https://veterinaryevidence.org/index.php/ve/issue/feed Veterinary Evidence 2021-04-16T10:40:32+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/399 Diagnostic accuracy of cytology for canine osteosarcoma compared to histopathology 2021-04-16T10:40:32+01:00 Ioannis Oikonomidis economidis.john@gmail.com Theodora Tsouloufi theodora.tsouloufi@ed.ac.uk <p><strong>PICO question</strong></p> <p>What is the sensitivity and specificity of cytology as a test for canine osteosarcoma when compared to histopathology as a gold standard?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Diagnosis</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Overall, four diagnostic validity studies (two prospective and two retrospective) were critically appraised</p> <p><strong>Strength of evidence</strong></p> <p>Weak to moderate</p> <p><strong>Outcomes reported</strong></p> <p>There is evidence of moderate strength to support that cytology is highly sensitive and specific for diagnosing histologically confirmed osteosarcomas as mesenchymal malignant neoplasms (cytological diagnosis of sarcoma). Evidence of weak strength suggests that the sensitivity and specificity of cytology for identifying the exact histotype (cytological diagnosis of osteosarcoma) are low and high, respectively. Finally, there is currently evidence of weak strength indicating that the sensitivity and specificity of cytology are comparable to that of preoperative histopathology after incisional biopsy for the diagnosis of canine osteosarcoma</p> <p><strong>Conclusion</strong></p> <p>Based on the available evidence, the diagnostic accuracy of cytology in diagnosing histologically confirmed osteosarcomas as sarcomas is high, whereas a confident conclusion cannot be drawn regarding the diagnostic accuracy of cytology for the identification of the exact histotype (cytological diagnosis of osteosarcoma). There is currently scant evidence suggesting that cytology has comparable diagnostic accuracy to preoperative histopathology (i.e. after incisional biopsy) for the diagnosis of canine osteosarcomas, however, more studies are warranted to confirm these results</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2021-04-16T10:24:39+01:00 Copyright (c) 2021 Ioannis Oikonomidis, Theodora Tsouloufi https://veterinaryevidence.org/index.php/ve/article/view/325 The effect of pre-emptive incisional bupivacaine block on postoperative pain after coeliotomy in dogs 2021-03-31T09:11:42+01:00 Kiriaki Pavlidou kellypav@gmail.com Lysimachos G Papazoglou mkdvm@vet.auth.gr <p><strong>PICO question</strong></p> <p>Is there an effect on analgesia following coeliotomy in dogs after a block with local anaesthetics?</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 the available evidence for this PICO question comes from clinical trials and one experimental/pharmacology study. All the studies were randomised; 5/7 were blinded clinical studies and 4/7 studies were prospective</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>It is not clear if the use of a local anaesthetic including bupivacaine or lidocaine as incisional blocks minimises the postoperative pain especially in the first 24 hours, as the results are not statistically significant between the groups</p> <p><strong>Conclusion</strong></p> <p>In conclusion, bupivacaine or lidocaine can minimise the postoperative pain but more clinical trials are needed</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2021-03-31T09:05:26+01:00 Copyright (c) 2021 Kiriaki Pavlidou, Lysimachos Papazoglou https://veterinaryevidence.org/index.php/ve/article/view/391 Is inhaled immunotherapy more effective than environmental management when treating equine asthma? 2021-03-25T13:30:56+00:00 Amy Leather al14572@bristol.ac.uk Sarah Smith sarah1.smith@bristol.ac.uk <p><strong>PICO question</strong></p> <p>In horses with severe equine asthma syndrome, is inhaled immunotherapy compared to environmental reduction of allergen exposure more effective in disease modification?</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>12 papers were critically reviewed. Nine clinical trials; one crossover study; one split-plot design study; and one cross-sectional study</p> <p><strong>Strength of evidence</strong></p> <p>Low</p> <p><strong>Outcomes reported</strong></p> <p>Four studies found inhaled immunotherapy to improve the clinical signs associated with equine asthma and the lung function of horses with asthma. Three papers found environmental modification by improved lung function and the clinical signs associated with equine asthma but two studies provide moderate evidence that environmental management alone is insufficient to permanently cure asthma</p> <p><strong>Conclusion</strong></p> <p>There is a low level of evidence to support the use of inhaled immunotherapy as a treatment for equine asthma</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2021-03-25T13:21:04+00:00 Copyright (c) 2021 Amy Leather, Sarah Smith https://veterinaryevidence.org/index.php/ve/article/view/337 ‘Don’t pee on that!’ Comparing environmental modification and medical management in cats with FIC 2021-03-11T14:22:10+00:00 Amelia Poole ameliakp@hotmail.com <p><strong>PICO question</strong></p> <p>In cats with feline idiopathic cystitis (FIC) is environmental modification superior than medical management in preventing reoccurrence?</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>16 papers were critically reviewed; 14 randomised trials and two case studies</p> <p><strong>Strength of evidence</strong></p> <p>Critical appraisal of the selected papers meeting the inclusion criteria collectively provide weak evidence in terms of their experimental design and implementation</p> <p><strong>Outcomes reported</strong></p> <p>There is weak evidence that any medication or environmental modification is successful in reducing the reoccurrence of FIC when compared to a placebo. Short-term use of amitriptyline can contribute to an increase in occurrence of FIC</p> <p><strong>Conclusion</strong></p> <p>In view of the strength of evidence and the outcomes from the studies the following conclusion is made; in cats with feline idiopathic cystitis there is weak evidence that environmental modification or medication are effective at preventing reoccurrence. Further research is required into the cause of FIC before comparisons on treatment options can be made, however, with the exception of short-term use of amitriptyline, environmental modification and systemic treatment of clinical signs did not contribute to an increase in occurrence of FIC</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2021-03-11T13:56:35+00:00 Copyright (c) 2021 Amelia Poole https://veterinaryevidence.org/index.php/ve/article/view/392 Promoting Evidence-based Veterinary Medicine through the online resource ‘EBVM Learning’: User feedback 2021-04-01T17:06:26+01:00 Ellie Sellers ellie.sellers@bristol.ac.uk Sarah Baillie sarah.baillie@bristol.ac.uk Rachel Dean rachel.dean@vetpartners.co.uk Sheena Warman sheena.warman@bristol.ac.uk Heidi Janicke HJanicke@sgu.edu Sebastian P Arlt sebastian.arlt@fu-berlin.de Clare Boulton clare@rcvsknowledge.org Marnie Brennan marnie.brennan@nottingham.ac.uk David Brodbelt dbrodbelt@rvc.ac.uk Fiona Brown f.brown@ed.ac.uk Louise Buckley louise.buckley@ed.ac.uk Myai Du myai@rcvsknowledge.org Emma Gallop emma.gallop@outlook.com George Goran gheorghegoran@fmvb.ro Douglas JC Grindlay Douglas.Grindlay@nottingham.ac.uk Laura Haddock laura.haddock@bristol.ac.uk Joanne Ireland Joanne.Ireland@liverpool.ac.uk Catherine McGowan C.M.Mcgowan@liverpool.ac.uk Heather K Moberly hmoberly@library.tamu.edu Emma Place emma.place@bristol.ac.uk Md Mizanur Rahman mizanuhcp@cvasu.ac.bd Gwen Rees gwen.rees@bristol.ac.uk Kristen Reyher kristen.reyher@bristol.ac.uk Javier Sanchez jsanchez@upei.ca Johan P Schoeman johan.schoeman@up.ac.za Laura Urdes urdeslaura@gmail.com John VanLeeuwen jvanleeuwen@upei.ca Kristien Verheyen kverheyen@rvc.ac.uk <p>Abstract</p> <p>‘<span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/ebvm-learning" target="_blank" rel="noopener">EBVM Learning</a></span>’ is a freely available resource created in 2015 by an international team with the support of RCVS Knowledge. The resource comprises a series of online modules teaching the fundamental concepts of evidence-based veterinary medicine (EBVM) (Ask, Acquire, Appraise, Apply &amp; Assess) supported by case studies, exercises, worked examples and quizzes. The aim of the current study (undertaken in 2019) was to review ‘EBVM Learning’ to ensure its ongoing relevance and usefulness to the range of learners engaged in EBVM. Feedback was gathered from stakeholder groups using website statistics and feedback forms, a survey and semi-structured interviews to provide a combination of quantitative and qualitative data.</p> <p>Website statistics revealed an international audience and a steady increase in visitors exceeding 1,000 per month in August 2020. Feedback via the online form (n=35) and survey (n=71) indicated that the resource was well structured, with an appropriate level and amount of content, useful examples and quizzes and the majority of respondents would use it again. Semi-structured interviews of educators (n=5) and veterinarians (n=8) identified three themes: features of the ‘EBVM Learning’ resource (strengths, suggestions for improvement), embedding the resource in education (undergraduate, postgraduate) and promoting EBVM (challenges, motivation for engagement). At a project team workshop the results were used to plan updates to the existing content and to identify new ways to promote learning and engagement. An updated version of ‘EBVM Learning’ was developed.