Veterinary Evidence

Do passive range of motion exercises lead to quicker postsurgical recovery of canine IVDD?

2023-10-24T11:23:17+01:00

PICO Question

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?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Five studies (two randomised controlled trials, two retrospective cohort studies and one retrospective case series) were critically appraised.

Strength of evidence

Weak.

Outcomes reported

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.

Conclusion

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.

How to apply this evidence in practice

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.

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.

Effectiveness of F3 feline facial pheromone analogue for acute stress reduction within clinical veterinary practice

2023-09-14T12:03:14+01:00

PICO Question

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?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

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.

Strength of evidence

Moderate.

Outcomes reported

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.

Conclusion

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.

How to apply this evidence in practice

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

The original article was published in Veterinary Evidence Vol 8, Issue 1 (2023): https://doi.org/10.18849/ve.v8i1.598

To aid interpretation, certain statements in the Knowledge Summary have been clarified. Refer to the full text and PDF for these amendments and corrections.

Evaluation of a method to measure the ratio of pelvic limb to thoracic limb girth in dogs

2023-08-24T12:08:14+01:00

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.

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.

Evidentiary value: Prospective study of 115 sound dogs measured by a single observer.

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 < 0.05.

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.

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.

Application: A landmark-incorporated limb girth measurement may guide clinicians in case progression and help pinpoint subclinical musculoskeletal disease in dogs.

The efficacy of recombinant feline interferon-omega in treating symptomatic cats infected with feline immunodeficiency virus

2023-08-24T12:00:45+01:00

PICO Question

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?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Three studies were critically reviewed, including one randomised controlled trial, one non-randomised controlled trial, and one uncontrolled clinical trial.

Strength of evidence

Weak.

Outcomes reported

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.

Conclusion

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.

How to apply this evidence in practice

Efficacy of omental graft to facilitate canine radial fracture repair

2023-08-24T11:56:01+01:00

PICO Question

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?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

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.

Strength of evidence

Weak.

Outcomes reported

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.

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.

Conclusion

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.

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.

How to apply this evidence in practice

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

PICO question

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?

Clinical bottom line

Category of research question

Treatment.

The number and type of study designs reviewed

Nine papers were critically reviewed. All of them were controlled trials, of which two were randomised control trials.

Strength of evidence

Moderate.

Outcomes reported

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.

Conclusion

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.

How to apply this evidence in practice

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

The original article was published in Veterinary Evidence Vol 7, Issue 4 (2022): https://doi.org/10.18849/ve.v7i4.608

Unfortunately the original version of the article was missing the following statement.

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.

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.

Thank you to our reviewers 2022

2023-01-31T20:57:52+00:00

As 2023, dawns we are faced with a very different world than at the start of 2022, COVID-19 is in the rear-view mirror, but we now face the war in Ukraine, energy prices and inflation. Perhaps this is a glimpse of the ‘new world’ where we will be continually challenged by crisis whether it be conflict, infectious disease or the impacts of global warming.

On a more positive note it has been another busy and productive year for Veterinary Evidence as we strive to continually improve the journal whether you are a reader, author or reviewer. In April we said ‘goodbye’ to Daniel Edwards who had covered Bridget Sheppard’s maternity leave as Managing Editor. I would like to take the opportunity to thank Dan for all his hard work for Veterinary Evidence initiating a number of projects that have come to fruition through the year and to welcome Bridget back. As Veterinary Evidence has grown, we have been fortunate to be able to expand our staff to meet the need and ensure efficient turnaround of submissions so another welcome, William Smith has joined the team and is now a permanent full time Editorial Assistant.

It is not just staff changes that happened in 2022, we have also improved the governance of Veterinary Evidence with the appointment of new board members and creation of a Deputy Editor-in-Chief position ably filled by Louise Buckley. We also submitted a successful application to COPE (The Committee on Publication Ethics) further strengthening the journal’s oversight and reputation.

We have had a major website redesign, now live, which has greatly improved the look, feel, and functionality of Veterinary Evidence for all users. Readers can find relevant papers quickly and efficiently. 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.

