https://veterinaryevidence.org/index.php/ve/issue/feed Veterinary Evidence 2024-06-14T16:53:26+01:00 John Hilton john@rcvsknowledge.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/693 Erratum to: Comparing the effectiveness of clomipramine and fluoxetine in dogs with anxiety-related behaviours 2024-06-14T16:53:26+01:00 Olivia Williamson oliviahwilliamson@gmail.com Valery Varela valery.varela05@gmail.com Christopher Minami chrisminami99@gmail.com Juliana Tom julianatom23@gmail.com Elizabeth Powell elizabeth.powell@midwestern.edu Jeffrey W. Norris jnorri@midwestern.edu <p><strong>The original article was published in <em>Veterinary Evidence</em> Vol 9, Issue 1 (2024):</strong> <a href="https://doi.org/10.18849/ve.v9i1.679">https://doi.org/10.18849/ve.v9i1.679</a></p> <p>In the original version of the article the contributions of one of the authors, Christopher Minami, were listed as "Investigation, Writing – Original draft". This has now been corrected to accurately reflect Minami's contributions, with the agreement of all the authors:</p> <p><strong>Christopher Minami:</strong> Conceptualisation, Methodology, Investigation, Writing – Original draft.</p> <p>This error was in both the HTML and PDF versions. This has now been updated in both the HTML and PDF versions, and can be found in the author contributions section.</p> 2024-06-14T00:00:00+01:00 Copyright (c) 2024 Olivia Williamson, Valery Valera, Christopher Minami, Juliana Tom, Elizabeth Powell, Jeffrey W. Norris https://veterinaryevidence.org/index.php/ve/article/view/685 Thank you to our reviewers 2023 2024-03-13T12:55:16+00:00 Kit Sturgess kit@vetfreedom.com <p>2024 has started with a bang or perhaps more accurately floods, snow and ice. The world remains an uncertain place with the conflict in Ukraine and Gaza as well as tension around the Korean peninsula, Sea of Japan and Taiwan. Economically 2023 was a very hard year with inflation exceeding wage increases making it hard for animal carers, with food banks in the UK seeing an increasing demand for pet food. Thankfully inflation is falling and the economic outlook, although not rosy, is perhaps not as gloomy as originally forecast. The big stories in publishing for 2023 were the explosion of large language models (LLM) like ChatGPT and their impact on publishing (we now have a policy on the use of artificial intelligence (AI) in papers submitted to <em>Veterinary Evidence</em>) and the burgeoning challenge of paper mills (organisations that produce and sell authorship of fabricated or manipulated manuscripts which resemble genuine legitimate research) that has led to some journals losing their citation.</p> <p><em>Veterinary Evidence </em>continues to grow and flourish with increased visits to our website and a regular stream of articles being published. Good governance and ethical publication remain a key focus of the Board that has been strengthened by a number of new members, bringing a broader range of expertise and experience. Our Student Awards continue to be a success and I would like to thank the whole team of staff and reviewers for turning round these submissions so quickly. I had the pleasure of talking to the prize-winning authors and it was great to hear their enthusiasm, but also how much they have valued the help and support from the journal.</p> <p>Our new submission system, Editorial Manager, has been installed and is working well providing better insight into how the publishing process is working for us. It has been a learning experience for all and like any new system there are a few areas where we can further improve the author and reviewer experience. Thanks to the hard work of staff, reviewers and Associate Editors, there are now no papers left in the old OJS system. The journal has strived to make the reviewing process as straightforward as possible with a prereview checklist to ensure papers are ready for review. A mentoring system is up and running for new reviewers open to all who may be interested in contributing to the publication of veterinary literature. <em>Veterinary Evidence</em> has been working hard on our next review date policy and processes so some of our early Knowledge Summaries can be updated as new literature becomes available. We are also preparing to make an application for citation in PubMed Central to increase the visibility of <em>Veterinary Evidence’s</em> content.</p> <p>None of this would be possible without the input from our volunteers and I would like to take this opportunity to say a huge thank you to all our reviewers, Associate Editors and everyone who has served on the Board this year for their tireless efforts on behalf of <em>Veterinary Evidence</em> without your support the journal could not exist. This year the Board has again had three online meetings, which have been essential in helping develop the strategy for <em>Veterinary Evidence</em>; such as our response to LLM, graphic content and further work on which types of evidence can be included in our Knowledge Summaries. On a personal note, my time as Editor-in-Chief is drawing to a close. It has been a great 3 years plus and I have had incredible support from everyone at <em>Veterinary Evidence</em> which has made my role so much easier and more enjoyable.