</p> <p>‘EBVM Learning’ is helping to produce the next generation of evidence-based practitioners and enabling to engage in the concepts of EBVM as part of their clinical practice.</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> 2021-02-25T11:26:04+00:00 Copyright (c) 2021 Ellie Sellers, Sarah Baillie, Rachel Dean , Sheena Warman, Heidi Janicke, Sebastian P Arlt, Clare Boulton, Marnie Brennan, David Brodbelt, Fiona Brown, Louise Buckley, Myai Du, Emma Gallop, George Goran, Douglas JC Grindlay, Laura Haddock, Joanne Ireland, Catherine McGowan, Heather K Moberly, Emma Place, Md Mizanur Rahman, Gwen Rees, Kristen Reyher, Javier Sanchez, Johan P Schoeman, Laura Urdes, John VanLeeuwen, Kristien Verheyen https://veterinaryevidence.org/index.php/ve/article/view/341 In horses undergoing volatile anaesthesia, does intraoperative alpha-2-agonist infusion improve recovery? 2021-02-19T20:53:18+00:00 Alison Bennell bennell@liverpool.ac.uk <p><strong>PICO question</strong></p> <p>In horses undergoing volatile anaesthesia with isoflurane or sevoflurane, does administration of an alpha-2 agonist as a CRI compared to anaesthetic maintenance with volatile alone improve recovery quality?</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 appraised. All prospective, randomised clinical trials. 7/8 papers were blinded and 4/8 were crossover design</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>One paper investigating detomidine and one on romifidine showed no improvement in recovery quality. 3/3 medetomidine papers and 2/3 dexmedetomidine papers showed a significant improvement in recovery quality in the alpha-2 agonist CRI group</p> <p><strong>Conclusion</strong></p> <p>In a healthy horse undergoing general anaesthesia with isoflurane or sevoflurane maintenance, an intra-operative constant rate of infusion (CRI) of medetomidine and dexmedetomidine can lead to better recovery quality when compared to horses who are maintained on isoflurane or sevoflurane alone</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2021-02-17T15:12:51+00:00 Copyright (c) 2021 Alison Bennell https://veterinaryevidence.org/index.php/ve/article/view/357 Does ranitidine administration improve gastrointestinal hypomotility in dogs? 2021-02-12T11:17:21+00:00 Lara Brunori lara.brunori@gmail.com <p><strong>PICO question</strong></p> <p>In dogs presenting with gastrointestinal (GI) hypomotility is ranitidine administration (any route) beneficial in improving GI motility?</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 prospective controlled clinical trial and five experimental crossover studies</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>The vast majority of the evidence investigating ranitidine as a prokinetic has been carried out in experimental settings both <em>in vivo</em> with healthy conscious and anaesthetised dogs and <em>in vitro</em>. Under these circumstances ranitidine has shown some prokinetic properties. However, it is difficult to translate these results into reliable clinical recommendations, as the doses mentioned in these studies are often higher than the ones clinically recommended and healthy canine patients might respond differently to clinically affected ones</p> <p><strong>Conclusion</strong></p> <p>Although in experimental settings ranitidine has shown some prokinetic activities, no reliable clinical recommendations can be drawn from the appraised studies. There is a need of prospective clinical trials evaluating the administration of ranitidine to dogs presenting with GI hypomotility. Until further relevant studies become available, the efficacy of ranitidine administration as a prokinetic agent in dogs with GI hypomotility remains uncertain</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2021-02-11T11:20:32+00:00 Copyright (c) 2021 Lara Brunori https://veterinaryevidence.org/index.php/ve/article/view/356 In bitches, is ovariectomy/ovariohysterectomy by laparoscopy less painful postoperatively than by midline open laparotomy? 