scholarly journals The incidence of uterine pathology in ovariectomised bitches

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Maria Norell Candetoft
Keyword(s):  
Research Question ◽  
Case Series ◽  
Individual Case ◽  
Clinical Expertise ◽  
Retrospective Case ◽  
Bottom Line ◽  
Gynaecological Examination ◽  
Long Term Follow Up ◽  
The Individual ◽  
Study Designs

PICO question What is the incidence of postoperative uterine pathology in ovariectomised bitches compared to ovariohysterectomised bitches?   Clinical bottom line Category of research question Incidence The number and type of study designs reviewed Three retrospective case series Strength of evidence Weak Outcomes reported 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 Conclusion 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.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals In horses with trigeminal-mediated headshaking, is neuromodulation with EquiPENS™ more effective than with electroacupuncture?

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Jennifer Hindmarsh
Keyword(s):  
Research Question ◽  
Clinical Signs ◽  
Case Series ◽  
Individual Case ◽  
Repeated Treatment ◽  
Clinical Expertise ◽  
Bottom Line ◽  
The Individual ◽  
Study Designs ◽  
Inform Decision Making

PICO question In horses diagnosed with trigeminal-mediated headshaking, is EquiPENS™ therapy more efficacious when compared to electroacupuncture in terms of remission of clinical signs?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three papers were critically reviewed, all three were descriptive case series Strength of evidence Weak Outcomes reported 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 Conclusion The evidence for EquiPENS™ treatment is more robust than for electroacupuncture, and remission defined more clearly, and so could be recommended with greater confidence   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Healing of equine heel bulb lacerations: Evidence behind casting compared to bandaging alone

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Julia Dubuc ◽  
Jonny Ruiz
Keyword(s):  
Research Question ◽  
Case Series ◽  
Individual Case ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Level Of Evidence ◽  
Expert Opinions ◽  
The Individual ◽  
Study Designs ◽  
Inform Decision Making

PICO question In horses with heel bulb lacerations, does casting the distal limb compared to bandaging result in increased speed of healing and functional outcome?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed A single retrospective study was found to be relevant to the topic along with one case report and two case series, including one tutorial article Strength of evidence The majority of the current recommendations come from expert opinions, making the level of evidence low Outcomes reported There are currently insufficient data to compare the effect of foot/slipper casts versus bandaging alone on the rate of healing of equine heel bulb lacerations Conclusion Based on the information from these three publications, it is not possible to recommend the use of a foot cast over a bandage alone at this time   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals In dogs with metaldehyde intoxication, are benzodiazepines more effective than methocarbamol in relaxing muscles and reducing tremors?

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
T Liatis
Keyword(s):  
Case Reports ◽  
Research Question ◽  
Case Series ◽  
Individual Case ◽  
Clinical Expertise ◽  
Retrospective Case ◽  
Bottom Line ◽  
Administration Routes ◽  
Retrospective Case Series ◽  
The Individual

PICO question In dogs with metaldehyde intoxication, are benzodiazepines (e.g. diazepam, midazolam) more effective than methocarbamol in relaxing muscles and reducing tremors?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Five papers were critically reviewed. There were five retrospective case series Strength of evidence Weak Outcomes reported Currently, five retrospective case series exist in the literature which discuss metaldehyde intoxication cases treated mainly with benzodiazepines, a few of which had methocarbamol. There is not really any study to compare directly benzodiazepines with methocarbamol. In addition to that, factors such as commercial (e.g. the low availability of methocarbamol in the UK market compared to the US market), administrational (e.g. multiple administration routes of benzodiazepines) and pharmacological (e.g. lack of anticonvulsant function of methocarbamol), have played an important role in the treatment choice. Several case reports exist as well Conclusion Currently, there is insufficient evidence to determine whether benzodiazepines are more effective than methocarbamol in relaxing muscles and reducing occurrence of muscle tremors   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Is a cross-match necessary before a cat’s first blood transfusion?

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Ben Safrany ◽  
Sophie Adamantos
Keyword(s):  
Blood Transfusion ◽  
Research Question ◽  
Case Series ◽  
Individual Case ◽  
Randomised Control Trial ◽  
Clinical Expertise ◽  
Retrospective Case ◽  
Bottom Line ◽  
Cross Sectional ◽  
Transfusion Reactions

PICO question In transfusion-naïve cats receiving a type specific blood transfusion is cross-matched blood (major and minor) associated with an increased haematocrit development and reduction in acute transfusion reactions when compared with those receiving non-crossmatched blood?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Ten papers were critically reviewed. There were four retrospective case series, three prospective cross-sectional surveys, a retrospective cohort study, a prospective case series and a prospective randomised control trial. Strength of evidence Weak Outcomes reported It would appear that in the United Kingdom the incidence of non-AB transfusion reactions is low.  A single study suggests that cross-matching may result in a greater improvement in haematocrit, but this is unlikely to be clinically significant. There is evidence to support the hypothesis that non-AB antigens (for example the Mik antigen) differ with geographic distribution. Conclusion Based on the information available it is it is challenging to establish a meaningful clinical conclusion on which to base a recommendation.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals In horses undergoing volatile anaesthesia, does intraoperative alpha-2-agonist infusion improve recovery?

