Veterinary Evidence

Thank you to our reviewers 2023

2024-03-13T12:55:16+00:00

2024 has started with a bang or perhaps more accurately floods, snow and ice. The world remains an uncertain place with the conflict in Ukraine and Gaza as well as tension around the Korean peninsula, Sea of Japan and Taiwan. Economically 2023 was a very hard year with inflation exceeding wage increases making it hard for animal carers, with food banks in the UK seeing an increasing demand for pet food. Thankfully inflation is falling and the economic outlook, although not rosy, is perhaps not as gloomy as originally forecast. The big stories in publishing for 2023 were the explosion of large language models (LLM) like ChatGPT and their impact on publishing (we now have a policy on the use of artificial intelligence (AI) in papers submitted to Veterinary Evidence) and the burgeoning challenge of paper mills (organisations that produce and sell authorship of fabricated or manipulated manuscripts which resemble genuine legitimate research) that has led to some journals losing their citation.

Veterinary Evidence continues to grow and flourish with increased visits to our website and a regular stream of articles being published. Good governance and ethical publication remain a key focus of the Board that has been strengthened by a number of new members, bringing a broader range of expertise and experience. Our Student Awards continue to be a success and I would like to thank the whole team of staff and reviewers for turning round these submissions so quickly. I had the pleasure of talking to the prize-winning authors and it was great to hear their enthusiasm, but also how much they have valued the help and support from the journal.

Our new submission system, Editorial Manager, has been installed and is working well providing better insight into how the publishing process is working for us. It has been a learning experience for all and like any new system there are a few areas where we can further improve the author and reviewer experience. Thanks to the hard work of staff, reviewers and Associate Editors, there are now no papers left in the old OJS system. The journal has strived to make the reviewing process as straightforward as possible with a prereview checklist to ensure papers are ready for review. A mentoring system is up and running for new reviewers open to all who may be interested in contributing to the publication of veterinary literature. Veterinary Evidence has been working hard on our next review date policy and processes so some of our early Knowledge Summaries can be updated as new literature becomes available. We are also preparing to make an application for citation in PubMed Central to increase the visibility of Veterinary Evidence’s content.

None of this would be possible without the input from our volunteers and I would like to take this opportunity to say a huge thank you to all our reviewers, Associate Editors and everyone who has served on the Board this year for their tireless efforts on behalf of Veterinary Evidence without your support the journal could not exist. This year the Board has again had three online meetings, which have been essential in helping develop the strategy for Veterinary Evidence; such as our response to LLM, graphic content and further work on which types of evidence can be included in our Knowledge Summaries. On a personal note, my time as Editor-in-Chief is drawing to a close. It has been a great 3 years plus and I have had incredible support from everyone at Veterinary Evidence which has made my role so much easier and more enjoyable.

Once again, a massive thank you to everyone who works for and supports Veterinary Evidence, wishing you all a safe and productive 2024.

Kit Sturgess

Editor-in-Chief

The peri / postoperative analgesic effect of intravenous paracetamol in dogs

2024-02-12T11:14:24+00:00

PICO Question

In healthy dogs undergoing a surgical procedure, is there improved pain control in dogs receiving intravenous paracetamol in the peri / postoperative period compared to dogs not receiving intravenous paracetamol?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Three randomised, controlled, and blinded studies. Two studies directly address the PICO question whereby postoperative pain assessment was clinically evaluated following intravenous (IV) paracetamol. The third study addressed the question to a lesser extent, whereby the impact on the sevoflurane minimum alveolar concentration (MAC) reduction in response to noxious stimuli was assessed following the administration of IV paracetamol.

Strength of evidence

Weak.

Outcomes reported

The findings of the first two studies presented appear to directly contradict each other. The first study demonstrated a reduction in pain in all groups and found no differences in analgesia between IV paracetamol and other non-steroidal anti-inflammatories drugs (NSAIDs), while the second study reported no analgesia effects from IV paracetamol and was terminated prematurely because a high number of dogs required rescue analgesia. The first study reported sufficient analgesic effects of IV paracetamol and the second study reported no analgesia effects of IV paracetamol. Both were blinded, randomised, controlled studies and directly addressed the PICO question in relation to the peri / postoperative analgesic effects of IV paracetamol. However, their methods and sample sizes were very different. The third study did not demonstrate a clinically relevant sevoflurane MAC reduction after IV paracetamol in dogs.