</p> <p>Once again, a massive thank you to everyone who works for and supports <em>Veterinary Evidence</em>, wishing you all a safe and productive 2024.</p> <p> </p> <p>Kit Sturgess</p> <p>Editor-in-Chief</p> 2024-03-28T00:00:00+00:00 Copyright (c) 2024 Kit Sturgess https://veterinaryevidence.org/index.php/ve/article/view/684 In dogs with thoracolumbar disc extrusion does the use of acupuncture improve clinical recovery? 2024-02-22T15:46:55+00:00 Justin Ng justedng@gmail.com <p><strong>PICO Question</strong><br />In dogs with thoracolumbar intervertebral disc extrusion does the use of acupuncture with medical management compared with medical management alone improve clinical recovery?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Three papers were critically appraised: one randomised controlled trial, one non-randomised controlled trial, and one cohort study.</p> <p><strong>Strength of evidence </strong></p> <p>Moderate.</p> <p><strong>Outcomes reported</strong></p> <p>Acupuncture, and more specifically the combination of electroacupuncture and manual stimulation of acupuncture points when used as an adjunct to medical management, is more likely to result in both the recovery of ambulation and a quicker recovery of ambulation in dogs presenting with nonambulatory paraparesis or paralysis with deep pain perception due to thoracolumbar intervertebral disc extrusion, compared with medical management alone. It is less likely to make a difference in dogs that present with paralysis and no pain sensation.</p> <p>There is less robust evidence supporting the use of bee venom injections in acupoints, however; it too may have a beneficial effect when used as an adjunct treatment in dogs with nonambulatory paraparesis or paralysis with deep pain perception due to thoracolumbar intervertebral disc extrusion, compared with medical management alone.</p> <p><strong>Conclusion</strong></p> <p>There is moderate evidence supporting the conclusion that there is a mild benefit in the use of acupuncture with medical management to improve the clinical recovery of dogs with thoracolumbar intervertebral disc extrusion.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2024-05-22T00:00:00+01:00 Copyright (c) 2024 Justin Ng https://veterinaryevidence.org/index.php/ve/article/view/683 The peri / postoperative analgesic effect of intravenous paracetamol in dogs 2024-02-12T11:14:24+00:00 Laura Mckay lauramckay2805@gmail.com <p><strong>PICO Question</strong></p> <p>In healthy dogs undergoing a surgical procedure, is there improved pain control in dogs receiving intravenous paracetamol in the peri / postoperative period compared to dogs not receiving intravenous paracetamol?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Three randomised, controlled, and blinded studies. Two studies directly address the PICO question whereby postoperative pain assessment was clinically evaluated following intravenous (IV) paracetamol. The third study addressed the question to a lesser extent, whereby the impact on the sevoflurane minimum alveolar concentration (MAC) reduction in response to noxious stimuli was assessed following the administration of IV paracetamol.</p> <p><strong>Strength of evidence </strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>The findings of the first two studies presented appear to directly contradict each other. The first study demonstrated a reduction in pain in all groups and found no differences in analgesia between IV paracetamol and other non-steroidal anti-inflammatories drugs (NSAIDs), while the second study reported no analgesia effects from IV paracetamol and was terminated prematurely because a high number of dogs required rescue analgesia. The first study reported sufficient analgesic effects of IV paracetamol and the second study reported no analgesia effects of IV paracetamol. Both were blinded, randomised, controlled studies and directly addressed the PICO question in relation to the peri / postoperative analgesic effects of IV paracetamol. However, their methods and sample sizes were very different. The third study did not demonstrate a clinically relevant sevoflurane MAC reduction after IV paracetamol in dogs.</p> <p><strong>Conclusion</strong></p> <p>At present, there is limited and weak evidence to suggest that IV paracetamol provides peri / postoperative analgesia in dogs. However, further studies are required to better assess its efficacy, its duration of action, and the appropriate doses that are necessary to reach therapeutic plasma levels. The reduced incidence of side effects at the currently recommended doses could support its peri / postoperative use, where NSAIDs use is contraindicated.