https://veterinaryevidence.org/index.php/ve/issue/feed Veterinary Evidence 2022-08-24T16:01:35+01:00 Jennifer Morris editor@veterinaryevidence.org Open Journal Systems Veterinary Evidence is an online only, open access, peer-reviewed journal owned and published by RCVS Knowledge. It publishes content relating to evidence-based veterinary medicine (EBVM) and its application in veterinary practice to enhance the quality of care provided to patients. https://veterinaryevidence.org/index.php/ve/article/view/599 When treating canine diabetic ketoacidosis, do balanced crystalloids provide superior outcomes compared to 0.9% Saline? 2022-08-24T16:01:35+01:00 Sara Marella sara.marella93@gmail.com <p><strong>PICO question</strong></p> <p>When treating canine diabetic ketoacidosis, do balanced crystalloids provide superior outcomes compared to 0.9% saline?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment and prognosis</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Zero</p> <p><strong>Strength of evidence</strong></p> <p>Zero</p> <p><strong>Outcomes reported</strong></p> <p>There is currently a lack of studies looking at comparing 0.9% saline to a buffered crystalloid solution (such as Hartmann's) in dogs with diabetic ketoacidosis</p> <p><strong>Conclusion</strong></p> <p>In view of the strength of evidence and the outcomes from the analysed studies, there is currently no evidence that the use of 0.9% saline or the use of a buffered crystalloid affects the outcome in dogs with diabetic ketoacidosis</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-08-24T15:35:58+01:00 Copyright (c) 2022 Sara Marella https://veterinaryevidence.org/index.php/ve/article/view/581 In dogs undergoing extrahepatic portosystemic shunt attenuation, does pretreatment with levetiracetam reduce postoperative seizure incidence? 2022-08-17T09:37:28+01:00 Connor Hawes connorh09@hotmail.com Kali Lazzerini kali.lazzerini@bristol.ac.uk <p><strong>PICO question</strong></p> <p>In dogs undergoing surgical attenuation of a congenital extrahepatic portosystemic shunt, does pretreatment with levetiracetam reduce the incidence of post attenuation seizures?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Four papers were critically reviewed. All were retrospective cohort studies</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>In one paper levetiracetam was found to reduce the risk of post-attenuation seizures. In the remaining three papers no difference was found between the frequency of post-attenuation seizures and the use of levetiracetam</p> <p><strong>Conclusion</strong></p> <p>That prophylactic levetiracetam is not indicated for the use of preventing post-attenuation seizures in dogs surgically treated for extrahepatic portosystemic shunts</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-08-17T09:30:40+01:00 Copyright (c) 2022 Connor Hawes, Kali Lazzerini https://veterinaryevidence.org/index.php/ve/article/view/473 In dogs with osteoarthritis, is intra-articular allogenic mesenchymal stem cell therapy more effective than placebo effect? 2022-08-10T10:52:30+01:00 Megan Moloney moloneymegan@hotmail.co.uk <p><strong>PICO question</strong></p> <p>In dogs diagnosed with osteoarthritis in the hip, elbow, stifle or shoulder joint, is treatment with intra-articular allogenic mesenchymal stem cell therapy, in comparison with a placebo effect, more effective at reducing lameness and pain?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>All three papers were randomised controlled trials</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Intra-articular allogenic stem cell therapy is effective at reducing pain and lameness in dogs with osteoarthritis when compared to a placebo effect. Two studies indicated a statistically significant improvement in both client and veterinary outcome measurements. Client outcome measurements utilised included: the canine brief pain inventory; a measure of any changes in pain and lameness based on owners perception, and the client-specific outcome measure; and an evaluation of the impact of osteoarthritis on three client selected activities and how this changed with treatment. Veterinary outcome measurements included veterinary pain score based on manipulation of the limb, veterinary assessment of clinical outcomes and veterinary pre and post lameness examinations, all of which were subjective measures.</p> <p>The final study identified a statistically significant improvement in both pain and lameness based on owner assessments utilising the canine brief pain inventory and the Hudson Visual Analogue Scale for lameness scoring. No statistically significant improvement was identified when considering subjective and objective veterinary measurements including force plate gait analysis and veterinary orthopaedic examination</p> <p><strong>Conclusion</strong></p> <p>There is moderate evidence from owner observation and veterinary assessment to suggest that intra-articular allogenic (adipose and umbilical derived) stem cell therapy has some efficacy for reducing pain and lameness compared to a placebo effect. However, it must be noted that these studies did not compare the use of intra-articular allogenic stem cells with conventional treatments such as intra-articular corticosteroid injections. Therefore, comparison trials are required.