Fecal Microbiota Transplant versus Probiotics as Therapy for Acute Hemorrhagic Diarrhea Syndrome in Dogs

Purpose and Brief Study Description:

This study aims to compare fecal microbiota transplantation and probiotics as treatments for acute hemorrhagic diarrhea syndrome (AHDS) in dogs. Prior to entry in this study, your dog must have a diagnosis of acute hemorrhagic diarrhea syndrome, based on initial screening blood work and short duration (<48 hours) of clinical signs and negative screening for infectious disease.

If your dog takes part in the study, he/she will have blood drawn for measurement of red and white blood cell counts (CBC), serum biochemistry panel (electrolytes and organ function) for inclusion, and intestinal permeability (LPS) at the time of admission to the hospital, after 72 hours of hospitalization (CBC, LPS), and at a 14-day recheck (LPS). Urine concentration will be measured in some dogs to estimate dehydration. We will also collect fecal samples on the day of admission to the hospital, after 72 hours of hospitalization, and after 14 days to look at bacterial population changes (dysbiosis index). For this clinical trial, your dog will be enrolled into one of three treatment groups: 1) probiotics with standard-of-care therapy, 2) fecal transplant with standard-of-care therapy, or 3) standard-of-care therapy without probiotics or fecal transplant. Your dog will receive either a daily probiotic medication or placebo in powder form for the 14 days of the study and either a single fecal microbiota transplant or saline enema on the day of admission. Your dog will also receive standard-of-care therapy, including IV fluids and anti-emetics, as indicated.

As a participant in this study, blood will be drawn using either a needle and syringe or butterfly catheter from a jugular or peripheral vein as deemed appropriate, and the samples submitted for testing. The procedures will be performed using standard protocol. Naturally-voided fecal samples will be collected in the hospital for infectious disease testing. For fecal transplant (FMT), prepared stool from healthy donor dogs will be administered once as an enema using a red rubber catheter.

Eligibility:

Diagnosis of AHDS based on:

• acute duration of clinical signs (<48 hours);
• consistent blood work findings (PCV >50% and normal serum total protein);
• exclusion of other systemic disease based on CBC and serum biochemistry panel;
• negative fecal flotation and direct smear for GI parasites;
• negative parvovirus snap test.

Exclusion criteria:

• steroid, probiotic, oral or IV antibiotic use within the previous month;
• history of chronic gastrointestinal disease (e.g. additional history of vomiting/diarrhea within previous 4 months;
• therapeutic use of novel protein or hydrolyzed diet to control historical gastrointestinal signs;
• evidence of systemic disease (e.g. renal disease, liver disease) on blood work.

Client Compensation:

For enrolled dogs, the study will cover the cost of complete blood cell count (CBC), LPS, biochemistry panels at admission, and CBC and LPS at 72 hours, and LPS at 14 day recheck, probiotic/placebo therapy, and fecal transplant/saline enema, infectious disease testing (parvovirus snap test, fecal flotation), and 72-hour and 14-day recheck examination fees, if applicable.

No direct compensation is provided and the owner is responsible for any additional testing, hospitalization or additional treatment, as recommended by the attending clinician.

Contact Information:

Please contact Kris Richardson, Clinical Trials Coordinator, for more information. Phone: (785)-532-3046; email: ClinicalTrials@vet.k-state.edu