scholarly journals ‘Don’t pee on that!’ Comparing environmental modification and medical management in cats with FIC

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Amelia Poole
Keyword(s):  
Medical Management ◽  
Research Question ◽  
Treatment Options ◽  
Clinical Signs ◽  
Clinical Expertise ◽  
Short Term ◽  
Bottom Line ◽  
Environmental Modification ◽  
Strength Of Evidence ◽  
Weak Evidence

PICO question In cats with feline idiopathic cystitis (FIC) is environmental modification superior than medical management in preventing reoccurrence?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed 16 papers were critically reviewed; 14 randomised trials and two case studies Strength of evidence Critical appraisal of the selected papers meeting the inclusion criteria collectively provide weak evidence in terms of their experimental design and implementation Outcomes reported 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 Conclusion 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   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 In ferrets with hyperadrenocorticism, does use of deslorelin acetate implants compared to adrenalectomy result in a superior prognosis?

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Megan Ballman
Keyword(s):  
Research Question ◽  
Clinical Signs ◽  
Individual Case ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Strength Of Evidence ◽  
Time To Recurrence ◽  
The Individual ◽  
Study Designs ◽  
Inform Decision Making

PICO question In ferrets with hyperadrenocorticism, does use of deslorelin acetate implants compared to adrenalectomy result in a superior prognosis?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed One study was reviewed, a retrospective cohort study that directly compared the outcomes of these treatments Strength of evidence Weak Outcomes reported The study found that in ferrets with hyperadrenocorticism, use of deslorelin acetate implants resulted in a longer average time to recurrence of clinical signs and a lower mortality rate than adrenalectomy. However, the strength of evidence for this study is weak and it has several design limitations Conclusion In view of the evidence, both deslorelin acetate implants and adrenalectomy are valid treatments for a ferret with hyperadrenocorticism, but it cannot be concluded based on the current literature that deslorelin acetate implants result in a superior prognosis   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 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 For horses undergoing general anaesthesia, are rope recoveries or free recoveries better?

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Ffion Lloyd ◽  
Pamela Murison
Keyword(s):  
Cohort Study ◽  
General Anaesthesia ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Controlled Trial ◽  
Research Question ◽  
Individual Case ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Weak Evidence

PICO question In horses undergoing general anaesthesia, does assistance with ropes result in better recoveries when compared to no assistance (‘free’ recovery)?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed One randomised, non-blinded controlled trial and two retrospective cohort studies Strength of evidence Weak Outcomes reported The three studies reviewed arrive at different conclusions regarding the utility of rope assistance in recovery from general anaesthesia in horses, but examine very different populations. The randomised controlled trial provides weak evidence that rope assistance can shorten recovery and improve recovery quality in healthy (American Society of Anesthesiologists (ASA) I–II) horses. One retrospective cohort study provides weak evidence that rope assistance confers a reduction in fatality in both healthy and sick horses. The other retrospective cohort study provides weak evidence that rope assistance confers no benefit to horses undergoing emergency colic surgery. Both assisted and unassisted groups in each study had fatalities and all studies reported complications related to the rope recovery system Conclusion Insufficient evidence is available to permit a full recommendation regarding rope assistance during recovery from general anaesthesia in horses. Rope assistance may improve recovery time and quality in some horses. The decision to perform a rope-assisted recovery must be made considering individual patient, team and clinic factors. Rope assistance cannot prevent fatalities in recovery   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 Is soybean therapy better than ClinOleic for reducing recovery time in cats with permethrin toxicosis?

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Shadira Gordon
Keyword(s):  
Soybean Oil ◽  
Olive Oil ◽  
Recovery Time ◽  
Case Reports ◽  
Research Question ◽  
Clinical Signs ◽  
Randomised Clinical Trial ◽  
Individual Case ◽  
Clinical Expertise ◽  
Bottom Line