We have also been developing our processes for reviewing papers to make sure that papers are ready to go out for review. We are working on ways to make sure that, for papers requiring revision, authors respond to each of the comments made by reviewers, and reviewers can quickly see that there has been an author response to their comments and suggestions. A new submission system, Editorial Manager, has been implemented that should make life easier for everyone as well as provide accessible data on papers as they go through the system so we can see what we do well and where we can do better.

None of this would be possible without the input from our reviewers and I would like to take this opportunity to say a huge thank you to all our reviewers and everyone who has served on the Editorial Board this year for their tireless efforts on behalf of Veterinary Evidence – 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 Veterinary Evidence such as how we ensure our Knowledge Summaries remain current, what literature should be included in Knowledge Summaries and how we improve the reviewer and author experience.

Once again, a massive thank you to everyone who works for and supports Veterinary Evidence, wishing you all a safe and productive 2023.

Kit Sturgess

Editor-in-Chief

Is symmetric dimethylarginine superior to creatinine for assessing glomerular filtration rate for cats with kidney disease?

2023-04-19T10:20:55+01:00

PICO question

Is symmetric dimethylarginine (SDMA) superior to creatinine for assessing glomerular filtration rate (GFR) for cats with chronic kidney disease?

Clinical bottom line

Category

Diagnosis.

Number and type of studies reviewed:

The literature searches returned four relevant papers that answered this PICO. Three of the studies were retrospective diagnostic test studies, and one was a randomised, controlled, unblinded study.

Strength of evidence

Moderate.

Outcomes reported

Three out of the four studies analysed found that there was no significant difference between the correlation between symmetric dimethylarginine (SDMA) and glomerular filtration rate (GFR) and creatinine (sCr) and GFR, whilst the other identified a stronger correlation between SDMA and GFR. Two papers also evaluated the sensitivity and specificity of SDMA compared to creatinine. One paper found a similar sensitivity for both biomarkers and a significantly higher specificity for creatinine using the upper reference interval of 18 µg/dL for SDMA and 155.6 µmol/L (1.76 mg/dL) sCr, whilst the other found SDMA to have a superior sensitivity and both biomarkers to have a similar specificity using the upper reference interval of 14 µg/dL for SDMA and 185.64 µmol/L (2.1 mg/dL) for sCr.

Conclusions

In view of the strength of evidence we conclude that the majority of the studies analysed do not demonstrate that SDMA is superior to creatinine for the assessment of GFR in cats with chronic kidney disease. More research is needed with larger sample sizes to investigate this further. Standardisation of the upper reference intervals across studies for creatinine and SDMA would be advantageous for comparison of sensitivity and specificity in future studies.

How to apply this evidence in practice

Systematic reviews of animal studies – Report of an international symposium

2023-08-11T17:26:10+01:00

Objective: The Symposium on Animal Systematic Reviews held 24 May 2022, sought to bring organisations working on animal literature searching and systematic reviews together into the same virtual space for introductions and discussion.

Background: Groups working on animal research synthesis are often siloed into preclinical, veterinary, and One Health settings. This symposium sought to define commonalities and differences in methodologies, resources, and philosophies and to discuss future needs.

Methods: The 3-hour virtual symposium for veterinarians, researchers, and information specialists began with introductions by panelists from organisations involved in searching the literature for animal studies and conducting systematic reviews. This was followed by a panel discussion and question and answer period.

Results: Panelists identified a need to ensure planning and accurate description of primary animal studies as a precursor to quality systematic reviews. They acknowledged and discussed differences in evidence synthesis expectations and tools based on the type of review, the types of studies available on the topic, and the focus on preclinical, veterinary, or One Health topics.

Conclusion: The need to increase the speed and quality of evidence reviews, and to automate updates, requires investing in the development of both skilled teams and platforms. The symposium provided a chance to identify existing resources, define challenges, and note gaps unique to systematic reviews of animal studies.

Application: This symposium acts as a baseline for ongoing discussions centred on improving the culture and pipeline for evidence syntheses of animal studies that inform decision-making.

In free-roaming dog populations, does egg-based oral rabies vaccination programmes result in improved bait efficacy?

2023-07-07T09:27:05+01:00

PICO Question

In free-roaming dog populations, does an egg-based oral rabies vaccination (ORV) compared with meat and fish based ORVs result in improved bait efficacy?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Three non-blinded, control trials were critically reviewed.

