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Update (June 17, 2026): Adjunctive FMT Reduces Lesion Severity and Medication Use in Canine Atopic Dermatitis — First RCT

Jun 17, 2026 2 min read

TL;DR

A June 2026 randomised controlled trial found that adjunctive faecal microbiota transplantation (FMT) reduced canine atopic dermatitis lesion severity and medication requirements compared with placebo over 90 days.

What just dropped

  • Felten et al. 2026 (Vet Dermatol, June 12 2026, DOI 10.1111/vde.70092): prospective, randomised, placebo-controlled, double-blinded clinical trial; 46 dogs enrolled, 40 completed (FMT n=20, placebo n=20).
  • Dogs received daily oral lyophilised FMT capsules plus three monthly rectal FMT administrations (Day 0, 30, 60) or sham placebo over 90 days; concomitant symptomatic therapies were permitted.
  • CADESI-04 scores were lower in the FMT group at Month 2 (7 +/- 6 vs 16 +/- 12; p=0.006) and Month 3 (8 +/- 6 vs 15 +/- 12; p=0.020).
  • Sustained responders (at least 50% CADESI-04 improvement at both Month 2 and Month 3) were more frequent with FMT (35% vs 5%; p=0.044).
  • Medication scores were lower in the FMT group at Month 2 (16 +/- 10 vs 23 +/- 11; p=0.033) and Month 3 (13 +/- 10 vs 24 +/- 15; p=0.007).
  • Pruritus VAS decreased in both groups without a statistically significant between-group difference. Owner Global Assessment of Treatment Efficacy favoured FMT (p=0.028). FMT was well tolerated.

Context

Gut-skin axis research has accelerated in veterinary dermatology. The Felten 2026 trial is among the first prospective RCTs to test faecal microbiota transplantation in client-owned dogs with naturally occurring canine atopic dermatitis (cAD).

The primary signal is on lesion scores and medication burden rather than pruritus -- a clinically important distinction. Reduction in medication score alongside maintained or improved lesion control suggests FMT may have an adjunct role that helps avoid dose escalation of JAK inhibitors, anti-IL-31 antibodies, or ciclosporin. Authors note the need for larger, longer-term trials and responder biomarker identification.

What this changes in lokivetmab-cytopoint-canine-atopic-dermatitis (https://www.thevoyage.ai/forvets/knowledge/lokivetmab-cytopoint-canine-atopic-dermatitis)

The Felten 2026 RCT adds a microbiome-based adjunct layer to the cAD treatment landscape. In dogs where anti-IL-31 or JAK inhibitor monotherapy controls pruritus but lesion burden remains high, adjunctive FMT now has a single high-quality RCT supporting a reduction in CADESI-04 scores and medication requirements. This does not alter the first-line role of approved pharmacological therapies but opens a practical conversation about add-on strategies in refractory cases.

References

  1. Felten V, West EA, Martini F, et al. Faecal Microbiota Transplantation Reduces Lesion Severity and Medication Use in Canine Atopic Dermatitis: A Randomised, Placebo-Controlled, Double-Blinded Clinical Trial. Vet Dermatol. 2026 Jun. DOI: 10.1111/vde.70092 (https://doi.org/10.1111/vde.70092)

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References

  1. Felten V et al. Faecal Microbiota Transplantation in cAD RCT. Vet Dermatol 2026. (2026)

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