Conclusion

At present, there is limited and weak evidence to suggest that IV paracetamol provides peri / postoperative analgesia in dogs. However, further studies are required to better assess its efficacy, its duration of action, and the appropriate doses that are necessary to reach therapeutic plasma levels. The reduced incidence of side effects at the currently recommended doses could support its peri / postoperative use, where NSAIDs use is contraindicated.

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.

Assessing the efficacy of acupuncture as the sole analgesic for canine chronic pain

2024-02-01T10:15:48+00:00

PICO Question

In dogs with chronic pain, is acupuncture alone, compared to a placebo, more efficacious in alleviating pain and pain-related dysfunction?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Four randomised, placebo-controlled clinical trials were critically appraised.

Strength of evidence

Weak.

Outcomes reported

A single study evaluating the efficacy of gold bead implantation, a form of permanent acupuncture, on pain associated with canine hip dysplasia (CHD) endorsed acupuncture’s superior pain alleviation and locomotion improvement through owner and veterinarian subjective outcome evaluation.

Three studies concluded that, overall, acupuncture was not efficacious regarding pain reduction or dysfunction improvement compared with placebo treatment.

Conclusion

Based on the limited current evidence, acupuncture could have analgesic effects as perceived by owners, but acupuncture, as a sole analgesic, is unlikely to be effective in alleviating pain and pain-related dysfunction in canine chronic pain associated with musculoskeletal causes. Evidence is lacking on chronic pain due to neurological and oncological causes. Further studies need to focus on researching various acupuncture modalities’ effects on chronic pain with musculoskeletal, neuropathic and oncological causes when utilised as a component of multimodal therapy. Currently, for canine patients with chronic pain, there is insufficient evidence for a veterinarian to recommend that a client utilise acupuncture as the sole method for pain management.

How to apply this evidence in practice

Effectiveness of mesenchymal stem cell therapy in cats with chronic gingivostomatitis

2024-01-09T17:19:28+00:00

PICO Question

In cats with chronic gingivostomatitis, does using intravenous mesenchymal stem cell therapy, compared to not using it, lead to the improvement of clinical signs?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Five interventional studies (clinical trials).

Strength of evidence

Moderate.

Outcomes reported

The reviewed studies indicate intravenous mesenchymal stem cell (MSC) therapy is safe to administer and can be effective in remission or alleviating the clinical signs of refractory, chronic gingivostomatitis in cats that have undergone full-mouth tooth extraction.

Conclusion

The collective evidence supports the intravenous administration of mesenchymal stem cell (MSC) therapy in cats with chronic gingivostomatitis following dental extraction. However, conducted clinical trials are prone to different degrees of bias due to the lack of independent control groups, the small number of subjects, and enrolling subjects with various severity of the disease. Therefore, more robust evidence can be obtained through well-designed randomised controlled trials to confirm the observed positive effects of the treatment in cats with a broader range of characteristics.

How to apply this evidence in practice

Comparing the effectiveness of clomipramine and fluoxetine in dogs with anxiety-related behaviours

2024-01-09T17:09:27+00:00

PICO Question

In dogs with anxious behaviours, is fluoxetine more effective than clomipramine in reducing anxiety-related behaviours?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Three controlled studies were critically appraised.

Strength of evidence

Moderate.

Outcomes reported

Administration of either fluoxetine or clomipramine to adult dogs reduces symptoms of fear and anxiety.

Conclusion

Both fluoxetine and clomipramine are effective in reducing acral lick dermatitis and tail chasing behaviours, but there is no evidence that one drug is more effective than the other.

How to apply this evidence in practice

Comparing internal versus external fixation for diaphyseal tibial and fibular fractures in skeletally immature dogs

2024-01-09T16:43:14+00:00

PICO Question

In skeletally immature dogs with simple non-displaced diaphyseal tibial and fibular fractures does internal fixation compared with external fixation result in less postoperative complications and improved fracture healing?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

There were no publications that answered the PICO question.

