Secrets to Resetting the Microbiome After Antibiotics with Melissa Natanson

01:00 Dr. Ruth Roberts: Welcome to Healing Tails. I'm Dr. Ruth Roberts, here to help you become the best pet parent you can be with simple natural care that works for real life, real budgets, and real pets. Hey y'all, welcome back to Healing Tails. I'm Dr. Ruth Roberts empowering change makers in pet health. And today we're diving into one of my favorite topics and that's gut health with an incredible guest, Melissa Knievel-Natansen. If you don't know Melissa, you should and you will shortly, but she is a certified holistic pet health coach and professional canine nutritionist who specializes in gut and kidney health, chronic inflammation and senior pet wellness. Her philosophy is all about healing from the inside out, starting with the microbiome as the foundation for whole body vitality. Melissa's journey into gut health is deeply personal. After her mother's battle with a rare GI cancer and her rescue Yorkie Darla facing severe IBD and food intolerances, Melissa discovered the transformative power of nutrition and microbiome restoration. Now through her work with Legacy Biome, she's helping pet parents everywhere understand the science of gut health and how it impacts their pets overall wellbeing. And Melissa, welcome to Healing Tails. How are you?

01:36 Melissa Natanson: Thank you, I'm doing great. So excited to be chatting with you again about one of our favorite topics. What an introduction, thank you so much, appreciate that.

01:46 Dr. Ruth Roberts: It is my pleasure. So let's start with a little bit about how you got here. So your journey into holistic pet health and how your experiences with Darla and your mother shaped your focus on the microbiome.

02:01 Melissa Natanson: Well, I'll try to make a 12 year long story very short, but it kind of starts out, we rescued little Darla about 12 years ago. And when we had originally rescued her, she was losing the hair around her mouth. She had hotspots everywhere and just kind of was not doing super great. And of course, because she was a rescue, they had found her in a heap of trash. Of course, we did what the standard protocol is in the veterinary world, which is let's toss a whole bunch of metronidazole at her, some antibiotics, let's do the kibble, things like that. But what I didn't realize at the time is how much Darla's microbiome was tied to these skin issues and how the antibiotics were really making, causing a huge problem. But it was a process that took me years to figure out. But part of how I started figuring it out is that my mom did have a rare GI cancer and I think only 3% of the population gets diagnosed with it. And I really started digging into what was behind that. And it all had to do with GI inflammation. And where does the GI inflammation start? In the gut. And there's all these amazing players that come in when it comes to the gut. And I think that's the purpose of our conversation today, why it's so important to start restoring the gut after antibiotic use because it can really have a long-term impact down the road. So kind of bringing that around to Darla a little bit, I dug into human holistic health after my mom's diagnosis because I thought there has to be a better way. And there has to be a better way in vet med as well because I kept getting the same old, have some more antibiotics, have some more steroids, have some more whatever. So at the time I didn't have a lot of resources when it came to integrative or holistic health. So I started using the human supplements I was using to help my own gut because I think we all have some leaky gut and started using them on Darla. And lo and behold, she started to improve.

04:13 Dr. Ruth Roberts: And there's—Right on, right on.

04:15 Melissa Natanson: You know, that kind of came around full circle. You know, she had these massive skin allergies but she also had a lot of massive food intolerances. And that's all linked back to leaky gut. And I can explain that whole thing, but it's all linked to leaky gut. And here's kind of where things opened up for me. Darla, many years down the road from having years and years and years and years of a microbiome imbalance, ended up getting C. diff. And we've talked about that big one before, clustered into FESL and it's a nasty intestinal infection. And the way we ended up getting through it this time was not an antibiotic. We did an FMT, which is a fecal microbiota transplant. And the amazing side effect of that, finally, is that Darla's allergy issues cleared up.

05:11 Surprise.

05:13 It only took me seven years to figure out.

05:18 Dr. Ruth Roberts: Well, and I think that's part of the deal too, because, and we'll talk a little bit more about FMT, but this, I mean, honestly, it is the way of the future. Because if we fix the gut, we can start to fix the foundation of any other issue that's there. But you mentioned antibiotics earlier and they can indeed be lifesaving, but they have a huge impact on the gut. So can you explain kind of what happens to the microbiome when a pet, a person is taking antibiotics and then after the antibiotics are finished?

