Fecal transfer gains ground in chronic diarrhea care

Version 1 — Brief

Fecal microbiota transplantation, or fecal transfer, is getting more attention in small-animal GI care as new veterinary evidence and clinical guidance come into focus. A 2025 Journal of Veterinary Internal Medicine study found that dogs with chronic enteropathy showed rapid clinical improvement after rectal fecal microbiota transplantation, with median disease activity scores dropping within a week and again by day 30, although the response lasted about 10 weeks on average and consistent microbiome changes were not demonstrated. Separately, a 2024 international consensus guideline from the Companion Animal FMT Consortium recommended FMT as an adjunctive option for chronic enteropathy in dogs and cats, alongside canine acute diarrhea and parvoviral enteritis, while stressing donor screening, product handling, and case selection. Practice-level interest also appears to be growing, with veterinary podcast discussions framing fecal transfer as a practical “toolbox” option for chronic diarrhea cases rather than a fringe idea. (academic.oup.com)

Why it matters: For veterinary professionals, the shift here is that fecal transfer is moving from fringe or anecdotal use toward a more standardized adjunct therapy, especially in chronic diarrhea cases that are difficult to manage. The evidence is still early and mostly canine, but the guidelines say FMT can be performed in many practice types, discourage unnecessary antimicrobials before treatment in the interest of stewardship, and note that repeated treatments may help some chronic enteropathy patients. That broader uptake is also showing up in clinician education and case-based discussion, where FMT is being presented as something general practitioners may increasingly consider in selected cases. Evidence in cats remains limited, with guideline authors describing feline use largely as anecdotal at this stage. (pure.ed.ac.uk)

What to watch: Expect more discussion around repeat-dosing protocols, donor-screening standards, and whether newer controlled trials can show durable benefit, especially in chronic enteropathy and feline cases. Also watch for more practical guidance aimed at everyday clinicians as interest spreads beyond referral and integrative settings. (pure.ed.ac.uk)