Strength of evidence

None.

Outcomes reported

Both external skeletal fixation and internal fixation are reported as techniques for diaphyseal tibial and fibular fracture management in companion animals, though no study has been reported to compare these techniques directly, or to report fracture healing and postoperative complications in skeletally immature dogs with non-displaced diaphyseal tibial fractures.

Conclusion

Given the absence of evidence answering the PICO, choice and recommendation on treatment for non-displaced diaphyseal tibial and fibular fractures in skeletally immature dogs should be decided on personal experience and stabilisation methods available to the veterinarian such as external fixation or internal fixation. Both surgical techniques have been reported in skeletally mature and immature dogs with diaphyseal tibial fractures, but not specifically in skeletally immature patients with non-displaced diaphyseal tibial and fibular fractures. They are both applicable methods of fixation for tibial fractures in companion animals, though there is lacking evidence for which has more favourable outcomes for non-displaced diaphyseal tibial and fibular fractures in skeletally immature dogs as no studies have directly compared these stabilisation techniques.

How to apply this evidence in practice

Evaluating the effect of equine tetanus antitoxin on mortality rates of dogs affected by tetanus

2023-12-06T13:15:17+00:00

PICO Question

In dogs with tetanus, does administering the equine tetanus antitoxin compared to not administering the antitoxin reduce mortality rates?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Three studies were reviewed for this Knowledge Summary, all of which were retrospective case-control studies.

Strength of evidence

Weak.

Outcomes reported

There was no difference in survival to discharge between dogs treated and dogs not treated with equine tetanus antitoxin.

Conclusion

The current literature suggests that administering the equine tetanus antitoxin to dogs affected by tetanus had no positive or negative effect on mortality rates, though the level of evidence amongst the literature is weak.

How to apply this evidence in practice

In dogs with chronic enteropathy (idiopathic inflammatory bowel disease) is budesonide more effective than prednisolone or prednisone in resolving clinical signs?

2023-11-17T10:21:44+00:00

PICO Question

In dogs with chronic enteropathy (idiopathic inflammatory bowel disease) is budesonide more effective than prednisolone or prednisone in resolving clinical signs or improving the canine inflammatory bowel disease (IBD) activity index (CIBDAI) or the canine chronic enteropathy clinical activity index (CCECAI)?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

One double-blinded randomised control trial.

Strength of evidence

Moderate.

Outcomes reported

The outcome of this study identified that no significant differences in remission rates (> 75% decrease in CIBDAI scores) were observed between the prednisone and budesonide groups. Frequency of adverse effects were also similar between the two groups.

Conclusion

A single study with moderate power of evidence alongside some significant limitations, particularly population size, cannot be used as the sole provider of an answer to the PICO question. As such, further studies with greater power would be required before a definitive assessment of comparative treatment efficacy can be made.

How to apply this evidence in practice

Postoperative analgesia and side effects of oral or injectable metamizole (dipyrone) in dogs and cats

2023-11-08T15:48:20+00:00

PICO Question

In dogs and cats after surgery, does the peri-operative administration of injectable or oral metamizole (dipyrone) as opposed to no intervention result in lower postoperative pain scores or higher incidence of side effects?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Three prospective, randomised, blinded, clinical studies were critically reviewed.

Strength of evidence

Weak.

Outcomes reported

Variables assessed included: different pain assessment methods, metamizole dose required to reduce peri- and postoperative pain scores, changes in cardiovascular variables (heart rate, systolic, mean and diastolic blood pressure), changes in respiratory variables and variations in haematological and biochemical variables.

Conclusion

In healthy cats and dogs undergoing ovariohysterectomy, the use of metamizole in the peri- and postoperative period was associated with some reduction in pain levels (i.e., lower pain score or reduced need for rescue analgesia). In dogs, metamizole alone provided insufficient analgesia. No study evaluating metamizole after orthopaedic surgery was found. No evidence suggested that using metamizole peri-operatively resulted in higher incidence of side effects.