05:52 Melissa Natanson: Sure. So maybe we can set up the gut in a way, again, which is my favorite way, is I like to think about it as a parking lot. And so we need cars, and think of the microbiome and the bacteria in the microbiome parking lot. So they're driving in their cars, they all have a place to park, and they need to park because they need to go to work in the bodybuilding. That's what we're gonna call it. So think of it like that. And all of the workers in the microbiome that are parking in those slots, they all have different duties within the bodybuilding and they all kind of work as a team. But when we start to use antibiotics, especially in a case where maybe an antibiotic isn't necessarily needed, then they can do as much of wiping out the bad guys as they do the good guys. So thinking about the microbiome parking lot and all the workers who need to work as a community, they all have different roles. If we put an antibiotic in there, then all of a sudden some of those good guys start getting sick. They don't show up to work. And then we start to have what's called an imbalance. We have slots that are open in the microbiome parking lot. Or we have, if the good guys aren't there, sometimes they keep the bad guys in check and they're saying, "Hey, bad guys, I know you're there, but because I'm here, I'm your boss. I'm keeping you in check." Well, if the good guys aren't around because they've been wiped out, then those slackers can start to form some chaos. They're not going to work. They're throwing a microbiome party. And nasty bacteria like a clostridium can sometimes overtake because they occur in the gut naturally anyways. But if no one's there to say, "Hey, chill," they can start to throw a microbiome party and the hangover is bad.

08:00 Dr. Ruth Roberts: That's a good way to put it. It is awful.
Yeah.
Yeah. And then you get hooligans in there and then it's all over.

08:06 Melissa Natanson: Yeah, I mean, some of these hooligans, but as we've been talking about, one of the most important things that we have found over the last couple of years is that it's not about the amount of bacteria in the gut necessarily, although there's trillions and trillions and trillions. It's about the balance and how those microbes work as a community. And think back about the parking lot again. There's all different color cars, but they have to go to work and make the body machine run smoothly as a team. And there's also certain things that they do. Some of them make short chain fatty acids, branched chain fatty acids, short chain fatty acids help the immune system know what to do. And again, if 70 to 90% of the immune system lies within the gut, then this is why the body building and the parking lot having the right team is so very important.

09:00 Dr. Ruth Roberts: Right on, and that makes sense. I mean, I like that analogy because it's like if the workers are not there, then the parking lot gets turned into party central and stuff gets trashed and the factory gets damaged and the tissues in the body are not replaced properly. So it's a big hot mess. The big hot mess. Yeah, so what can people do? So, you know, dang it. I didn't realize all this would happen. And my dog just finished a round of Clavamox or whatever it was last week because of the skin infection. So what are some first steps pet parents can take to help their pets' guts recover after having antibiotics?

09:44 Melissa Natanson: Yeah, I mean, this is really important. I wanna ask you later firstly, a question about antibiotics, but to answer your question, that's just so I remind myself later because sometimes my brain moves faster than my mouth. I am human, everyone. But okay, pet parents, first, don't despair. It's not the end of the world if your pet does a course of antibiotics. I think we need to be a little discerning about when and how to use antibiotics in Vet Med. So let's make sure that we're using them in the right application and not necessarily for a virus or yeast, which antibiotics do nothing for and really just do more to knock out the microbiome. So employing some gut healing herbs and making sure the gut microbes that are the good guys have stuff to grow on is really important. So being on a whole fresh food diet, because the good guys love to grow on plant matter. They like their fresh fruits and vegetables, but the gut also needs protein to repair. So being on a good meat and vegetable diet, which is anti-inflammatory, can help the gut rebuild naturally. Just to note, Clostridium and the bad guys, they love simple carbs, they love sugar. Give me more. Number one, we want to make it hard on the bad guys to keep living there and really easy on the good guys to keep living there. So that's kind of step number one, but more importantly, we need to start shifting the microbiome back to one of balance. And there's two ways you can do that. Because I'm a part of Legacy Biome, a fantastic company that's making huge strides in both microbiome research and in FMT. In my case, what I suggest to most clients is, let's start with an FMT, because some of the good consequences of that is, if you have some lingering allergy issues, if you have some lingering IBD or gut issues, then FMT comes in and repaves the parking lot. It gets those workers to come back in that may have been held back or kicked out by the antibiotics and says, "Hey, come back to work, we need you." And it's really resetting and grafting an entire microbial community that gets the workforce back on track at bodybuilding. So I feel like it is such an important and powerful tool, because now we're transplanting a community. And remember, I said it has to work as a community. If that's not necessarily an option, then sometimes just throwing a probiotic about it isn't necessarily the way to go. You've got a good stat on this, Dr. Ruth, that sometimes just throwing a probiotic at a pet right after antibiotic use can actually slow down the getting back into balance. Was that right? That's it.

