Science is increasingly recognizing the importance of the microbiome, which is endogenous to the gastrointestinal tracts of cats, dogs and other mammals.
Research shows that flora in the GI tract play a profound role in the development and maturation of the immune system after birth. It is also widely asserted that approximately 80% to 85% of the immune system is located in the gut.
This figure is not surprising, given the vast quantity of microorganisms in the body. A human body has over 100 trillion microbes, made up of over 500 species, which works out to about two to five pounds of microorganisms per person.1,2 There are more microbes than actual cells, since they are so much smaller than human cells. Yet when we administer probiotics to support gut health, we use only one to 20 species of microorganisms. This may be completely inadequate, considering that hundreds of species may need to be replaced. Since this diversity of flora is responsible for the health of the immune system, a lack of these normal symbiotic microbes could be the reason for a failing immune system, which results not only in GIT disease, but cancer, allergies and autoimmune issues as well as mental health problems.
If probiotics have limited effect, how do we restore the microbiome? While our first reaction might be abhorrence, research all over the world indicates that microbiome restorative therapy (MBRT) – giving feces from a healthy animal or human to the same species – may be the most efficient way to reboot the gut flora. Microbiome restorative therapy enables the immune system to use the body’s own innate mechanisms to utilize the newly introduced microbes to start a new symbiosis, which in turn can help with healing.
Microbiome restorative therapy can improve a range of gastrointestinal-related health issues in dogs and cats, including irritable bowel disease, diarrhea, skin disorders, an aggressive disposition and more. Microbiome restorative therapy can be administered orally or by enema, transplanting feces from a healthy donor into the immune-compromised animal.
Research shows positive results
Multiple peer reviewed articles have shown that both oral and rectal infusion of fecal material in humans has been able to create a balanced GI tract and stop a Clostridium difficile overgrowth.3,4
Early evidence points to microbiome restorative therapy as key to future treatments for gastrointestinal and immune system problems in mammals. At Main Street Animal Services of Hopkinton (MASH), over 350 MBRTs on dogs and cats have produced major health improvements and even cures.
While the idea of using feces as a therapy may be foreign, consider that doctors have been therapeutically using other body fluids and parts like breast milk, blood, bone marrow and even organs, for years. Other cultures have used urine therapeutically for centuries.
For dogs and cats, the contents of a prey animal’s intestinal tract are a part of their ancestral diet. In the wild, the intestines and organs of the prey are often the first parts eaten. They contain pre and probiotics from the digested plant material. Dogs also scavenge rotting meat, thereby obtaining even more microorganisms.
Using microbiome restorative therapy in your practice
This protocol is very easy and can be integrated into conventional and holistic practices. The most important step is selecting a healthy fecal donor. This is critical. Preparation needs no special equipment. Administration is easy yet does need to be tailored to the needs of the animal, especially cats.
1. Selecting the donor
Fecal donors need to be healthy, pesticide and drug free, and match the following criteria:
- Are minimally vaccinated with vaccines that do not contain mercury preservations and aluminum hydroxide.
- Drink filtered well water with no chlorine or fluoride.
- Have no use of oral or topical pesticides for fleas and ticks; minimal heartworm preventatives; no lawn chemicals or fertilizers used on the property.
- Fed a raw meat diet from sources free of antibiotics, pureed organic vegetables and organic non-GMO grains (oats, millet, quinoa).
- Be physically active, spending extensive time outdoors.
- Have never been on antibiotics, NSAIDS and other GIT suppressive medicine.
- Are treated with herbs, nutraceuticals, TCVM, homeopathy or other natural modalities for any illnesses.
- Have negative fecal parasite exams and normal immunoglobulin A, G and M levels per Plechner’s Endocrine Immune Evaluation.5
- Have periodic fecal evaluations to provide information about the gut composition, looking for species of Clostridium dif and perfinges, and Camphlobactor.
- Have their reproductive organs intact to help with the balance of natural immune system ebb and flow.
The fecal sample for donation is simply collected on an observed walk or from the litter box right after defecation, placed in a plastic bag, then labeled and refrigerated. In the clinic, you can simply take a glove with some aloe as lubricant, insert a finger and take a sample. The freshest daily samples are used.
3. Administration to the patient
The feces are given fresh, from a sample taken that day, or if desperate from frozen stock.
• Push the dosage amount of feces into the back of the throat.
• Make a “meatball” by wrapping some raw ground meat around the fecal material.