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2024-04-04T00:00:00+01:00 Copyright (c) 2024 Laura Mckay https://veterinaryevidence.org/index.php/ve/article/view/681 Assessing the efficacy of acupuncture as the sole analgesic for canine chronic pain 2024-02-01T10:15:48+00:00 Jianjian Gong chezmozart@gmail.com Mary Frances Thompson mary.thompson@sydney.edu.au <p><strong>PICO Question</strong></p> <p>In dogs with chronic pain, is acupuncture alone, compared to a placebo, more efficacious in alleviating pain and pain-related dysfunction?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Four randomised, placebo-controlled clinical trials were critically appraised.</p> <p><strong>Strength of evidence </strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>A single study evaluating the efficacy of gold bead implantation, a form of permanent acupuncture, on pain associated with canine hip dysplasia (CHD) endorsed acupuncture’s superior pain alleviation and locomotion improvement through owner and veterinarian subjective outcome evaluation.</p> <p>Three studies concluded that, overall, acupuncture was not efficacious regarding pain reduction or dysfunction improvement compared with placebo treatment.</p> <p><strong>Conclusion</strong></p> <p>Based on the limited current evidence, acupuncture could have analgesic effects as perceived by owners, but acupuncture, as a sole analgesic, is unlikely to be effective in alleviating pain and pain-related dysfunction in canine chronic pain associated with musculoskeletal causes. Evidence is lacking on chronic pain due to neurological and oncological causes. Further studies need to focus on researching various acupuncture modalities’ effects on chronic pain with musculoskeletal, neuropathic and oncological causes when utilised as a component of multimodal therapy. Currently, for canine patients with chronic pain, there is insufficient evidence for a veterinarian to recommend that a client utilise acupuncture as the sole method for pain management.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2024-03-06T00:00:00+00:00 Copyright (c) 2024 Jianjian Gong, Mary Frances Thompson https://veterinaryevidence.org/index.php/ve/article/view/680 Effectiveness of mesenchymal stem cell therapy in cats with chronic gingivostomatitis 2024-01-09T17:19:28+00:00 Omid Nekouei omid.nekouei@cityu.edu.hk San Tung Wong santwong3-c@my.cityu.edu.hk Tiffany Ka Yi Leung tkyleung4-c@my.cityu.edu.hk Qi An Ngai qangai2-c@my.cityu.edu.hk Wing Sum Wong wswong484-c@my.cityu.edu.hk Angel Almendros aalmendr@cityu.edu.hk <p><strong>PICO Question</strong></p> <p>In cats with chronic gingivostomatitis, does using intravenous mesenchymal stem cell therapy, compared to not using it, lead to the improvement of clinical signs?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Five interventional studies (clinical trials).</p> <p><strong>Strength of evidence </strong></p> <p>Moderate.</p> <p><strong>Outcomes reported</strong></p> <p>The reviewed studies indicate intravenous mesenchymal stem cell (MSC) therapy is safe to administer and can be effective in remission or alleviating the clinical signs of refractory, chronic gingivostomatitis in cats that have undergone full-mouth tooth extraction.</p> <p><strong>Conclusion</strong></p> <p>The collective evidence supports the intravenous administration of mesenchymal stem cell (MSC) therapy in cats with chronic gingivostomatitis following dental extraction. However, conducted clinical trials are prone to different degrees of bias due to the lack of independent control groups, the small number of subjects, and enrolling subjects with various severity of the disease. Therefore, more robust evidence can be obtained through well-designed randomised controlled trials to confirm the observed positive effects of the treatment in cats with a broader range of characteristics.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2024-02-07T00:00:00+00:00 Copyright (c) 2024 Omid Nekouei, San Tung Wong, Tiffany Ka Yi Leung, Qi An Ngai, Wing Sum Wong, Angel Almendros https://veterinaryevidence.org/index.php/ve/article/view/679 Comparing the effectiveness of clomipramine and fluoxetine in dogs with anxiety-related behaviours 2024-01-09T17:09:27+00:00 Olivia Williamson oliviahwilliamson@gmail.com Valery Varela valery.varela05@gmail.com Christopher Minami chrisminami99@gmail.com Juliana Tom julianatom23@gmail.com Elizabeth Powell elizabeth.powell@midwestern.edu Jeffrey W. Norris jnorri@midwestern.edu <p><strong>PICO Question</strong></p> <p>In dogs with anxious behaviours, is fluoxetine more effective than clomipramine in reducing anxiety-related behaviours?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Three controlled studies were critically appraised.</p> <p><strong>Strength of evidence </strong></p> <p>Moderate.</p> <p><strong>Outcomes reported</strong></p> <p>Administration of either fluoxetine or clomipramine to adult dogs reduces symptoms of fear and anxiety.