12:51 Dr. Ruth Roberts: Yeah, unfortunately that's what the research says, which is very shocking. And the exception to that is, if you've been using probiotics like a sporulated probiotic like Megaspor, for instance, before the antibiotics were started, then you're able to maintain some of that diversity and richness.

13:11 Melissa Natanson: Yeah, and spor was coming up next. Which is interesting, but if you think again about the balance in the community, and if we're just feeding a couple of strains with a probiotic, what it does is just exacerbate the imbalance without really getting the microbiome back on track. So like Dr. Ruth just said, incorporating a spore-forming probiotic like Megaspor that encourages the gut to produce more of the gut guys, or a soil-based probiotic that kind of works in the same capacity is another option. But throwing a lactobacillus or throwing a Bifido in there isn't necessarily the answer. Not so much. There he is.

13:58 Dr. Ruth Roberts: Right. And even there's some question about using Darcomyces, which is not a bacterial organism, but a fungal organism or yeast as to whether that would help or not help. And so that's it. Sometimes all we can do after antibiotics is just plow the field, so to speak, and get the gut ready to heal.

14:19 Melissa Natanson: Yeah, I mean, it is really interesting. The research just keeps coming out, and a similarity can be really great at stopping the diarrhea if there's something going on, if it's been a go-to for me, it's a good stop or upper. But I wonder, what do you think now? I have a hard time answering this question sometimes because I don't wanna overstep, so I'm gonna go straight to the root with you as a veterinarian. When antibiotics should be used?

14:49 Dr. Ruth Roberts: I mean, there's the thing. And again, it depends on the case. So what tends to happen in veterinary practice is that a dog comes in with two or three skin lesions, let's say, and that's when the antibiotics come out because we don't want it to get worse, antibiotics and steroids typically, instead of going to something like a topical therapy to treat just those spots. And the difficulty is knowing, okay, is it really just gonna stay at those three spots or is it gonna explode into 100? And that's the hard part. I think urinary tract infections, especially in older dogs, can become life-threatening, and can impact the kidneys pretty severely. There are certain cases where antibiotics for GI problems are warranted. I mean, C. diff is a gnarly bugger, for sure. Many dogs and people no longer respond to metronidazole because that's what's been used. And then we're looking at things like vancomycin, which is a really difficult to handle type of antibiotic. And that typically is reserved for very profound infections. So it just depends, but I mean, there are so many instances where antibiotics can be helpful, but I think that they're way overused. And unfortunately, the goal for antibiotic stewardship, meaning we know that there are so many resistant organisms, like the most commonly thought of one is MRSA, the Methicillin-Resistant Staphylococcus aureus. That's not good, but there are other ones out there that are resistant as well. So we really need to get into the habit of doing everything we can to sort of flood the system. And we can do this topically as well. With probiotic organisms. So essentially what we're doing is helping to out-compete the bad guys and bring the balance back under control that way.

17:07 Melissa Natanson: Yeah. Yeah. Well, it's just, it's interesting. And I tell this story a lot. I'm gonna tell it again now. You know, the way we got through C. diff, which is becoming largely antibiotic resistant, is we did an FMT. And within 90 days, Darla tested negative for it, which is amazing because people will go on antibiotics or pets will go on antibiotics for weeks and weeks and weeks or months and not have that kind of turnout with it. So it's really amazing.

