https://www.veterinaryevidence.org/index.php/ve/issue/feed Veterinary Evidence 2020-03-26T12:29:50+00:00 Jennifer Morris Jennifer@rcvsknowledge.org Open Journal Systems Veterinary Evidence is an online only, open access, peer-reviewed journal owned and published by RCVS Knowledge. It publishes content relating to evidence-based veterinary medicine (EBVM) and its application in veterinary practice to enhance the quality of care provided to patients. https://www.veterinaryevidence.org/index.php/ve/article/view/270 In dogs does low level laser therapy reduce healing time? 2020-03-26T12:29:50+00:00 Emma Jane Suiter if18053@bristol.ac.uk <p><strong>PICO question<br></strong></p> <p>In dogs with a surgical or open wound does low level laser therapy increase the speed of wound contracture and reduce the healing time?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong><strong>Category of research question</strong></strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Five papers were critically reviewed. Four were randomised controlled trials and one was a case report</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>Three out of the five studies currently available assessing low level laser therapy to improve wound healing, suggest that low level laser therapy has no beneficial effect on the healing of open or incisional wounds. Of the papers that used statistical analysis, no statistical significance was found in wound surface area over time or tissue histological findings between wounds treated with laser therapy and those who were not. Two papers identified did find decreased wound healing times however the strength of evidence is far poorer for both, with only subjective assessment of the wound in the controlled trial and the other being a case report without control</p> <p><strong>Conclusion</strong></p> <p>Currently there is no strong evidence that low level laser therapy increases the speed of wound contracture and reduced healing time. More studies are recommended to provide stronger evidence towards the use of low level laser therapy in wound healing, preferably with a larger population of dogs and with laser settings which are consistent with previous studies for comparison</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>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.</p> <p>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.&nbsp;</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2020-03-26T12:22:22+00:00 Copyright (c) 2020 Emma Jane Suiter https://www.veterinaryevidence.org/index.php/ve/article/view/248 Age at first calving in dairy cows: which months do you aim for to maximise productivity? 2020-03-20T09:52:03+00:00 Mike Steele mike@dairyconsulting.vet <p><strong>PICO question</strong></p> <p>In dairy cattle, which months should producers target age at first calving in order to maximise milk yield, minimize risk of non-voluntary culling and optimize fertility?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Risk</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Seventeen papers were critically reviewed: 15 sets of case series, one review of case series and cohort studies and one randomised control trial, summarising over 2.4 million individual cow records</p> <p><strong>Strength of evidence</strong></p> <p>Strong</p> <p><strong>Outcomes reported</strong></p> <p>An optimum range of age at first calving (AFC) on dairy farms appears to be 22–25 months inclusive. Lower or higher than this figure can bring lower first lactation 305 day and lifetime milk yields, lower fertility and lower chances of surviving to a second lactation. Achieving an AFC of 22–25 months can bring the highest economic return to dairies</p> <p><strong>Conclusion</strong></p> <p>Age at first calving is a useful and key performance parameter to measure in dairy cattle. Achieving a range of 22–25 months at first calving can help to optimise both long term milk yield, fertility and longevity within the herd</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>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.</p> <p>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.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2020-03-19T16:35:24+00:00 Copyright (c) 2020 Mike Steele https://www.veterinaryevidence.org/index.php/ve/article/view/235 Are bisphosphonates a more effective treatment than intra-articular steroids in horses with distal hock osteoarthritis? 2020-03-11T14:42:32+00:00 Hannah Greene hannah.greene@wsu.edu <p><strong>PICO question</strong></p> <p>In horses that are lame due to osteoarthritis of the distal tarsal joints (bone spavin), is intra-articular medication with corticosteroids compared to systemic bisphosphonate treatment more effective in long-term lameness reduction?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question </strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Three papers were critically reviewed. Two were randomised controlled trials, and one was a retrospective study.</p> <p><strong>Strength of evidence </strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>There is insufficient evidence to support the use of systemic bisphosphonates over intra-articular corticosteroids to treat distal hock osteoarthritis in horses.