2021-02-10T15:28:09+00:00 Chris Webb ym19332@bristol.ac.uk Julia Deutsch jd17368@bristol.ac.uk <p><strong>PICO question</strong></p> <p>In bitches, is an ovariectomy/ovariohysterectomy by laparoscopy superior to an ovariectomy/ovariohysterectomy by a midline surgical laparotomy in causing less postoperative 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>Seven papers were critically appraised. They comprised of three blinded randomised controlled trials, two non-blinded randomised controlled trials and two non-blinded non-randomised controlled trials</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>In bitches, ovariectomy/ovariohysterectomy by laparoscopy is superior to ovariectomy/ovariohysterectomy by a midline laparotomy in causing less postoperative pain</p> <p><strong>Conclusion</strong></p> <p>Despite the widely held belief that laparoscopic surgery is associated with less postoperative pain, the available veterinary literature only provides weak evidence to support this in bitches undergoing ovariectomy/ovariohysterectomy. There are many uncontrolled variables to consider across these underpowered studies including surgeon number (and experience), the choice of perioperative analgesia, method of pain scoring and the laparoscopic technique. It is therefore clear that laparoscopic procedures cannot be viewed equally and the strength of the answer to the clinical question may change based upon these variables. It is also important to note that the incidence of complications or the effect of the above variables on postoperative pain have not been critically reviewed and warrant careful consideration when deciding on a laparoscopic approach</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2021-02-05T11:48:54+00:00 Copyright (c) 2021 Chris Webb, Julia Deutsch https://veterinaryevidence.org/index.php/ve/article/view/352 In horses with trigeminal-mediated headshaking, is neuromodulation with EquiPENS™ more effective than with electroacupuncture? 2021-01-22T14:55:45+00:00 Jennifer Hindmarsh jkhindmarsh@outlook.com <p><strong>PICO question</strong></p> <p>In horses diagnosed with trigeminal-mediated headshaking, is EquiPENS™ therapy more efficacious when compared to electroacupuncture in terms of remission of clinical signs?</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 were descriptive case series</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Remission was achieved following both EquiPENS™ and electroacupuncture therapy in a proportion of horses for variable lengths of time. Median remission times appear to be longer with repeated treatment of EquiPENS™ compared to electroacupuncture</p> <p><strong>Conclusion</strong></p> <p>The evidence for EquiPENS™ treatment is more robust than for electroacupuncture, and remission defined more clearly, and so could be recommended with greater confidence</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2021-01-21T13:30:57+00:00 Copyright (c) 2021 Jennifer Hindmarsh https://veterinaryevidence.org/index.php/ve/article/view/464 Thank you to our 2020 reviewers 2021-01-22T14:57:44+00:00 Kit Sturgess kit.sturgess@btopenworld.com <p>2020 will be a year to remember! One of the standout features for me has been the speed with which ‘science’ has responded to the crisis in terms of developing and disseminating new information to the community highlighting the importance of digital communication – a space that&nbsp;<em>Veterinary Evidence&nbsp;</em>comfortably occupies. The availability of pre peer-reviewed papers has become the norm but it has also emphasised the essential need and benefit of the peer-review process as a significant number of pre-review papers have not made it through to ‘publication’ as issues were identified during the peer-review process.</p> <p>As Editor-in-chief it makes me proud and thankful that&nbsp;<em>Veterinary Evidence&nbsp;</em>has a strong but agile peer-review process and I would like to thank all of our editors and reviewers for their continued support and their diligence in meeting demanding timelines during these challenging times allowing <em>Veterinary Evidence</em>&nbsp;to publish more content than ever before. Without your highly valued knowledge, expertise and insights&nbsp;<em>Veterinary Evidence</em><span class="apple-converted-space">&nbsp;</span>would not be growing into the key knowledge source that it is today.</p> <p>The<span class="apple-converted-space">&nbsp;</span><em>Veterinary Evidence</em><span class="apple-converted-space">&nbsp;</span>Editorial Board Meeting was held for the first time digitally on 7 December with the largest number of editorial board members able to attend. Members from across the globe were able to take part in wide and varied discussions around the development of the journal, resulting in important strategic initiatives and some key action points to pursue. The availability of the board to attend digitally will facilitate more frequent meetings allowing the journal to be more inclusive, and responsive to the changing landscape, as well as providing a digital recording of the event available for those board members unable to attend.