VetMedChronic enteropathy in dogs: faecal microbiota transplantation vs sham/placebo or standard care alone — MAYBE (weak evidence) (the treatment made no difference)
In dogs with chronic enteropathy, does faecal microbiota transplantation vs sham/placebo improve clinical activity scores and faecal dysbiosis indices?
Shelf #389 · gate-verified and displayed under the developer's blinded-trial rule
STAMP: MAYBE (weak evidence) (the treatment made no difference): Three small blinded randomised trials in dogs with chronic enteropathy, each comparing faecal microbiota transplantation (FMT) against a control, found no clear benefit of FMT on clinical activity scores or dysbiosis measures. Allerton 2026 (PMID: 41997887; blinded randomised trial, 42 dogs with chronic enteropathy) compared a single FMT retention enema plus diet change against diet change alone: by day 90, owner-defined clinical improvement was 76% (CI 54% to 90%) with FMT and 73% (CI 40% to 92%) with diet alone, with no significant differences in owner-reported improvement, Canine Inflammatory Bowel Disease Activity Index or faecal score, and the authors note the small sample cannot exclude a type II error. Hanifeh 2026 (PMID: 42486172; prospective, randomised, double-blind, placebo-controlled trial in tylosin-responsive enteropathy, 13 dogs analysed) found relapse in 2 of 7 FMT-treated dogs (28.6%) and 3 of 6 placebo-treated dogs (50.0%), and the dysbiosis index decreased over time in both groups with no treatment effect. Collier 2022 (PMID: 36256653; double blinded, randomised trial, 13 dogs with inflammatory bowel disease, all on corticosteroids and a hypoallergenic diet) found the canine chronic enteropathy clinical activity index fell over time in both groups with no significant difference between FMT and placebo at any time point (p = 0.40). Design class (a): randomisation and blinding are established by carded records answering this shelf's own comparison in dogs with chronic enteropathy. The stamp stays at MAYBE (weak evidence) because the carded total is only about 68 analysed dogs across three small trials in different chronic-enteropathy subpopulations (general chronic enteropathy, tylosin-responsive enteropathy, inflammatory bowel disease) using different FMT routes and regimens (single retention enema, 4 weeks of oral FMT, FMT added to corticosteroids), so a modest effect in any one subgroup is not excluded; the null is a statement about the tested protocols, not proof FMT can never help. Uncontrolled studies fetched at drafting (before-after and observational series reporting improvement after FMT) are documented on the synthesis card and were not carded as claim-carriers, because without a control group their improvements cannot be separated from diet change, co-treatment and time — the very effects the controlled trials show are large. Diet-first management of chronic enteropathy is a different intervention and is shelf #157's home; nothing is re-carded from it here. Drafted Nov 10, 2026 (VetMed build, topic #389); all figures from the abstracts fetched and verified at drafting.
Allerton 2026: a single FMT retention enema added to diet change made no difference vs diet change alone in 42 dogs with chronic enteropathy — owner-defined improvement at day 90 was 76% vs 73%
Blinded, randomised controlled trial (record's own wording; publication types: Journal Article, Randomized Controlled Trial, Veterinary)
Who: Dogs: 42 client-owned dogs with chronic enteropathy (more than 3 weeks of small or mixed intestinal diarrhoea; median Canine Inflammatory Bowel Disease Activity Index 6, range 4 to 11) in a blinded, randomised controlled trial. Dogs were randomly allocated 1:1 via blinded selection to standard treatment (diet change only, n = 17 assigned) or diet change plus a single faecal microbiota transplantation (n = 25 assigned), given as a retention rectal enema of fresh faecal material from donor dogs screened for selected enteropathogens. Outcomes were the Canine Inflammatory Bowel Disease Activity Index, faecal score and owner-reported improvement.
Result: A progressive improvement in stool consistency (reduced faecal score) was recorded over time for most dogs in both groups. By day 90, the rates of owner-defined clinical improvement were 76% (CI 54% to 90%) in the faecal microbiota transplantation group and 73% (CI 40% to 92%) in the standard treatment group. No significant differences were evident between the two groups in the proportion of owners reporting clinical improvement, Canine Inflammatory Bowel Disease Activity Index score or faecal score (the treatment made no difference). The authors conclude the study did not demonstrate a clear clinical benefit for adjunctive faecal microbiota transplantation via single retention enema compared with diet change alone, while noting the small sample size means a type II error cannot be excluded, and that the similar outcomes support high rates of food responsiveness in this cohort.
Watch out: The control group received diet change alone — there was no sham enema — so this trial tests FMT as an adjunct to diet, not against a placebo procedure; expectation effects on owner-reported outcomes cannot be fully separated, even though the record describes the trial as blinded and allocation as by blinded selection. The imbalance in the assigned group sizes (25 FMT vs 17 control, despite the stated 1:1 allocation ratio) and the wide confidence intervals mean a modest benefit or harm is not excluded. One protocol only: a single enema of fresh donor material; repeated or oral protocols are the other cards' questions.
