https://www.veterinaryevidence.org/index.php/ve/issue/feed Veterinary Evidence 2023-01-25T12:56:12+00:00 Jennifer Morris editor@veterinaryevidence.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/627 Erratum to: Clinical audit of POM-V / POM prescriptions by remote consultation via a veterinary video telemedicine smartphone application 2022-06-20T10:15:27+01:00 Sheila Smith sheila.smith@vet-ai.com Tamsin Day tamsin.day@vet-ai.com Samantha Webster samantha.webster@vet-ai.com Sam Davies sam.davies@vet-ai.com Trevor Hardcastle th@vet-ai.com Adele Williams adele.williams@vet-ai.com <p>The original version of the article has been corrected, please see the full text for details of the correction.</p> 2022-06-20T00:00:00+01:00 Copyright (c) 2022 Sheila Smith, Tamsin Day, Samantha Webster, Sam Davies, Trevor Hardcastle, Adele Williams https://www.veterinaryevidence.org/index.php/ve/article/view/626 Erratum to: Should we prescribe oral metronidazole or probiotics for acute gastroenteritis in dogs? 2022-06-28T13:59:15+01:00 Emily Moore moor1662@umn.edu Wanda J Gordon-Evans wgordone@umn.edu <p>The original version of the article has been corrected, please see the full text for details of the correction.</p> 2022-06-28T00:00:00+01:00 Copyright (c) 2022 Emily Moore, Wanda J Gordon-Evans https://www.veterinaryevidence.org/index.php/ve/article/view/608 Does the use of supraglottic device in rabbits cause less injury than other airway management devices? 2022-12-02T11:09:57+00:00 Jasmine Gheini jghe8559@uni.sydney.edu.au Sanaa Zaki sanaa.zaki@sydney.edu.au <p><strong>PICO question</strong></p> <p>In rabbits, undergoing general anaesthesia, does the placement of a v-gel® device result in less airway trauma compared to the use of other airway management devices?</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 appraised, two blinded randomised experimental trial studies and one randomised crossover experimental trial study</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>One blinded randomised trial study demonstrated that the trauma to the upper airways of rabbits during anaesthesia is not significantly different between the use of v-gel® and an endotracheal tube. The other blinded randomised trial study demonstrated that the trauma to the upper airway caused by endotracheal intubation is significantly more than that caused by v-gel® placement. The randomised crossover trial study demonstrated that v-gel® placement causes more significant compression to the larynx compared to a laryngeal mask or face mask</p> <p><strong>Conclusion</strong></p> <p>The current evidence suggests that use of the v-gel® in rabbits causes less trauma / injury to the airways compared to placement of an endotracheal tube but not compared to the use of a laryngeal or face mask. However, based on the low number and quality of published studies, this evidence is weak, and better-quality studies are required to support the routine use of v-gel® over other airway devices in rabbits. While v-gel® may be a safer alternative for securing airways in rabbits compared to endotracheal intubation, knowing the injuries this device can cause to the upper airways is useful for managing rabbits during post anaesthesia recovery</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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> 2022-12-02T00:00:00+00:00 Copyright (c) 2022 Jasmine Gheini, Sanaa Zaki https://www.veterinaryevidence.org/index.php/ve/article/view/604 Impacts of Schmallenberg virus infection in early lambing sheep flocks following the second wave of virus circulation in South West England in 2012/2013: a mixed-methods descriptive study 2022-07-13T11:50:27+01:00 Michael Glover mikeglover@torchfarmvets.com Neil Blake neilblake@torchfarmvets.com Clare Phythian clare.phythian@nmbu.no <p><strong>Abstract</strong></p> <p><strong>Background</strong></p> <p>The first cases of Schmallenberg virus (SBV) infection in the UK were confirmed in congenitally malformed lambs born in South East England in January 2012. Epidemiological studies confirmed that SBV infection could have severe negative impacts on animal welfare and productivity in affected flocks of sheep (<em>Ovis aries</em>), but there was a lack of specific research on the impacts of infection on recorded reproductive performance, animal welfare, financial performance, and farmers’ emotional well-being in some of the first affected early lambing flocks in South West England in 2012 / 2013.</p> <p><strong>Objectives</strong></p> <p>This mixed methods veterinary practice-based descriptive study aimed to describe the clinical signs observed by sheep farmers in the region experiencing outbreaks of disease due to SBV for the first time; to evaluate physical records (quantitative data) on reproductive performance in early lambing flocks prior to and during the affected 2012 / 2013 production year; and to gauge farmers’ perceptions (qualitative interview data and quantitative severity scores) of the impacts of SBV infection on animal welfare, financial performance, and their emotional well-being, and risks of future outbreaks of disease and preventive strategies including SBV vaccination.