Strength of evidence

Weak.

Outcomes reported

Variables assessed in this Knowledge Summary included the type of bait that stray dogs were most interested in, and whether or not the dog was successfully vaccinated by release of the vaccine sachet into the oral cavity.

Conclusion

There is weak evidence to show that stray dogs prefer egg-based baits in compared to other bait types, despite egg-based baits allowing for more successful perforation of the vaccine sachet, and hence a higher chance of a successful oral rabies vaccination.

How to apply this evidence in practice

The efficacy of administration of prazosin in reducing the risk of recurrent urethral obstruction in male cats

2023-09-25T09:51:25+01:00

PICO Question

In male cats presenting with urethral obstruction, does administration of prazosin compared with no administration of prazosin reduce the incidence of recurrent urethral obstruction within the first month of initial presentation?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

A total of three studies were included in this appraisal. Two of which were prospective double-blind clinical studies and one retrospective study.

Strength of evidence

Weak.

Outcomes reported

Both double-blind studies found no significant difference between prazosin administration and the development of recurrent urethral obstruction (rUO) when compared with a placebo. Both studies, however, did report that cats had a shorter urinary catheterisation time with prazosin administration. The retrospective study found no association between prazosin administration and the risk of rUO and found that after 14 days post discharge, significantly more 73/302 (24%) cats that received prazosin had experienced rUO compared to 11/86 (13%) of cats that did not. One study found side effects to the administration of prazosin which may be detrimental to the overall recovery.

Conclusion

Administration of prazosin does not reduce the risk of rUO within 30 days of presentation. However, the strength of evidence is weak and would benefit from further clinical studies.

How to apply this evidence in practice

Ultrasonographic detection of cranial cruciate ligament pathology in canine stifles without cranio-caudal instability

2023-01-26T15:57:53+00:00

Objective

Explore the value of musculoskeletal ultrasound in detecting cruciate ligament pathology

Background

Partial tears of the cranial cruciate ligament (CCL) can be difficult to diagnose due to the lack of instability present on orthopedic examination. Advanced diagnostics would be required for further evaluation. While a common tool in human medicine, MRI is of limited use in canines due to cost and the need for general anesthesia. Musculoskeletal ultrasound (MSK-US) can be performed without anesthesia but there are no current studies to date evaluating its usefulness in detecting partial tears of the cruciate ligaments

Evidentiary value

This is a retrospective case series (n=32) of dogs that underwent diagnostic MSK-US of the stifle who later had a surgical procedure (stifle arthroscopy/arthrotomy) to evaluate the intra-articular space.

Methods

Medical records were evaluated between May 2014 - April 2020 for canines with clinically stable stifles that underwent both an MSK-US of the stifle followed by stifle surgery. Ultrasound findings of the CCL were compared to surgical findings (considered gold standard).

Results

Compared to arthroscopy, ultrasound was a very sensitive test in detecting CCL pathology however it is less specific. Its sensitivity (SN), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) were 100%, 58.3%, 81.5%, and 100% respectively.

Conclusion

MSK-US is a non-invasive test that can be performed with little to no sedation. Using a high frequency 18-5MHz linear transducer, MSK-US is a sensitive test for detecting partial CCL injuries in dogs and may aid in its diagnosis for canines without stifle instability and be useful in guiding treatment. As it is less specific, arthroscopy would be necessary to further confirm the intra-articular pathology.

Application

Diagnostic MSK-US is a non-invasive tool that can be used to detect CCL pathology in the stifle. Its application can help guide treatment recommendations prior to a more invasive diagnostic/therapeutic procedure such as surgery or arthroscopy.

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

The original version of the article has been corrected, please see the full text for details of the correction.

Erratum to: Should we prescribe oral metronidazole or probiotics for acute gastroenteritis in dogs?

2022-06-28T13:59:15+01:00

The original version of the article has been corrected, please see the full text for details of the correction.

The effect of anti-nerve growth factor monoclonal antibodies on the clinical signs of degenerative joint disease in cats

2023-06-15T14:48:56+01:00

PICO Question

Are felinised anti-nerve growth factor monoclonal antibodies (frunevetmab) effective at reducing the clinical signs of pain and immobility in cats with degenerative joint disease when compared with no treatment?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Three peer-reviewed randomised controlled trial treatment studies, two of which were pilot studies.