Allerton F; Whittle MJ; Durkin L; Prior C; Trehy M; Swales H; Duplan F; Borgonovi S; Pinchbeck G; Gajanayake I; Dunning M; Sparks T; Watson P; Amos GCA; McCallum K; Bazelle J; Kent A. Clinical benefit of faecal microbiota transplantation administered via a single retention enema as an adjunctive treatment in dogs with chronic enteropathy: a randomised controlled trial. J Small Anim Pract. 2026;67(9):798-809. PMID: 41997887. Registry ID: none in the record. MeSH: Animals · Dogs · Chronic Disease · Diarrhea/veterinary/therapy · Dog Diseases*/therapy · Enema*/veterinary/methods · Fecal Microbiota Transplantation*/veterinary/methods · Feces/microbiology · Inflammatory Bowel Diseases*/veterinary/therapy · Treatment Outcome
Hanifeh 2026: oral FMT vs placebo in tylosin-responsive enteropathy — relapse 2 of 7 (28.6%) vs 3 of 6 (50.0%), and the dysbiosis index fell in both groups with no treatment effect
Prospective, randomized, double-blind, placebo-controlled trial (record's own wording; publication types: Journal Article, Randomized Controlled Trial, Veterinary, Research Support, Non-U.S. Gov't)
Who: Dogs: 14 client-owned dogs with confirmed tylosin-responsive enteropathy entered the treatment phase of a prospective, randomized, double-blind, placebo-controlled trial (August 2020 to December 2022); dogs received oral faecal microbiota transplantation (n = 7) or placebo (n = 7) for 4 weeks, and 1 placebo-treated dog was excluded (pyometra), leaving 7 FMT-treated and 6 placebo-treated dogs analysed. Canine Chronic Enteropathy Clinical Activity Index, fecal consistency and fecal biomarkers (dysbiosis index, core bacteria, bile acids, short-chain fatty acids, lactate, calprotectin) were assessed before and after treatment; intestinal permeability was evaluated with serum iohexol.
Result: Relapse occurred in 2 of 7 FMT-treated dogs (28.6%) and 3 of 6 placebo-treated dogs (50.0%). The dysbiosis index decreased over time in both groups, with no treatment effect. Faecalibacterium spp increased, with higher posttreatment values in the FMT group, whereas Turicibacter spp increased in both groups; Peptacetobacter hiranonis increased over time without between-group differences; bile acid conversion was observed in a subset of dogs without group differences; other biomarkers showed no consistent treatment-specific effects. The authors conclude oral FMT was associated with variable microbiome changes and inconsistent clinical response, with no clear treatment-specific effects compared with placebo.
Watch out: Only 13 dogs were analysed, so the relapse percentages (28.6% vs 50.0%) rest on 2 versus 3 events — the record itself reports no clear treatment-specific effect, and no significance claim for the relapse difference is made or should be read into it. The population is one chronic-enteropathy subtype (tylosin-responsive enteropathy) and the protocol is oral FMT for 4 weeks; results do not transport to enema protocols or to diet- or steroid-refractory disease.
Hanifeh M; Huhtinen M; Ganz HH; Heilmann RM; Huang W; Spillmann T; Suchodolski JS. Clinical trial reveals limited clinical and microbiome effects following oral fecal microbiota transplantation in dogs with chronic enteropathy responsive to tylosin. J Am Vet Med Assoc. 2026;264(10):1314-1324. PMID: 42486172. Registry ID: none in the record. MeSH: Animals · Dogs · Female · Male · Administration, Oral · Anti-Bacterial Agents*/therapeutic use · Chronic Disease · Dog Diseases*/therapy/microbiology/drug therapy · Double-Blind Method · Dysbiosis/veterinary · Fecal Microbiota Transplantation*/veterinary · Feces/microbiology/chemistry · Gastrointestinal Microbiome* · Intestinal Diseases*/veterinary/therapy · Prospective Studies · Tylosin*/therapeutic use
Collier 2022: FMT added to corticosteroids and hypoallergenic diet made no difference to clinical activity scores vs placebo in 13 dogs with inflammatory bowel disease (between-group p = 0.40)
Double blinded, randomized clinical trial (record's own wording; publication types: Journal Article, Randomized Controlled Trial, Veterinary, Research Support, Non-U.S. Gov't)
Who: Dogs: 13 client-owned dogs with inflammatory bowel disease in a double blinded, randomized clinical trial. All dogs received corticosteroid therapy and a hypoallergenic diet and were randomized to receive either placebo or faecal microbial transplant. The measured outcome was the canine chronic enteropathy clinical activity index (CCECAI) at 1 week and 1 month after enrolment; fecal microbiota were profiled using 16S amplicon sequencing. Dogs in the placebo group not responding after 1 month were offered FMT.