</p> <p><strong>Evidentiary value</strong></p> <p>This mixed-methods descriptive study reported farmers’ detailed experiences, and recorded and perceived impacts, of SBV infection in six pedigree and purebred flocks in South West England, lambing early between November 2012 and January 2013. Previous surveys were larger than the current study and assessed the impacts of SBV at farm rather than flock level and on a more diverse range of British sheep farms lambing over extended periods; impacts were compared between three categories of farms based on laboratory confirmation or farmers’ suspicions of infection i.e. ‘SBV confirmed’, ‘SBV suspected’ and ‘SBV not suspected’. This study was able to capture and compare the reproductive performance of these flocks in the SBV affected production year in 2012 / 2013 with up to three previous unaffected years; it found variable negative effects of SBV not only on ewe and lambs losses, stillbirths and abortions, levels of dystocia and need for variable levels of assistance to deliver lambs, but also on overall flock reproductive performance, barren rate, lambing percentage and lamb rearing percentage. The qualitative elements of the study enabled new insights into the variable effects of SBV infection in flocks on ewes and lambs and on farmers’ perceptions of the impacts on animal welfare, flock financial performance and their own emotional well-being. The findings suggest previous surveys may not have fully captured the impacts of SBV infection in high value pedigree and purebred early lambing flocks infected for the first time during the second wave of virus circulation and peak midge vector activity in the southwest region in summer and autumn 2012. The findings highlight the need for further research to explore factors influencing uptake of SBV vaccination by farmers to protect flocks against future waves of infection, and to develop more rational vaccination programmes based on ‘early warning’ surveillance systems.</p> <p><strong>Methods</strong></p> <p>Face-to-face semi-structured interviews were conducted in 2013. Qualitative interview data were thematically analysed to gain an understanding of the perspectives, perceptions and lived experiences of sheep farmers. Quantitative data in the form of (i) farmers’ self-appraised severity scores of the perceived impacts on flock welfare, financial performance and their emotional well-being; and (ii) flock records of pregnancy scanning results, lambing dates, and mortality records for ewes and lambs, were collected for the SBV affected 2012/2013 production year and for up to 3 previous years for comparison.</p> <p><strong>Results</strong></p> <p>Farmers perceived generally high but widely variable negative impacts of SBV infection on animal welfare (median score: 3.5/5, range: 2–5), financial performance (median score: 3.5/5, range: 2–5) and their own well-being (median score: 4/5, range: 2–5); variation between farmers in the severity of impacts appeared not to be directly related to recorded lamb losses (of all lambs born, an overall average of 21% (range: 13.7–42.6%) were stillborn or died within 7 days; 15% (range: 4.1–42.6%) were stillborn or died due to SBV), or to reductions in lamb rearing percentage (10–38% fewer lambs reared in the affected year compared to previous reproductive performance or an industry benchmark). The qualitative elements of the study enabled new insights into the variable effects of SBV infection in flocks on ewes and lambs and on farmers’ perceptions of the impacts on animal welfare, flock financial performance and their own emotional well-being. The semi-structure interviews captured narrative descriptions of the distressing clinical signs seen in ewes and lambs, the variable levels of dystocia, and the lived experiences of farmers caring for affected sheep including the increased workload during the lambing period, greater feelings of tiredness and anxiety than in ‘normal’ lambing periods, depression, and also more positive emotions of resilience and ability to cope with an unexpected and novel disease outbreak. Three of the six farmers subsequently vaccinated with SBV vaccine to protect their early lambing flocks before the next early breeding season. Of the three farmers who decided not to vaccinate: one delayed the start of the subsequent breeding season; the second felt uncertain about using the rapidly developed and authorised vaccine so close to the start of the breeding season but was reassured by veterinary advice that the risk of a further disease outbreak in the subsequent breeding season was low as flock SBV seroprevalence was high (~90% of ewe were seropositive) following the first outbreak; and the third experienced the lowest sheep losses of the six farmers in the first outbreak and perceived the severity of the impacts to be at the lowest level, but felt uncertain about the risks of repeat infections and future disease outbreaks.</p> <p><strong>Conclusion</strong></p> <p>Severity of farmer perceived impacts of SBV infection was generally high; farmers’ detailed descriptions of their experiences during the outbreak, and perceptions of the impacts on ewe and lamb welfare, financial performance and their emotional well-being, captured during semi-structured interviews, are reported for the first time. Variation in severity of impacts appeared not to be directly related to the number and proportion of lambs stillborn or that died in the first week of life and the overall reduction in percentage of lambs reared for sale. Qualitative interview data taken together with quantitative data on recorded flock performance suggested multiple factors and variable effects of SBV in flocks were likely to have contributed to, and variably influenced, the severity of impacts perceived by farmers. Uncertainty