</p> <p>Whilst all three papers showed significant improvements in the subjective measurements, objective data outcomes and assessment by board certified veterinary surgeons failed to find a significant improvement in peak vertebral force or lameness with the use of intra-articular stem cell therapy in comparison to a placebo effect. Furthermore, whilst no significant adverse reactions to intra-articular stem cell therapy were recorded, information regarding the safety for multiple dosing is lacking and ambiguity remains as to the most appropriate lineage and quantity of allogenic stem cells for the best clinical effect</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-08-10T10:44:29+01:00 Copyright (c) 2022 Megan Moloney https://veterinaryevidence.org/index.php/ve/article/view/530 Does trazodone reduce anaesthetic agent requirement in dogs? 2022-08-03T14:08:03+01:00 Gemma Stewart gstewartrvn@hotmail.com <p><strong>PICO question</strong></p> <p>In dogs undergoing anaesthesia, does the use of oral trazodone given 2 hours before induction of anaesthesia reduce injectable or inhalant anaesthetic agent requirements?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Two randomised controlled trials were critically appraised</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>Trazodone was shown to have a significant isoflurane minimum alveolar concentration (MAC) sparing effect for isoflurane. There is also evidence to suggest trazodone has a similar effect on the cardiovascular system as acepromazine</p> <p><strong>Conclusion</strong></p> <p>Trazodone should be considered as part of a multimodal approach to anaesthesia in dogs to reduce the injectable and inhalant anaesthetic agent requirements</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-08-03T13:59:22+01:00 Copyright (c) 2022 Gemma Stewart https://veterinaryevidence.org/index.php/ve/article/view/578 An assessment of client and clinician satisfaction in veterinary teleconsultation compared to in-person consultations 2022-07-27T09:25:12+01:00 Narakhanti Soenardi nsoenardi18@rvc.ac.uk Maxim Bembinov mbembinov18@rvc.ac.uk <p><strong>PICO question</strong></p> <p>Compared to in-person veterinary consultations, does teleconsultation lead to similar levels of client and clinician satisfaction?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Qualitative assessment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Eight studies were critically appraised. There were six cross-sectional studies, one randomised controlled clinical trial, and one case report</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>All eight studies provided weak evidence of similar levels of clinician and / or client satisfaction</p> <p><strong>Conclusion</strong></p> <p>Teleconsultation can lead to similar levels of client and clinician satisfaction when compared to in-person consultations. However, the evidence is weak due to the subjectivity and varied methods of measuring satisfaction. Furthermore, the current applicability of veterinary teleconsultation is still very limited to certain select scenarios in which it is appropriate (e.g., emergency, triage, remote locations, non-complicated routine postoperative checks, nutrition and behavioural consults)</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-07-27T09:21:12+01:00 Copyright (c) 2022 Narakhanti Soenardi, Maxim Bembinov https://veterinaryevidence.org/index.php/ve/article/view/458 Can straw based enrichment treat tail biting in pigs? 2022-07-20T10:23:14+01:00 Abigail Liston al00556@surrey.ac.uk <p><strong>PICO question</strong></p> <p>Can straw based enrichment be used successfully as a treatment intervention to reduce tail biting injuries in weaner to finisher pigs housed in indoor farming systems?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Three papers were critically reviewed. All three papers answered the PICO question and matched the inclusion criteria for this Knowledge Summary, providing moderate evidence. One non-randomised controlled trial and two randomised controlled trials.