17:46 Dr. Ruth Roberts: And like we've talked about before, in humans you have to fail antibiotics for C. diff at least once. And I am here to tell you, this is one of the most miserable experiences of my life. I've had it three times. I, you know, and I ended up with a secondary problem called SIBO or small intestinal bacterial overgrowth. And I think Darla went through the same issue even after the C. diff was cleared. Yeah. And so, I mean, that haunted me for years. And because of regulations in the United States, unless you have failed antibiotic therapy for C. diff, you don't get FMT. Yeah. And there's a couple of other instances, but I mean, it's crystal clear on the human side, for people with Crohn's disease, for people with Parkinson's disease even, FMT can have very marked benefits in helping the body to regulate those conditions.

18:48 Melissa Natanson: That's amazing. The gut-brain connection is something that just fascinates me. And we see, you know, that's yet another reason. So many—I see so many dogs and kitties even, but more often in dogs—that they'll go through a round of antibiotics and they have a similar story to Darla. Well, within a couple of months or in the next few years, they start to develop allergies. A lot of these allergies don't just happen all overnight. And it doesn't mean your dog is just, you know, necessarily allergic to turkey or had a blow-up. But what the antibiotics do when they shift the microbiome community is they also confuse the immune system because the immune system lies in the gut. And so after a certain period of time of this immune confusion, then something like, say for instance, the wind—like with Darla—you know, she was, after the metronidazole, she started to get itchy here, she started to have more hotspots. And then one day the wind started blowing and Darla's gut immune system was like, hmm, should I just handle that? Or should I evoke a full-blown immune response? Well, it chose violence. And she broke out in hives all over the place. And that was a buildup of the imbalance in the gut's radar that, as far as the immune system starting to get confused. It's not that she was necessarily allergic to pollen or turkey or the whatever. It's that without the right microbiome in place, the immune system gets confused and starts firing away at things that normally shouldn't be a problem.

20:37 Dr. Ruth Roberts: Right. And part of that is this whole concept of leaky gut. So really as the microbiome imbalance worsens, then there—and the bad guys are starting to get in charge—what they are doing is then breaking down the tight junctions between enterocytes, so the cells in the intestine. And when that happens, then things can go straight to that gut-activated lymphoid tissue and the immune system is like, oh my gosh, this is a foreign invader. We have to kill it all. And really what it is, is an improperly digested piece of turkey. So, or turkey protein that's not been broken down properly or whatever it is the dog or the cat is eating at the time. So I think that's critical to understand as well. If there's leaky gut, if that dog is experiencing having an immune response to whatever it is they're eating or exposed to, if they get a whopping big dose of it, you can see these horrible reactions like you did with Darla.

21:42 Melissa Natanson: Well, yeah. And well, thank you for explaining that because I jumped past that part and just went straight to reaction part.

21:51 Dr. Ruth Roberts: It's adult urticaria, yeah, right on.

21:54 Melissa Natanson: But some of the other parts of this and why allergies pop up and why this conversation is so important when it comes to really getting the gut back in balance after antibiotics is those inflammatory conditions persist not only with allergies—and it's interesting. We think of histamine as the bad guy. It's what causes these flares and the hives and the issues and whatever. But histamine is just the messenger. And here's an interesting thing—it’s also connected with the brain as it's not just an allergy chemical, it's also a neurotransmitter. But here's an interesting thing that maybe most pet parents don't know. There's an enzyme in the gut called DAO, that's diamine oxidase, that's responsible for breaking down histamine. So there are microbes in the gut that produce histamine. There's also microbes in the gut that degrade histamine. DAO helps with that. But guess what happens in a gut that is leaky or inflamed? DAO action plummets. So then it's so much easier for a dog to have histamine overload like Darla did. And it's behind these allergies because the gut, you know, gall isn't inflamed like you were talking about. Histamine is like getting overloaded and DAO starts plummeting. There's the immune chaos right there, which sets the stage for allergies, but later and more severely, things like IBD, things like IBS, where it starts to affect the other organs. And one thing that I wanna mention because I'm seeing it so much right now in my senior clients that have had a history of IBD and IBS is they're starting to have the kidney issues because when the gut is inflamed, the kidneys bear the brunt of that. The small bowel processes a lot when it comes to the kidneys. And this is why I encourage FMT and the right microbial support so strongly.

24:07 Dr. Ruth Roberts: Right on, and that totally makes sense, right? Because there's supposed to be this processing and this removal of nitrogenous waste products so the kidneys don't have to work so hard. So it totally makes sense. So for folks that are listening, I think we've given them some clues about what some common signs are that there may be some gut health imbalances. But what do you think the most common signs are when there's not like vomiting and diarrhea that folks may miss?