</p> <p><strong>Conclusion</strong></p> <p>Horses with distal hock osteoarthritis should not be treated with systemic bisphosphonates until further blinded randomised controlled trials are completed. Additionally, supportive evidence for the use of intra-articular corticosteroids as a treatment for degenerative hock osteoarthritis is limited to a retrospective study where modest, short-term improvements are reported: 58% of horses improved after an average of 56 days (Labens et al., 2007). Evidence does not support significant improvement in long-term outcomes: 50% of horses improved after 4 months (Watts et al., 2016) and only 38% of horses improved after a mean follow-up period of 787 days (Labens et al., 2007).</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>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.</p> <p>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.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2020-03-11T14:18:48+00:00 Copyright (c) 2020 Hannah Greene https://www.veterinaryevidence.org/index.php/ve/article/view/204 Distal tarsal joints osteoarthritis: Evidence behind bisphosphonates and NSAIDs to improve lameness 2020-02-28T10:14:47+00:00 Julia Dubuc julia.dubuc@nottingham.ac.uk <p><strong>PICO question</strong></p> <p>In lame horses affected by osteoarthritis of the distal tarsal joints (bone spavin), are bisphosphonates more effective than NSAIDs in long-term alleviation of lameness?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question </strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Two papers were critically reviewed. There was one field study and a multicentric randomised double-blind placebo control study</p> <p><strong>Strength of evidence </strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Each study looked at the effect of either Tiludronate or Firocoxib on alleviation of tarsal lameness. Both Tiludronate and Firocoxib, while administered independently, provided some degree of relief (for up to 120 days) and improved the lameness related to tarsal osteoarthritis</p> <p><strong>Conclusion</strong></p> <p>Since no study was found to directly compare the use of non-steroidal anti-inflammatory drugs and bisphosphonates and that none evaluate the long-term effects of these treatment options on lameness, it is not possible to recommend one treatment option over the other to alleviate lameness caused by tarsal osteoarthritis in horses</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="http://www.ebvmlearning.org/apply/" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>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.</p> <p>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.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2020-02-28T10:09:41+00:00 Copyright (c) 2020 Julia Dubuc https://www.veterinaryevidence.org/index.php/ve/article/view/249 There is no superior treatment method for medial shoulder instability in dogs 2020-02-20T12:29:34+00:00 Nina R Kieves nkieves@gmail.com Stephen Jones jones.5609@osu.edu <p><strong>PICO question</strong></p> <p>In dogs with medial shoulder instability, what treatment option results in the best patient outcomes medical vs. surgical management?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question </strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>10 papers were critically reviewed. Whilst one study was prospective in nature, it was performed in research dogs that were then euthanised to evaluate outcome of various surgical procedures. Of the remaining nine papers reviewed, six were retrospective studies, two were case reports, and one was a combination of a cadaveric project with case report</p> <p><strong>Strength of evidence </strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Surgical and medical treatment of medial shoulder instability can be successful. There is no strong evidence to support one surgical treatment over another</p> <p><strong>Conclusion</strong></p> <p>Dogs diagnosed with medial shoulder instability may be treated successfully with either medical or surgical management</p> <p><strong>&nbsp;</strong></p> <p><a href="http://www.ebvmlearning.org/apply/" target="_blank" rel="noopener"><strong>How to apply this evidence in practice</strong></a></p> <p>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.</p> <p>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.<strong>&nbsp;</strong></p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2020-02-20T12:17:00+00:00 Copyright (c) 2020 Nina R Kieves, Stephen Jones https://www.veterinaryevidence.org/index.php/ve/article/view/218 Insufficient evidence intraperitoneal fluid is equivalent or superior to intravenous fluid therapy in dehydrated calves 2020-02-11T16:00:19+00:00 Allan John Gunn algunn@csu.edu.au Timothy Crawshaw tim_crawshaw@hotmail.com Victoria Brookes vbrookes@csu.edu.au <p><strong>PICO question</strong></p> <p>In calves &lt;14 days old which are moderately to severely dehydrated (5–9%) or acidaemic (base excess -5 to&nbsp; -15 mM), does intraperitoneal fluid therapy result in comparable or superior clinical improvement when compared to intravenous fluid therapy?