about the safety, efficacy and use of the vaccine so close to the next early breeding season when it was first authorised in May 2013, and the risks of repeat SBV infections and future disease outbreaks for farmers who decided not to vaccinate their flocks may have added to the impact on farmers’ emotional well-being. Reductions in lamb rearing percentage appeared to be higher in flocks that artificially inseminated ewes in synchronised oestrus in July 2012 than in those that mated ewes naturally in spontaneous oestrus in June 2012. These findings are important and suggest that recorded lamb losses and reduction in rearing percentage should not be used as proxy measures of the severity of impacts of SBV infection on farmers and sheep flocks. Further outbreaks have occurred in the UK in 2016/2017 and 2021/2022 and it is expected this pattern of virus circulation and disease re-emergence will be repeated every 3–6 years. Flocks remain at-risk of future SBV infection and, in high risk flocks, of severe impacts on animal health and welfare, flock financial performance and farmers’ emotional well-being. Further research is needed to explore farmers’ future risk perceptions, uncertainty and decision-making around preventive vaccination, and to explore the potential for more rational vaccination programmes based on active arbovirus (SBV and Bluetongue virus [BTV]) surveillance systems.</p> <p><strong>Application</strong></p> <p>These findings will be of interest to all stakeholders in the sheep industry e.g. farmers, veterinarians, advisers, researchers, welfare organisations, pharmaceutical companies, the UK Government, industry levy boards and other research funding bodies. The study offers new insights into the impacts of SBV infection in sheep flocks, particularly in production systems dependent upon early breeding (so called ‘out of season breeding’) overlapping with periods of peak midge activity and circulation of SBV in which risks of high impacts appear to be greater. Other studies are needed to investigate further possible associations between variability in reproductive outcomes and factors such as breed (not reported here) and timing and method of breeding (natural mating or artificial insemination; at a spontaneous or synchronised oestrus). Research is needed to better understand farmers’ decision-making around SBV vaccination and to investigate the potential for more rational vaccination programmes based on early warning systems, such as national or Europe-wide arbovirus surveillance systems.</p> 2023-02-08T00:00:00+00:00 Copyright (c) 2023 Michael Glover, Neil Blake, Clare Phythian https://www.veterinaryevidence.org/index.php/ve/article/view/599 When treating canine diabetic ketoacidosis, do balanced crystalloids provide superior outcomes compared to 0.9% Saline? 2022-08-24T16:01:35+01:00 Sara Marella sara.marella93@gmail.com <p><strong>PICO question</strong></p> <p>When treating canine diabetic ketoacidosis, do balanced crystalloids provide superior outcomes compared to 0.9% saline?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment and prognosis</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Zero</p> <p><strong>Strength of evidence</strong></p> <p>Zero</p> <p><strong>Outcomes reported</strong></p> <p>There is currently a lack of studies looking at comparing 0.9% saline to a buffered crystalloid solution (such as Hartmann's) in dogs with diabetic ketoacidosis</p> <p><strong>Conclusion</strong></p> <p>In view of the strength of evidence and the outcomes from the analysed studies, there is currently no evidence that the use of 0.9% saline or the use of a buffered crystalloid affects the outcome in dogs with diabetic ketoacidosis</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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> 2022-08-24T00:00:00+01:00 Copyright (c) 2022 Sara Marella https://www.veterinaryevidence.org/index.php/ve/article/view/598 In dogs diagnosed with osteoarthritis, how safe and effective is long-term treatment with bedinvetmab in providing analgesia? 2022-11-30T10:29:52+00:00 Katrin Kronenberger K.Kronenberger@sms.ed.ac.uk <p><strong>PICO question</strong></p> <p>In dogs diagnosed with osteoarthritis (OA), how safe is treatment with bedinvetmab, when compared to a placebo and how effective in long-term reduction of the severity of the clinical signs associated with OA-related pain?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Two papers were critically reviewed. One was a randomised, blinded, multi-arm laboratory safety study; the other a multi-center field trial consisting of a block-randomised, double blind, placebo-controlled phase, followed by a non-comparative, open-label case series study.</p> <p><strong>Strength of evidence</strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>One study rated the reduction of the severity of clinical signs associated with OA pain using owner Canine Brief Pain Inventory (CBPI) ratings and non-validated veterinary clinical assessments (VCAs). Safety was addressed by evaluating adverse health effects (AHEs), concentration of antidrug antibodies (ADAs), and clinical pathology. Significant improvements in pain scores and VCAs were reported in this treatment study. The second safety-only study used clinical observation to evaluate AHEs. Both studies reported AHEs.