https://veterinaryevidence.org/index.php/ve/issue/feed Veterinary Evidence 2021-01-14T10:35:02+00:00 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/464 Thank you to our 2020 reviewers 2021-01-14T10:35:02+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 2021-01-08T19:27:48+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? 2020-12-21T09:45:55+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? 2020-12-16T15:55:00+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 2020-12-09T13:34:56+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? 2020-12-09T15:32:14+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? 2020-12-02T14:39:19+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? 2020-11-25T12:59:08+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? 2020-11-18T15:59:58+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? 2020-11-12T11:44:30+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? 2020-11-04T14:23:53+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 https://veterinaryevidence.org/index.php/ve/article/view/349 Veterinary Telemedicine: A literature review 2020-12-08T14:23:00+00:00 Lori Massin Teller lteller@tamu.edu Heather K Moberly hmoberly@tamu.edu <p>As telemedicine becomes more mainstream in the veterinary profession, it is important to understand when and how to utilise it successfully, and its potential downsides. This literature review supports the use of veterinary telemedicine for teleconsultations, and using wearable and mobile health (mHealth) devices for monitoring animal health. Data supporting the provision of virtual care directly to a client within an established veterinarian-client-patient relationship (VCPR) is more limited, and some of what we know comes from paediatric medicine on the human side. As we have learned from human health care providers, we must be aware there could be a tendency to overprescribe antimicrobials in a virtual visit compared to an in-person visit. Data have also shown telemedicine can be just as effective in diagnosing respiratory disease when compared to traditional visits to a doctor’s office or hospital. Telemedicine is especially effective in areas where access to care is limited, whether because of geography, finances, or lack of resources. Overall, veterinary telemedicine and telehealth can provide positive results.</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> 2020-10-30T00:00:00+00:00 Copyright (c) 2020 Lori Massin Teller, Heather K Moberly https://veterinaryevidence.org/index.php/ve/article/view/331 The incidence of uterine pathology in ovariectomised bitches 2020-11-26T11:48:05+00:00 Maria Norell Candetoft maria.norell.candetoft@anicura.se <p><strong>PICO question</strong></p> <p>What is the incidence of postoperative uterine pathology in ovariectomised bitches compared to ovariohysterectomised bitches?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Incidence</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Three retrospective case series</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>None of the reviewed case series found any uterine pathology for ovariectomised bitches in the long-term follow-up of several years, although none of the studies performed a proper gynaecological examination to confirm a lack of pathology</p> <p><strong>Conclusion</strong></p> <p>With the limited evidence available, it appears that leaving the uterus when gonadectomising bitches does not seem to have a high risk for developing pathology as long as the ovaries are completely removed.</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> 2020-09-18T13:30:06+01:00 Copyright (c) 2020 Maria Norell Candetoft https://veterinaryevidence.org/index.php/ve/article/view/301 Non-Steroidal Anti-inflammatories: Does carprofen or meloxicam have fewer gastrointestinal side effects? 2020-11-06T15:29:18+00:00 Aaron Harold Andrew Fletcher afletcher53@gmail.com <p><strong>PICO question</strong></p> <p>In canines, does the oral administration of carprofen, when compared to meloxicam, result in fewer gastrointestinal side effects?</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 prospective randomised controlled trials were critically reviewed</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Treatment with carprofen or meloxicam results in no significant difference in gastric lesion scoring, increased intestinal mucosal permeability or diminished small bowel absorptive capacity</p> <p><strong>Conclusion</strong></p> <p>There is insufficient evidence supporting preferential administration of carprofen or meloxicam to reduce gastrointestinal side effects</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> 2020-09-11T11:53:04+01:00 Copyright (c) 2020 Aaron Harold Andrew Fletcher https://veterinaryevidence.org/index.php/ve/article/view/316 In Greyhounds with paw pad corns, is surgical excision more effective at resolving lameness than extirpation? 