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Two papers were critically reviewed (one randomised clinical trial and one case series)</p> <p><strong>Strength of evidence</strong></p> <p>Weak evidence relevant to the topic question</p> <p><strong>Outcomes reported</strong></p> <p>Statistically significant differences were not found between treatment groups (administration of intravenous fluids [n = 27] or intra-peritoneal fluids [n = 28]) in the clinical trial, and findings relevant to the topic question were not reported in the case series of 18 calves</p> <p><strong>Conclusion</strong></p> <p>These studies provide insufficient evidence that intraperitoneal (IP) fluid is comparable to, or &nbsp;provides superior clinical improvement, when compared to intravenous (IV) fluid therapy in moderately to severely dehydrated (5–9 %) or acidaemic calves (base excess -5 to -15 mM) aged &lt;&nbsp;14 days of age</p> <p>&nbsp;</p> <p><strong><a href="http://www.ebvmlearning.org/apply/" target="_blank" rel="noopener">How to apply this evidence in practice</a></strong></p> <p>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.</p> <p>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.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2020-02-11T15:13:17+00:00 Copyright (c) 2020 Allan John Gunn https://www.veterinaryevidence.org/index.php/ve/article/view/220 There is no evidence that the addition of antimicrobials reduce the risk of sepsis after intra-articular corticosteroids in horses with arthritis 2020-01-14T14:04:16+00:00 Elena Gogua goguaveter@gmail.com <p><strong>PICO question</strong></p> <p>In horses with arthritis, does the treatment with intra-articular antimicrobials concurrently with intra-articular corticosteroids reduce the risk of sepsis compared to intra-articular corticosteroids alone?</p> <p><strong>Clinical bottom line</strong></p> <p>The three studies identified did not demonstrate a reduction of risk when antimicrobials were used. However, the strength of evidence provided by the studies was weak. The power of the studies to detect an effect of antimicrobials was low due to the small number of sepsis cases recorded. Further studies are therefore required to draw conclusions.</p> <p><br><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2020-01-14T11:39:12+00:00 Copyright (c) 2020 Elena Gogua https://www.veterinaryevidence.org/index.php/ve/article/view/247 Can vaccinating sheep reduce the occurrence of caseous lymphadenitis? 2020-01-22T11:28:19+00:00 Vitória Souza de Oliveira Nascimento vitoriasoliveira.n@gmail.com <p><strong>PICO question</strong></p> <p>Is there a decrease of caseous lymphadenitis in vaccinated sheep compared to unvaccinated sheep?</p> <p><strong>Clinical bottom line</strong></p> <p>The evidence provided by the studies used is strong (all have been randomised controlled trials), supporting the hypothesis that sheep vaccinated against caseous lymphadenitis (CLA) are less likely to develop the disease when compared to unvaccinated sheep. Vaccination may be a useful tool in the prevention and control of clinical CLA following a risk assessment.</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2020-01-06T11:41:55+00:00 Copyright (c) 2020 Vitória Souza de Oliveira Nascimento https://www.veterinaryevidence.org/index.php/ve/article/view/315 Thank you to our 2019 reviewers 2020-02-24T16:13:43+00:00 Peter Cockcroft p.cockcroft@surrey.ac.uk <p>As Editor-in-chief I would like to thank all of our editors and reviewers for their continued support of the&nbsp;<em>Veterinary Evidence</em>&nbsp;journal and their diligence in meeting demanding timelines. Their knowledge, expertise and insights are duly acknowledged and highly valued.&nbsp;All reviewers who have taken the time to review for&nbsp;<em>Veterinary Evidence</em> are listed in the full text.</p> <p>The <em>Veterinary Evidence</em> Editorial Board Meeting was held on November 8th. There were some important strategic initiatives discussed and some key action points defined. These included the implementation and promotion of the new format of the clinical bottom line, the implementation of a systematic approach for generating knowledge summary questions for important conditions, initiatives to increase the engagement and scope of topics submitted by veterinary nurses, commissioning of articles on work-placed based education and other key topics, the publication of consolidated annual lists of knowledge summaries identifying weak or no evidence to sign post areas requiring future research and the promotion of quality improvement and audit case studies. I look forward to realising these important initiatives in the coming year and acknowledge the support and dedication of everyone involved in the continued innovation and success of the Journal.</p> <p><br><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"></p> 2020-01-16T14:33:46+00:00 Copyright (c) 2020 Peter Cockcroft https://www.veterinaryevidence.org/index.php/ve/article/view/265 Quality improvement and audits in clinical practice 2020-02-25T12:16:35+00:00 Peter Cockcroft p.cockcroft@surrey.ac.uk <p><em>Veterinary Evidence</em> champions the use of evidence to enhance the quality of care provided to animals, and I am pleased to announce that the Journal will now include quality improvement case studies.</p> 2020-02-24T16:09:14+00:00 Copyright (c) 2020 Peter Cockcroft https://www.veterinaryevidence.org/index.php/ve/article/view/244 Field trials and tribulations: mortality, morbidity and liveweight following multivalent clostridial and Pasteurella vaccination of lambs on six English commercial sheep flocks 2020-01-21T15:22:04+00:00 Clare J Phythian clare.phythian@nmbu.no <p><strong>Objective: </strong>This field trial aimed to assess the effect of a multivalent clostridial and <em>Pasteurella</em> vaccine (Heptavac P Plus, MSD Animal Health, 2015), administered to lambs at two different time points, on lamb mortality (primary outcome), morbidity and growth rates (secondary outcomes) as compared to unvaccinated lambs.