</p> <p><strong>Conclusion</strong></p> <p>A single study suggests that treatment with bedinvetmab is effective. Two studies support the drug having few AHEs. Both studies have significant design limitations preventing the evaluation of bedinvetmab effectiveness. There is weak / inconclusive evidence for long-term efficacy and short-term safety of OA treatment with bedinvetmab. The decision to use bedinvetmab remains dependent on the judgement and experience of the clinician.</p> <h3><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></h3> <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> 2023-02-01T00:00:00+00:00 Copyright (c) 2023 Katrin Kronenberger https://www.veterinaryevidence.org/index.php/ve/article/view/588 Erratum to: In horses undergoing volatile anaesthesia, does intraoperative alpha-2-agonist infusion improve recovery? 2022-05-31T10:27:02+01:00 Alison Bennell bennell@liverpool.ac.uk <p>The original version of the article has been corrected, please see the full text for details of the correction.</p> 2022-05-31T00:00:00+01:00 Copyright (c) 2022 Jennifer Morris https://www.veterinaryevidence.org/index.php/ve/article/view/587 Surgical castration in dogs: does the incision approach influence postoperative recovery? 2022-10-26T10:33:08+01:00 Ariel Brunn ariel.brunn@lshtm.ac.uk <p><strong>PICO question</strong></p> <p>In male dogs undergoing surgical castration, does a pre-scrotal approach in comparison to a scrotal approach lead to a superior recovery, in terms of duration of postoperative pain and/or reduced post-operative complications?</p> <h3> </h3> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviewed</strong></p> <p>Two prospective clinical trials were critically appraised.</p> <p><strong>Strength of evidence</strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>Woodruff et al. (2015) evaluated postoperative recovery in 206 dogs following surgical castration using a scrotal incision in comparison to 231 dogs using a pre-scrotal approach. Complications observed in order of frequency, included: incisional swelling; haemorrhage; pain; and self-trauma, however, apart from self-trauma, complications were not influenced by incision location. Dogs castrated using a scrotal approach had reduced odds of self-trauma (OR: 0.51, P = 0.04, 95% CI 0.27–0.97). Moreover, mean duration of surgery was faster for the scrotal versus the pre-scrotal approach (3.6 minutes, P&lt;0.01, 95% CI 3.38–3.82 versus 5.1 minutes, 95% CI 4.86–5.41).</p> <p>Miller et al. (2018) evaluated complication rates following open or closed castration using a scrotal approach in 400 shelter dogs under the age of 6 months. Complications involving intra-operative bleeding were not observed, while marginal rates of post-operative events were reported, including peri-incisional dermatitis (2.3%), skin bruising (1.0%), and swelling (0.3%). No self-trauma or rescue analgesia was recorded. In comparing surgical time, the mean duration was 1 minute ± 0.2 minutes in dogs undergoing scrotal surgery, in comparison to canine patients undergoing the same procedure using a pre-scrotal approach, where the mean duration was 3.5 minutes ± 0.4 minutes.</p> <p><strong>Conclusion</strong></p> <p>The outcomes of these two studies imply that a scrotal incisional approach in canine castration is at least no worse in the first 24 hours than a traditional pre-scrotal approach and may also reduce mean duration of surgery. However, limitations to the evidence do not permit a firm conclusion and it also remains unclear whether these advantages persist in the longer postoperative period. Further research is needed to confirm initial findings suggested here.</p> <p> </p> <p><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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.</p> 2022-12-29T00:00:00+00:00 Copyright (c) 2022 Ariel Brunn https://www.veterinaryevidence.org/index.php/ve/article/view/585 Does the selective serotonin reuptake inhibitor (SSRI) fluoxetine modify canine anxiety related behaviour? 2022-11-23T13:36:02+00:00 Nicole Echeverri nech5972@uni.sydney.edu.au Merran Govendir merran.govendir@sydney.edu.au <p><strong>PICO question</strong></p> <p>Does administration of the selective serotonin reuptake inhibitor (SSRI) fluoxetine reduce the severity and / or frequency of some anxiety related behaviours in companion dogs, of at least 8 months of age, when compared with no pharmacological treatment?</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 studies, both randomised, were critically appraised. Each had a placebo control group and the dog's owners were blinded to the treatments</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>Both studies provide moderate evidence that fluoxetine, when dispensed at 1–2 mg/kg per day by oral administration and not involving a behavioural modification program for the patient, may reduce some behaviours associated with separation anxiety and / or compulsive disorders. Both studies indicate that a reduction in some unwanted behaviours may be observed after 1 week of fluoxetine medication. Both studies recommend that behavioural and environmental modifications are important adjuncts to pharmacologic treatment of dogs with either compulsive disorders or separation anxiety. Both studies also report that some dogs treated with fluoxetine experienced anorexia / decreased appetite and lethargy, although most of these effects were transient</p> <p><strong>Conclusion</strong></p> <p>The clinical recommendation is that fluoxetine at 1–2 mg/kg administered orally, once daily, may be beneficial in reducing the severity of some canine anxiety related behaviours</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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> 2022-11-23T00:00:00+00:00 Copyright (c) 2022 Nicole Echeverri, Merran Govendir https://www.veterinaryevidence.org/index.php/ve/article/view/584 Immune-mediated polyarthritis in dogs: Are corticosteroids the best bet? 2023-01-25T12:56:12+00:00 Hannah Walker hannah3walker@gmail.com <p><strong>PICO question</strong></p> <p>In dogs with type I immune-mediated polyarthritis (IMPA), is sole treatment with other immunosuppressive agents as effective as treatment with corticosteroids at reducing clinical signs?