PICO question Is soybean oil-based intravenous lipid emulsion (IVLE) therapy more effective than olive oil-based (ClinOleic IVLE therapy) for reducing time to recovery in cats with permethrin toxicosis?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Five case reports and one randomised clinical trial Strength of evidence Weak Outcomes reported Soybean oil-based and ClinOleic IVLE therapies can be used safely as adjuvant treatments to reduce time to recovery in cats with permethrin intoxication. However, the evidence collected suggests that soybean oil-based IVLE therapy is better in reducing the recovery time after permethrin toxicosis as compared to ClinOleic IVLE therapy Conclusion The overall findings showed that the average recovery time after soybean oil-based IVLE therapy across patients with permethrin intoxication was 8.5 hours and the average time to recovery after olive oil-based emulsions (ClinOleic therapy) was 39 hours. This may suggest that soybean oil-based formulations are a better option for reducing the recovery time in cats after permethrin toxicity. Dermal decontamination, supportive care, muscle relaxers, and anticonvulsant drugs are examples of recommended treatments before the administration of any intralipid therapies and must be used based on the clinical signs of each patient   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 Use of the feline interdigital semiochemical (FIS) to redirect unwanted scratching behaviour in cats

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Matt Goins
Keyword(s):  
Statistical Significance ◽  
Research Question ◽  
Individual Case ◽  
Clinical Expertise ◽  
Single Group ◽  
Bottom Line ◽  
The Third ◽  
Weak Evidence ◽  
The Individual ◽  
Study Designs

PICO question Can the use of a synthetic feline interdigital semiochemical (FIS), with the provision of a scratching post, redirect unwanted scratching behaviour in cats better than provision of a scratching post alone?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three studies were evaluated. One was a randomised blinded trial on a single group of subjects following a crossover repetition design (Cozzi et al., 2013), the second was an open, uncontrolled study (Beck et al., 2018), and the third was a randomised unblinded trial on a single group of subjects using a placebo (Zhang et al., 2019). Strength of evidence Weak Outcomes reported In two of the three studies where the FIS pheromone was applied to the scratching posts resulted in a statistically significant increase in the cats’ scratching behaviour compared to the control. The third study showed a result approaching statistical significance (p = 0.06). Conclusion Based on the assessed studies there is weak evidence that FIS used in conjunction with the provision of a scratching post is more successful in redirecting unwanted scratching behaviour than provision of a scratching post alone. However, further studies using larger and more representative cohorts are needed in order to confirm the accuracy of these results.   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 Do papillomaviruses cause feline cutaneous squamous cell carcinoma?

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Alexander Teh ◽  
Mark Krockenberger
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Research Question ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Clinical Expertise ◽  
Case Control Studies ◽  
Bottom Line ◽  
Strength Of Evidence

PICO question In cats infected with papillomavirus, is the risk of developing feline cutaneous squamous cell carcinoma greater than cats that are not infected with papillomavirus?   Clinical bottom line Category of research question Risk The number and type of study designs reviewed Eleven papers were critically reviewed, nine were case-control studies and two were experimental in vitro studies Strength of evidence Moderate Outcomes reported Infection of feline epithelial skin cells with Felis catus papillomavirus type 2 (FcaPV-2) is a risk factor for the development of feline cutaneous squamous cell carcinoma. The pathogenesis of FcaPV-2 infection and neoplastic transformation into malignant cells shares similar pathways to the human papillomavirus (HPV) model of pathogenesis and carcinogenesis with some differences Conclusion In conclusion, there is moderate strength of evidence in the literature to support a role of FcaPV-2 in the development of cutaneous squamous cell carcinomas in cats. Therefore, prevention of infection with FcaPV-2 should prevent some cancers   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 Distal tarsal joints osteoarthritis: Evidence behind bisphosphonates and NSAIDs to improve lameness

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Julia Dubuc
Keyword(s):  
Research Question ◽  
Treatment Options ◽  
Individual Case ◽  
Placebo Control ◽  
Clinical Expertise ◽  
Long Term Effects ◽  
Bottom Line ◽  
Double Blind ◽  
The Individual

PICO question In lame horses affected by osteoarthritis of the distal tarsal joints (bone spavin), are bisphosphonates more effective than NSAIDs in long-term alleviation of lameness?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Two papers were critically reviewed. There was one field study and a multicentric randomised double-blind placebo control study Strength of evidence Weak Outcomes reported Each study looked at the effect of either Tiludronate or Firocoxib on alleviation of tarsal lameness. Both Tiludronate and Firocoxib, while administered independently, provided some degree of relief (for up to 120 days) and improved the lameness related to tarsal osteoarthritis. Conclusion Since no study was found to directly compare the use of non-steroidal anti-inflammatory drugs and bisphosphonates and that none evaluate the long-term effects of these treatment options on lameness, it is not possible to recommend one treatment option over the other to alleviate lameness caused by tarsal osteoarthritis in horses.   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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