How to apply this evidence in practice

Do passive range of motion exercises lead to quicker postsurgical recovery of canine IVDD?

2023-10-24T11:23:17+01:00

PICO Question

In canine patients recovering from surgery for intervertebral disc disease, do passive range of motion exercises, compared to no intervention, lead to a shorter or faster rate of recovery?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Five studies (two randomised controlled trials, two retrospective cohort studies and one retrospective case series) were critically appraised.

Strength of evidence

Weak.

Outcomes reported

There is no evidence that passive range of motion (PROM) exercises are associated with a quicker postsurgical recovery in the canine intervertebral disc disease (IVDD) patient.

Conclusion

There is a lack of evidence about specific rehabilitation techniques for the postoperative canine IVDD patient. Based on the current data, a multimodal approach, including basic and intense rehabilitation techniques is suggested.

How to apply this evidence in practice

Effectiveness of F3 feline facial pheromone analogue for acute stress reduction within clinical veterinary practice

2023-09-14T12:03:14+01:00

PICO Question

In cats within a clinical veterinary context, does the application of the F3 feline facial pheromone (Feliway™), when compared to placebo, reduce signs of acute stress?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Five papers were critically reviewed. There were three prospective, double-blinded, randomised controlled trials, one prospective, single-blinded, randomised controlled trial and one prospective, single-blinded, non-randomised controlled trial.

Strength of evidence

Moderate.

Outcomes reported

Four studies found improvement in select indicators of acute stress following F3 feline facial pheromone analogue (FFPA) exposure. One study showed FFPA reduced patient stress during routine physical examination, and improved caregiver impression of patient relaxation and ease of handling. One study revealed FFPA decreased vocalisations but had no effect upon systolic blood pressure during physical examination. One study determined that FFPA calmed but did not reduce struggling during venous catheterisation. One study demonstrated reduced time to sedation and propofol induction dose for routine surgical procedures when a transport protocol incorporating FFPA was applied. Finally, one study found no significant effect of FFPA upon behavioural and physiologic measures of acute stress during physical examination. No studies reported outward negative effects associated with FFPA exposure.

Conclusion

It can be concluded that FFPA may reduce signs of acute stress within a clinical veterinary context. Additionally, exposure to FFPA is unlikely to cause patient harm. To optimise patient welfare, FFPA is not recommended as a sole agent for stress mitigation and should instead be incorporated holistically with patient friendly handling, clinic design, and pharmacotherapy where indicated.

How to apply this evidence in practice

Erratum to: In dogs diagnosed with osteoarthritis, how safe and effective is long-term treatment with bedinvetmab in providing analgesia?

2023-09-11T10:18:06+01:00

The original article was published in Veterinary Evidence Vol 8, Issue 1 (2023): https://doi.org/10.18849/ve.v8i1.598

To aid interpretation, certain statements in the Knowledge Summary have been clarified. Refer to the full text and PDF for these amendments and corrections.

Evaluation of a method to measure the ratio of pelvic limb to thoracic limb girth in dogs

2023-08-24T12:08:14+01:00

Objective: To determine if a landmark-incorporated limb girth measurement in sound dogs, utilising the greater trochanter and the acromion process, would be both reliable and have a consistent ratio between pelvic limb (PL) and thoracic limb (TL) muscle measurements.

Background: To establish a reliable and reproducible reference range for sound dogs. This reference range may help clinicians further evaluate dogs during lameness and musculoskeletal examinations.

Evidentiary value: Prospective study of 115 sound dogs measured by a single observer.

Methods:Examinations were performed by one observer, using a Gullick II tape measure for PL to TL ratio (PL:TL) measurements for 115 dogs. Bodyweight, breed, body condition score (BCS), and sex were recorded. Each limb was measured three times. The average PL:TL per dog was calculated. Further statistical analysis was used to calculate intra-observer variance and the correlation of limb girth to body weight, BCS, and sex, with significance set at P < 0.05.