</p> <p><strong>Conclusion</strong></p> <p>Both fluoxetine and clomipramine are effective in reducing acral lick dermatitis and tail chasing behaviours, but there is no evidence that one drug is more effective than the other.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2024-03-13T00:00:00+00:00 Copyright (c) 2024 Olivia Williamson, Valery Varela, Christopher Minami, Juliana Tom, Elizabeth Powell, Jeffrey W. Norris https://veterinaryevidence.org/index.php/ve/article/view/678 Does early neutering increase the risk of cranial cruciate ligament rupture? 2024-01-09T16:51:09+00:00 Daniel Low daniel.kuan.chong.low@gmail.com <p><strong>PICO Question</strong></p> <p>In bitches, does gonadectomy before 1 year of age compared to gonadectomy at 1 year of age or older, increase the risk of cranial cruciate ligament disease during their life?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Risk.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Eight studies were reviewed, four of which were retrospective cohort studies, two of which were prospective longitudinal cohort studies, one of which was a retrospective case-control study and one of which was a prospective case-control study.</p> <p><strong>Strength of evidence </strong></p> <p>Moderate.</p> <p><strong>Outcomes reported</strong></p> <p>The evidence was mixed, but overall was suggestive that gonadectomy before 1 year of age increased the risk of cranial cruciate ligament disease in bitches. Gonadectomy before 1 year of age was found to increase the risk of cranial cruciate ligament disease in seven of eight studies. Most studies assessed a narrow range of breeds and the generalisability of these results to all dogs is thus limited. The one study which assessed a range of 35 breeds noted an increase in risk of cranial cruciate ligament disease in 6 of 35 breeds associated with gonadectomy before 1 year of age. Direct comparison of studies is limited by the varying age stratifications, breed analyses, and study methodologies.</p> <p><strong>Conclusion</strong></p> <p>Gonadectomy before 1 year of age in Golden Retriever, German Shepherd, and Rottweiler bitches may increase the risk of cranial cruciate ligament disease. In other breeds, limited evidence is available to draw conclusions.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2024-04-25T00:00:00+01:00 Copyright (c) 2024 Daniel Low https://veterinaryevidence.org/index.php/ve/article/view/677 Comparing internal versus external fixation for diaphyseal tibial and fibular fractures in skeletally immature dogs 2024-01-09T16:43:14+00:00 Jake Chitty jake.chitty@vets-now.com Paul Aldridge paul.aldridge@vets-now.com <p><strong>PICO Question</strong></p> <p>In skeletally immature dogs with simple non-displaced diaphyseal tibial and fibular fractures does internal fixation compared with external fixation result in less postoperative complications and improved fracture healing?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>There were no publications that answered the PICO question.</p> <p><strong>Strength of evidence </strong></p> <p>None.</p> <p><strong>Outcomes reported</strong></p> <p>Both external skeletal fixation and internal fixation are reported as techniques for diaphyseal tibial and fibular fracture management in companion animals, though no study has been reported to compare these techniques directly, or to report fracture healing and postoperative complications in skeletally immature dogs with non-displaced diaphyseal tibial fractures.</p> <p><strong>Conclusion</strong></p> <p>Given the absence of evidence answering the PICO, choice and recommendation on treatment for non-displaced diaphyseal tibial and fibular fractures in skeletally immature dogs should be decided on personal experience and stabilisation methods available to the veterinarian such as external fixation or internal fixation. Both surgical techniques have been reported in skeletally mature and immature dogs with diaphyseal tibial fractures, but not specifically in skeletally immature patients with non-displaced diaphyseal tibial and fibular fractures. They are both applicable methods of fixation for tibial fractures in companion animals, though there is lacking evidence for which has more favourable outcomes for non-displaced diaphyseal tibial and fibular fractures in skeletally immature dogs as no studies have directly compared these stabilisation techniques.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2024-01-31T00:00:00+00:00 Copyright (c) 2024 Jake Chitty, Paul Aldridge https://veterinaryevidence.org/index.php/ve/article/view/676 Evaluating the effect of equine tetanus antitoxin on mortality rates of dogs affected by tetanus 2023-12-06T13:15:17+00:00 Berry Wong mrberrywong@hotmail.com <p><strong>PICO Question</strong></p> <p>In dogs with tetanus, does administering the equine tetanus antitoxin compared to not administering the antitoxin reduce mortality rates?