</p> <p>Key areas discussed included development of the format of PICOs and further refining the process for approving them, strategies to encourage engagement and submissions from veterinary nurses, and the development of policies to encourage diversity and inclusion within the board and contributors to the journal, as well as ways to increase the reach of the journal. Having only been Editor-in-chief since September, I have been very impressed by how active and dedicated our reviewers and board members are and how dynamic and forward-looking&nbsp;<em>Veterinary Evidence&nbsp;</em>is as it matures into a key contributor to veterinary literature. None of this would be possible without your support for which I am very grateful.</p> <p>Within the Full Text you can see the names of all of our 2020 reviewers. Thank you to all who have contributed.&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"></p> 2021-01-13T11:53:54+00:00 Copyright (c) 2021 Kit Sturgess https://veterinaryevidence.org/index.php/ve/article/view/345 Pet owners' online information searches and the perceived effects on interactions and relationships with their veterinarians 2021-01-22T14:59:31+00:00 Nanette Lai lain@uoguelph.ca Deep K. Khosa dkhosa@uoguelph.ca Andria Jones-Bitton aqjones@uoguelph.ca Cate E. Dewey c.dewey@exec.uoguelph.ca <p><strong>Objective: </strong>To explore pet owners’ online search experiences for pet health information and the perceived effects on their interactions and relationships with veterinarians.</p> <p><strong>Background:</strong> Few studies have examined pet owners’ online searches for pet health information; even less is known about how these search experiences may impact pet owners’ interactions and relationships with veterinarians, including any effects on bond-centered care.</p> <p><strong>Methods: </strong>Qualitative study consisting of five focus groups conducted with 26 pet owners in the Greater Toronto Area, Ontario, Canada, between June to September 2016. All interviews were audio-recorded and transcribed verbatim. QSR NVivo 11® was used to facilitate organisation of focus group data for thematic analysis.</p> <p><strong>Results:</strong> Participating pet owners frequently referred to their relationships with veterinarians when discussing experiences searching online for pet health information. Owners reported choosing either to disclose or withhold declaring their online searches to veterinarians, depending on whether participants perceived a beneficial or detrimental impact on a “good” professional relationship with their veterinarian. Perceptions of veterinarians' reactions towards declaration of online searches were mixed, and influenced pet owners’ views of the existing relationship.</p> <p><strong>Conclusion: </strong>Pet owners viewed their veterinarians as their most trusted source of pet health information, but many owners also wanted supplemental information from online searches. Owners preferred veterinarians refer them to online pet health resources, ideally those affiliated with the veterinary profession. Searching for pet health information online does not displace veterinarians’ guidance. Rather, the veterinarian-owner relationship was perceived to be strengthened when online searches were openly discussed with veterinarians.</p> <p><strong>Implications</strong>: Findings offer insight into pet owners’ expectations of veterinarians within the context of online pet health information, providing ideas for veterinarians to strengthen bonds with owners such as; showing support of owners’ online pet health information searching by recommending resources and considerations about communicating professional opinions to owners regarding online information.</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> 2021-01-08T19:16:38+00:00 Copyright (c) 2021 Nanette Lai, Deep K. Khosa, Andria Jones-Bitton, Cate E. Dewey https://veterinaryevidence.org/index.php/ve/article/view/339 Does meniscal release confer similar clinical benefits to meniscal tear treatment when compared to meniscectomy? 2021-01-22T15:01:26+00:00 Ben Garland ben.veterinary@gmail.com <p><strong>PICO question</strong></p> <p>In adult dogs with naturally occurring medial meniscal tears concurrent to cranial cruciate ligament disease does meniscal release confer the same benefits in lameness resolution as meniscectomy?