24:41 Melissa Natanson: I think absolutely the skin thing. When skin is the largest organ and the gut is 70 to 90% of the immune system, then for me with my clients, the first place we see it is the skin. We kind of talked about it. And I missed that when it comes to Darla. So if you've got hotspots or if you've got the corncob chewing on the paws, that's another good sign. The yeasty ears, runny nose, watery eyes—that's all histamine overload. And it doesn't necessarily come out in the diarrhea or any stool problems. Darla never had any problems with her stool. She always had perfect poos, but the itching was something that really happened a lot. And sometimes monitoring their digestion can be another clue. If there's some burping going on, some acid reflux, some GERD, all of that is still connected to the gut. And that can be another sign. They may not necessarily have the like blaring, "Hi, I want diarrhea." So therefore I have a lot of imbalance. I think diarrhea actually is one of the final things we see when the microbiome imbalance is tipped so far over the edge that we finally get diarrhea.

25:51 Dr. Ruth Roberts: Right on, right on. So what do you think are some of the biggest misconceptions about recovering gut health?

26:00 Melissa Natanson: I think that parents may think that it's going to be hard or that it may not be necessary because we've been told something different for so long, which is go on the hydrolyzed diet or go on the prescription GI health diet, which is just kicking the can down the road. And I'm surprised when I hear about how much the microbiome is not being considered. So it doesn't have to be hard. The right microbial support, via FMT or Megaspor, is really crucial. And then going on that anti-inflammatory diet. But I think another misconception is that we're going to have really a fast change or you're going to see the fallout from the antibiotics right away. That's not necessarily true. Some of these changes can take weeks or months. So starting to get the gut back in shape, can it take time? Yeah, absolutely. It's a living community in there. And sometimes the antibiotics start a fight. And sometimes it takes a little while to broker a peace treaty in there when it comes to the gut. But is the peace in the gut worth it? Absolutely. It's always worth it every single time. So it's so very important after antibiotic use. I'm such a big believer in Legacy Biome's FMT because I have seen the remarkable work that is done not only with my own dog, but other clients as well.

27:40 Dr. Ruth Roberts: Right on. One of the other things that I think is super interesting is that you're also using a myriad of options to help support people's pets. And one of them is traditional Chinese veterinary medicine and Chinese herbal formulas. So how, when you're starting to think about the medical paradigm that is TCVM, how do those principles kind of apply to supporting microbiome healing, really for lack of a better descriptor? And supporting pets' overall health?

28:19 Melissa Natanson: Well, it's really interesting. And this is the reason I love TCVM so much because again, it's looking at the body as a system and it's looking at more of the terrain of the gut rather than what we may be feeding or what an antibiotic is doing. So for example, there are some herbs in TCVM that I've liked to use before with really nasty gut bacteria, ginseng and astragalus combination as one of them. That makes the terrain way less inhabitable for those bad guys and starts kicking them out at the same time. So when Darla had C. diff, I did that. And I also had used some coptis to help make the terrain less habitable for those nasty bugs while employing an FMT. And it worked, it seemed to work pretty darn well. So I think that's where TCVM can be so important. It's really looking at the bottom as a system. It's kind of a system of fluids and terrain rather than—it’s a different concept. It's hard when we think in the Western like, oh, here's a symptom, then we have to give this. But with TCVM, looking at it, the start of it may be much more up the chain. And it's, I feel like it's hard to explain sometimes. You're probably right.

29:41 Dr. Ruth Roberts: It is hard to explain and it's like, it's what makes everybody's head want to explode when they start learning it. But what was interesting to me is I learned TCVM first and then I learned functional medicine, but the basic concepts were very similar in that instead of looking at just the gut, you look at the entire body and its interactions. So that you use all of those concepts to bring things back into balance. So I think from that perspective, it's just been an amazing tool.

30:18 Melissa Natanson: Amazing, and because it will look at things like there are herbs that—is there a spleen qi deficiency? So digestive power has gone down. That means motility has gone down. That means that if motility isn't happening, then some of those bad guys can linger and grow in the gut longer. So employing those in addition to some of these other things can really be helpful.

