scholarly journals Age at first calving in dairy cows: which months do you aim for to maximise productivity?

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Mike Steele
Keyword(s):  
Dairy Cattle ◽  
Milk Yield ◽  
Research Question ◽  
Case Series ◽  
Individual Case ◽  
Randomised Control Trial ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Age At First Calving ◽  
The Individual

PICO question In dairy cattle, which months should producers target age at first calving in order to maximise milk yield, minimize risk of non-voluntary culling and optimize fertility?   Clinical bottom line Category of research question Risk The number and type of study designs reviewed Seventeen papers were critically reviewed: 15 sets of case series, one review of case series and cohort studies and one randomised control trial, summarising over 2.4 million individual cow records Strength of evidence Strong Outcomes reported An optimum range of age at first calving (AFC) on dairy farms appears to be 22–25 months inclusive. Lower or higher than this figure can bring lower first lactation 305 day and lifetime milk yields, lower fertility and lower chances of surviving to a second lactation. Achieving an AFC of 22–25 months can bring the highest economic return to dairies Conclusion Age at first calving is a useful and key performance parameter to measure in dairy cattle. Achieving a range of 22–25 months at first calving can help to optimise both long term milk yield, fertility and longevity within the herd   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 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 In mares with placentitis does the duration of antibiotic treatment affect foal outcome?

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Elizabeth Barter
Keyword(s):  
Antibiotic Treatment ◽  
Research Question ◽  
Individual Case ◽  
Controlled Trials ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Length Of Treatment ◽  
Diseased State ◽  
The Individual ◽  
Short Courses

PICO question In mares with placentitis does treatment with long-term antibiotics result in improved foal viability when compared to repeated short courses of 7 to 10 days?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed The literature search identified six publications that included length of antibiotic treatment and foetal outcome. The publications consisted of four non-randomised non-blinded controlled trials and two randomised non-blinded controlled trials Strength of evidence Collectively there was weak evidence to support either an intermittent or continuous antibiotic protocol in the treatment of placentitis in mares Outcomes reported The literature involved experimental induction of ascending placentitis with foal survival or viability as the outcome Conclusion Further research is required into the diagnosis of placentitis, length of treatment and choice of antibiotic/s to penetrate the uterus in a diseased state   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 Greyhounds with paw pad corns, is surgical excision more effective at resolving lameness than extirpation?

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Dan Kenny
Keyword(s):  
Research Question ◽  
Case Series ◽  
Surgical Excision ◽  
Individual Case ◽  
Repeated Treatment ◽  
Clinical Expertise ◽  
Recurrence Rates ◽  
Bottom Line ◽  
Level Of Evidence

PICO question In Greyhounds (and Sighthounds) with recurring pedal corns, is surgical excision in comparison to corn extirpation more effective at resolving lameness?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three case series were included, all three were retrospective, one included a prospective component. There was one opinion-based narrative review and one opinion-based article. Strength of evidence Weak Outcomes reported Extirpation allows only a short palliation of lameness and repeated treatment is required at variable intervals. Surgical excision may provide good rates of short-term resolution however, in the long-term recurrence rates are still moderate. It should also be born in mind that further corns may develop in different digits. Conclusion In Greyhounds (and Sighthounds) with recurring pedal corns, surgical excision of the corn is more likely to provide long-term resolution of lameness in comparison to extirpation. However, the current level of evidence on this topic is weak.   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 Are bisphosphonates a more effective treatment than intra-articular steroids in horses with distal hock osteoarthritis?

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Hannah Greene
Keyword(s):  
Retrospective Study ◽  
Randomised Controlled Trials ◽  
Research Question ◽  
Individual Case ◽  
Controlled Trials ◽  
Clinical Expertise ◽  
Bottom Line ◽  
The Individual ◽  
Randomised Controlled

PICO question In horses that are lame due to osteoarthritis of the distal tarsal joints (bone spavin), is intra-articular medication with corticosteroids compared to systemic bisphosphonate treatment more effective in long-term lameness reduction?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three papers were critically reviewed. Two were randomised controlled trials, and one was a retrospective study. Strength of evidence Weak Outcomes reported There is insufficient evidence to support the use of systemic bisphosphonates over intra-articular corticosteroids to treat distal hock osteoarthritis in horses. Conclusion Horses with distal hock osteoarthritis should not be treated with systemic bisphosphonates until further blinded randomised controlled trials are completed. Additionally, supportive evidence for the use of intra-articular corticosteroids as a treatment for degenerative hock osteoarthritis is limited to a retrospective study where modest, short-term improvements are reported: 58% of horses improved after an average of 56 days (Labens et al., 2007). Evidence does not support significant improvement in long-term outcomes: 50% of horses improved after 4 months (Watts et al., 2016) and only 38% of horses improved after a mean follow-up period of 787 days (Labens et al., 2007).   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.  

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