</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>Veit et al<em>. </em>(2016) found that straw based enrichment can reduce tail biting, similarly, Larson et al. (2018) found straw based enrichment could reduce tail biting, however, other factors contribute more so to reducing tail biting. Haigh et al. (2019) did not find evidence to suggest straw-based enrichment could reduce tail biting. Triggers for tail biting injuries are multifaceted, therefore enrichment alone will not eliminate pen mate manipulation</p> <p><strong>Conclusion</strong></p> <p>In view of the strength of evidence and the outcomes from the studies the following conclusions have been made; it is expected that these findings provide enough evidence to encourage farmers to introduce novel straw based enrichment as a treatment measure, however it would be most effective if other husbandry factors could be considered in addition</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-07-20T10:19:34+01:00 Copyright (c) 2022 Abigail Liston https://veterinaryevidence.org/index.php/ve/article/view/517 When treating medial patellar luxation in dogs is a block trochleoplasty superior over a wedge trochleoplasty? 2022-07-15T11:28:18+01:00 Maria Norell Candetoft maria.norell.candetoft@anicura.se <p><strong>PICO question</strong></p> <p>As part of the surgical correction for medial patellar luxation in dogs, which procedure results in a better outcome for the patient: block or wedge recession trochleoplasty?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Three studies satisfied the inclusion criteria for answering the PICO; one cadaver study, one retrospective observational study and one clinical case series</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Postoperative complications including reluxation rates.</p> <p>Ex vivo: Trochlear groove depth, patella articular contact, percentage of recessed trochlear surface area, resistance to medial patella luxation</p> <p><strong>Conclusion</strong></p> <p>There is only weak evidence to support block recession trochleoplasty over wedge recession trochleoplasty as part of the surgical correction for medial patella luxation in dogs. Both procedures are associated with a good clinical outcome. There are some proposed benefits to trochlear block recession made from an ex vivo study comparing the two procedures. These include an increased patellar volume under the trochlear ridges when the stifle is extended. The articular contact and recessed trochlear surface area were also increased in the trochlear block recession group when compared to trochlear wedge recession. However, the clinical relevance of these perceived benefits remains unproven. In practice, and until prospective randomised controlled trials are carried out, veterinary surgeon preference and previous experience remain relevant factors in choosing which procedure to perform</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-07-15T11:02:37+01:00 Copyright (c) 2022 Maria Norell Candetoft https://veterinaryevidence.org/index.php/ve/article/view/563 A comparison of supraglottic airway devices versus endotracheal intubation for use in rabbit anaesthesia 2022-07-06T09:33:36+01:00 Sarah Daphne Foo sfoo8590@uni.sydney.edu.au <p><strong>PICO question</strong></p> <p>In domestic rabbits undergoing anaesthesia, how does the use of supraglottic airway devices compare to endotracheal intubation for ease of use in achieving a patent airway and maintaining a stable anaesthesia?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Five papers were reviewed to answer this clinical question including four randomised controlled trials, one of which was a randomised crossover trial and one peer-reviewed conference proceeding</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>There is evidence to support that supraglottic devices were easier and faster to insert than endotracheal tubes and were used effectively to achieve and maintain a patent airway and anaesthesia. They were however, more easily displaced and took up more space in the oral cavity. Evidence also supports endotracheal intubation can be used to effectively achieve a patent airway and maintain a stable anaesthesia however, can result in more damage to tracheal mucosa when attempted blindly and required higher doses of induction drugs to use</p> <p><strong>Conclusion</strong></p> <p>Based on current available evidence, endotracheal intubation is an excellent option for maintaining a patent airway and anaesthesia in rabbit patients as it is a tried and tested method, however, can cause tracheal damage if conducted blindly. Supraglottic airways devices can be used as an alternative where endotracheal intubation is unsuccessful. They can also be used where speed of obtaining a patent airway is imperative such as in an emergency as they may be easier and faster to apply, especially in inexperienced practitioners without the necessary equipment for safe endotracheal intubation. Supraglottic devices are unsuitable for procedures that require access to the oral cavity and / or patient movement, due to the size and easier loss of seal during movement potentiating risk of aspiration. Both supraglottic devices and endotracheal intubation are superior to face masks which evidence shows have more leakage, dead space and increased risk of hypercapnia</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-07-06T09:26:22+01:00 Copyright (c) 2022 Sarah Daphne Foo https://veterinaryevidence.org/index.php/ve/article/view/573 Does treatment with clomipramine reduce cat psychogenic alopecia? 