scholarly journals Diagnostic accuracy of cytology for canine osteosarcoma compared to histopathology

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Ioannis Oikonomidis ◽  
Theodora Tsouloufi
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Research Question ◽  
Individual Case ◽  
Malignant Neoplasms ◽  
Cytological Diagnosis ◽  
Clinical Expertise ◽  
Incisional Biopsy ◽  
Bottom Line ◽  
Canine Osteosarcoma

PICO question What is the sensitivity and specificity of cytology as a test for canine osteosarcoma when compared to histopathology as a gold standard?   Clinical bottom line Category of research question Diagnosis The number and type of study designs reviewed Overall, four diagnostic validity studies (two prospective and two retrospective) were critically appraised Strength of evidence Weak to moderate Outcomes reported 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 Conclusion 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   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 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 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 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 Can dog appeasing pheromone ameliorate stress behaviours associated with anxiety in mature domestic dogs?

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Chun Fung Wong ◽  
Merran Govendir
Keyword(s):  
Research Question ◽  
Individual Case ◽  
Management Plan ◽  
Therapeutic Benefit ◽  
Domestic Dogs ◽  
Residual Effects ◽  
Clinical Effects ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Hospitalised Patients

PICO question Does use of dog-appeasing pheromone reduce the frequency and/or severity of non-specific stress behaviours associated with anxiety in domestic dogs, older than 6 months, when compared with no treatment?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Eight controlled trials were appraised. Four were randomised and four were either non-randomised or did not clearly describe the method of allocating subjects into treatment groups. Strength of evidence Weak Outcomes reported There was no evidence that any dog appeasing pheromone (DAP) formulation (spray, diffuser, or collar) was superior. There was moderate evidence that DAP could reduce some behavioural manifestations of fear and/or anxiety stemming from thunderstorm noise and weak evidence that it could ameliorate some non-specific stress behaviours in hospitalised patients. In shelter dogs, there was mild evidence that DAP could reduce barking intensity and increase some behaviours associated with relaxation. When behavioural changes occurred, most were observed during exposure to DAP and there were minimal residual effects post-treatment. Conclusion The evidence for using DAP to manage stress behaviours associated with anxiety in dogs over six months of age remains weak. Until there is a stronger evidentiary basis, clinicians should be aware that a true clinical benefit is undetermined. Nevertheless, DAP is unlikely to cause harm and may still provide some therapeutic benefit. Therefore, DAP may still be employed in a multimodal management plan for some behaviour cases and may exert a placebo effect. However, if an owner’s financial resources are restrictive, clinicians should not prioritise pheromone therapy at the omission of other therapies that have established clinical effects   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 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 Comparison of alfaxalone versus propofol as anaesthetic induction agents in increasing the rate of survival and vigour of neonates

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Lesca Monica Sofyan ◽  
Fernando Martinez-Taboada
Keyword(s):  
Research Question ◽  
Survival Rates ◽  
Individual Case ◽  
Induction Agent ◽  
Main Concern ◽  
High Survival ◽  
Clinical Expertise ◽  
Anaesthetic Induction ◽  
Bottom Line ◽  
Induction Agents

PICO question In routine canine caesareans, is alfaxalone a superior anaesthetic induction agent than propofol in increasing the rate of survival and vigour of neonates?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three randomised positive clinical trials have compared the efficacy between alfaxalone and propofol in routine canine caesarean sections for increased neonatal survival and vigour Strength of evidence Weak Outcomes reported Although two studies found alfaxalone to be associated with higher Apgar scores for neonates than propofol, each study nonetheless revealed positive vigour and high survival rates from the use of either alfaxalone or propofol. The evidence is too weak to suggest that one induction agent is superior to another. The selection between the two induction agents may not be the main concern in regard to neonatal depression and 24 hour survival post-delivery, provided that the entire canine caesarean protocol is thoroughly and carefully studied Conclusion Text here   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.  

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