https://veterinaryevidence.org/index.php/ve/issue/feed Veterinary Evidence 2021-06-24T16:50:06+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/401 In dogs with osteoarthritis, how effective is treatment with tramadol in providing analgesia? 2021-06-24T16:50:06+01:00 Adrian Wong adrian.m.wong@sydney.edu.au Fernando Martinez-Taboada fernando.martinez@sydney.edu.au <p><strong>PICO question</strong></p> <p>In dogs with osteoarthritis how effective is treatment with tramadol in reducing the severity of the clinical signs associated with pain when compared to no treatment?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Two papers were critically reviewed. There was one randomised crossover controlled trial and one non-randomised controlled trial</p> <p><strong>Strength of evidence</strong></p> <p>Strong</p> <p><strong>Outcomes reported</strong></p> <p>Budsberg et al. (2018) found no significant differences in the objective gait analyses (vertical ground reaction forces, and peak vertical force) between baseline and end of treatment, between tramadol and placebo. Similarly, there was no significant difference in the proportion of dogs with positive response based on the subjective Canine Brief Pain Inventory questionnaire (CBPI) between tramadol and placebo. The positive control of carprofen yielded significant differences to both placebo and tramadol in all outcomes measured.</p> <p>Malek et al. (2012) found no significant differences in the objective outcomes measured (gait analyses, and total daily activity) between tramadol and placebo. There were significant improvements in the subjective CBPI (total score, pain severity and pain interference score) between the baseline and end of treatment, within the tramadol group. However, there was no significant difference in the percentage change of the total score, pain severity or pain interference score between all treatment groups including tramadol and placebo</p> <p><strong>Conclusion</strong></p> <p>In dogs with osteoarthritis, the use of tramadol alone did not demonstrate any significant analgesic 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> 2021-06-24T11:20:49+01:00 Copyright (c) 2021 Adrian Wong, Fernando Martinez-Taboada https://veterinaryevidence.org/index.php/ve/article/view/373 Can sedation be used for equine lameness investigation? 2021-06-18T16:20:59+01:00 Helene Termansen termansen94@gmail.com Lucinda Meehan lucy.meehan@bristol.ac.uk <p><strong>PICO question</strong></p> <p>In horses undergoing lameness investigation, does sedation with a<sub>2</sub>-adrenergic agonists alone versus sedation with a<sub>2</sub>-adrenergic agonists in combination with butorphanol tartrate effect the degree of lameness?</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>Six papers were critically reviewed. There were two crossover clinical studies, three crossover controlled clinical studies and a randomised controlled clinical study</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>There was limited evidence to suggest that xylazine and romifidine in combination with butorphanol has an effect on forelimb lameness and that detomidine has an effect on hindlimb lameness.</p> <p>Most evidence suggests that xylazine alone or in combination with butorphanol has no effect on the lameness</p> <p><strong>Conclusion</strong></p> <p>In general, sedating a horse with an a<sub>2</sub>-adrenergic agonist alone or in combination with butorphanol tartrate does not change the baseline degree of lameness. Due to the large variation in the measurements, the small magnitude of few significant effects and the inconsistency of these significant findings, there is insufficient evidence to recommend avoiding the use of sedation in cases where it would increase the safety of those involved. However, regardless of protocol used, clinicians must appreciate the possibility of individual horse variation</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> 2021-06-18T16:16:48+01:00 Copyright (c) 2021 Helene Termansen, Lucinda Meehan https://veterinaryevidence.org/index.php/ve/article/view/395 Uncomplicated gallbladder mucoceles – is it better for prognosis to perform cholecystectomy or medically manage? 2021-06-10T15:22:43+01:00 Rachel T. Griffiths grif0325@umn.edu Wanda J. Gordon-Evans wgordone@umn.edu <p><strong>PICO question</strong></p> <p>In dogs with an uncomplicated gallbladder mucocele, is the long-term survival when surgically managed superior, inferior, or equal to those medically managed?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment and prognosis</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Three papers were critically reviewed. All of the studies were retrospective analyses of medical records, two of which were cohort studies, and one which was a case control study</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>There is some evidence that surgical management of gallbladder mucoceles is associated with longer survival times than medically managed cases, although there is no direct analysis of uncomplicated vs complicated cases</p> <p><strong>Conclusion</strong></p> <p>We cannot clearly make a conclusion based on the available evidence. To date, there is only one retrospective analysis that directly compares the long-term survival of cases medically vs surgically managed, but this study does not separate uncomplicated vs complicated cases of gallbladder mucocele. In order to more accurately determine which type of treatment should be recommended for uncomplicated cases of gallbladder mucoceles, a prospective study comparing long-term survival with each treatment should be performed. These studies should also standardise medical management in order to more accurately compare survival time to surgical treatment</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> 2021-06-10T15:18:01+01:00 Copyright (c) 2021 Rachel T. Griffiths, Wanda J. Gordon-Evans https://veterinaryevidence.org/index.php/ve/article/view/368 Does medical or surgical treatment for aortic stenosis improve outcome in dogs? 2021-06-04T12:04:11+01:00 Julia Thomas jt16942@bristol.ac.uk Sophie Marshall sm16229@bristol.ac.uk Karin Gormley kg16729@bristol.ac.uk Georgia Conway gc16669@bristol.ac.uk Kieran Borgeat k.borgeat@bristol.ac.uk <p><strong>PICO question</strong></p> <p>In adult dogs with aortic stenosis does treatment with beta blockers compared with surgical intervention show a longer survival time with improved clinical parameters?