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Three studies were reviewed for this Knowledge Summary, all of which were retrospective case-control studies.</p> <p><strong>Strength of evidence </strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>There was no difference in survival to discharge between dogs treated and dogs not treated with equine tetanus antitoxin.</p> <p><strong>Conclusion</strong></p> <p>The current literature suggests that administering the equine tetanus antitoxin to dogs affected by tetanus had no positive or negative effect on mortality rates, though the level of evidence amongst the literature is weak.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2024-03-20T00:00:00+00:00 Copyright (c) 2024 Berry Wong https://veterinaryevidence.org/index.php/ve/article/view/673 In dogs with chronic enteropathy (idiopathic inflammatory bowel disease) is budesonide more effective than prednisolone or prednisone in resolving clinical signs? 2023-11-17T10:21:44+00:00 Victoria Alice Coates victoriaalee96@gmail.com <p><strong>PICO Question</strong></p> <p>In dogs with chronic enteropathy (idiopathic inflammatory bowel disease) is budesonide more effective than prednisolone or prednisone in resolving clinical signs or improving the canine inflammatory bowel disease (IBD) activity index (CIBDAI) or the canine chronic enteropathy clinical activity index (CCECAI)?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>One double-blinded randomised control trial.</p> <p><strong>Strength of evidence </strong></p> <p>Moderate.</p> <p><strong>Outcomes reported</strong></p> <p>The outcome of this study identified that no significant differences in remission rates (&gt; 75% decrease in CIBDAI scores) were observed between the prednisone and budesonide groups. Frequency of adverse effects were also similar between the two groups.</p> <p><strong>Conclusion</strong></p> <p>A single study with moderate power of evidence alongside some significant limitations, particularly population size, cannot be used as the sole provider of an answer to the PICO question. As such, further studies with greater power would be required before a definitive assessment of comparative treatment efficacy can be made.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2023-12-13T00:00:00+00:00 Copyright (c) 2023 Victoria Alice Coates https://veterinaryevidence.org/index.php/ve/article/view/671 Postoperative analgesia and side effects of oral or injectable metamizole (dipyrone) in dogs and cats 2023-11-08T15:48:20+00:00 Jakub Stadnicki jakub.stadnicki@anicura.se Mathieu Raillard mathieu_raillard@yahoo.it <p><strong>PICO Question</strong></p> <p>In dogs and cats after surgery, does the peri-operative administration of injectable or oral metamizole (dipyrone) as opposed to no intervention result in lower postoperative pain scores or higher incidence of side effects?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Three prospective, randomised, blinded, clinical studies were critically reviewed.</p> <p><strong>Strength of evidence </strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>Variables assessed included: different pain assessment methods, metamizole dose required to reduce peri- and postoperative pain scores, changes in cardiovascular variables (heart rate, systolic, mean and diastolic blood pressure), changes in respiratory variables and variations in haematological and biochemical variables.</p> <p><strong>Conclusion</strong></p> <p>In healthy cats and dogs undergoing ovariohysterectomy, the use of metamizole in the peri- and postoperative period was associated with some reduction in pain levels (i.e., lower pain score or reduced need for rescue analgesia). In dogs, metamizole alone provided insufficient analgesia. No study evaluating metamizole after orthopaedic surgery was found. No evidence suggested that using metamizole peri-operatively resulted in higher incidence of side effects.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2023-12-20T00:00:00+00:00 Copyright (c) 2023 Jakub Stadnicki, Mathieu Raillard https://veterinaryevidence.org/index.php/ve/article/view/670 Do passive range of motion exercises lead to quicker postsurgical recovery of canine IVDD? 2023-10-24T11:23:17+01:00 Alexander Wallace alexanderwallace@icloud.com <p><strong>PICO Question</strong></p> <p>In canine patients recovering from surgery for intervertebral disc disease, do passive range of motion exercises, compared to no intervention, lead to a shorter or faster rate of recovery?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Five studies (two randomised controlled trials, two retrospective cohort studies and one retrospective case series) were critically appraised.</p> <p><strong>Strength of evidence </strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>There is no evidence that passive range of motion (PROM) exercises are associated with a quicker postsurgical recovery in the canine intervertebral disc disease (IVDD) patient.