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment.</p> <p><strong>Number and type of study designs reviews</strong></p> <p>One pragmatic open-label randomised controlled clinical trial.</p> <p><strong>Strength of evidence</strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>In the single randomised controlled clinical trial reviewed, 7/10 (70%) of dogs in both treatment groups (prednisone or cyclosporine), were reported to have shown resolution of owner-reported symptoms, clinical symptoms and improved locomotor scores and cytologic signs of disease at the end of the 90 day trial period. Of the remaining dogs, 2/3 cyclosporine treated dogs required change to prednisone, and 2/3 prednisone treated dogs required combination therapy to achieve clinical response.</p> <p><strong>Conclusion</strong></p> <p>There is insufficient evidence to support the use of alternative immunosuppressive agents in place of corticosteroids for the treatment of IMPA type I. Further controlled clinical trials are needed before a change to clinical practice can be considered.</p> <p> </p> <h3><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></h3> <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> 2023-01-25T00:00:00+00:00 Copyright (c) 2023 Hannah Walker https://www.veterinaryevidence.org/index.php/ve/article/view/582 In horses undergoing volatile anaesthesia, is recovery quality superior with sevoflurane compared to isoflurane? 2022-08-03T12:16:15+01:00 Alexandra Robinson arr945@outlook.com Tsim Christopher Sun christopher.sun@sydney.edu.au Eduardo Uquillas eduardo.uquillas@sydney.edu.au <p><strong>PICO question</strong></p> <p>In horses undergoing volatile anaesthesia, is recovery quality superior with the use of sevoflurane compared to isoflurane during the maintenance phase?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong style="font-size: 0.875rem;">The category of research question</strong></p> <p>Treatment</p> <p><strong style="font-size: 0.875rem;">Number and type of study designs reviewed</strong></p> <p>Seven papers were available for critical appraisal. Of the seven papers, six were prospective, randomised trials and four of these were of crossover design. Of the same seven papers, three were experimental and four were clinical.</p> <p><strong><span style="font-size: 0.875rem;">Strength of</span></strong><strong style="font-size: 0.875rem;"> evidence</strong></p> <p>Moderate</p> <p><strong style="font-size: 0.875rem;">Outcomes reported</strong></p> <p>Five out of seven critically appraised articles found that there was no clinically significant improvement in recovery quality following volatile anaesthesia with sevoflurane compared to isoflurane. Two of the seven articles did find improvement in recovery quality following the use of sevoflurane over isoflurane, but both studies were of crossover design, one of these studies used non-blinded evaluators and the second study used both unblinded and blinded evaluators and a recovery quality scoring scale that did not show interobserver reliability.</p> <p><strong style="font-size: 0.875rem;">Conclusion</strong></p> <p>In healthy horses presented for elective surgical and diagnostic imaging procedures in a clinical setting, there is no significant difference in recovery quality following the use of sevoflurane or isoflurane for the maintenance phase.</p> <p> </p> <h3><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50">How to apply this evidence in practice</a></h3> <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> 2023-01-18T00:00:00+00:00 Copyright (c) 2023 Alexandra Robinson, Tsim Christopher Sun, Eduardo Uquillas Uquillas https://www.veterinaryevidence.org/index.php/ve/article/view/581 In dogs undergoing extrahepatic portosystemic shunt attenuation, does pretreatment with levetiracetam reduce postoperative seizure incidence? 2022-08-17T09:37:28+01:00 Connor Hawes connorh09@hotmail.com Kali Lazzerini kali.lazzerini@bristol.ac.uk <p><strong>PICO question</strong></p> <p>In dogs undergoing surgical attenuation of a congenital extrahepatic portosystemic shunt, does pretreatment with levetiracetam reduce the incidence of post attenuation seizures?</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>Four papers were critically reviewed. All were retrospective cohort studies</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>In one paper levetiracetam was found to reduce the risk of post-attenuation seizures. In the remaining three papers no difference was found between the frequency of post-attenuation seizures and the use of levetiracetam</p> <p><strong>Conclusion</strong></p> <p>That prophylactic levetiracetam is not indicated for the use of preventing post-attenuation seizures in dogs surgically treated for extrahepatic portosystemic shunts</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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> 2022-08-17T00:00:00+01:00 Copyright (c) 2022 Connor Hawes, Kali Lazzerini https://www.veterinaryevidence.org/index.php/ve/article/view/578 An assessment of client and clinician satisfaction in veterinary teleconsultation compared to in-person consultations 2022-07-27T09:25:12+01:00 Narakhanti Soenardi nsoenardi18@rvc.ac.uk Maxim Bembinov mbembinov18@rvc.ac.uk <p><strong>PICO question</strong></p> <p>Compared to in-person veterinary consultations, does teleconsultation lead to similar levels of client and clinician satisfaction?