</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>A single prospective cross-sectional study was reviewed, that fulfilled the criteria</p> <p><strong>Strength of evidence</strong></p> <p>None</p> <p><strong>Outcomes reported</strong></p> <p>Meniscal release, meniscectomy (partial, hemi- or complete), or the two combined performed for concurrent medial meniscal pathology at time of surgery for naturally occurring cranial cruciate ligament (CCL) rupture resulted in an acceptable long-term outcome. Difference in outcome between the techniques was not reported</p> <p><strong>Conclusion</strong></p> <p>There is no evidence that meniscal release provides an equal or superior treatment option for medial meniscal injury treated at the time of surgery for CCL rupture when compared to meniscectomy. The study critically reviewed performed meniscal release via radial transection through the meniscotibial ligament, and therefore does not represent mid-body abaxial radial release. Neither is this summary appropriate for considering prophylactic meniscal release of the normal meniscus. In addition, the surgical treatments for cranial cruciate ligament rupture were either ‘Tightrope’ or tibial plateau levelling osteotomy (TPLO) procedures. Further studies are required to compare clinical outcome between meniscal release or meniscectomy for treatment of concurrent meniscal tears</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2020-12-21T09:42:21+00:00 Copyright (c) 2020 Ben Garland https://veterinaryevidence.org/index.php/ve/article/view/347 Should we offer total hip replacement to feline patients? 2021-01-22T15:02:54+00:00 Katie Smithers kasmithers789@outlook.com <p><strong>PICO question</strong></p> <p>In cats with traumatic coxofemoral injury, does total hip replacement (THR) offer improved outcome when compared with femoral head and neck excision (FHNE) arthroplasty?</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 paper was critically reviewed. It was a non-randomised retrospective observational study</p> <p><strong>Strength of evidence</strong></p> <p>Moderate evidence</p> <p><strong>Outcomes reported</strong></p> <p>THR results in superior clinical outcome and owner satisfaction compared to FHNE in cats</p> <p><strong>Conclusion</strong></p> <p>In cats with traumatic coxofemoral injury, although the evidence is not conclusive and somewhat limited, the literature reviewed here suggests that THR offers a superior outcome in feline patients.</p> <p>There is currently insufficient evidence to determine if there is a difference in long-term outcome, complications or osteoarthritis (OA) development following THR or FHNE in feline patients</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2020-12-16T15:25:29+00:00 Copyright (c) 2020 Katie Smithers https://veterinaryevidence.org/index.php/ve/article/view/307 Continuous digital hypothermia in the prevention and treatment of acute equine laminitis 2021-01-22T15:04:18+00:00 Karen Pickering karen.pickering66@gmail.com Joanne Ireland joanne.ireland@liverpool.ac.uk <p><strong>PICO question</strong></p> <p>Does continuous digital hypothermia improve clinical outcome in equids with acute laminitis compared to supportive treatment alone?</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>Six experimental randomised controlled trials and one multicentre retrospective case series were reviewed</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>The outcomes reported were reduced severity of histopathological lamellar lesions in limbs treated with continuous digital hypothermia (CDH; initiated prior to or soon after the onset of experimentally induced acute laminitis) compared to limbs remaining at an ambient temperature in all five experimental studies where histology was performed. A significant reduction was observed in the prevalence or severity of clinical signs of laminitis in limbs treated with CDH compared to limbs remaining at an ambient temperature. In a single retrospective case series, significantly reduced prevalence of clinical laminitis was reported amongst animals receiving CDH compared to those that did not in a referral hospital population of animals treated for colitis</p> <p><strong>Conclusion</strong></p> <p>There is moderate evidence to support that CDH when used prior to or in the early stages of clinical signs, may reduce the severity and progression of lamellar lesions in acute laminitis and no evidence demonstrating that it improves clinical outcome compared to supportive treatment alone. Further research into the clinical outcome of equids treated for acute laminitis using CDH is warranted</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2020-12-09T13:30:13+00:00 Copyright (c) 2020 Karen Pickering, Joanne Ireland https://veterinaryevidence.org/index.php/ve/article/view/437 Erratum to: In canine acute diarrhoea with no identifiable cause, does daily oral probiotic improve the clinical outcomes? 