Powdered Fecal Material for Transplant via Enema (Canine)

Enema FMT for Domestic Dogs

Procedure based on methods described in Pereira et al.,2018

Follow standard practices prior to surgical procedures.

Dosage: 4.5 ml fecal slurry per 1 lb body weight (10ml/kg)

Prepare a 1:4 dilution of saline with the powdered fecal suspension.

Ratio of powder to 0.9% NaCl :  2 g (powder) to 8 ml (0.9% NaCl)

Recommend using a red rubber catheter 10 Fr or greater because the fecal slurry will easily clog the tube.

Determine catheter size according to patient’s weight (Typically a 10-12Fr for a small 15 lb dog)

For 90 mL for a 20 lb dog:

1. Using a wide mouth bottle with a lid, add 80 ml of 0.9% NaCl to 20 g powdered canine fecal matter
2. Mix thoroughly until a slurry-like consistency is obtained
3. Draw up the fecal slurry into (3) 30 ml catheter-tip syringes for administration to the recipient.

Prepare patient.

Sedation is recommended to minimize discomfort.

Place the recipient dog into right lateral recumbency with their pelvis slightly elevated.

Administration of warm water enema prior to procedure is recommended.

Administer a warm water enema via a lubricated red rubber catheter attached to a 60 ml catheter-tip syringe, pre-filled with warm water (to avoid introducing air into the colon), introduce up to the estimated location of the transverse colon.

Deliver FMT via catheter.

Immediately after the enema, introduce a second lubricated red rubber catheter rectally. Push some of the fecal slurry into the catheter prior to its administration in order to avoid introducing air into the colon. Gently advance catheter up to the estimated location of the transverse colon. Administer desired volume of fecal slurry slowly, while the anus is held closed by an assistant.

Retention period after FMT delivery.

After completing the FMT infusion, keep recipient in right lateral recumbency for 15 additional minutes, and then place in sternal position for another 15 minutes, and then place in left lateral recumbency for additional 15 minutes (total retention period of 45 minutes).

Material Checklist:

• Powdered canine fecal matter
• Wide mouth bottle with lid
• Red rubber catheter
• Sterile lube
• 0.9% Saline Injectable (NaCl)
• Catheter tip syringes (30mL or 60 mL)
• Gloves

Reference:

Pereira, Giorgio Q., Lucas A. Gomes, Iago S. Santos, Alice F. Alfieri, J. S. Weese, and Marcio C. Costa. "Fecal Microbiota Transplantation in Puppies with Canine Parvovirus Infection." Journal of Veterinary Internal Medicine 32.2 (2018): 707-11. Print.

Parvo puppy protocol

For FMT, 10 g of the donor’s feces was diluted in 10 mL of 0.9% sodium chloride solution, which was mixed and aspirated in a 20-mL syringe, connected to a urethral catheter, introduced anally, and the contents deposited in the proximal portion of the rectum. Sedation or anesthesia was not used.

The animal was maintained in lateral recumbency for 2 minutes, with the pelvis raised to approximately 458 from the surface, to aid in the diffusion of the transplanted contents by gravity. The FMT was performed between 6 and 12 hours post-admission and repeated every 48 hours until resolution of diarrhea or a total of 5 applications.