Powdered Fecal Material for Transplant via Enema (Feline)

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Enema FMT for Domestic Cats

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 smaller tubes.

 

Prepare FMT.

  1.  Using a lidded wide mouth jar, add the volume of 0.9% NaCl to the weighted fecal powder. Pour slowly onto the inside wall of the jar to minimize powder aerosolization.
  2. Secure lid. Mix thoroughly by shaking (1 minute) until a smooth-consistency slurry results.
  3. Transfer the fecal slurry into a catheter-tipped syringe(s) for administration to the patient.
  4. The fecal slurry should be administered within 2-4 hours of reconstitution.

For example: 45 mLs for a 10 lb cat:

  1. Using a wide mouth jar with a lid or a 60 mL syringe, add 40 mL 0.9% NaCl to 10 g powdered feline fecal matter. 
  2. Mix thoroughly until a slurry-like consistency is obtained.
  3. Draw up the fecal slurry into (1) 60 mL catheter-tip syringe if using a mixing jar for administration to the patient.

    Prepare patient.

    Sedation is recommended to minimize discomfort.

    Place the recipient 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.

     

    The science behind AnimalBiome is pretty amazing, and with millions of bacteria being analyzed, there’s a lot of information – if you want to learn more:

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