30:42 Dr. Ruth Roberts: Right on, right on. And one of the other things that I wanted to make sure we touch on is that you're now part of Legacy Biome, which is amazing. And you're doing some really fun work. And we got to talk together to help launch their podcast, which is amazing. But can you talk a little bit more about their approach and their products and what they're doing to help dogs and cats actually recover fully and thrive?

31:11 Melissa Natanson: Absolutely. I am so thrilled to be part of the Legacy Biome team. It is a fantastic group of people over there. And I have to tell you, one of the reasons that I joined their team is because at the heart of it all, they're in it for the animals. That is their number one goal, is that they want to make a difference in the lives of the pets. And it started out with Dr. Margo Roman many years ago. She was really kind of a pioneer for this and using FMT to get to the root of some of these GI issues, IBD, anxiety issues. So Legacy Biome is truly her legacy. These are her dogs, the donors. They are the donors. So the FMT matter, the microbial therapy, we call it sometimes, comes from her dogs. They are running around in a pristine woodland with getting their paws in the ground. They're fed a whole foods diet, minimally vaccinated. So do we really know what an optimal microbiome is supposed to look like in a dog? No, but what we do know from Legacy Biome doing nearly 30,000 FMTs now is that her dogs are pretty darn close because they are seeing some remarkable results. And some of the fun things that we have coming up is we have more of an amino acid based FMT product coming out. So Dr. Roman's dogs are fed a significant amount of plant matter. Some canine nutritionists are like, what?

32:49 (Laughs)

32:49 Melissa Natanson: So even me sometimes, it's something I've been digging into because I'm like, okay, I got to figure this out. I'm like calculating. But more of an amino acid protein-based FMT. The other exciting thing is that there is a cat product coming very soon. And I feel like cats are so underserved when it comes to this, but they can have the worst IBD. I mean, so many kitties are just plagued by IBD.

33:19 Dr. Ruth Roberts: Yeah. And for them, I mean, this is where it gets really awful because often that IBD can progress into small bowel lymphoma. And that's just heartbreaking for kids and their parents.

33:33 Melissa Natanson: And the most exciting thing—That is very cool. Oh, I'm sorry. And I was gonna say the most—Please. We've got a really cool podcast coming up. I feel like we're on this line together. You've got your new podcast doing lots of recording. I've got this new podcast. I'm doing lots of recording. There's lots of exciting stuff coming up. So I'm glad that we can swap.

33:54 (Laughs)

33:54 Dr. Ruth Roberts: Right on, right on, and share it. Because I think that's the critical thing is that the more we put these messages out there, the more pet parents hear it, then the more they begin to get comfortable with it. And frankly, for my colleagues that practice conventional veterinary medicine, this information is not getting to them very quickly because there's not something a drug rep can bring in their office and have a speaker come and educate on. So I think that getting this information out for pet parents for the entire veterinary community is gonna be super critical to help people understand better how to support the gut and understanding that it truly is the foundation to health.

34:44 Melissa Natanson: Well, yeah. And I think part of what we're doing is that education part when it comes to both, like you said, why can't a rectal FMT be a first option for a nasty intestinal infection rather than an antibiotic? Because we're seeing tremendous results. So getting it into the hands of the vet where they can do it, it doesn't necessarily have to be a capsule. And the second thing that Legacy Biome really wants to focus on is education when it comes to breeders or puppies being born because when a puppy is not born vaginally, or if the mama is missing the right microbiome, then these puppies are being born deficient in their microbiome from the get-go and it sets the stage.

35:32 Dr. Ruth Roberts: Right, absolutely. And I think that's something that's critical to understand. And there are a lot of breeders that, yeah, this litter of puppies probably is gonna get diarrhea so they just give them all a round of Metronidazole and it's like, ah. Right?

35:46 Dr. Ruth Roberts: Mm-hmm, yeah, it's really interesting.

35:49 Melissa Natanson: That came from a breeder too and we're working through it. This little dog is on an FMT right now, Dr. Ruth. The yeast and the skin lesions on this little one are massive and it's been on. Oh, and I can't, you know, I said, this is classic microbiome deficiency, insufficiency, imbalance and we're working on it and the little one's getting better.