2020-11-06T15:29:18+00:00 Dan Kenny dan-kenny@hotmail.co.uk <p><strong>PICO question</strong></p> <p>In Greyhounds (and Sighthounds) with recurring pedal corns, is surgical excision in comparison to corn extirpation more effective at resolving lameness?</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 case series were included, all three were retrospective, one included a prospective component. There was one opinion-based narrative review and one opinion-based article.</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Extirpation allows only a short palliation of lameness and repeated treatment is required at variable intervals. Surgical excision may provide good rates of short-term resolution however, in the long-term recurrence rates are still moderate. It should also be born in mind that further corns may develop in different digits.</p> <p><strong>Conclusion</strong></p> <p>In Greyhounds (and Sighthounds) with recurring pedal corns, surgical excision of the corn is more likely to provide long-term resolution of lameness in comparison to extirpation. However, the current level of evidence on this topic is weak.</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> 2020-09-03T13:55:12+01:00 Copyright (c) 2020 Dan Kenny https://veterinaryevidence.org/index.php/ve/article/view/311 Can garlic prevent, repel or kill fleas that infest dogs? 2020-11-06T15:29:19+00:00 Louise Anne Buckley louise.buckley@ed.ac.uk <p><strong>PICO question</strong></p> <p>In dogs, is oral or topical administration of garlic, compared to no treatment, efficacious at preventing or reducing parasitism by fleas?</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>Zero</p> <p><strong>Strength of evidence</strong></p> <p>Critical appraisal of the selected papers meeting the inclusion criteria collectively provide zero evidence in terms of their experimental design and implementation</p> <p><strong>Outcomes reported</strong></p> <p>The outcomes reported were none</p> <p><strong>Conclusion</strong></p> <p>It is concluded that there is a lack of peer-reviewed scientific <em>in vivo </em>evidence to address the PICO</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> 2020-08-28T11:49:46+01:00 Copyright (c) 2020 Louise Anne Buckley https://veterinaryevidence.org/index.php/ve/article/view/313 Comparison of the safety of alfaxalone and propofol as anaesthetic induction agents in bitches undergoing c-section 2020-11-06T15:29:19+00:00 Benjamin Haythornthwaite bhaythornthwaite@hotmail.co.uk <p><strong>PICO question</strong></p> <p>In bitches and their puppies undergoing caesarean section, is an alfaxalone or a propofol induction safer?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Risk</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Six papers were critically reviewed. There were two randomised controlled trials directly comparing alfaxalone and propofol inductions, two randomised controlled trials including a propofol induction in one of the experimental groups and two non-comparative studies.</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>Propofol and alfaxalone can both be used safely for the anaesthesia of bitches and their puppies undergoing caesarean section. There is evidence that alfaxalone may provide better anaesthesia quality for the bitches, and the puppies may be delivered with higher indicators of puppy vitality following its use. Further research into the beneficial clinical outcomes of alfaxalone should be investigated.</p> <p><strong>Conclusion</strong></p> <p>The use of both propofol and alfaxalone for the induction of bitches undergoing caesarean section can be recommended.</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> 2020-08-19T11:56:46+01:00 Copyright (c) 2020 Benjamin Haythornthwaite https://veterinaryevidence.org/index.php/ve/article/view/319 In pregnant bitches, is elective caesarean section more effective than vaginal delivery at improving puppy survival? 2020-11-06T15:29:19+00:00 Mullika Borisoot mb15544@bristol.ac.uk <p><strong>PICO question</strong></p> <p>In pregnant bitches due to whelp, is elective caesarean section more effective than vaginal delivery to improve puppy survival?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>The category of the research question is regarding the incidence of puppy mortalities as a result of vaginal delivery, emergency caesarean section and elective caesarean section.</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Two retrospective articles were reviewed and critically appraised; one retrospective study with high single canine breed bias and one study on different canine breeds but limited support in directly answering the PICO question.</p> <p><strong>Strength of evidence</strong></p> <p>The studies selected both had strong uses of experimental designs but together provided weak evidence to determine a definitive answer to the PICO question.