scholarly journals In an Adult Horse With Severe Asthma (Previously Recurrent Airway Obstruction) Does Using Inhaled Corticosteroids Result in an Equal Improvement in Clinical Signs When Compared to Systemic Corticosteroids?

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Natasha A Jocelyn
Keyword(s):  
Open Access ◽  
Airway Obstruction ◽  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Clinical Signs ◽  
The Body ◽  
Recurrent Airway Obstruction ◽  
Bottom Line ◽  
Systemic Corticosteroids ◽  
Equine Asthma

<strong>PICO question</strong><br /><p>In an adult horse with severe asthma (previously recurrent airway obstruction (RAO)) does using inhaled corticosteroids result in an equal improvement in clinical signs when compared to systemic corticosteroids?</p><strong>Clinical bottom line</strong><br /><p>The level of confidence in the outcomes from the body of evidence in the 4 papers identified is high. This suggests inhaled corticosteroids (fluticasone and beclomethasone) when used at an appropriate dose can have equivalent effects on severe equine asthma as systemic intravenous dexamethasone. Inhaled corticosteroids can take longer to have the desired effects. </p><br /> <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" />

scholarly journals Is Topical or Systemic Antimicrobial Therapy More Effective for the Treatment of Feline Acne With Secondary Bacterial Infection?

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Wendy Kwok ◽  
Kate Charlotte Mellor
Keyword(s):  
Open Access ◽  
Bacterial Infection ◽  
Antimicrobial Therapy ◽  
Systemic Treatment ◽  
Clinical Signs ◽  
Sufficient Evidence ◽  
Bottom Line ◽  
Secondary Bacterial Infection

<strong>PICO question</strong><br /><p>In cats with feline acne and secondary bacterial folliculitis or furunculosis, is topical or systemic antimicrobial therapy superior for reducing time to resolution and severity of clinical signs?</p><strong>Clinical bottom line</strong><br /><p>There is no sufficient evidence to compare topical versus systemic treatment in feline acne with secondary folliculitis/furunculosis.</p><br /> <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" />

scholarly journals Equine Recurrent Airway Obstruction

2014 ◽  
Vol 37 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Artur Niedźwiedź
Keyword(s):  
Pulmonary Function ◽  
Airway Obstruction ◽  
Environmental Changes ◽  
Clinical Signs ◽  
Dust Exposure ◽  
Common Disease ◽  
Recurrent Airway Obstruction ◽  
Organic Dust ◽  
Mucus Production ◽  
Neutrophilic Inflammation

AbstractEquine Recurrent Airway Obstruction (RAO), also known as heaves or broken wind, is one of the most common disease in middle-aged horses. Inflammation of the airway is inducted by organic dust exposure. This disease is characterized by neutrophilic inflammation, bronchospasm, excessive mucus production and pathologic changes in the bronchiolar walls. Clinical signs are resolved in 3-4 weeks after environmental changes. Horses suffering from RAO are susceptible to allergens throughout their lives, therefore they should be properly managed. In therapy the most importanthing is to eliminate dust exposure, administration of corticosteroids and use bronchodilators to improve pulmonary function.

scholarly journals Is inhaled immunotherapy more effective than environmental management when treating equine asthma?

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Amy Leather ◽  
Sarah Smith
Keyword(s):  
Environmental Management ◽  
Lung Function ◽  
Research Question ◽  
Clinical Signs ◽  
Individual Case ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Equine Asthma

PICO question In horses with severe equine asthma syndrome, is inhaled immunotherapy compared to environmental reduction of allergen exposure more effective in disease modification?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed 12 papers were critically reviewed. Nine clinical trials; one crossover study; one split-plot design study; and one cross-sectional study Strength of evidence Low Outcomes reported Four studies found inhaled immunotherapy to improve the clinical signs associated with equine asthma and the lung function of horses with asthma. Three papers found environmental modification by improved lung function and the clinical signs associated with equine asthma but two studies provide moderate evidence that environmental management alone is insufficient to permanently cure asthma Conclusion There is a low level of evidence to support the use of inhaled immunotherapy as a treatment for equine asthma   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 Iodine-restricted Diets Normalise Serum Total Thyroxine (TT4) and Subsequently Improve Clinical Signs in Cats With Hyperthyroidism?