Results: The average PL:TL of the sample was 1.515 ± 0.049. Fifty-two dogs of the 115 cases (45%) had a PL:TL ratio of 1.500. PL:TL measurements were not related to dog weight, BCS, or sex. The intra-class correlation was reported to be 0.99.

Conclusion: Our study suggests that a landmark-incorporated measurement in a weight-bearing position can be reproducible. Further investigation is required to determine if this measurement can be reproducible between multiple observers.

Application: A landmark-incorporated limb girth measurement may guide clinicians in case progression and help pinpoint subclinical musculoskeletal disease in dogs.

The efficacy of recombinant feline interferon-omega in treating symptomatic cats infected with feline immunodeficiency virus

2023-08-24T12:00:45+01:00

PICO Question

In symptomatic cats with feline immunodeficiency virus (FIV), does high-dose subcutaneous recombinant feline interferon-omega (rFeIFN-ω) administration lead to reduced clinical signs compared to cats who were not administered rFeIFN-ω?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Three studies were critically reviewed, including one randomised controlled trial, one non-randomised controlled trial, and one uncontrolled clinical trial.

Strength of evidence

Weak.

Outcomes reported

Each of the studies reported that rFeIFN-ω administration significantly reduced clinical signs in FIV infected cats. However, all three papers have limitations in their study design and statistical analysis which lower the strength of the evidence they provide.

Conclusion

There is only weak evidence demonstrating that rFeIFN-ω administration leads to reduced clinical signs in FIV positive cats. Currently, there is a lack of well-designed, double-blinded, randomised, placebo-controlled clinical trials which have an adequate sample size and specifically focus on FIV positive cats. As a result, more robust evidence is needed to prove the definitive therapeutic benefit of rFeIFN-ω in symptomatic FIV patients. Treatment with rFeIFN-ω may still be considered by clinicians for cats with clinical signs potentially associated with retroviral infection, such as oral lesions and stomatitis, particularly if they are not responding well to supportive therapy alone.

How to apply this evidence in practice

Efficacy of omental graft to facilitate canine radial fracture repair

2023-08-24T11:56:01+01:00

PICO Question

In dogs with a displaced radial fracture, does the use of a free autologous greater omental graft, combined with other standard fracture repair methods, compared to not using a greater omental graft, reduce fracture healing time?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Three papers were critically reviewed: one retrospective clinical study and two experimental case control studies. All three papers answered the PICO question. Each of the three papers had a very small sample size, with two having a sample size of 16 (n = 4 in the relevant experimental group, and n = 4 for the control). The third had an initial sample of 25 that was later reduced to 19, as six dogs were excluded from the study.

Strength of evidence

Weak.

Outcomes reported

Two papers were experimental case control studies, which looked at radial fracture healing of dogs that had undergone an osteotomy, followed by bone plate and screw fixation, as well as either with a free autologous greater omental graft (OG) or without. Healing was measured in both studies via radiographical analysis using a modified Lane and Sandhu scoring system, and histopathological analysis post euthanasia with Heiple’s histopathological scoring system. Both studies found higher radiographic and higher histopathological scores in the OG group, though there was a large overlap between group scores. There was no mention of randomisation or power analysis in either of these studies, and blinding was only mentioned regarding histopathological analysis.

The other was a retrospective study, looking at the outcomes of radial and ulna fractures in small breed dogs, after being surgically treated with a plate and screw, and either with or without OG. They found that dogs with omental grafts healed faster than those without, and had no major complications (whereas the non-OG group did). Note that this study was not (and could not) be randomised due to its nature, and it made no mention of blinding.

Conclusion

All three studies concluded that the use of OG assisted healing in canine radial fractures. However, care must be taken when applying these results to practice, as the studies lack robustness. While two of the studies had a good study design, both had very small sample sizes and neither mentioned randomisation. Blinding was only mentioned in the histopathological analysis, not radiographical analysis, and while both studies reported significant differences between their respective OG and control groups, they failed to account for multiple comparisons in statistical analysis, which likely skewed the results. The third study also represents a weak level of evidence, due to its retrospective nature and other limitations. Its small sample size, and the fact that 4/8 control (non-OG) dogs received a different type of graft, contributed to this.