</p> <p><strong>Conclusion</strong></p> <p>There is a lack of evidence about specific rehabilitation techniques for the postoperative canine IVDD patient. Based on the current data, a multimodal approach, including basic and intense rehabilitation techniques is suggested.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2023-11-15T00:00:00+00:00 Copyright (c) 2023 Alexander Wallace https://veterinaryevidence.org/index.php/ve/article/view/669 Effectiveness of F3 feline facial pheromone analogue for acute stress reduction within clinical veterinary practice 2023-09-14T12:03:14+01:00 Ebony Crump ebony_crump@hotmail.com <p><strong>PICO Question</strong></p> <p>In cats within a clinical veterinary context, does the application of the F3 feline facial pheromone (Feliway™), when compared to placebo, reduce signs of acute stress?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Five papers were critically reviewed. There were three prospective, double-blinded, randomised controlled trials, one prospective, single-blinded, randomised controlled trial and one prospective, single-blinded, non-randomised controlled trial.</p> <p><strong>Strength of evidence </strong></p> <p>Moderate.</p> <p><strong>Outcomes reported</strong></p> <p>Four studies found improvement in select indicators of acute stress following F3 feline facial pheromone analogue (FFPA) exposure. One study showed FFPA reduced patient stress during routine physical examination, and improved caregiver impression of patient relaxation and ease of handling. One study revealed FFPA decreased vocalisations but had no effect upon systolic blood pressure during physical examination. One study determined that FFPA calmed but did not reduce struggling during venous catheterisation. One study demonstrated reduced time to sedation and propofol induction dose for routine surgical procedures when a transport protocol incorporating FFPA was applied. Finally, one study found no significant effect of FFPA upon behavioural and physiologic measures of acute stress during physical examination. No studies reported outward negative effects associated with FFPA exposure.</p> <p><strong>Conclusion</strong></p> <p>It can be concluded that FFPA may reduce signs of acute stress within a clinical veterinary context. Additionally, exposure to FFPA is unlikely to cause patient harm. To optimise patient welfare, FFPA is not recommended as a sole agent for stress mitigation and should instead be incorporated holistically with patient friendly handling, clinic design, and pharmacotherapy where indicated.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2023-12-06T00:00:00+00:00 Copyright (c) 2023 Ebony Crump https://veterinaryevidence.org/index.php/ve/article/view/668 Erratum to: In dogs diagnosed with osteoarthritis, how safe and effective is long-term treatment with bedinvetmab in providing analgesia? 2023-09-11T10:18:06+01:00 Katrin Kronenberger k.kronenberger@sms.ed.ac.uk <p><strong>The original article was published in <em>Veterinary Evidence</em> Vol 8, Issue 1 (2023): <a href="https://doi.org/10.18849/ve.v8i1.598" target="_blank" rel="noopener">https://doi.org/10.18849/ve.v8i1.598</a></strong></p> <p> </p> <p>To aid interpretation, certain statements in the Knowledge Summary have been clarified. Refer to the full text and PDF for these amendments and corrections.</p> 2023-09-22T00:00:00+01:00 Copyright (c) 2023 Katrin Kronenberger https://veterinaryevidence.org/index.php/ve/article/view/667 Evaluation of a method to measure the ratio of pelvic limb to thoracic limb girth in dogs 2023-08-24T12:08:14+01:00 Elisabeth A. Fox elisabeth.a.fox@gmail.com Kirsty E. Oliver keoliver@vscvets.com Matthew W. Brunke drmattbrunke@gmail.com <p>Objective: To determine if a landmark-incorporated limb girth measurement in sound dogs, utilising the greater trochanter and the acromion process, would be both reliable and have a consistent ratio between pelvic limb (PL) and thoracic limb (TL) muscle measurements.</p> <p>Background: To establish a reliable and reproducible reference range for sound dogs. This reference range may help clinicians further evaluate dogs during lameness and musculoskeletal examinations.</p> <p>Evidentiary value: Prospective study of 115 sound dogs measured by a single observer.</p> <p>Methods:Examinations were performed by one observer, using a Gullick II tape measure for PL to TL ratio (PL:TL) measurements for 115 dogs. Bodyweight, breed, body condition score (BCS), and sex were recorded. Each limb was measured three times. The average PL:TL per dog was calculated. Further statistical analysis was used to calculate intra-observer variance and the correlation of limb girth to body weight, BCS, and sex, with significance set at P &lt; 0.05.