2021-01-22T15:16:05+00:00 Jacqueline Oi Ping Tong jactong48@gmail.com <p>The original version of the article has been corrected, please see the full text for details of the correction.</p> 2020-12-09T12:51:58+00:00 Copyright (c) 2020 Jacqueline Oi Ping Tong https://veterinaryevidence.org/index.php/ve/article/view/318 In dogs undergoing elective procedures is medetomidine superior to acepromazine when used as a premedication? 2021-01-22T15:05:44+00:00 Rebecca Littlehales beckylittlehales@gmail.com <p><strong>PICO question</strong></p> <p>In dogs undergoing elective procedures does the use of medetomidine during premedication result in an increase in anaesthetic complication rates, when compared to acepromazine?</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 of which were randomised controlled trials</p> <p><strong>Strength of evidence</strong></p> <p>Strong</p> <p><strong>Outcomes reported</strong></p> <p>There were some statistically significant differences between using medetomidine and acepromazine as premedications in the outcomes measured, but as the clinical parameters including blood pressure were still within acceptable clinical limits, the clinical benefits of these findings remain undetermined. There is also evidence to suggest that patients premedicated with medetomidine have less of a perioperative stress response than those receiving acepromazine, but in addition may have increased risk of cardiac conduction disturbances, but the clinical importance of these findings is also unknown</p> <p><strong>Conclusion</strong></p> <p>The overall findings showed that either drug can be used as a suitable premedication, but the differences in pain score postoperatively shown in one small study mean that due to its poor analgesic properties it is recommended when using acepromazine instead of medetomidine, that additional analgesia should be given to reduce postoperative pain for better animal welfare</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2020-12-02T14:31:47+00:00 Copyright (c) 2020 Rebecca Littlehales https://veterinaryevidence.org/index.php/ve/article/view/308 Does the use of topical honey result in a faster rate of second intention wound healing in dogs? 2021-02-26T11:20:22+00:00 Louisa Marcombes louisa.marcombes@gmail.com <p><strong>PICO question</strong></p> <p>In healthy dogs undergoing open wound management, does the topical application of honey, when compared to wounds treated with daily saline washes only, reduce the time to complete wound healing?</p> <p>&nbsp;</p> <p><strong>Editorial notice:</strong>&nbsp;Upon conducting the literature search for this Knowledge Summary the author discovered that the same&nbsp;paper had been published in two separate journals and that a third paper by the same author appeared to have used data from the same experimental subjects as the duplicate publication, despite reporting different methodology. The duplicate publications have been appraised by the author as one paper. The editorial office alerted the journals in question which resulted in the article that appeared in the Iranian Journal of Veterinary Surgery (Jalali, F.S. S., Tajik, H., Saifzaideh, S and Fartash, B. (2007b) Topical Application of Natural Urmia Honey on Experimental Burn Wounds in the Dog: Clinical and Microbiological Studies. <em>Iranian Journal of Veterinary Surgery.</em>&nbsp;2(2),<strong>&nbsp;</strong>13–21)&nbsp;being retracted:&nbsp;<a href="http://www.ivsajournals.com/article_114759.html" target="_blank" rel="noopener">http://www.ivsajournals.com/article_114759.html</a>. See&nbsp;<a href="https://veterinaryevidence.org/index.php/ve/misconduct-policy" target="_blank" rel="noopener">our own policy on duplicate publication</a>&nbsp;for more information.</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 studies satisfied the inclusion criteria for answering the PICO; both were prospective randomised controlled trials</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>The studies demonstrated a possible effect size of clinical importance of the use of honey in the treatment of canine wounds in terms of time to complete wound healing and antibacterial effect. However, the strength of the evidence provided by both studies is severely weakened by flaws in trial design, implementation and reporting, and the possible risk of pseudo replication between the two trials reported</p> <p><strong>Conclusion</strong></p> <p>The use of topical honey in canine open wound management may reduce time to complete wound healing. However, the evidence for this is weak. At present, the evidence that use of topical honey in canine wounds reduces time to healing is insufficient to warrant a change in clinical practice</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2020-11-25T12:47:16+00:00 Copyright (c) 2020 Louisa Marcombes https://veterinaryevidence.org/index.php/ve/article/view/335 Managing atopic dermatitis in dogs: are antihistamines as effective as glucocorticoids? 