Figure 2 . Equipment required to prepare the sample . Figure 3 . Prepared sample , ready for transplantation .
PREPARING THE SAMPLE
The sample was mixed at a ratio of 1:6 faeces to saline , blended to a slurry and filtered through a cheesecloth ( Figures 2 and 3 ). The equipment was purchased for the procedure and disposed of afterwards .
PROCEDURE
Logan was anaesthetised so the sample could be placed endoscopically throughout the gastrointestinal system . A gastroscope was used to examine the oesophagus , stomach and pylorus . A 10 ml volume of the transplant material was distributed into the bowel from distal to proximal direction while retracting the endoscope back into the stomach , stopping at the duodenal papilla .
A rectal exam and Higginson ’ s syringe enema were performed and a gastroscope used to examine the descending colon , splenic flexure , transverse colon , hepatic flexure and ascending colon . The ileocolic aperture was identified and the aspiration catheter containing the transplant material was advanced through until approximately 80 cm was in the distal jejunum . A 10 ml volume of the sample was instilled from proximal to distal direction , transfusing 20 ml overall ( Figure 4 ). Maropitant was given to treat any post-procedure ileus , and Logan recovered from the anaesthesia well .
FMT : the outcome
Within 48 hours of the procedure , Logan had passed his first solid faeces in 2 years . Over the past year , there have only been two incidences of self-limiting diarrhoea : one shortly after a house move and the other following ingestion of a ripe , fat mouse . Apart from these incidences , his faeces have been solid throughout the period .
After a long struggle to maintain a healthy microbiome in Logan , the FMT seemed to reset his system and break the cycle of diarrhoea and malnourishment that was affecting his quality of life . Due to his suspected EPI , he is maintained on pancreatic enzymes ( VetPlus Lypex 0.6 g SID ). However , his drinking and eating habits are back to normal , with a BCS of 5 / 9 and a healthy weight of 5.6 kg .
Veterinary nurse involvement
Veterinary nurses are often the first point of contact for clients with cats with diarrhoea , whether over the phone or during a nursing consultation . In some cases , clients may not be aware of the persistence of their cat ’ s diarrhoea if they toilet outside . Therefore , in order to gather further information , it would be helpful to teach clients how to body-condition score and identify other signs of illness such as polydipsia . If diet trials are
20 Veterinary Nursing Journal