2022-06-29T19:34:15+01:00 Anne-Claude Griesser ac.griesser@bluewin.ch <p><strong>PICO question</strong></p> <p>In cats with psychogenic alopecia, is overgrooming reduced by the use of clomipramine compared to untreated cats?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>One pseudo-randomised controlled study</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Effect of clomipramine using owner report of number, intensity, and / or duration of grooming episodes, owner reported clinical improvement, and veterinary measured alopecia, extent of tissue damage, and hair regrowth</p> <p><strong>Conclusion</strong></p> <p>The only controlled study found no evidence that clomipramine alone is effective in reducing grooming episodes, alopecia, or improved hair regrowth. Further&nbsp;research with randomised, double blind controlled trials and limitation of confounding factors is required to determine the efficacy of clomipramine alone or in addition to behavioural / environmental therapies</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-06-29T19:28:34+01:00 Copyright (c) 2022 Anne-Claude Griesser https://veterinaryevidence.org/index.php/ve/article/view/626 Erratum to: Should we prescribe oral metronidazole or probiotics for acute gastroenteritis in dogs? 2022-06-28T13:59:15+01:00 Emily Moore moor1662@umn.edu Wanda J Gordon-Evans wgordone@umn.edu <p>The original version of the article has been corrected, please see the full text for details of the correction.</p> 2022-06-28T13:56:50+01:00 Copyright (c) 2022 Emily Moore, Wanda J Gordon-Evans https://veterinaryevidence.org/index.php/ve/article/view/569 In dogs with atopic skin disease, is lokivetmab more effective than oclacitinib in reducing the score of a recognised scoring system? 2022-06-22T10:01:40+01:00 Bonnie Yuan Tone Cheung bytc2@cam.ac.uk <p><strong>PICO question</strong></p> <p>In dogs with atopic skin disease, is lokivetmab more effective than oclacitinib in reducing the Canine Atopic Dermatitis Lesion Index score (or some other recognised scoring system)?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>One randomised controlled trial and one before and after study were critically appraised</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>One randomised controlled trial studied the effects of lokivetmab and oclacitinib and found that both drugs were similar in reducing the Canine Atopic Dermatitis Lesion Index (CADESI-03) score.</p> <p>An additional study was evaluated but had non-standardised data as it was a before-and-after study on use of lokivetmab. The paper noted that dogs’ response to oclacitinib can be used to predict how well these dogs respond to lokivetmab. This study also reported a reduction in Pruritus Visual Analog Scale (PVAS) score between before and after lokivetmab administration</p> <p><strong>Conclusion</strong></p> <p>In view of the strength of evidence and outcomes from the studies, there is insufficient quality of evidence to answer the PICO question and so further comparative study is required</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-06-22T09:57:36+01:00 Copyright (c) 2022 Bonnie Yuan Tone Cheung https://veterinaryevidence.org/index.php/ve/article/view/627 Erratum to: Clinical audit of POM-V / POM prescriptions by remote consultation via a veterinary video telemedicine smartphone application 2022-06-20T10:15:27+01:00 Sheila Smith sheila.smith@vet-ai.com Tamsin Day tamsin.day@vet-ai.com Samantha Webster samantha.webster@vet-ai.com Sam Davies sam.davies@vet-ai.com Trevor Hardcastle th@vet-ai.com Adele Williams adele.williams@vet-ai.com <p>The original version of the article has been corrected, please see the full text for details of the correction.</p> 2022-06-20T10:00:55+01:00 Copyright (c) 2022 Sheila Smith, Tamsin Day, Samantha Webster, Sam Davies, Trevor Hardcastle, Adele Williams https://veterinaryevidence.org/index.php/ve/article/view/502 Comparing delayed versus on-arrival administration of a modified live viral vaccine in feedlot cattle 2022-06-15T09:23:00+01:00 Ashlee Ambs ashleemadams101@gmail.com Heather Moberly hmoberly@library.tamu.edu Sarah Capik sarah.capik@ag.tamu.edu <p><strong>PICO question</strong></p> <p>In auction market calves at high risk of developing bovine respiratory disease (BRD), does delayed (14–30 days) vaccination with a modified live vaccine (MLV) for viral respiratory pathogens versus administration of MLV on-arrival (within 24 hours of arrival) to the feedlot, result in a decreased percentage of calves with BRD morbidity diagnosed based on visual signs and rectal temperature &gt;40 degrees Celsius?