Due to the small number of animals in each study and the poor-quality design, it is concluded that there is weak evidence to support the PICO question. Further randomised blinded clinical trials with larger samples sizes are recommended, to increase the strength of the evidence before the routine clinical use of greater omentum grafts for aiding fracture repair can be recommended, considering that this means an additional abdominal surgical procedure.

How to apply this evidence in practice

Pre-weaning socialisation with non-littermates in piglets: reduced weaning stress when regrouped with unfamiliar piglets post-weaning?

2023-08-24T11:49:04+01:00

PICO question

In piglets in indoor housing systems does pre-weaning socialisation with non-littermates compared to no pre-weaning socialisation with non-littermates result in lower weaning stress when regrouped with unfamiliar piglets post-weaning?

Clinical bottom line

Category of research question

Treatment.

The number and type of study designs reviewed

Nine papers were critically reviewed. All of them were controlled trials, of which two were randomised control trials.

Strength of evidence

Moderate.

Outcomes reported

In terms of behavioural indicators of weaning stress, piglets socialised with non-littermates during lactation showed less aggressive behaviours (in the six papers that investigated aggression) and fewer skin lesions (in the six out of seven papers that investigated skin lesions) than non-socialised piglets when regrouped with unfamiliar piglets post-weaning. One of two papers showed that the cortisol level of socialised piglets had a smaller increase from pre-weaning to post-weaning level than non-socialised piglets. Four out of five papers that investigated average daily weight gain (ADG) found that the difference between socialised and non-socialised piglets in ADG was insignificant.

Conclusion

Based on behavioural indicators, there was strong evidence suggesting that pre-weaning socialisation with non-littermates could reduce aggression and skin lesions when regrouped with unfamiliar piglets post-weaning. However, due to the weak evidence for the physiological indicator and growth performance, the effect of pre-weaning socialisation on weaning stress was inconclusive.

How to apply this evidence in practice

Erratum to: Does the use of supraglottic device in rabbits cause less injury than other airway management devices?

2023-02-10T18:20:35+00:00

The original article was published in Veterinary Evidence Vol 7, Issue 4 (2022): https://doi.org/10.18849/ve.v7i4.608

Unfortunately the original version of the article was missing the following statement.

This Knowledge Summary has reviewed the available evidence on the use of a SGAD (v-gel®) in rabbit anaesthesia. Since writing a new design of a single use supraglottic airway device (SGAD) has been introduced; currently there is no published evidence on whether this new device has an impact on the risk of injury.

This error was in both the HTML and PDF versions. This has now been updated in both the HTML and PDF versions, and can be found in the clinical bottom line and the evidence section.

Thank you to our reviewers 2022

2023-01-31T20:57:52+00:00

As 2023, dawns we are faced with a very different world than at the start of 2022, COVID-19 is in the rear-view mirror, but we now face the war in Ukraine, energy prices and inflation. Perhaps this is a glimpse of the ‘new world’ where we will be continually challenged by crisis whether it be conflict, infectious disease or the impacts of global warming.

On a more positive note it has been another busy and productive year for Veterinary Evidence as we strive to continually improve the journal whether you are a reader, author or reviewer. In April we said ‘goodbye’ to Daniel Edwards who had covered Bridget Sheppard’s maternity leave as Managing Editor. I would like to take the opportunity to thank Dan for all his hard work for Veterinary Evidence initiating a number of projects that have come to fruition through the year and to welcome Bridget back. As Veterinary Evidence has grown, we have been fortunate to be able to expand our staff to meet the need and ensure efficient turnaround of submissions so another welcome, William Smith has joined the team and is now a permanent full time Editorial Assistant.

It is not just staff changes that happened in 2022, we have also improved the governance of Veterinary Evidence with the appointment of new board members and creation of a Deputy Editor-in-Chief position ably filled by Louise Buckley. We also submitted a successful application to COPE (The Committee on Publication Ethics) further strengthening the journal’s oversight and reputation.