Strength of evidence

Moderate.

Outcomes reported

All three studies concluded that there was a statistical reduction in pain and an improvement in mobility in the groups administered frunevetmab, when compared to the groups administered the placebo.

Conclusion

There is moderate evidence suggesting that the administration of frunevetmab by injection led to a reduction in pain and an increase in mobility. Injections were given at day 0; day 0 and 28, or day 0, 28 and 56 depending on the study. Further research should be conducted to ensure repeatability, involving more objectively measured outcomes to reduce the reliance on subjective measures which are more likely to have associated bias.

How to apply this evidence in practice

Treatment options for dogs diagnosed with sinonasal aspergillosis

2023-05-23T10:23:15+01:00

PICO question

In dogs diagnosed with SNA, does inclusion of debridement in the treatment protocol improve clinical outcomes compared to dogs treated without debridement?

Clinical bottom line

Category of research question

Treatment

The number and type of study designs reviewed

No papers that directly addressed the PICO were reviewed. Four retrospective case series which partially addressed the PICO question were discussed in the appraisal.

Strength of evidence

Zero.

Outcomes reported

None.

Conclusion

No conclusions can be made based on the current level of evidence, however the studies discussed in the appraisal suggest that there may be an association between the inclusion of debridement in the treatment protocol for SNA and an improved clinical outcome. Undertaking further higher-level studies (comparative, blind, prospective, randomised) would be required to confirm this. Ethical implications would not preclude such studies, for there is evidence that treatment protocols including topical deposition of antifungal agents alone are efficacious.

How to apply this evidence in practice

In canine cranial cruciate ligament disease, are conservative treatment and lateral fabellotibial suture recoveries comparable?

2023-06-20T14:43:31+01:00

PICO question

In dogs with cranial cruciate ligament disease, is conservative non-surgical treatment as effective as surgical treatment with the lateral fabellotibial suture technique in reducing time to recovery?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

One retrospective study.

Strength of evidence

Zero.

Outcomes reported

There is no evidence that surgical treatment with the lateral fabellotibial suture (LFTS) reduces time to recovery compared to conservative treatment in dogs with cranial cruciate ligament disease.

Conclusion

In dogs with cranial cruciate ligament disease there is no statistical evidence to support recommendation of surgical treatment with the LFTS technique compared to conservative treatment in reducing time to recovery.

How to apply this evidence in practice

Does the use of supraglottic device in rabbits cause less injury than other airway management devices?

2022-12-02T11:09:57+00:00

There is an erratum to this paper published in Veterinary Evidence Vol 8, Issue 2 (2023): https://doi.org/10.18849/ve.v8i2.663

PICO question

In rabbits, undergoing general anaesthesia, does the placement of a v-gel® device result in less airway trauma compared to the use of other airway management devices?

Clinical bottom line

Category of research question

Treatment

The number and type of study designs reviewed

Three papers were critically appraised, two blinded randomised experimental trial studies and one randomised crossover experimental trial study

Strength of evidence

Weak

Outcomes reported

One blinded randomised trial study demonstrated that the trauma to the upper airways of rabbits during anaesthesia is not significantly different between the use of v-gel® and an endotracheal tube. The other blinded randomised trial study demonstrated that the trauma to the upper airway caused by endotracheal intubation is significantly more than that caused by v-gel® placement. The randomised crossover trial study demonstrated that v-gel® placement causes more significant compression to the larynx compared to a laryngeal mask or face mask

Conclusion

The current evidence suggests that use of the v-gel® in rabbits causes less trauma / injury to the airways compared to placement of an endotracheal tube but not compared to the use of a laryngeal or face mask. However, based on the low number and quality of published studies, this evidence is weak, and better-quality studies are required to support the routine use of v-gel® over other airway devices in rabbits. While v-gel® may be a safer alternative for securing airways in rabbits compared to endotracheal intubation, knowing the injuries this device can cause to the upper airways is useful for managing rabbits during post anaesthesia recovery

How to apply this evidence in practice