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Two papers were critically reviewed. Both are randomised complete block designs</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Delaying administration of a modified live respiratory vaccine to feedlot cattle may result in lower BRD retreatments</p> <p><strong>Conclusion</strong></p> <p>In feedlot calves, delaying modified live vaccine administration for viral respiratory pathogens may result in lower BRD retreatment rates than cattle receiving the vaccine on arrival to the feedlot. Significant statistical data from one study supported this conclusion while another showed numerically less retreatments in calves vaccinated on arrival versus delayed vaccination</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-06-15T09:15:46+01:00 Copyright (c) 2022 Ashlee Ambs, Heather Moberly, Sarah Capik https://veterinaryevidence.org/index.php/ve/article/view/553 Clinical audit of POM-V / POM prescriptions by remote consultation via a veterinary video telemedicine smartphone application 2022-06-20T10:13:38+01:00 Sheila Mary Smith sheila.smith@vet-ai.com Tamsin Day tamsin.day@vet-ai.com Samantha Georgina Webster samantha.webster@vet-ai.com Sam Davies sam.davies@vet-ai.com Trevor Peter Hardcastle th@vet-ai.com Adele Williams adele.williams@vet-ai.com <p><strong>There is an erratum to this paper published in&nbsp;<em>Veterinary Evidence</em> Vol 7, Issue 2 (2022): <a href="https://doi.org/10.18849/ve.v7i2.627" target="_blank" rel="noopener">10.18849/VE.V7I2.627</a></strong></p> <p><strong>Objective: </strong>To assess outcomes of a limited period (7 months) of remote video consultation with prescribing of prescription-only (POM) or prescription-only-veterinary (POM-V) medications by Royal College of Veterinary Surgeons (RCVS) registered veterinary surgeons to UK clients via a veterinary telemedicine smartphone application.</p> <p><strong>Background:</strong> Objective evidence is needed to inform the veterinary profession on the impact that remote prescribing, without physical examination in person, has on animal health and welfare. During the COVID-19 pandemic, the RCVS allowed remote prescribing temporarily.</p> <p><strong>Methods: </strong>Clinical records from all veterinary video consultations from 1 April–31 October 2020 were reviewed. Details were assessed pertaining to: signalment, body system / disease categories managed, referrals into practice, medication classes prescribed and outcomes following POM-V / POM medications. Records of adverse events and antimicrobial prescribing were reviewed.</p> <p><strong>Results:</strong> 16.6% (3,541/21,383) of video consults had a POM-V / POM prescribed; with a (mild) adverse event rate of 0.8% (30/3541). Antibacterials were prescribed in 5.88% of all consultations (1,258/21,383), 99.3% (1249/1258) being first line. Follow-up on prescribing was available in 67.7% (2,399/3541) of cases. 89% (2135/2399) of all known treatment outcomes were complete or had an expected response to treatment. Dermatological disease was the most common body system / disease category seen and prescribed for.</p> <p><strong>Conclusion: </strong>Low prescribing rates (including antibacterials) were recorded, treatments were efficacious and no harm was done by prescribing remotely via a veterinary video consult app.</p> <p><strong>Application:</strong> Veterinary surgeons and governing bodies are invited to use the information provided in this clinical audit to inform decisions on the suitability of remote consultations and prescribing in veterinary medicine.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-06-08T14:36:41+01:00 Copyright (c) 2022 Sheila Mary Smith , Tamsin Day, Samantha Georgina Webster , Sam Davies, Trevor Peter Hardcastle, Adele Williams https://veterinaryevidence.org/index.php/ve/article/view/588 Erratum to: In horses undergoing volatile anaesthesia, does intraoperative alpha-2-agonist infusion improve recovery? 2022-05-31T10:27:02+01:00 Alison Bennell bennell@liverpool.ac.uk <p>The original version of the article has been corrected, please see the full text for details of the correction.</p> 2022-05-31T10:17:05+01:00 Copyright (c) 2022 Jennifer Morris https://veterinaryevidence.org/index.php/ve/article/view/393 Should we prescribe oral metronidazole or probiotics for acute gastroenteritis in dogs? 2022-06-28T14:06:03+01:00 Emily Moore moor1662@umn.edu Wanda Gordon-Evans wgordone@umn.edu <p><strong>There is an erratum to this paper published in&nbsp;<em>Veterinary Evidence</em>&nbsp;Vol 7, Issue 2 (2022):&nbsp;<span style="color: #0000ff;"><a style="color: #0000ff;" href="https://doi.org/10.18849/ve.v7i2.626" target="_blank" rel="noopener">10.18849/VE.V7I2.626</a></span></strong></p> <p>&nbsp;</p> <p><strong>PICO question</strong></p> <p>In dogs with acute gastroenteritis, is metronidazole faster, slower, or comparable in resolving clinical signs when compared to probiotic administration?