• Give as an enema, especially for cats. The blender method is the best.
a. Blender method: Using a small personal blender, add two tablespoons feces and about 60cc normal saline, just enough to create a slurry. Blend for as short a time as needed to prevent any extra heating. Strain into a cup and then dose as below in “e”.
b. Cup method: Pierce the bottom of a plastic cup multiple times with an 18 gauge needle to create a sieve. Into a second cup, place about one tablespoon of feces and mix with 20cc of normal saline, stirring well until it is a slurry. Place the pierced cup into a third cup and pour the slurry through the sieve cup into the final cup.
c. Before introducing this into the colon, ozone/ oxygen gas (dose dependent on weight and condition) is given as a rectal insufflation via a catheter (using natural lubricants like aloe gel since any antibacterials in the lubricant will nullify the procedure) to reduce the intestinal biofilm that exists in most intestines.
d. Remove the catheter. Tuck the patient’s tail, holding it for about 15 minutes to prevent leakage of the ozone insufflation. The dog is taken out and the cat allowed access to a litter box to pass any stool.
e. Pull up the dose of strained feces into a 35cc to 60cc syringe, leaving about 5cc to 10cc of air behind to help clear the feces from the catheter.
f. Dosage of the slurry in small dogs and cats is 10cc to 20cc; for larger dogs, it’s 30cc to 50cc.
g. Replace the naturally lubricated catheter and infuse the fecal slurry.
h. Again, hold the tail down and massage the animal’s abdomen, trying to bring the stool into the descending colon, then up into the transverse colon. For small animals, you can raise the rear end and gently shake.
i. Do not allow the dog to walk around outside your clinic – get him in the client’s car and try to keep him from defecating for four hours, and if possible, not until the next day. Most do not defecate.
Fecal transplants in veterinary practice
To increase the success of a fecal transfer, prime the gut flora with digestive enzymes, probiotics, whole food glandulars, green tripe and a raw meat diet for a least two weeks, if the patient’s condition allows. The animal should be off antibiotics for at least a week so as to not destroy the newly introduced biome. Some patients can also be supported with additional antioxidants, organic spirulina, or prescription ultra fatty acids. This improves survival of the new microbes and promotes normal symbioses in the patient’s system.
We found that microbiome restorative therapy accelerates positive outcomes in patients also receiving other treatments, such as chemotherapy, acupuncture, homeopathy, and chiropractic work.
As we always do with any holistic approach, we tailor the treatment to the patient and his response. Some of our cases have needed only one dose for complete and sustained recovery. Others have a two-week improvement then seem to slightly relapse, so need repeat doses every few days to weeks. What we think is happening is that the replenishing is occurring, but the surface of the gut does not have the ability to bind to the intestinal wall because that wall is not strong. We may need a “Binder of Feces” to help hold on to the intestinal mucosa.
Therefore, caretakers will take home the microbiome restorative therapy material, keeping it frozen and removing pieces to be given repeatedly. More study is needed from more veterinary clinics along with MASH to determine how much fecal matter should be transferred and over what period to optimally rebalance gut microbiome.
Diseases/signs we have successfully treated in our practice include chronic diarrhea and vomiting; inflammatory bowel disease; severe ataxia with very elevated hepatic values; hypothyroid disease; severe aggression; anxiety; a variety of skin conditions; multiple types of cancer; Lyme, kidney issues and nausea; recurrent cystitis with chronic ear, skin and GIT issues; chronic Giardia duodenalis with emaciation, limping, vomiting and anorexia; atopic dermatitis; and demodex.
Make microbiome restorative therapy client friendly. We are being a little silly about this serious procedure. We call it “fecal friends” and “no shit…yes shit”. We call the samples that come from donor dogs named Lilihana and Geneva, “Lili-poops” or “Geneva Peace Poops” respectively.
The future of microbiome restorative therapy
Through research in fecal bacterio-therapy, we will someday identify the 500+ species and thousands of subspecies of microbes present in the entire digestive tract. Someday there will be catalogues of bacteria/microbes that you can purchase to fill the gaps in an individual’s GI tract.
We will also someday understand the symbiotic relationships of different species. We will appreciate that certain species of microbe stimulate the immune system with specific functions. For example, could a specific immune system function need support from a microbe whose interaction prevents cancer or strengthens the body against Lyme disease?
A first step could be to start a fecal donor directory that can match up healthy dogs and cats with animals in need of re-establishing a reboot of their own microbiome.
1Power SE, O’Toole PW, Stanton C, et al. “Intestinal microbiota, diet and health”. British Journal of Nutrition, 2014; 111(03): 387-402.
2Fujimura KE, Slusher NA, Cabana MD, et al. “Role of the gut microbiota in defining human health”. Expert Rev Anti Infect Ther, 2011; 8(4):435-454.
3van Nood E, Vrieze A, Nieuwdorp M, et al. “Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile.” N Engl J Med, 2013; 368:407-415.
4Forsythe P, Chew MV, Escaravage E, et al. “Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve”. PNAS, 2011; 108(4):16050-16055.
5Plechner, Al. “Plechner’s Syndrome or Atypical Cortisol Estrogen Imbalance Syndrome (ACEIS)”. drplechner.com/learn/ plechner-syndrome, Accessed 25 May 2014.