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Oliver Gilman
Keyword(s):  
Open Access ◽  
Clinical Signs ◽  
Normal Diet ◽  
Compelling Evidence ◽  
Restricted Diet ◽  
Bottom Line ◽  
Total Thyroxine

<strong>PICO question</strong><br /><p>In cats with hyperthyroidism, does an iodine-restricted diet normalise the serum TT4 (total thyroxine) levels and reduce the severity of the clinical signs when compared to cats on a normal diet?</p><strong>Clinical bottom line</strong><br /><p>Whilst there is some evidence that iodine-restricted diets can help to renormalise serum TT4 in cats with hyperthyroidism, this is not always effective and there is a lack of compelling evidence to suggest this is associated with a resolution of clinical signs in the long-term.</p><br /> <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" />

scholarly journals Choosing Treatment for Dogs With Generalised Demodicosis – Isoxazolines or Imidacloprid and Moxidectin?

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Sarah Long
Keyword(s):  
Open Access ◽  
Study Design ◽  
Clinical Signs ◽  
Positive Control ◽  
Comparable Efficacy ◽  
Regulatory Body ◽  
Bottom Line ◽  
Routes Of Administration ◽  
The Uk ◽  
Generalised Demodicosis

<p><strong>PICO question</strong></p><p>In dogs with generalised demodicosis, are isoxazolines as effective as a combined formulation of imidacloprid and moxidectin at reducing mite count and the severity of associated clinical signs?</p><p><strong>Clinical bottom line</strong></p><p>Five single-blinded, randomised, positive control trials, most under laboratory conditions, directly compared the use of isoxazolines against moxidectin/imidacloprid to treat canine generalised demodicosis. All of them showed comparable efficacy of isoxazolines. Three different isoxazolines were studied with two routes of administration (oral and topical) and four different dosing frequencies of moxidectin/imidacloprid. This made the papers more challenging to compare however, the evidence provided is sufficient to support their use. All of these trials were sponsored by the manufacturers of their respective isoxazoline products which may bias the study design and reporting of results. It is worth noting that sarolaner (Simparica™, Zoetis UK) was licensed in the UK for the treatment of canine demodicosis in January 2018 and that in the UK the Cascade should be followed when prescribing treatments. The licensed use of isoxazolines in other countries is beyond the scope of this article and the reader is urged to check local regulatory body advice before prescribing the below medications.</p><br /> <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" />

Embracing the Cascade part 3: clinical decision making in equine asthma

UK-Vet Equine ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 19-29
Author(s):  
James Bailey ◽  
Mark Bowen
Keyword(s):  
Severe Asthma ◽  
Clinical Decision Making ◽  
Inhaled Corticosteroids ◽  
Rescue Therapy ◽  
Clinical Decision ◽  
Airway Disease ◽  
Evidence Base ◽  
Lower Airway ◽  
Mucus Production ◽  
Equine Asthma

Equine asthma is the current terminology that covers chronic non-infectious lower airway disorders in the horse. Mild and moderate equine asthma reflect the syndrome previously referred to as inflammatory airway disease, while severe asthma reflects both recurrent airway obstruction and summer pasture-associated obstructive airway disease. Corticosteroids are the most important therapeutic agents for the management of horses with all severities of equine asthma. Prednisolone and dexamethasone products are authorised for use in horses and can be used for the management of asthma. Inhaled corticosteroids have the potential advantages of reduced systemic effects and reduced detection times in competition animals. ‘Special’ (extemporaneous) formulations of oral dexamethasone may be valuable in horses with severe asthma. A range of bronchodilator therapies can be used for the management of severe asthma; although the clinical efficacy of systemic bronchodilators still lacks a robust evidence base, they may have a particular role in ‘rescue-therapy’ and in acute exacerbations. The evidence for the use of mucolytic agents is limited and excessive mucus production should resolve with improvements in airway inflammation. Inhaled saline and inhaled acetylcysteine may provide useful improvements in mucus secretion without any effects on competition horses. Mast cell stabilisers may have a role in the management of mild equine asthma, although they have a limited evidence base for their use. The use of the prescribing cascade provides access to a range of medications that are useful in the management of equine asthma.

scholarly journals Does Adding Transdermal Nitroglycerine to Other Therapies Used for Management of Left-sided Congestive Heart Failure in Dogs Speed the Resolution of Clinical Signs?