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Five studies total, all were blinded, randomised controlled trials</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>The use of probiotics as a treatment for acute, uncomplicated diarrhoea in dogs may improve clinical signs faster when compared to a placebo, but showed no difference when compared directly to metronidazole. Metronidazole, when compared to a placebo, produced mixed results with one study finding that treatment with metronidazole did significantly reduce the time to resolution of diarrhoea, while another study found the difference with placebo was not significant</p> <p><strong>Conclusion</strong></p> <p>Based on the evidence evaluated, the use of oral metronidazole will not decrease time to resolution of clinical signs in cases of acute, uncomplicated diarrhoea in dogs when compared to probiotic administration and thus should not be a first-line treatment in such cases</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-05-18T14:26:51+01:00 Copyright (c) 2022 Emily Moore, Wanda Gordon-Evans https://veterinaryevidence.org/index.php/ve/article/view/450 Propofol-diazepam or propofol-midazolam co-induction in healthy dogs: effects on propofol dosages, cardiovascular and respiratory events 2022-05-20T10:07:12+01:00 Joshua Coward jcow6072@uni.sydney.edu.au Mathieu Raillard mathieu_raillard@yahoo.it <p><strong>PICO question</strong></p> <p>In healthy dogs, does the use of diazepam or midazolam administered in co-induction with propofol result in a reduction in the dose of propofol required to induce anaesthesia and a decrease in adverse cardiovascular and respiratory events?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Eight papers were critically reviewed. A total of six manuscripts were prospective, randomised, blinded, clinical studies. One trial was prospective, randomised, blinded, clinical with a Latin square, incomplete design. One study was retrospective, randomised, blinded, crossover, experimental</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>Variables assessed in this Knowledge Summary included: propofol dose required to induce anaesthesia (considering successful orotracheal intubation as an end point), changes in cardiovascular variables (heart rate, systolic, mean and diastolic blood pressure) and changes in respiratory variables (development of apnoea, changes in respiratory rates)</p> <p><strong>Conclusion</strong></p> <p>In healthy dogs, using propofol-diazepam or propofol-midazolam co-induction resulted in a reduction in propofol dose required to induce anaesthesia in some trials only. Midazolam appeared more effective than diazepam in this context. The dosages, timing and sequence of drug administration seemed relevant. No evidence suggested that using propofol-diazepam or propofol-midazolam co-induction resulted in a reduction of adverse cardiovascular or respiratory events. In addition, although this was out of the scope of the PICO question addressed here, adverse events (e.g. excitement, poorer quality of induction) were reported in several studies when diazepam or midazolam were used in co-induction</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-05-04T09:32:22+01:00 Copyright (c) 2022 Joshua Coward, Mathieu Raillard https://veterinaryevidence.org/index.php/ve/article/view/512 Practice what you preach: Importance of veterinarian involvement in zoonotic disease prevention – A Michigan focus 2022-04-27T10:02:25+01:00 Stephanie Baiyasi stephaniebaiyasi@yahoo.com Rubén Juárez juarerub@gmail.com Jodi Brookins-Fisher fishe1jb@cmich.edu Jeff Inungu inung1j@cmich.edu Thomas Gehring gehri1tm@cmich.edu Zigmond Kozicki zigpsych@sbcglobal.net <p><strong>Objective: </strong>Determine the extent to which practicing veterinarians in Michigan, USA engaged in commonly recommended practices for the prevention of zoonotic diseases (ZDs).</p> <p><strong>Background:</strong> Follow-up to Lipton et al. (2008) Washington State study.</p> <p><strong>Methods: </strong>Online survey link was emailed February 2020 to 3,410 Michigan licensed veterinarians practicing clinical medicine with emails on file with Michigan Licensing and Regulatory Affairs.</p> <p><strong>Results:</strong> 402 veterinarians responded. A high proportion (161/214 [75%]) of respondents agreed it was very important for veterinarians to advise clients about the potential for ZD, yet only 34% (74/215) reported they had initiated discussions about ZDs with clients on a daily basis, although 64% (137/214) indicated they had client educational materials on ZDs available in their practices. Nearly 62% (47/76) of veterinarians who obtained their degree after 2010 were likely to eat / drink in animal handling areas as compared to only 33% (18/54) of those who graduated before 1989. Over 30% of respondents (64/210) indicated there were no written infection control guidelines for staff members in the practice, and 28% (60/214) reported having been infected with a ZD in practice.