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There are many causes, or combination of causes, including infectious, managerial, and environmental factors.
Foal diarrhoea can lead to dehydration, electrolyte imbalances, and, in severe cases, systemic infections. In such cases, it can become life-threatening.
Diarrhoea and Systemic Inflammatory Response Syndrome (SIRS) in foals are interconnected conditions that demand immediate attention. While diarrhoea is a frequent occurrence, it can escalate to SIRS, particularly when associated with severe infections or when significant dehydration and systemic stress occur.
A common contributor to diarrhoea in foals is dysbiosis, or a disruption in the normal intestinal microbiota. Could restoring this microbial balance be a potential solution for managing this potentially fatal condition?
Faecal microbiota transplantation (FMT) has been used in adult horses to reduce diarrhoea and improve alpha diversity, a measure of the variety of microbial species within an individual’s gut.
A recent study in Australia, published in the Journal of Veterinary Internal Medicine, explored the effects of FMT in foals with diarrhoea and SIRS. The study, led by Jillian Bell, involved clinicians from three equine veterinary hospitals. It included 25 foals under six months of age with diarrhoea and SIRS who were admitted for treatment.
In the randomised, placebo-controlled cohort study, 19 foals were enrolled in the FMT group, while 9 were in the control group. The treatment groups received either FMT or an electrolyte solution once daily for three days. Researchers collected faecal samples from the foals on days 0 (D0), D1, D2, D3, and D7 to monitor changes.
The FMT solution was prepared 15 minutes prior to treatment. from fresh manure collected from healthy donor horses (previously screened for pathogenic agents). About 300 g of manure was blended with 1 L of warm chlorinated water (95°F) for 30 to 60 seconds, then strained through a wire strainer or gauze into a clean container.
The study found that FMT was associated with improvements in some clinical signs and certain clinicopathological parameters. FMT had no significant impact on survival rates (P = 0.3) or the resolution of diarrhoea (P = 0.4). Foals receiving FMT, however, showed a significantly lower heart rate, white blood cell (WBC) count, and packed cell volume (PCV), as well as higher serum chloride concentrations, compared to pretreatment values and the control group. Notably, on Day 3, the WBC count in the FMT group was significantly lower than in the control group (P = 0.04), and heart rate decreased over time in the FMT group.
Additionally, although three foals initially in the control group were later transferred to the FMT group, diarrhoea resolved in two of them after FMT treatment.
FMT was also associated with a greater diversity in the gut microbiota, with enrichment of beneficial bacteria such as the phylum Verrucomicrobiota, genus Akkermansia, and family Prevotellaceae. Previous studies have shown that Akkermansia is linked to the maintenance of the mucin layer in the intestines and can reduce bowel inflammation in humans. Members of the Prevotellaceae family have been associated with anti-inflammatory effects and improved intestinal health.
The authors concluded that FMT appears to be a safe treatment for foals with diarrhoea and can lead to some clinical and microbiota changes that suggest beneficial effects.
However, further research is needed to confirm its impact on survival and long-term outcomes in affected foals.
For more details, see:
Bell J, Raidal SL, Cuming RS, Trope G, Hughes KJ.
Effects of fecal microbiota transplantation on clinical outcomes and fecal microbiota of foals with diarrhea.
J Vet Intern Med. 2024; 38(5): 2718-2728.
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