</p> <p>&nbsp;</p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Qualitative assessment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Eight studies were critically appraised. There were six cross-sectional studies, one randomised controlled clinical trial, and one case report</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>All eight studies provided weak evidence of similar levels of clinician and / or client satisfaction</p> <p><strong>Conclusion</strong></p> <p>Teleconsultation can lead to similar levels of client and clinician satisfaction when compared to in-person consultations. However, the evidence is weak due to the subjectivity and varied methods of measuring satisfaction. Furthermore, the current applicability of veterinary teleconsultation is still very limited to certain select scenarios in which it is appropriate (e.g., emergency, triage, remote locations, non-complicated routine postoperative checks, nutrition and behavioural consults)</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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> 2022-07-27T00:00:00+01:00 Copyright (c) 2022 Narakhanti Soenardi, Maxim Bembinov https://www.veterinaryevidence.org/index.php/ve/article/view/573 Does treatment with clomipramine reduce cat psychogenic alopecia? 2022-06-29T19:34:15+01:00 Anne-Claude Griesser ac.griesser@bluewin.ch <p><strong>PICO question</strong></p> <p>In cats with psychogenic alopecia, is overgrooming reduced by the use of clomipramine compared to untreated cats?</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>One pseudo-randomised controlled study</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>Effect of clomipramine using owner report of number, intensity, and / or duration of grooming episodes, owner reported clinical improvement, and veterinary measured alopecia, extent of tissue damage, and hair regrowth</p> <p><strong>Conclusion</strong></p> <p>The only controlled study found no evidence that clomipramine alone is effective in reducing grooming episodes, alopecia, or improved hair regrowth. Further&nbsp;research with randomised, double blind controlled trials and limitation of confounding factors is required to determine the efficacy of clomipramine alone or in addition to behavioural / environmental therapies</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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> 2022-06-29T00:00:00+01:00 Copyright (c) 2022 Anne-Claude Griesser https://www.veterinaryevidence.org/index.php/ve/article/view/569 In dogs with atopic skin disease, is lokivetmab more effective than oclacitinib in reducing the score of a recognised scoring system? 2022-06-22T10:01:40+01:00 Bonnie Yuan Tone Cheung bytc2@cam.ac.uk <p><strong>PICO question</strong></p> <p>In dogs with atopic skin disease, is lokivetmab more effective than oclacitinib in reducing the Canine Atopic Dermatitis Lesion Index score (or some other recognised scoring system)?</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>One randomised controlled trial and one before and after study were critically appraised</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>One randomised controlled trial studied the effects of lokivetmab and oclacitinib and found that both drugs were similar in reducing the Canine Atopic Dermatitis Lesion Index (CADESI-03) score.</p> <p>An additional study was evaluated but had non-standardised data as it was a before-and-after study on use of lokivetmab. The paper noted that dogs’ response to oclacitinib can be used to predict how well these dogs respond to lokivetmab. This study also reported a reduction in Pruritus Visual Analog Scale (PVAS) score between before and after lokivetmab administration</p> <p><strong>Conclusion</strong></p> <p>In view of the strength of evidence and outcomes from the studies, there is insufficient quality of evidence to answer the PICO question and so further comparative study is required</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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> 2022-06-22T00:00:00+01:00 Copyright (c) 2022 Bonnie Yuan Tone Cheung https://www.veterinaryevidence.org/index.php/ve/article/view/564 Does high-intensity laser therapy speed return to primary function in horses with suspensory ligament desmopathy? 2022-11-03T01:02:33+00:00 James Rushing J.B.Rushing@sms.ed.ac.uk <p><strong>PICO question</strong></p> <p>In horses with a suspensory ligament branch injury, does high-intensity laser therapy (energy output greater than 500 mW) combined with conservative management, compared to conservative management alone, result in a faster return to primary function?</p> <h3> </h3> <p><strong>Clinical bottom line</strong></p> <p><strong>Category research</strong></p> <p>Treatment.</p> <p><strong>Number and type of study deisgns reviewed</strong></p> <p>The number and type of study designs that were critically appraised were two peer-reviewed studies: a non-randomised controlled clinical trial and a randomised controlled experimental study.