@inproceedings{01HDZVCY554FBDGTWZ5V7PPNAT,
  abstract     = {{The management of dogs with idiopathic epilepsy (IE) remains challenging, because antiseizure 
drugs (ASDs) are still unsuccessful in one third of the cases. Therefore, interest in innovative 
therapeutic targets, like the microbiota-gut-brain axis (MGBA) is increasing. Based on growing 
literature, the MGBA shows high potential with low associated risks and adverse effects. 
Therefore, the MGBA was targeted in a canine IE patient with a severe, drug-resistant phenotype via 
faecal microbial transplantation (FMT).

A 1.5 years old female entire Cavalier King Charles Spaniel, diagnosed with IE (Tier II) at the age of 1 
year, was presented at the UGent Small Animal Clinic for optimization of antiseizure management. At 
first presentation the dog received levetiracetam 23 mg/kg TID with a high mean seizure frequency 
(MSF). ASD management was adapted and phenobarbital 4.6 mg/kg BID was started, while tapering 
down levetiracetam. Reaching an optimal serum concentration of phenobarbital, MSF remained high 
and potassium bromide was added at 20 mg/kg BID but lowered to 15 mg/kg BID after 3 weeks due 
to side effects. The MSF did not decrease. Therefore, additional management options were discussed 
with the owner. Firstly, the diet was changed to a medium chain triglycerides diet (MCTD, Purina 
Neurocare®). Six weeks later MSF remained high and consequently FMT was performed.

Fresh faeces was collected on the day of FMT together with frozen faeces the day before (to achieve 
an adequate amount), after donor screening. The resulting faecal slurry was given via a naso-
oesophagal tube at a dose of 5g/kg. The dog was hospitalized for the procedure and received 
omeprazole (1 mg/kg) and metoclopramide (0,3 mg/kg) before FMT.
 The FMT procedure was well tolerated without adverse effects. Follow-up management included 
enteric coated capsules with lyophilised faeces from the same donor at 207 mg/kg twice weekly. This 
follow up treatment started 3 weeks after FMT, for a period of 12 weeks. Faecal samples were 
collected before FMT and at multiple timepoints after FMT for future assessment of the engraftment 
of the donor microbiome via 16sDNA sequencing. Ten weeks after the FMT, MSF showed a very mild 
but clinically irrelevant decrease.

In conclusion, this case reports confirms safety and feasibility of FMT in a clinical case of canine IE. 
In this dog however, the effect on MSF was negligible. The lack of effect could be due to three main 
aspects. Firstly, the current protocol might have caused inadequate donor engraftment. 16sDNA 
sequencing will reveal performance of the protocol. Secondly, variable effects on MSF might be seen 
in different dogs, similar to medical and nutritional management of canine IE. Thirdly, the MGBA 
might not be an ideal target in the management of canine IE.}},
  author       = {{Verdoodt, Fien and Hesta, Myriam and Willemse, Tijmen and Van Ham, Luc and Bhatti, Sofie}},
  booktitle    = {{2023 BVNS (British Veterinary Neurology Society) Symposium 'Microbiome and the brain', Abstracts}},
  language     = {{eng}},
  location     = {{Manchester, UK}},
  title        = {{Faecal microbial transplantation in a Cavalier King Charles Spaniel with drug-resistant idiopathic epilepsy}},
  url          = {{http://www.bvns.org.uk/index.php/program-of-the-symposium}},
  year         = {{2023}},
}