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Jenefer R Stillion ◽  
Søren R Boysen
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Open Access ◽  
Experimental Evidence ◽  
Clinical Signs ◽  
Evidence Based ◽  
Bottom Line

<p><strong><strong>There is an erratum to this paper published in <em>Veterinary Evidence</em> Vol 3, Issue 1 (2018): <a id="pub-id::doi" href="/index.php/ve/article/view/168/220" target="_blank">http://dx.doi.org/10.18849/ve.v3i1.168</a></strong></strong></p><p><strong>Clinical bottom line</strong></p><p>There is very weak veterinary clinical and experimental evidence based upon a limited number of studies to indicate that adding transdermal nitroglycerine to other therapies used for management of left-sided congestive heart failure in dogs speeds the resolution of clinical signs.</p><p> </p><br /> <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" />

Relationship between clinical signs and lung function in horses with recurrent airway obstruction (heaves) during a bronchodilator trial

2010 ◽  
Vol 32 (5) ◽  
pp. 393-400 ◽  
Author(s):  
N. E. Robinson ◽  
M. A. Olszewski ◽  
D. Boehler ◽  
C. Berney ◽  
J. Hakala ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Clinical Signs ◽  
Recurrent Airway Obstruction

Dual biologic therapy in a patient with severe asthma and other allergic disorders

2021 ◽  
Vol 14 (5) ◽  
pp. e242211
Author(s):  
Joshua Ray Caskey ◽  
David Kaufman
Keyword(s):  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Chronic Idiopathic Urticaria ◽  
High Dose ◽  
Dramatic Improvement ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Systemic Corticosteroids ◽  
Acute Exacerbations ◽  
H1 Antihistamines

Severe asthma is very difficult to manage in many individuals, and systemic corticosteroids are often used to prevent or manage acute exacerbations. Furthermore, comorbid allergic conditions may render standard therapies inadequate. A 51-year-old man presented with severe eosinophilic asthma requiring nearly constant oral corticosteroid usage despite using high-dose inhaled corticosteroids and secondary asthma controllers. His condition was complicated by aspirin-exacerbated respiratory disease, including severe nasal polyposis, chronic rhinosinusitis, as well as chronic idiopathic urticaria. Mepolizumab was initiated and led to dramatic improvement of asthma over 6 months. However, he continued to experience exacerbations of chronic idiopathic urticaria not responsive to H1-antihistamines. Omalizumab was added, and the patient’s urticaria attained marked improvement with only an occasional breakthrough rash. Dual biologic therapies can be a unique and useful steroid-sparing treatment option for patients with uncontrolled severe asthma and chronic idiopathic urticaria.

scholarly journals Comparing Rest Alone to Bandaging and Rest in Horses With Superficial Digital Flexor Tendinopathy

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Rafael Alzola ◽  
Sarah Louise Freeman
Keyword(s):  
Open Access ◽  
Scientific Evidence ◽  
Tendon Healing ◽  
The Body ◽  
Bottom Line ◽  
Cast Immobilisation ◽  
Inflammatory Phase ◽  
Level Of Confidence ◽  
Short Period

<strong>PICO question</strong><br /><p>In horses with superficial digital flexor tendonitis is bandaging and rest compared to rest alone more effective at promoting healing?</p><strong>Clinical bottom line</strong><br /><p>There is currently a lack of scientific evidence to suggest that bandaging promotes effective tendon healing following injury. However, rigid bandages significantly limit lesion propagation in equine superficial digital flexor (SDF) tendinopathies. The result of this PICO question suggests that a short period (ten days) of cast immobilisation during the initial inflammatory phase of the injury improves prognosis by limiting lesion propagation. The level of confidence in the outcomes from the body of evidence in the four studies identified is moderate.</p><br /> <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" />

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