affiliations

Bell, Jillian
  • Charles Sturt University School of Agricultural, Environmental and Veterinary Sciences, Wagga Wagga, New South Wales, Australia.
Radial, Sharanne L
  • Charles Sturt University School of Agricultural, Environmental and Veterinary Sciences, Wagga Wagga, New South Wales, Australia.
Cuming, Rosemary S
  • Scone Equine Hospital, Scone, New South Wales, Australia.
Trope, Gareth
  • South Eastern Equine Hospital, Narre Warren North, Victoria, Australia.
Hughes, Kristopher J
  • Charles Sturt University School of Agricultural, Environmental and Veterinary Sciences, Wagga Wagga, New South Wales, Australia.

MeSH Terms

  • Animals
  • Horses
  • Diarrhea / veterinary
  • Diarrhea / therapy
  • Diarrhea / microbiology
  • Fecal Microbiota Transplantation / veterinary
  • Horse Diseases / therapy
  • Horse Diseases / microbiology
  • Female
  • Feces / microbiology
  • Male
  • Gastrointestinal Microbiome
  • Prospective Studies
  • Treatment Outcome
  • Animals, Newborn
  • Dysbiosis / veterinary
  • Dysbiosis / therapy
  • Cohort Studies

Grant Funding

  • Agrifutures Australia

Conflict of Interest Statement

Kristopher J. Hughes serves as Associate Editor for the Journal of Veterinary Internal Medicine. He was not involved in review of this manuscript. No other authors declare a conflict of interest.

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Citations

This article has been cited 2 times.
  1. Tian R, Chong CJ, Bai YY, Chen N, Qiao RR, Wang K, Wang YW, Zhao P, Zhao CB, Tang YP, Zhang L, Zhang Q. The role of gut microbiota in diarrhea and its alleviation through microbiota-targeted interventions. Front Microbiol 2025;16:1630823.
    doi: 10.3389/fmicb.2025.1630823pubmed: 41229686google scholar: lookup
  2. Cantas L, Goll R, Fenton CG, Paulssen RH, Sørum H. Impact of fecal microbiota transplantation in dogs. Front Vet Sci 2025;12:1505226.
    doi: 10.3389/fvets.2025.1505226pubmed: 40666732google scholar: lookup
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