scholarly journals Current evidence supporting simultaneous prophylactic gastropexy in canine patients undergoing complete splenectomy

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Olivia Harris
Keyword(s):  
Research Question ◽  
Case Series ◽  
Conclusive Evidence ◽  
Current Evidence ◽  
Clinical Expertise ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Retrospective Case ◽  
Bottom Line ◽  
Cross Sectional

PICO question In dogs that have undergone a complete splenectomy, does performing a concurrent gastropexy decrease the risk of future gastric dilatation-volvulus (GDV) development when compared to not performing a concurrent gastropexy?   Clinical bottom line Category of research question Risk The number and type of study designs reviewed Five papers were critically reviewed which included one retrospective case series, one retrospective case-control study, and three combined retrospective cohort and cross-sectional survey studies Strength of evidence Weak Outcomes reported In dogs that have had a complete splenectomy, there is no conclusive evidence that prophylactic gastropexy decreases the risk of lifetime GDV development Conclusion Based on the limited information available, it is difficult to conclude if prophylactic gastropexy should be recommended routinely at the time of complete splenectomy   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 Can IDEXX Angio Detect™ accurately detect canine Angiostrongylosis?

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Natashia Weir ◽  
Jo Ireland
Keyword(s):  
Research Question ◽  
False Negative ◽  
Case Series ◽  
High Specificity ◽  
Individual Case ◽  
Post Inoculation ◽  
Clinical Expertise ◽  
Retrospective Case ◽  
Bottom Line ◽  
Cross Sectional

PICO question In dogs, is IDEXX Angio Detect™ as accurate as Baermann coprology when diagnosing Angiostrongylus vasorum infection?   Clinical bottom line Category of research question Diagnosis The number and type of study designs reviewed Eight papers were critically reviewed: three diagnostic accuracy studies, two cross-sectional studies (one of which also included a retrospective case series), one cohort study, one case-control study, and one case series Strength of evidence Weak Outcomes reported Angio Detect™ (IDEXX) was shown to have low-moderate sensitivity and high specificity in comparison to Baermann coprology. Occasionally, false-negative results occurred with Angio Detect™ when compared to Baermann coprology. This was thought to be due to antigen-antibody complex formation. Positive Angio Detect™ assays were obtained in both symptomatic and asymptomatic canine patients. In an experimental setting, Angio Detect™ was shown to obtain a positive result five weeks post-inoculation Conclusion There is weak evidence supporting Angio Detect™ as a highly specific and moderately sensitive diagnostic test when compared to Baermann coprology   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 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 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 In cats and dogs with traumatic diaphragmatic rupture, does surgical timing affect outcome?

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Alison Robertson
Keyword(s):  
Mortality Rate ◽  
Research Question ◽  
Case Series ◽  
Diaphragmatic Rupture ◽  
Sufficient Evidence ◽  
Current Evidence ◽  
Bottom Line ◽  
Surgical Timing ◽  
Significant Information ◽  
Traumatic Diaphragmatic Rupture

PICO question In cats and dogs with traumatic diaphragmatic rupture undergoing herniorrhaphy does surgical timing affect outcome?   Clinical bottom line Category of research question Prognosis The number and type of study designs reviewed Ten studies were critically appraised. All of these were retrospective case series Strength of evidence Zero Outcomes reported Overall, there is not sufficient evidence reporting if timing of surgical intervention has an effect on the mortality rate in dogs and cats with traumatic diaphragmatic rupture. Mortality rate was 6.8–50% in all cases Conclusion There is no statistically significant information available with only several retrospective studies published that are a low quality of evidence. Clinical practice can be reviewed based upon current evidence assessing timing of herniorrhaphy of traumatic diaphragmatic rupture. However, there are no clear recommendations and future studies are warranted   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 There is no superior treatment method for medial shoulder instability in dogs

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Nina R Kieves ◽  
Stephen Jones
Keyword(s):  
Shoulder Instability ◽  
Treatment Options ◽  
Case Series ◽  
Treatment Method ◽  
Individual Case ◽  
Clinical Expertise ◽  
Retrospective Case ◽  
Bottom Line ◽  
The Individual ◽  
Inform Decision Making

PICO question In dogs with medial shoulder instability, what treatment option results in the best patient outcomes medical vs. surgical management? Clinical bottom line To date only one retrospective case series is available to compare treatment options for shoudler instability. This manuscript suggests that surgical treatment of medial shoulder instability (MSI) may be superior to medical management, however, this was not a prospective randomly assigned study and thus is wrought with limitations. There is no evidence of superiority of one surgical intervention over another for the treatment of MSI. The clinician must evaluate each individual case and consider clincial experience when deciding on the ideal treatment for MSI. 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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