</p> <p><strong>Strength of evidence</strong></p> <p>Weak.</p> <p><strong>Outcomes reported</strong></p> <p>The outcomes reported are summarised as follows: the two appraised studies report positive effects of high-intensity laser therapy (HILT) on equine tendon and ligament injuries as measured by pain to palpation, lameness, swelling and ultrasonographic and magnetic resonance imaging (MRI) evaluation of HILT-treated lesions.</p> <p><strong>Conclusion</strong></p> <p>In view of the strength of evidence and the outcomes from the studies the following conclusion is made: the two appraised studies provide only weak evidence to show that horses treated with high-intensity laser therapy (HILT) and conservative management return to primary function sooner than horses treated with conservative management alone. Issues of design, methodology, statistical analysis and reporting reduce the reliability and external validity of these studies.</p> <p> </p> <h3><a href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></h3> <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> 2023-01-12T00:00:00+00:00 Copyright (c) 2023 James Rushing https://www.veterinaryevidence.org/index.php/ve/article/view/563 A comparison of supraglottic airway devices versus endotracheal intubation for use in rabbit anaesthesia 2022-07-06T09:33:36+01:00 Sarah Daphne Foo sfoo8590@uni.sydney.edu.au <p><strong>PICO question</strong></p> <p>In domestic rabbits undergoing anaesthesia, how does the use of supraglottic airway devices compare to endotracheal intubation for ease of use in achieving a patent airway and maintaining a stable anaesthesia?</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>Five papers were reviewed to answer this clinical question including four randomised controlled trials, one of which was a randomised crossover trial and one peer-reviewed conference proceeding</p> <p><strong>Strength of evidence</strong></p> <p>Moderate</p> <p><strong>Outcomes reported</strong></p> <p>There is evidence to support that supraglottic devices were easier and faster to insert than endotracheal tubes and were used effectively to achieve and maintain a patent airway and anaesthesia. They were however, more easily displaced and took up more space in the oral cavity. Evidence also supports endotracheal intubation can be used to effectively achieve a patent airway and maintain a stable anaesthesia however, can result in more damage to tracheal mucosa when attempted blindly and required higher doses of induction drugs to use</p> <p><strong>Conclusion</strong></p> <p>Based on current available evidence, endotracheal intubation is an excellent option for maintaining a patent airway and anaesthesia in rabbit patients as it is a tried and tested method, however, can cause tracheal damage if conducted blindly. Supraglottic airways devices can be used as an alternative where endotracheal intubation is unsuccessful. They can also be used where speed of obtaining a patent airway is imperative such as in an emergency as they may be easier and faster to apply, especially in inexperienced practitioners without the necessary equipment for safe endotracheal intubation. Supraglottic devices are unsuitable for procedures that require access to the oral cavity and / or patient movement, due to the size and easier loss of seal during movement potentiating risk of aspiration. Both supraglottic devices and endotracheal intubation are superior to face masks which evidence shows have more leakage, dead space and increased risk of hypercapnia</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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> 2022-07-06T00:00:00+01:00 Copyright (c) 2022 Sarah Daphne Foo https://www.veterinaryevidence.org/index.php/ve/article/view/562 Thank you to our 2021 reviewers 2022-01-21T15:05:15+00:00 Kit Sturgess kit.sturgess@btopenworld.com <p>As 2021 draws to a close I suspect few of us could have foreseen the past year. In the early part of the year, as COVID-19 vaccination gathered pace, like many, I was hopeful that we would be seeing coronavirus in the rear-view mirror by the end of the year ― only then to find ourselves in the midst of another wave of cases.</p> <p>Despite all the headwinds of coronavirus and the impact of working from home,&nbsp;<em>Veterinary Evidence</em>&nbsp;has continued to flourish, publishing more papers this year than last. Published papers have covered an amazing range of different topics, illustrating not just the wide diversity of questions that are being answered, but the depth and breadth of the team of reviewers that give their time to extend veterinary knowledge, supported by a dedicated group of assistant editors and staff at the journal who coordinate activity, ensure standards, and continue to develop the journal.</p> <p>As a journal,&nbsp;<em>Veterinary Evidence</em>&nbsp;is maturing with two of the main focuses this year being to further develop our internal journal systems ― which has allowed us to apply for membership of COPE (Committee on Publication Ethics) ― and work towards improving the discoverability and accessibility of our published papers. In order to achieve this, the team is working hard to redesign our current website and fulfil the criteria for inclusion in other citation databases beyond CAB Abstracts, such as Medline.