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Alison Bennell
Keyword(s):  
Research Question ◽  
Individual Case ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Healthy Horse ◽  
Multiple Factors ◽  
Constant Rate ◽  
The Individual ◽  
Study Designs ◽  
Inform Decision Making

PICO question 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?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Eight papers were critically appraised. All prospective, randomised clinical trials. 7/8 papers were blinded and 4/8 were crossover design Strength of evidence Moderate Outcomes reported 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 Conclusion 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   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Can garlic prevent, repel or kill fleas that infest dogs?

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Louise Anne Buckley
Keyword(s):  
Research Question ◽  
Topical Administration ◽  
Individual Case ◽  
Clinical Expertise ◽  
Inclusion Criteria ◽  
Bottom Line ◽  
The Individual ◽  
Study Designs ◽  
Inform Decision Making

PICO question In dogs, is oral or topical administration of garlic, compared to no treatment, efficacious at preventing or reducing parasitism by fleas?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Zero Strength of evidence Critical appraisal of the selected papers meeting the inclusion criteria collectively provide zero evidence in terms of their experimental design and implementation Outcomes reported The outcomes reported were none Conclusion It is concluded that there is a lack of peer-reviewed scientific in vivo evidence to address the PICO   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Does ranitidine administration improve gastrointestinal motility in dogs presented with vomit and/or anorexia?

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Lara Brunori
Keyword(s):  
Research Question ◽  
Individual Case ◽  
Controlled Clinical Trial ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Clinical Recommendations ◽  
The Individual ◽  
Study Designs

PICO question In dogs presenting with gastrointestinal (GI) hypomotility is ranitidine administration (any route) beneficial in improving GI motility?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed One prospective controlled clinical trial and five experimental crossover studies Strength of evidence Weak Outcomes reported The vast majority of the evidence investigating ranitidine as a prokinetic has been carried out in experimental settings both in vivo with healthy conscious and anaesthetised dogs and in vitro. 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 Conclusion 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   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Insulin choice in feline diabetes mellitus

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Yaiza Gomez Mejias
Keyword(s):  
Diabetes Mellitus ◽  
Research Question ◽  
Clinical Signs ◽  
Individual Case ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Strength Of Evidence ◽  
Good Glycaemic Control ◽  
The Individual ◽  
Study Designs

PICO question In cats with diabetes mellitus, do protamine zinc insulin (PZI) and glargine show a similar effect in reducing clinical signs and hypoglycaemia episodes?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed The number and type of study designs that were critically appraised was one. This study was a non-randomised retrospective trial. A systematic review was also found, which analyses the influence of insulin in diabetic remission Strength of evidence Weak Outcomes reported Compared to PZI, using glargine in recently diagnosed diabetic cats fed exclusively an ultra-low carbohydrate-high protein canned diet, may result in lower fructosamine and mean 12 hour blood glucose concentrations as well as less episodes of hypoglycaemia Conclusion In view of the strength of evidence and the outcomes from the study the following conclusion is made: in cats with diabetes mellitus where currently licensed insulin fails to result in a good glycaemic control, glargine may be considered   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals It is unclear what impact pheromonotherapy has on stress in dogs in shelter environments

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Tighearnan Fiachra Mooney
Keyword(s):  
Repeated Measures ◽  
Research Question ◽  
Individual Case ◽  
Controlled Study ◽  
Apparent Difference ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Strength Of Evidence ◽  
The Individual ◽  
Study Designs

PICO question In dogs in shelters does pheromonotherapy reduce stress compared to untreated dogs?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Two studies were evaluated, one was a prospective blinded randomised placebo-controlled study (Tod et al., 2005) and the other was a prospective unblinded repeated measures study Strength of evidence The papers evaluated provide a weak-to-moderate strength of evidence, due to the limited sample size and short duration of the intervention Outcomes reported In both studies pheromonotherapy resulted in a statistically significant reduction in mean bark amplitude but not in duration or peak bark amplitude. Neither study found a significant change in expression of fear-related behaviours in response to a neutral stranger or a stressor Conclusion Based on th1e studies assessed in this Knowledge Summary it is not possible to determine if pheromonotherapy reduces stress in dogs in shelter environments. It cannot be determined whether the small absolute reduction in bark amplitude present in both studies is clinically or biologically significant. Additionally, barking is a non-specific behaviour (Protopopova, 2016; Pongráczet al., 2010; Taylor & Mills, 2007; and Yin, 2002), so these results cannot be interpreted as a reduction in stress without further study. It is beyond the scope of this Knowledge Summary to comment on any perceived or apparent difference in the effectiveness of pheromonotherapy in the shelter environment compared to the home environment   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Can sedation be used for equine lameness investigation?

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Helene Termansen ◽  
Lucinda Meehan
Keyword(s):  
Clinical Studies ◽  
Research Question ◽  
Individual Case ◽  
Clinical Expertise ◽  
Adrenergic Agonists ◽  
Bottom Line ◽  
Small Magnitude ◽  
The Individual ◽  
Randomised Controlled ◽  
Study Designs

PICO question In horses undergoing lameness investigation, does sedation with a2-adrenergic agonists alone versus sedation with a2-adrenergic agonists in combination with butorphanol tartrate effect the degree of lameness?   Clinical bottom line Category of research question Diagnosis The number and type of study designs reviewed Six papers were critically reviewed. There were two crossover clinical studies, three crossover controlled clinical studies and a randomised controlled clinical study Strength of evidence Moderate Outcomes reported 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. Most evidence suggests that xylazine alone or in combination with butorphanol has no effect on the lameness Conclusion In general, sedating a horse with an a2-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   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

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