We have had a major website redesign, now live, which has greatly improved the look, feel, and functionality of Veterinary Evidence for all users. Readers can find relevant papers quickly and efficiently. Our student awards continue to be a success and I would like to thank the whole team of staff and reviewers for turning round these submissions so quickly. I had the pleasure of talking to the prize-winning authors and it was great to hear their enthusiasm but also how much they have valued the help and support from the journal.

We have also been developing our processes for reviewing papers to make sure that papers are ready to go out for review. We are working on ways to make sure that, for papers requiring revision, authors respond to each of the comments made by reviewers, and reviewers can quickly see that there has been an author response to their comments and suggestions. A new submission system, Editorial Manager, has been implemented that should make life easier for everyone as well as provide accessible data on papers as they go through the system so we can see what we do well and where we can do better.

None of this would be possible without the input from our reviewers and I would like to take this opportunity to say a huge thank you to all our reviewers and everyone who has served on the Editorial Board this year for their tireless efforts on behalf of Veterinary Evidence – without your support the journal could not exist. This year the Board has again had three online meetings, which have been essential in helping develop the strategy for Veterinary Evidence such as how we ensure our Knowledge Summaries remain current, what literature should be included in Knowledge Summaries and how we improve the reviewer and author experience.

Once again, a massive thank you to everyone who works for and supports Veterinary Evidence, wishing you all a safe and productive 2023.

Kit Sturgess

Editor-in-Chief

Is symmetric dimethylarginine superior to creatinine for assessing glomerular filtration rate for cats with kidney disease?

2023-04-19T10:20:55+01:00

PICO question

Is symmetric dimethylarginine (SDMA) superior to creatinine for assessing glomerular filtration rate (GFR) for cats with chronic kidney disease?

Clinical bottom line

Category

Diagnosis.

Number and type of studies reviewed:

The literature searches returned four relevant papers that answered this PICO. Three of the studies were retrospective diagnostic test studies, and one was a randomised, controlled, unblinded study.

Strength of evidence

Moderate.

Outcomes reported

Three out of the four studies analysed found that there was no significant difference between the correlation between symmetric dimethylarginine (SDMA) and glomerular filtration rate (GFR) and creatinine (sCr) and GFR, whilst the other identified a stronger correlation between SDMA and GFR. Two papers also evaluated the sensitivity and specificity of SDMA compared to creatinine. One paper found a similar sensitivity for both biomarkers and a significantly higher specificity for creatinine using the upper reference interval of 18 µg/dL for SDMA and 155.6 µmol/L (1.76 mg/dL) sCr, whilst the other found SDMA to have a superior sensitivity and both biomarkers to have a similar specificity using the upper reference interval of 14 µg/dL for SDMA and 185.64 µmol/L (2.1 mg/dL) for sCr.

Conclusions

In view of the strength of evidence we conclude that the majority of the studies analysed do not demonstrate that SDMA is superior to creatinine for the assessment of GFR in cats with chronic kidney disease. More research is needed with larger sample sizes to investigate this further. Standardisation of the upper reference intervals across studies for creatinine and SDMA would be advantageous for comparison of sensitivity and specificity in future studies.

How to apply this evidence in practice

Does local anaesthetic reduce pain in rubber ring castration of neonatal lambs?

2023-10-23T10:54:25+01:00

PICO Question

In lambs less than 7 days old undergoing castration with rubber rings does administration of local anaesthetic compared to no local anaesthetic result in a reduction of pain-related behaviours?

Clinical bottom line

Category of research

Treatment.

Number and type of study designs reviewed

Six studies were appraised; all were controlled clinical or field trials.

Strength of evidence

Moderate.

Outcomes reported

Local anaesthetic administered to lambs castrated with rubber rings resulted in the demonstration of fewer pain related behaviours and also diminished the increases in plasma cortisol in the immediate post-castration period when compared to lambs castrated without local anaesthetic. Local anaesthetic administered at least 15 minutes before rubber ring castration may significantly reduce behavioural signs of pain and plasma cortisol changes.

Conclusion

In lambs less than 7 days old undergoing castration with rubber rings, local anaesthetic reduces markers of pain when compared to lambs castrated without local anaesthetic.

How to apply this evidence in practice