Fecal Microbiota Transplantation in a Domestic Ferret Suffering from Chronic Diarrhea and Maldigestion-Fecal Microbiota and Clinical Outcome: A Case Report

Abstract

This case report describes the effects of fecal microbiota transplantation (FMT) administered via enema in a 4-year-old spayed, champagne Domestic Ferret (Mustela putorius furo) with chronic diarrhea, maldigestion and weight loss. We aimed to establish a protocol for FMT as a novel therapeutic treatment for chronic diarrhea in domestic ferrets. We mapped the fecal microbiome by 16S rRNA gene amplicon sequencing to track the patient's fecal microbiota throughout the treatment and observation period. Initial oral FMTs were associated with temporary weight improvement but subsequent treatments, via enema and oral delivery, showed varied outcomes. Molecular analysis highlighted distinct gut microbiota composition profiles between the healthy donor and the diseased ferret. The diseased ferret initially exhibited high abundance of Enterobacteriaceae, Escherichia, and Enterobacter, which ultimately normalized to level like those found in the donor ferret. Overall, the gut microbiota of the recipient became more similar to the donor microbiota using a Yue-Clayton theta coefficients analysis. After a restoration of the gut microbiota and clinical improvement, the recipient's symptoms returned indicating that repeated FMTs might be required for long-term resolution of symptoms and complete restructuring of the gut microbiota. Future studies are warranted to map the microbiome of a larger population of domestic ferrets to investigate a potential correlation between fecal microbiota profiles and chronic/acute gastrointestinal disorders.

Keywords: FMT; exotic pets; fecal microbiota transplant; gut microbiome; microbiota restoration.

Figure 1

Timeline. FMT and sample collection.

Figure 2

Clinical observations during the duration of the study including body weight (A), daily attitude/activity (B), and daily stool consistency (C). Enema FMT (blue) and oral FMT (red) administrations are represented by vertical bars.

Figure 3

(A) Heatmap showing the relative abundances of all 31 bacterial taxa detected in the fecal microbiota of the donor (DF) and recipient (RF) fecal samples. The stars indicate taxa statistically equally abundant over between all the donor samples combined and the recipient over the period indicated (day 1–7: after eFMT, day 7.5–12: after oFMT, and day 13–15: after initiation of loperamide) (statistical test was Kolmogorov–Smirnoff test, p-value < 0.05). Taxa in green were similar at all three period, taxa in red were similar at the first two periods, while taxa in Orange were similar only at the period after eFMT. (B) Stacked bar plot showing the relative abundance of the top 11 bacterial taxa for each sample. The number associated with the donor (DF and DFS) and recipient (RF) indicates the day of collection. Note that two separate samples were collected on day 7.

Figure 4

Comparison of the composition of the fecal microbiota of the donor to the recipient. Yue-Clayton theta values are plotted for each recipient fecal microbiota compared to the average composition of the donor fecal microbiota. The lower Yue-Clayton theta value is the more similar are the microbiota composition.