Search

Abstract Background While limited information is available, it is possible that high or low sub-bandage pressures cause injury with external coaptation. Fiberglass casting tape is a common splinting material that is custom made for the first bandage and reused in subsequent bandage changes. The aim of this preliminary study was to determine sub-bandage pressure changes in canine hindlimbs between initial splint placement and replacement of the bandage by a different person. The hypothesis was that there would be a clinically meaningful change in sub-bandage pressures with reapplication of the splint in at least one location. Sub-bandage pressures were measured at five different anatomic locations on each of 11 canine hind limbs with dogs standing and in lateral recumbency after customizing a fiberglass lateral tarsal splint for each dog. A second clinician then reapplied the bandage, reusing the same fiberglass splint. Second bandages failed if there was a change in pressure of 20 mmHg at any location. Results Ten of 11 bandages failed (90%). All but one location failed due to increases in pressure. There were significant changes between lateral recumbency and standing pressures, but there was no consistent pattern of these changes among the dogs. Conclusion There are changes in sub-bandage pressures when the splint is reused in 90% of bandages. In addition, changes in pressure occur unpredictably when transitioning from lateral recumbency to standing. Further study of the relationship of sub-bandage pressures to bandage complications is vital to help establish safe ranges and inform bandaging improvements.

There is an erratum to this paper published in Veterinary Evidence Vol 7, Issue 2 (2022): 10.18849/VE.V7I2.626 PICO question In dogs with acute gastroenteritis, is metronidazole faster, slower, or comparable in resolving clinical signs when compared to probiotic administration? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Five studies total, all were blinded, randomised controlled trials Strength of evidence Moderate Outcomes reported The use of probiotics as a treatment for acute, uncomplicated diarrhoea in dogs may improve clinical signs faster when compared to a placebo, but showed no difference when compared directly to metronidazole. Metronidazole, when compared to a placebo, produced mixed results with one study finding that treatment with metronidazole did significantly reduce the time to resolution of diarrhoea, while another study found the difference with placebo was not significant Conclusion Based on the evidence evaluated, the use of oral metronidazole will not decrease time to resolution of clinical signs in cases of acute, uncomplicated diarrhoea in dogs when compared to probiotic administration and thus should not be a first-line treatment in such cases 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.

PICO question In dogs with congenital extrahepatic portosystemic shunts that are treated with surgical attenuation what is the persistency, frequency, severity and outcome of neurological signs when compared to dogs that are treated medically? Clinical bottom line Category of research question Prognosis The number and type of study designs reviewed Ten papers were critically reviewed Strength of evidence Weak Outcomes reported For short-term success, owners reported an overall decrease in neurological signs associated with neurological dysfunction and an increase in quality of life after the initiation of either medical management or surgical management. Surgical management has a weak association with higher mortality or severe neurological signs in the immediate postoperative period Conclusion It is challenging to make a direct comparison between medical and surgical management but, overall, both strategies seemed to decrease neurological signs in the short term. There was a lack of evidence and available data about the efficacy of each for long-term control of neurological signs 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.

PICO question In dogs with uncomplicated corneal ulcers does treatment with prophylactic antibacterial eye drops reduce the risk of secondary infection when compared to no treatment with prophylactic antibacterial eye drops? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Zero Strength of evidence Zero Outcomes reported None Conclusion There were no published papers found to address the PICO 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.

PICO question In dogs with cranial cruciate ligament disease treated non-surgically with rehabilitation, is the outcome inferior/equivalent/superior as measured by owner and/or veterinarian evaluation to dogs treated non-surgically without rehabilitation? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Four papers were critically appraised. One paper reviewed was a prospective, randomised clinical trial. The remaining three papers were retrospective cohort studies Strength of evidence Weak Outcomes reported There are no studies available that directly compare dogs managed non-surgically with and without rehabilitation following cranial cruciate ligament injury. In one study, 66% of dogs treated non-surgically with rehabilitation are reported to have successful outcomes 1 year following initiation of treatment. For dogs managed non-surgically without rehabilitation, successful outcomes varied from 19%–90% of cases among several retrospective studies Conclusion There is evidence suggesting the addition of rehabilitation to conservative therapy is beneficial, but based on the current literature, it is impossible to say whether it is superior to conservative treatment without rehabilitation How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

Objective: To evaluate the correlation between wound cosmesis and pet owner satisfaction, to determine the agreement among vet surgeons, and pet owners evaluating a surgical wound with a visual assessment score (VAS), and to determine the agreement between the VAS, a semi-quantitative score of wound inflammation, and wound width.Background: Perception of post-surgical cosmesis by human patients has been found to influence their satisfaction and perceived adequacy of vet surgeons. Due to the trend of owners anthropomorphising pets, this logic can be extended to veterinary patients. Also, there is a lack of consistent, reliable methods to evaluate cosmesis have been developed, creating the need for a scoring system that is accurate and reproducible.Evidentiary value: This was a prospective cohort study with one hundred and seven patients. This study may not change day-to-day practices, but it will bring to light for practitioners the discordance between pet owners and vet surgeons concerning attractiveness of an incision as well as overall satisfaction with a procedure.Methods: Photographs of surgical wounds were taken immediately, 2 weeks, and 8 weeks after surgery in dogs. Owners were asked to evaluate satisfaction with the procedure and attractiveness of the incision using the VAS. Photos were evaluated for cosmetic outcome by pet owner and vet surgeon evaluators with different scoring systems. The reliability of the scoring systems was evaluated using intraclass correlations and kappa statistics as appropriate.Results: Owners’ evaluation of cosmetic outcome correlated with their overall satisfaction. (r2=0.37, where r2 is the coefficient of determination, and can be used to determine what proportion of variance in one variable is predictable from the other variableThere was generally poor reliability of the subjective scoring between both vet surgeons and pet owners, and the less subjective scoring systems.Conclusion: The cosmetic outcome as judged by the owner accounted for 37% of the variability in satisfaction, that is to say that 37% of the total variation in satisfaction could be explained by the cosmetic outcome as evaluated by the owner. This suggests that wound cosmesis significantly influences clients’ satisfaction. However, the other methods of rating cosmesis evaluated in this study were unreliable.Application: The results of this study are relevant to all veterinarians in clinical practice, from general practice to tertiary referral centers. This study should be kept in mind when speaking with owners to establish pre-surgical expectations as well as mediating conflict due to a difference in opinion with regards to a surgical outcome.