</p> <p><strong>Background:</strong> This veterinary practice-based study was motivated by a knowledge gap identified during flock health planning activities and engagement between veterinarians and commercial sheep producers in a regional knowledge exchange programme in South West England. Common queries to the veterinary practice from sheep producers during summer to autumn 2012 included the value and timing of vaccinations to prevent disease associated with pasteurellosis. Discussions between veterinarians and consultants working in preventive sheep flock health planning stimulated a scientific literature search, which highlighted the lack of published data on field vaccine testing of <em>Pasteurella</em> components under British sheep commercial farming systems, and a lack of strong evidence in order to inform practical questions regarding the optimal timing of vaccinations aimed at preventing lamb mortalities in the pre-, peri- and post-weaning periods.</p> <p><strong>Evidentiary value:</strong> A field vaccine trial was conducted on six commercial sheep flocks in South West England. From April 2013, across the six farms a total of 900 twin-born lambs (<em>Ovis aries</em>) were systematically randomly allocated into 1. unvaccinated, 2. early- (6 to 8-week-old) or 3. late- (18 to 20-week-old) vaccination groups. The study provides evidence to support recommendations for sheep producers regarding risks for clostridial disease in fully unvaccinated sheep flocks, supports the benefits of preventive ewe vaccination, and indicates that pre-weaning vaccination of lambs may be beneficial for reducing peri- and post-weaning losses on some flocks. The study highlights the challenges of identifying the reasons for mortality in grazing lambs, and provides new evidence to support the need for early intervention and treatment of ocular lesions in young lambs, in order to reduce their negative impact on lamb performance.</p> <p><strong>Methods</strong>. During the 6-month trial, lambs were assessed for ocular lesions, orf lesions, clinical respiratory disease, lameness, diarrhoea, and ear tag losses. Monthly liveweights (kg) and mortalities were recorded. Lambs were removed from the study when they reached producer-defined finishing objectives, ≥46 kg liveweight or when they died.</p> <p><strong>Results:</strong> Overall, low levels of mortality and disease outcomes were observed in both control and vaccinated lambs. A mortality rate of 33 deaths per 1000 lambs at-risk, 0.8% lameness (95% CI 0.6–1.1), 1.7% diarrhoea (95% CI 1.4–2.2), 3% ocular disease (including ocular discharge and/or entropion) (95% CI 2.2–3.2), and 2.6% orf lesions (95% CI 2.2–3.1) were recorded over the trial period. A higher proportion of mortalities occurred in unvaccinated or partially vaccinated lambs (n=23; 76.7%), as compared to trial lambs that had received a primary vaccine course (n=7; 13.3%). A small proportion of mortalities (n=3; 10.0%) occurred in lambs whose vaccination status could not be confirmed No clinical signs of respiratory disease were recorded during veterinary or producer assessments of control or vaccinated trial lambs. Mixed-effects models found significant between-farm and time differences in liveweights (p&lt;0.001) but no significant effect of vaccination status on lamb growth rates. A dramatic decrease in lamb growth rates across all farms coincided with the weaning period – this was also the period in the study were the majority of grazing lamb mortalities were identified in flocks that routinely vaccinated their ewes against clostridial disease and pastuerellosis.</p> <p><strong>Conclusion: </strong>A clear trend was found with fewer mortalities occurring in lambs that received a multivalent clostridial and <em>Pastuerella</em> <em>spp</em>. vaccination course compared to unvaccinated lambs. The reasons behind mortalities in grazing lambs were not diagnosed given the low submission of carcases for veterinary necropsy examination that was attributed to carcase scavenging and decomposition. No significant effects of vaccination were found on lamb growth rates or clinical outcomes. However, a secondary finding was the significant negative effect of ocular conditions (including discharge and entropion) on growth rates of lambs aged 6 weeks and over – supporting the need for early recognition and intervention in order to reduce animal welfare and production impacts.</p> <p><strong>Application:</strong> We highlight study findings, field experiences and discuss some of the practical challenges and considerations in design and conduct of field vaccine trials used to inform evidence-based veterinary practice. The study will be of interest to veterinary surgeons, sheep producers, flock health and agricultural consultants, pharmaceutical agencies and advisors, researchers and those engaged in applied studies in animal health and welfare, veterinary epidemiology, preventive health management researchers, and participants and advisors in field vaccine trial design and development.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p> 2020-01-21T15:13:30+00:00 Copyright (c) 2020 Clare J Phythian