</p> <p><strong>Outcomes reported</strong></p> <p>The outcomes from both retrospective studies suggests that the mortality rates of newborn puppies can be reduced if pregnant bitches are scheduled ahead for elective caesareans, in comparison to undergoing an emergency caesarean section when complications develop, particularly in breeds with higher risks of dystocia. Therefore, there is some evidence to support that it may be advantageous to consider the breed, age and overall health of the bitch during pregnancy to determine whether elective caesarean sections, for the safe delivery of puppies, should be considered.</p> <p><strong>Conclusion</strong></p> <p>There are currently insufficient studies, literatures and evidence in veterinary medicine for caesarean sections to become a routine procedure in first opinion practices. Future prospective studies should be conducted and include the optimum anaesthetic protocols with the lowest associated risks for the pregnant bitch and puppies.</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> 2020-08-13T14:25:21+01:00 Copyright (c) 2020 Mullika Borisoot https://veterinaryevidence.org/index.php/ve/article/view/288 In dogs diagnosed with osteoarthritis, is meloxicam superior to carprofen for reducing patient discomfort? 2020-11-06T15:29:20+00:00 Lesca Monica Sofyan lesca.sofyan.xx@hotmail.com <p><strong>PICO question</strong></p> <p>In dogs diagnosed with osteoarthritis, is meloxicam superior to carprofen for reducing patient discomfort?</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>Only two papers have compared the efficacy between meloxicam and carprofen in the treatment of dogs diagnosed with osteoarthritis. Both of the papers were clinical, prospective and randomised trials.</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>One randomised controlled clinical trial compared the level of efficacy between meloxicam and carprofen in reducing pain and discomfort in dogs diagnosed with osteoarthritis<sup>1</sup>. Orthopaedic surgeons found dogs treated with either meloxicam or carprofen showed significant improvement in ground reaction forces (GRF). The study emphasised that dogs treated with meloxicam had GRF values that returned to normal baseline values, with owners also commenting on gait improvement. This study however, had a low sample size, did not use a validated metrology instrument for assessment by owners and the data used to assess GRF was not conclusive on all parameters to favour meloxicam.</p> <p>An additional study was evaluated but this also had very small case numbers, no control group and gave no detailed statistical analysis<sup>2</sup>. The paper descriptively suggests meloxicam to show a better response than carprofen but there was no scientific analysis or evidence to statistically support and validate this.</p> <p><strong>Conclusion</strong></p> <p>Both meloxicam and carprofen are validated as effective treatments for canine osteoarthritis but it cannot be suggested that meloxicam is superior to carprofen as the available evidence is weak. To accurately assess this, a future clinical study using validated metrology instruments, adequate sample sizes and proper statistical analysis is required.</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> 2020-07-29T12:11:59+01:00 Copyright (c) 2020 Lesca Monica Sofyan https://veterinaryevidence.org/index.php/ve/article/view/317 In horses with osteoarthritis, is mesenchymal stem cell therapy more effective at managing lameness than intra-articular corticosteroids? 2020-11-06T15:29:20+00:00 Laura Pratley hllpratl@liv.ac.uk <p><strong>PICO question</strong></p> <p>In horses with osteoarthritis, is mesenchymal stem cell therapy more effective at managing lameness than intra-articular corticosteroids?</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>Nine papers were critically reviewed; seven experimental trials and two randomised controlled double-blinded trials.</p> <p><strong>Strength of evidence</strong></p> <p>Weak to moderate</p> <p><strong>Outcomes reported</strong></p> <p>There is moderate evidence to suggest that chondrogenically induced mesenchymal stem cells combined with equine allogenic plasma have a good efficacy at reducing lameness in the short-term, in horses with mild to moderate lameness associated with osteoarthritis. However, there is no definitive evidence directly comparing mesenchymal stem cell therapy and corticosteroids, to identify if mesenchymal stem cell therapy is more effective than intra-articular corticosteroids.</p> <p><strong>Conclusion</strong></p> <p>In horses with mild to moderate lameness associated with osteoarthritis, there is moderate evidence to suggest that mesenchymal stem cell therapies are effective at managing lameness. However, it is undetermined whether they are more effacious than intra-articular corticosteroids.</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> 2020-07-23T14:54:54+01:00 Copyright (c) 2020 Laura Pratley