</p> <p>Results: The average PL:TL of the sample was 1.515 ± 0.049. Fifty-two dogs of the 115 cases (45%) had a PL:TL ratio of 1.500. PL:TL measurements were not related to dog weight, BCS, or sex. The intra-class correlation was reported to be 0.99.</p> <p>Conclusion: Our study suggests that a landmark-incorporated measurement in a weight-bearing position can be reproducible. Further investigation is required to determine if this measurement can be reproducible between multiple observers.</p> <p>Application: A landmark-incorporated limb girth measurement may guide clinicians in case progression and help pinpoint subclinical musculoskeletal disease in dogs.</p> 2023-10-25T00:00:00+01:00 Copyright (c) 2023 Elisabeth A. Fox, Kirsty E. Oliver, Matthew W. Brunke https://veterinaryevidence.org/index.php/ve/article/view/666 The efficacy of recombinant feline interferon-omega in treating symptomatic cats infected with feline immunodeficiency virus 2023-08-24T12:00:45+01:00 Rachel Garrett rachel.c.garrett@gmail.com <p><strong>PICO Question</strong></p> <p>In symptomatic cats with feline immunodeficiency virus (FIV), does high-dose subcutaneous recombinant feline interferon-omega (rFeIFN-ω) administration lead to reduced clinical signs compared to cats who were not administered rFeIFN-ω?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <h3> </h3> <p><strong>Number and type of study designs reviewed</strong></p> <p>Three studies were critically reviewed, including one randomised controlled trial, one non-randomised controlled trial, and one uncontrolled clinical trial.</p> <p> </p> <p><strong>Strength of evidence </strong></p> <p>Weak.</p> <p> </p> <p><strong>Outcomes reported</strong></p> <p>Each of the studies reported that rFeIFN-ω administration significantly reduced clinical signs in FIV infected cats. However, all three papers have limitations in their study design and statistical analysis which lower the strength of the evidence they provide.</p> <p><strong> </strong></p> <p><strong>Conclusion</strong></p> <p>There is only weak evidence demonstrating that rFeIFN-ω administration leads to reduced clinical signs in FIV positive cats. Currently, there is a lack of well-designed, double-blinded, randomised, placebo-controlled clinical trials which have an adequate sample size and specifically focus on FIV positive cats. As a result, more robust evidence is needed to prove the definitive therapeutic benefit of rFeIFN-ω in symptomatic FIV patients. Treatment with rFeIFN-ω may still be considered by clinicians for cats with clinical signs potentially associated with retroviral infection, such as oral lesions and stomatitis, particularly if they are not responding well to supportive therapy alone.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2023-09-15T00:00:00+01:00 Copyright (c) 2023 Rachel Garrett https://veterinaryevidence.org/index.php/ve/article/view/665 Efficacy of omental graft to facilitate canine radial fracture repair 2023-08-24T11:56:01+01:00 Rhyanna Dietrich vet.rhyanna.dietrich@gmail.com <p><strong>PICO Question</strong></p> <p>In dogs with a displaced radial fracture, does the use of a free autologous greater omental graft, combined with other standard fracture repair methods, compared to not using a greater omental graft, reduce fracture healing time?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Three papers were critically reviewed: one retrospective clinical study and two experimental case control studies. All three papers answered the PICO question. Each of the three papers had a very small sample size, with two having a sample size of 16 (n = 4 in the relevant experimental group, and n = 4 for the control). The third had an initial sample of 25 that was later reduced to 19, as six dogs were excluded from the study.</p> <p><strong>Strength of evidence </strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>Two papers were experimental case control studies, which looked at radial fracture healing of dogs that had undergone an osteotomy, followed by bone plate and screw fixation, as well as either with a free autologous greater omental graft (OG) or without. Healing was measured in both studies via radiographical analysis using a modified Lane and Sandhu scoring system, and histopathological analysis post euthanasia with Heiple’s histopathological scoring system. Both studies found higher radiographic and higher histopathological scores in the OG group, though there was a large overlap between group scores. There was no mention of randomisation or power analysis in either of these studies, and blinding was only mentioned regarding histopathological analysis.</p> <p>The other was a retrospective study, looking at the outcomes of radial and ulna fractures in small breed dogs, after being surgically treated with a plate and screw, and either with or without OG. They found that dogs with omental grafts healed faster than those without, and had no major complications (whereas the non-OG group did). Note that this study was not (and could not) be randomised due to its nature, and it made no mention of blinding.