</p> <p>We have been delighted this year to expand our Editorial Board ensuring, as the journal grows, we have the necessary range of skills on the Board to maintain high quality, effective reviews delivered in a timely manner. I would like to take this opportunity to thank all our reviewers and everyone who has served on the Board this year for their tireless efforts on behalf of&nbsp;<em>Veterinary Evidence</em>&nbsp;– without your support the journal could not exist. This year the Board has had three online meetings, more than ever before, which have been essential in helping develop the strategy for&nbsp;<em>Veterinary Evidence</em>&nbsp;over the coming years, expanding the influence and reach of the journal with various strategic initiatives. Other key areas have included developing our policy on standard terminology, looking at the best ways to ensure Knowledge Summaries remain current and working towards making editorial decisions as consistent as possible.</p> <p>And finally… a huge thank you to everyone who works for and supports&nbsp;<em>Veterinary Evidence</em>, wishing you all a safe and productive 2022.</p> <p>&nbsp;</p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"></p> 2022-01-21T00:00:00+00:00 Copyright (c) 2022 Kit Sturgess https://www.veterinaryevidence.org/index.php/ve/article/view/560 Do inhaled or oral glucocorticoids more effectively control feline asthma? 2022-12-07T10:22:07+00:00 Savannah Williams savannah_williams@hotmail.com <p><strong>PICO question</strong></p> <p>In cats with chronic bronchospasm and airway hypersensitivity (asthma) do oral glucocorticoids or inhaled glucocorticoids more effectively control the clinical signs?</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 prospective randomised clinical trials were appraised. Two of the studies followed a crossover design and had a control group, whilst the third study described an interrupted time series</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>The available studies deemed a reduction in eosinophilia on bronchoalveolar lavage fluid analysis, and a reduction in airway resistance as markers of treatment efficacy</p> <p><strong>Conclusion</strong></p> <p>There is weak evidence to suggest equal treatment efficacy of oral and inhaled glucocorticoid therapy for management of feline asthma. Higher powered studies would be required before a definitive recommendation can be made</p> <p>&nbsp;</p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" 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> 2022-12-07T00:00:00+00:00 Copyright (c) 2022 Savannah Williams https://www.veterinaryevidence.org/index.php/ve/article/view/553 Clinical audit of POM-V / POM prescriptions by remote consultation via a veterinary video telemedicine smartphone application 2022-06-20T10:13:38+01:00 Sheila Mary Smith sheila.smith@vet-ai.com Tamsin Day tamsin.day@vet-ai.com Samantha Georgina Webster samantha.webster@vet-ai.com Sam Davies sam.davies@vet-ai.com Trevor Peter Hardcastle th@vet-ai.com Adele Williams adele.williams@vet-ai.com <p><strong>There is an erratum to this paper published in&nbsp;<em>Veterinary Evidence</em> Vol 7, Issue 2 (2022): <a href="https://doi.org/10.18849/ve.v7i2.627" target="_blank" rel="noopener">10.18849/VE.V7I2.627</a></strong></p> <p><strong>Objective: </strong>To assess outcomes of a limited period (7 months) of remote video consultation with prescribing of prescription-only (POM) or prescription-only-veterinary (POM-V) medications by Royal College of Veterinary Surgeons (RCVS) registered veterinary surgeons to UK clients via a veterinary telemedicine smartphone application.</p> <p><strong>Background:</strong> Objective evidence is needed to inform the veterinary profession on the impact that remote prescribing, without physical examination in person, has on animal health and welfare. During the COVID-19 pandemic, the RCVS allowed remote prescribing temporarily.</p> <p><strong>Methods: </strong>Clinical records from all veterinary video consultations from 1 April–31 October 2020 were reviewed. Details were assessed pertaining to: signalment, body system / disease categories managed, referrals into practice, medication classes prescribed and outcomes following POM-V / POM medications. Records of adverse events and antimicrobial prescribing were reviewed.</p> <p><strong>Results:</strong> 16.6% (3,541/21,383) of video consults had a POM-V / POM prescribed; with a (mild) adverse event rate of 0.8% (30/3541). Antibacterials were prescribed in 5.88% of all consultations (1,258/21,383), 99.3% (1249/1258) being first line. Follow-up on prescribing was available in 67.7% (2,399/3541) of cases. 89% (2135/2399) of all known treatment outcomes were complete or had an expected response to treatment. Dermatological disease was the most common body system / disease category seen and prescribed for.</p> <p><strong>Conclusion: </strong>Low prescribing rates (including antibacterials) were recorded, treatments were efficacious and no harm was done by prescribing remotely via a veterinary video consult app.</p> <p><strong>Application:</strong> Veterinary surgeons and governing bodies are invited to use the information provided in this clinical audit to inform decisions on the suitability of remote consultations and prescribing in veterinary medicine.</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> 2022-06-08T00:00:00+01:00 Copyright (c) 2022 Sheila Mary Smith , Tamsin Day, Samantha Georgina Webster , Sam Davies, Trevor Peter Hardcastle, Adele Williams