</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 studies were reviewed. One was a randomised controlled study, three were cohort studies, one was a case series and three were case reports</p> <p><strong>Strength of evidence</strong></p> <p>Moderate to weak</p> <p><strong>Outcomes reported</strong></p> <p>Intervention appeared to improve survival times ± physiological parameters when compared to no treatment at all. The severity of clinical signs was reduced, but the risk of sudden cardiac-related death was not diminished according to a number of papers. The direct comparison of surgical treatment with the use of beta blockers showed no significant difference in survival times or physiological parameters across all papers. There is not enough evidence available comparing the different beta blockers used for treatment to draw a meaningful conclusion as to which is more effective</p> <p><strong>Conclusion</strong></p> <p>Treatment of some form should be given to a dog diagnosed with aortic stenosis. This will improve clinical signs and there is evidence to say that it will prolong survival as well as improve quality of life.<br>More research into this area is essential. Controlled, randomised clinical trials should be carried out in order to find a reliable and strong recommendation for treatment. Ethical implications need to be considered when going forward with this, which is why the evidence pool is likely to be so limited currently</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> 2021-06-03T15:27:32+01:00 Copyright (c) 2021 Julia Thomas, Sophie Marshall, Karin Gormley, Georgia Conway, Kieran Borgeat https://veterinaryevidence.org/index.php/ve/article/view/383 Clinical governance and continuous Quality Improvement in the veterinary profession: A mixed-method study 2021-06-03T19:31:07+01:00 Tom Ling tling@randeurope.org Ashley Doorly ashley@rcvsknowledge.org Chris Gush chris@rcvsknowledge.org Lucy Hocking lhocking@randeurope.org <p>96% of the veterinary profession agrees that Quality Improvement (QI) improves veterinary care. While clinical governance is an RCVS professional requirement, over the last year only 60% spent up to 3 days on the Quality Improvement activities which allow clinical governance to take place. 11% spent no time on it at all. A lack of time, know-how and organisational support were among the barriers preventing its adoption in practice.</p> <p>Rather than being an individual reaction to a problem, Quality Improvement is a formal approach to embedding a set of recognised practices, including clinical audit, significant event audit, guidelines and protocols, benchmarking and checklists. This framework should be applied within a just culture where errors are redefined as learning opportunities, and precedence is given to communication, team-work and team-morale, patient safety, and distributed leadership.</p> <p>Addressing this gap will require evolution – rather than a revolution. Persistent packages, given enough time and addressing the whole flow of the patient journey, trump one-off ‘heroic’ and narrowly-focused interventions. Creating a rhythm of learning alongside stability of practice allows lessons to be absorbed and improvements routinised. Doing good things well is better than doing perfect things sporadically and helps address the widespread concern that there is insufficient time for QI by making the time commitment more predictable and manageable.</p> <p>The research provides a robust, evidence-based, roadmap for the entire sector including professional organisations, educators, those in management positions and care providers.</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> 2021-05-12T12:17:45+01:00 Copyright (c) 2021 Tom Ling, Ashley Doorly, Chris Gush, Lucy Hocking https://veterinaryevidence.org/index.php/ve/article/view/358 Quality Improvement: origins, purpose and the future for veterinary practice 2021-05-05T16:12:55+01:00 Freya Rooke svxfr@exmail.nottingham.ac.uk John Burford svzjhb@exmail.nottingham.ac.uk Sarah Freeman sarah.freeman@nottingham.ac.uk Tim Mair tim.mair@btinternet.com Jo Suthers Jo.Suthers@bwequinevets.co.uk Marnie Brennan svzmb1@exmail.nottingham.ac.uk <p><strong>Introduction</strong></p> <p>Providing the highest quality veterinary care can often be a delicate balancing act: the client/owner’s wishes, financial parameters and emotional needs have to be considered, whilst also meeting the animal’s clinical needs. But what actually defines quality care? It is a term frequently used in both the human and veterinary healthcare literature, but often has little explanation or definition attached to it. ‘Quality’ in relation to care delivered is not a static concept and will hold different meanings to different individuals within a healthcare service. John Ruskin, a Victorian writer and critic of art and society observed: ‘Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skilful execution’.</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> 2021-05-05T16:06:43+01:00 Copyright (c) 2021 Freya Rooke, John Burford, Sarah Freeman, Tim Mair, Jo Suthers, Marnie Brennan https://veterinaryevidence.org/index.php/ve/article/view/361 Do dogs with non-surgically managed cranial cruciate ligament disease have better outcomes with rehabilitation? 2021-04-23T09:56:33+01:00 Joshua Merickel Meric034@umn.edu Wanda Gordon-Evans wgordone@umn.edu <p><strong>PICO question</strong></p> <p>In dogs with cranial cruciate ligament disease treated non-surgically with rehabilitation, is the outcome inferior/equivalent/superior as measured by owner and/or veterinarian evaluation to dogs treated non-surgically without rehabilitation?</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 appraised. One paper reviewed was a prospective, randomised clinical trial. The remaining three papers were retrospective cohort studies</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>There are no studies available that directly compare dogs managed non-surgically with and without rehabilitation following cranial cruciate ligament injury. In one study, 66% of dogs treated non-surgically with rehabilitation are reported to have successful outcomes 1 year following initiation of treatment. For dogs managed non-surgically without rehabilitation, successful outcomes varied from 19%–90% of cases among several retrospective studies</p> <p><strong>Conclusion</strong></p> <p>There is evidence suggesting the addition of rehabilitation to conservative therapy is beneficial, but based on the current literature, it is impossible to say whether it is superior to conservative treatment without rehabilitation</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> 2021-04-23T09:47:38+01:00 Copyright (c) 2021 Joshua Merickel, Wanda Gordon-Evans 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? 2021-05-13T11:30:36+01:00 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 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