A single faecal microbiota transplant did not improve outcomes over diet change alone in dogs with chronic enteropathy, suggesting that a structured diet trial remains a cornerstone of management, and that newer microbiome-based interventions may not add benefit in every case.
The randomised controlled trial compared two approaches in 42 dogs with chronic enteropathy. One group received a diet change alone, using a hydrolysed or novel-protein diet, while the other received the same diet change plus faecal microbiota transplantation.
The FMT was given as a single retention rectal enema using fresh faecal material from screened donor dogs. Researchers assessed response using the Canine Inflammatory Bowel Disease Activity Index, faecal score and owner-reported clinical improvement.
Dogs in both groups generally improved during the study, particularly in stool consistency. However, adding FMT did not produce a clear advantage.
By day 90, owner-reported clinical improvement was recorded in 76% of dogs in the FMT group and 73% of dogs in the diet-only group. There were no significant differences between groups in owner-reported improvement, CIBDAI or faecal score.
The study was small, with 42 dogs, so it may have missed a modest treatment effect. The authors note that a type II error cannot be excluded.
The findings also apply to one specific protocol: a single rectal FMT given alongside a diet trial. They should not be taken as evidence against all FMT use, repeated FMT protocols, oral preparations, or use in dogs with refractory disease.
The study population was also selective. Dogs with severe hypoalbuminaemia, exclusively large-intestinal diarrhoea or extra-intestinal causes of diarrhoea were excluded, so the findings may not apply to more severe or complex chronic enteropathy cases.
For GP vets, the key message is that a properly managed diet trial remains central in dogs with chronic enteropathy. This study does not support adding a single FMT enema as a routine first-line adjunct when starting dietary management, particularly in mild to moderate cases.
The results also reinforce how many chronic enteropathy cases may be food-responsive. In practice, that means careful diet selection, owner compliance and adequate trial duration are still likely to matter more than reaching early for newer microbiome-based interventions.
Overall, this is a useful cautionary trial. It suggests that, for many dogs starting chronic enteropathy management, single-enema FMT may add cost and complexity without clear clinical gain over diet change alone.