</p> <p><strong>Conclusion</strong></p> <p>All three studies concluded that the use of OG assisted healing in canine radial fractures. However, care must be taken when applying these results to practice, as the studies lack robustness. While two of the studies had a good study design, both had very small sample sizes and neither mentioned randomisation. Blinding was only mentioned in the histopathological analysis, not radiographical analysis, and while both studies reported significant differences between their respective OG and control groups, they failed to account for multiple comparisons in statistical analysis, which likely skewed the results. The third study also represents a weak level of evidence, due to its retrospective nature and other limitations. Its small sample size, and the fact that 4/8 control (non-OG) dogs received a different type of graft, contributed to this.</p> <p>Due to the small number of animals in each study and the poor-quality design, it is concluded that there is weak evidence to support the PICO question. Further randomised blinded clinical trials with larger samples sizes are recommended, to increase the strength of the evidence before the routine clinical use of greater omentum grafts for aiding fracture repair can be recommended, considering that this means an additional abdominal surgical procedure.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2023-11-08T00:00:00+00:00 Copyright (c) 2023 Rhyanna Dietrich https://veterinaryevidence.org/index.php/ve/article/view/664 Pre-weaning socialisation with non-littermates in piglets: reduced weaning stress when regrouped with unfamiliar piglets post-weaning? 2023-08-24T11:49:04+01:00 Dongyue Du dodu5900@uni.sydney.edu.au Jenny-Ann Toribio jenny-ann.toribio@sydney.edu.au <p><strong>PICO question</strong></p> <p>In piglets in indoor housing systems does pre-weaning socialisation with non-littermates compared to no pre-weaning socialisation with non-littermates result in lower weaning stress when regrouped with unfamiliar piglets post-weaning?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment.</p> <p> </p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Nine papers were critically reviewed. All of them were controlled trials, of which two were randomised control trials.</p> <p> </p> <p><strong>Strength of evidence</strong></p> <p>Moderate.</p> <p> </p> <p><strong>Outcomes reported</strong></p> <p>In terms of behavioural indicators of weaning stress, piglets socialised with non-littermates during lactation showed less aggressive behaviours (in the six papers that investigated aggression) and fewer skin lesions (in the six out of seven papers that investigated skin lesions) than non-socialised piglets when regrouped with unfamiliar piglets post-weaning. One of two papers showed that the cortisol level of socialised piglets had a smaller increase from pre-weaning to post-weaning level than non-socialised piglets. Four out of five papers that investigated average daily weight gain (ADG) found that the difference between socialised and non-socialised piglets in ADG was insignificant.</p> <p> </p> <p><strong>Conclusion</strong></p> <p>Based on behavioural indicators, there was strong evidence suggesting that pre-weaning socialisation with non-littermates could reduce aggression and skin lesions when regrouped with unfamiliar piglets post-weaning. However, due to the weak evidence for the physiological indicator and growth performance, the effect of pre-weaning socialisation on weaning stress was inconclusive.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></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> 2023-09-27T00:00:00+01:00 Copyright (c) 2023 Dongyue Du, Jenny-Ann Toribio https://veterinaryevidence.org/index.php/ve/article/view/663 Erratum to: Does the use of supraglottic device in rabbits cause less injury than other airway management devices? 2023-02-10T18:20:35+00:00 Jasmine Gheini jghe8559@uni.sydney.edu.au Sanaa Zaki sanaa.zaki@sydney.edu.au <p><strong>The original article was published in <em>Veterinary Evidence</em> Vol 7, Issue 4 (2022): <a href="https://doi.org/10.18849/ve.v7i4.608" target="_blank" rel="noopener">https://doi.org/10.18849/ve.v7i4.608</a></strong></p> <p> </p> <p>Unfortunately the original version of the article was missing the following statement.</p> <p>This Knowledge Summary has reviewed the available evidence on the use of a SGAD (v-gel®) in rabbit anaesthesia. Since writing a new design of a single use supraglottic airway device (SGAD) has been introduced; currently there is no published evidence on whether this new device has an impact on the risk of injury.</p> <p>This error was in both the HTML and PDF versions. This has now been updated in both the HTML and PDF versions, and can be found in the clinical bottom line and the evidence section.</p> 2023-05-05T00:00:00+01:00 Copyright (c) 2023 Jasmine Gheini, Sanaa Zaki