Result: The CCECAI significantly decreased over time in both groups (p = 0.001). There were no significant differences between the CCECAI of the placebo and FMT groups at each time point (F test from ANOVA, p = 0.40) (the treatment made no difference). No adverse effects were reported in the 30 days following FMT. The authors conclude that adding FMT to standard therapy for inflammatory bowel disease was feasible, that no significant differences in CCECAI were observed between groups, and that large-scale trials can be performed using these methods to evaluate longer-term effects.
Watch out: A preliminary feasibility-sized study: 13 dogs, 30 days, and every dog was also on corticosteroids and a hypoallergenic diet — the improvement over time in both arms shows how much co-treatment and time alone can do, which is exactly why the uncontrolled FMT series on the synthesis card cannot carry this shelf's claim. The trial was designed to test feasibility; it cannot exclude a modest FMT effect.
Collier AJ; Gomez DE; Monteith G; Plattner BL; Verbrugghe A; Webb J; Weese JS; Blois SL. Investigating fecal microbial transplant as a novel therapy in dogs with inflammatory bowel disease: A preliminary study. PLoS One. 2022;17(10):e0276295. PMID: 36256653. Registry ID: none in the record. MeSH: Dogs · Animals · Fecal Microbiota Transplantation/methods · Inflammatory Bowel Diseases*/therapy/veterinary/etiology · Feces · Microbiota* · Remission Induction · Treatment Outcome
Synthesis: every blinded randomised test of FMT in canine chronic enteropathy found no difference from its control, while uncontrolled series report improvement — MAYBE (weak evidence) (the treatment made no difference)
Synthesis
Who: Synthesis of the three cards above (Allerton 2026, 42 dogs, single FMT enema plus diet vs diet alone; Hanifeh 2026, 13 dogs analysed, oral FMT vs placebo in tylosin-responsive enteropathy; Collier 2022, 13 dogs, FMT vs placebo added to corticosteroids and diet in inflammatory bowel disease) and of the uncontrolled records documented in the result, fetched at drafting and deliberately not carded as claim-carriers.
Result: (1) Controlled evidence: across the three blinded randomised trials, no FMT protocol beat its control on clinical activity scores (day-90 owner improvement 76% vs 73%; CCECAI between-group p = 0.40), on relapse (2/7 vs 3/6), or on the dysbiosis index (fell in both groups, no treatment effect). (2) Uncontrolled records, not carded: Vecchiato 2025 (PMID: 40199985), a before-after study of 20 dogs refractory to diet, reported CIBDAI and dysbiosis index improvements 1 month after FMT with 17 dogs improved up to 3 months; Pérez-Accino 2025 (PMID: 39778887), 7 dogs given a single rectal FMT with no control group, reported median CCECAI falling from 8 to 1 by day 30 while recipient microbiota composition did not change; Toresson 2026 (PMID: 41223536), a prospective observational study of repeated FMT in 39 dogs with refractory chronic enteropathy, reported 28 of 39 responded and corticosteroid tapering in 13 responders; Alves 2023 (PMID: 37245211) compared FMT once via enema with psyllium husk in 30 working dogs with chronic large bowel diarrhoea — an active-comparator study with no sham or placebo arm — and found similar improvement in both groups. Because the randomised trials show dogs improving over time on diet change or corticosteroids alone, these uncontrolled improvements cannot be attributed to FMT. (3) Design class (a): randomisation and blinding are established by the carded records for this shelf's own comparison and population; the MAYBE (weak evidence) stamp reflects the small total sample (about 68 analysed dogs), three different subpopulations and protocols, and the type II error the largest trial's authors themselves flag.
Watch out: One-home check at drafting: PMIDs 41997887, 42486172 and 36256653 do not appear in any other pack on disk, and none of the documented near-miss PMIDs is a claim-carrier elsewhere. Practical reading: this shelf does NOT prove FMT is useless in canine chronic enteropathy — it shows the three protocols so far tested under blinded randomised conditions (single enema adjunct to diet, 4 weeks oral in tylosin-responsive disease, adjunct to steroids in inflammatory bowel disease) did not beat their controls, in samples too small to exclude a modest effect. Shelf #157 (diet-first chronic enteropathy management) is a different intervention and is cross-pointed, not re-carded.
Synthesis of Allerton F et al. PMID: 41997887; Hanifeh M et al. PMID: 42486172; Collier AJ et al. PMID: 36256653. Near-miss records documented, not carded: PMID: 40199985; PMID: 39778887; PMID: 41223536; PMID: 37245211. Registry IDs as on the individual cards (none in the records).
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