36:16 Dr. Ruth Roberts: That's amazing. That is truly amazing. And I think it's critical to know too, if you go down this path with FMT, if you've got a super, super sick dog, it may be that you really cannot start with a full dose because the detoxification reaction or the Herxheimer reaction can be pretty uncomfortable. So that's where working with Melissa, working with the folks at Legacy Biome will help you go on the right path so that you don't end up thinking, oh my God, this stuff is just terrible. When in fact, what's happening is actually a good sign because that means that the microbiome is starting to shift and as the bad guys die off, you're saying it ain't fun.

37:00 Melissa Natanson: Right, it's the hangover. It can be, you know, we're kicking them out of the party and they throw a fit on the way out because they don't want to leave the microbiome party because they're in there making chaos. So, you know, I've heard some pet parents say, well, my dog now has really bad gas after being on the FMT for a couple of weeks. Well, when those bad guys start getting kicked out, those toxins produce gas and they're throwing a fit. Sometimes pulling back on the FMT to maybe every other day can help a little bit, but oftentimes just charging through it, like the gas will go away. You'll get there, but gas is better than diarrhea or using a binder.

37:40 Dr. Ruth Roberts: Amen to that. Amen to that. Right on. Well, cool. So for folks that are out there and they're just not sure where to start, they've gotten the idea that, okay, maybe this chronic skin issue, yeah, that really may be related to the gut. Oh yeah, that did start after that round of antibiotics he had as a puppy because of kennel cough or something. So what would you suggest to people? They're starting to connect the dots. What is the first best step for them to take?

38:16 Melissa Natanson: The very first best step in my opinion is of course diet. The diet is absolutely foundational because if we don't have the diet in place, we can't be throwing an FMT or even giving a probiotic after the antibiotics—they have to have something to grow on. And the gut needs a break. If the gut is inflamed from a kibble or toxins in the environment or stress or hydrolyzed diet, whatever it is, it can't repair and the microbiome can't be reset and replenished unless it's got the right stuff, the cellular nutrition that it needs. So I always love recommending your CrockPET Diet, Dr. Ruth, because it's full of protein and it's full of veggies and the good stuff, the prebiotics and even postbiotics that those microbes love to work on. And I'm gonna throw in my second step anyways. FMT is easy. You order it, you pop a capsule for 30 days and it starts working its magic. But we gotta have the right diet for that to work on because I don't think kibble and FMT and probiotics are really very good friends.

39:42 Dr. Ruth Roberts: No, no, because the kibble is always going to be selected for a different population than what is optimal for the health of that pet. We may see some temporary improvements and then it starts to slide right on.

39:55 Melissa Natanson: I'm sorry if you can hear my cat. He's outside like a "meow." Hello.

40:01 Dr. Ruth Roberts: He's like, "Spare me."

40:04 Dr. Ruth Roberts: So where can our audience learn more about your work and Legacy Biome’s mission?

40:13 Melissa Natanson: Yeah, so everything is kind of—we're getting close to launching everything. So if you want more information on the microbiome and Legacy Biome and FMT in general, check out LegacyBiome.com. There are some informative blogs coming up written by yours truly and some podcasts that are coming up. And I'm really diving into GI, FMT and microbiome research, what's the latest and greatest, and trying to keep pet parents up to date on it because it is really, truly so important. And it's really crazy to think about the 10 years I spent on this and trying to figure it out. And I'm so thankful to you that I was able to become a holistic pet health coach and then have the lines open to wonderful companies like Legacy Biome because I'm really inspired to make great things happen with them.

41:09 Dr. Ruth Roberts: And that was—yeah, thank you.

41:13 Dr. Ruth Roberts: Wonderful, Melissa, this has been a pleasure as always. And I look forward to our next conversation because I know we'll have one.

41:24 Dr. Ruth Roberts: That’s for sure. So folks, for those of you listening in, there will be new and amazing episodes coming up. So stay tuned, subscribe to the channel, hit the like button on YouTube, all of those good things so that you'll know when the next episodes come out. Until then, give your pups and your kitties a big hug and a kiss for us.

41:44Dr. Ruth Roberts: Thanks for listening to Healing Tails where pet parents become healers, one tail wag at a time. Want more tools and support? Head to DrRuthRoberts.com. Until next time, trust your gut, question the noise, and keep showing up for your pet.