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 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 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 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 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 Do dogs with non-surgically managed cranial cruciate ligament disease have better outcomes with rehabilitation?

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Joshua Merickel ◽  
Wanda Gordon-Evans
Keyword(s):  
Cruciate Ligament ◽  
Research Question ◽  
Randomised Clinical Trial ◽  
Individual Case ◽  
Ligament Injury ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Cranial Cruciate Ligament ◽  
Successful Outcomes ◽  
Cranial Cruciate Ligament Disease

PICO question In dogs with cranial cruciate ligament disease treated non-surgically with rehabilitation, is the outcome inferior/equivalent/superior as measured by owner and/or veterinarian evaluation to dogs treated non-surgically without rehabilitation?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Four papers were critically appraised. One paper reviewed was a prospective, randomised clinical trial. The remaining three papers were retrospective cohort studies Strength of evidence Weak Outcomes reported There are no studies available that directly compare dogs managed non-surgically with and without rehabilitation following cranial cruciate ligament injury. In one study, 66% of dogs treated non-surgically with rehabilitation are reported to have successful outcomes 1 year following initiation of treatment. For dogs managed non-surgically without rehabilitation, successful outcomes varied from 19%–90% of cases among several retrospective studies Conclusion There is evidence suggesting the addition of rehabilitation to conservative therapy is beneficial, but based on the current literature, it is impossible to say whether it is superior to conservative treatment without rehabilitation   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 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 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.  

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