2021-01-22T15:09:11+00:00 Sarah Long sarahmlong@hotmail.co.uk <p><strong>PICO question</strong><strong><br><br></strong></p> <p>In dogs with atopic dermatitis, are antihistamines as effective as glucocorticoids at reducing the severity of clinical signs?</p> <p><strong>&nbsp;</strong></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 control trials and one crossover placebo-controlled trial</p> <p><strong>Strength of evidence</strong></p> <p>Critical appraisal of the selected papers meeting the inclusion criteria collectively provide weak evidence in terms of their experimental design and implementation</p> <p><strong>Outcomes reported</strong></p> <p>The outcomes reported were conflicting. Two studies reported that fexofenadine may be as effective as methylprednisolone at reducing the severity of clinical signs after 6 weeks of treatment however, the study size was small in one and there was limited reporting of the data in the other. The third study, the crossover placebo-controlled trial, tested a variety of antihistamines and prednisone with limited reporting of statistical analysis of the data and found that antihistamines did not provide a sufficient reduction in pruritus unless combined with prednisone</p> <p><strong>Conclusion</strong></p> <p>In view of the strength of evidence and the outcomes from the studies, there is insufficient quality of evidence to answer the PICO question and further comparative study is needed</p> <p><strong>&nbsp;</strong></p> <p><a href="http://www.ebvmlearning.org/apply/">How to apply this evidence in practice</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> <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> 2020-11-18T15:48:41+00:00 Copyright (c) 2020 Sarah Long https://veterinaryevidence.org/index.php/ve/article/view/340 In dogs undergoing anaesthesia do pre-anaesthetic gastroprotectants reduce gastro-oesophageal reflux? 2021-01-22T15:10:38+00:00 Leanne Barry leanne_barry@hotmail.com <p><strong>PICO question</strong></p> <p>In dogs undergoing anaesthesia do pre-anaesthetic gastroprotectants reduce gastro-oesophageal reflux?</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 critically reviewed. There was a randomised prospective study, two randomised blinded prospective studies, randomised non-blinded prospective study and a randomised, double blinded and placebo-controlled prospective study.</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>Evidence of high quality suggests omeprazole or cisapride with esomeprazole decrease the incidence of gastro-oesophageal reflux (GOR) in the anaesthetised dog. In addition, a study of lower quality showed that continuous infusion of metoclopramide at a higher than normal dose rate decreased the incidence of GOR.</p> <p><strong>Conclusion</strong></p> <p>Omeprazole or cisapride with esomeprazole decreases the incidence of GOR in the anaesthetised dog.</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2020-11-12T11:40:50+00:00 Copyright (c) 2020 Leanne Barry https://veterinaryevidence.org/index.php/ve/article/view/300 In dogs with congestive heart failure, is torasemide superior to furosemide as a first line diuretic treatment? 2021-01-22T15:12:23+00:00 Leo Packham lafpackham@outlook.com <p><strong>PICO question</strong></p> <p>In dogs with congestive heart failure, does the use of torasemide as a first line diuretic result in a superior survival time when compared to furosemide?</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 were critically appraised, they were all prospective randomised controlled trials</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>There is currently a lack of studies looking at comparing furosemide directly with torasemide in patients with congestive heart failure. There are many similarly drawn conclusions from the studies: torasemide is not inferior to furosemide in the treatment of CHF, torasemide is comparable to furosemide at one tenth the dose (or less) and that torasemide may be more effective at diuresis than furosemide with a prolonged duration of action</p> <p><strong>Conclusion</strong></p> <p>There is currently no clear and obvious benefit for the use of torasemide, over furosemide, as a first line diuretic for dogs with congestive heart failure</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" 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> 2020-11-04T14:18:49+00:00 Copyright (c) 2020 Leo Packham