</p> <p><strong>Conclusion: </strong>Veterinarians appreciate their important role in ZD prevention and welcome increased communication between human and veterinary medicine plus assistance from public health agencies regarding ZD prevention. Communication / coordination / collaboration among human medicine / animal medicine / environmental health (i.e., One Health) is necessary to protect the public’s health from zoonoses.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-04-27T09:46:21+01:00 Copyright (c) 2022 Stephanie Baiyasi, Rubén Juárez, Jodi Brookins-Fisher, Jeff Inungu, Thomas Gehring, Zigmond Kozicki https://veterinaryevidence.org/index.php/ve/article/view/509 A comparison of gonadotropin-releasing hormone and human chorionic gonadotropin in dairy cows with ovarian follicular cysts 2022-06-09T15:17:09+01:00 Kathryn Kesler keslerka@msu.edu Grace Longcore ertlegra@msu.edu Alex Russell russe484@msu.edu <p><strong>PICO question</strong></p> <p>In adult dairy cows with ovarian follicular cysts, does treatment with gonadotropin-releasing hormone (GnRH) compared to human chorionic gonadotropin (hCG) result in a more rapid return to cyclicity?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>The publications consisted of six non-blinded randomised comparative or controlled trials</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Recovery time, clinical cure, and interval to conception were consistently evaluated. Many studies also evaluated other fertility parameters such as first estrus or first treatment conception, overall pregnancy and conception risks, and breedings per conception</p> <p><strong>Conclusion</strong></p> <p>At this time, there is insufficient evidence to suggest whether GnRH or hCG is more efficacious for treating ovarian follicular cysts in dairy cattle. Ultimately, further research is essential to elucidate which treatment results in a more rapid return to cyclicity for dairy cattle afflicted with cystic ovarian follicles</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.</p> <p>Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-04-21T09:42:00+01:00 Copyright (c) 2022 Kathryn Kesler, Grace Longcore, Alex Russell https://veterinaryevidence.org/index.php/ve/article/view/543 Personal health and nutrition information-seeking attitudes and behaviours of first year Canadian and United States veterinary students 2022-04-13T12:49:19+01:00 Shelby Nielson snielson@uoguelph.ca May Kamleh may.kamleh@gmail.com Peter Conlon pconlon@ovc.uoguelph.ca Jennifer McWhirter j.mcwhirter@uoguelph.ca Elizabeth Stone estone@uoguelph.ca Deep Khosa dkhosa@uoguelph.ca <p><strong>Objective: </strong>To identify the primary sources of information first year Canadian and US veterinary students relied on for their personal health and nutrition information, and to explore their attitudes towards, and perceptions of, health information resources.</p> <p><strong>Background:</strong> Though the animal health information-seeking behaviours (HISB) of veterinary students have been explored, research regarding personal HISB of this professional student population is limited.</p> <p><strong>Evidentiary value:</strong> Participants were first year veterinary students (n=322) at the five Canadian veterinary schools and five randomly selected US veterinary schools. An online questionnaire was used to gather students’ demographic information, sources of health and nutrition information, and information-seeking attitudes and perceptions. This study may impact practice at the institutional level for veterinary educators.</p> <p><strong>Methods: </strong>STATA 15.1<sup>©</sup> was used for quantitative analysis; involving multivariate logistic regression models, univariate analyses, and measures of frequency.</p> <p><strong>Results:</strong> Results indicated high reliance on the Internet for personal health 213/322 (66%) and nutrition 196/322 (61%) information. While respondents revealed high trust levels in dietary recommendations from family doctors, 132/322 (41%) of students revealed their doctor did not provide any information on healthy diets. Students who reported the use of peer-reviewed journal articles for personal nutrition information were at greater odds of having confidence in knowing where to find nutrition information (Odds Ratio [OR] = 6.61, p&lt;0.001).</p> <p><strong>Conclusion: </strong>Participating students reported a high reliance on the Internet search engine Google, and a general lack of guidance from medical professionals regarding general health needs.</p> <p><strong>Application:</strong> Veterinary schools should consider this information to enhance student information literacy skills, particularly to facilitate personal HISB, and consequently help in management of personal health throughout the growing demands of the programme.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2022-04-13T10:09:42+01:00 Copyright (c) 2022 Shelby Nielson, May Kamleh, Peter Conlon, Jennifer McWhirter, Elizabeth Stone, Deep Khosa