Evidence‐Based Medicine in Canine Reproduction: Quality of Current Available Literature

The objective of this study was to evaluate the quality of published literature on reproduction in dogs. A systematic search in online databases revealed 287 papers that met the inclusion criteria. For evaluation a questionnaire comprising 40 criteria regarding materials and methodology, study design, statistics, presentation and information content, applicability and conclusions was developed. In a pre‐test including seven independent scientists the applicability and explanatory power of the questionnaire and its results were validated. Out of 287 publications evaluated, 90 (31.4%) were classified as clinical trials. The remaining 197 publications were case reports or contained information based on personal experience. Not a single meta‐analysis was found. Sixty (66.7%) of the 90 clinical trials included a control group. Randomization was conducted in 23 and blinding in eight articles respectively. In total five articles were determined as randomized, controlled and blinded clinical trials. Information content of the publications was variable concerning details on included animals, type or dosage of used remedies or conducted interventions. For example, in 99.7% of the articles, the exact number of animals was given, but in 79.8%, housing and feeding of the animals were not described. Statistical procedures of clinical trials were determined adequate in 55.6%. However, the data of 67.9% of the articles were evaluated to be not sufficient to draw valid conclusions. This study revealed evidence of deficits in the field of canine reproduction. The demand for more high quality clinical research is obvious. Requisite for the further implementation of the evidence‐based veterinary medicine is an improvement of the quantity and the quality of well‐designed, conducted and reported clinical trials. The practitioner should always assess the quality of information before implementing results into practice to provide best available care for the animals.     

Evidence-based complementary and alternative veterinary medicine--a contradiction in terms?

Complementary and Alternative Medicine (CAM) like acupuncture, herbal medicine and homeopathy is increasingly used in the treatment of human and animal disease. On the other hand, CAM is discussed controversially, especially in the context of Evidence-Based Veterinary Medicine (EBVM). This paper provides a balanced analysis of the currently available data on CAM in human and veterinary medicine. In conclusion, little rigorous research data concerning the efficacy and safety of CAM has been published. However, acupuncture is gaining increasing acceptance in academic medicine, based on several metaanalyses that show efficacy for specific conditions. In practice, decisions concerning CAM therapies should also be based on the best available evidence provided by scientifically valid data. This implies that CAM interventions must be validated by stringent high quality research to obtain an objective and replicable overview of efficacy and safety. Nevertheless, trials should be designed according to important aspects of CAM therapies (e.g. individual treatment). In conclusion, Evidence-Based Alternative Veterinary Medicine is not a contradiction in terms.     

Pathology of traumatic brain injury

Although traumatic brain injury (TBI) is frequently encountered in veterinary practice in companion animals, livestock and horses, inflicted head injury is a common method of euthanasia in domestic livestock, and malicious head trauma can lead to forensic investigation, the pathology of TBI has generally received little attention in the veterinary literature. This review highlights the pathology and pathogenesis of cerebral lesions produced by blunt, non-missile and penetrating, missile head injuries as an aid to the more accurate diagnosis of neurotrauma cases. If more cases of TBI in animals that result in fatality or euthanasia are subjected to rigorous neuropathological examination, this will lead to a better understanding of the nature and development of brain lesions in these species, rather than extrapolating data from human studies.     

中兽药在畜牧业生产中的应用概况

中兽药以其绿色天然、安全无污染、且兼有营养和药用双重作用而深受人们青睐。为在畜牧业中安全有效地使用中兽药,以达到既能降低畜禽饲养成本、提高畜禽养殖的经济效益和畜禽产品安全性又能降低养殖业对环境的污染以维持畜牧业可持续发展的目的。论文在论述中兽药具有毒性低、无残留、无毒副作用和不产生抗药性等作用特点的基础上,着重就中兽药在畜牧生产中,包括在预防和治疗畜禽疾病方面、在畜禽免疫调节和抗应激方面、在提高畜禽的生产性能方面、在改善畜产品品质等方面的应用及中兽药制剂的开发前景等进行了较为详尽地综述。     

The Effectiveness of Coxiella burnetii Vaccines in Occupationally Exposed Populations: A Systematic Review and Meta‐Analysis

To estimate the effect of vaccination in preventing acute Q fever in individuals occupationally exposed to Coxiella burnetii, a systematic review and meta‐analysis were undertaken in controlled trials and observational studies. Publications were obtained through a scoping study of English and non‐English articles, and those reporting a commercially licensed or licensable vaccine compared with an unvaccinated or placebo control group were included in the review. Two authors performed independent assessment of risk of systematic error and data extraction. One controlled trial and five cohort publications met the inclusion criteria. All trials used a Henzerling phase I vaccine. A random‐effects meta‐analysis estimated significant protection in abattoir workers (RR = 0.07; 95% confidence interval [CI] 0.02–0.22) compared with the control individuals. In individuals with rare or sporadic contact with the abattoir, a significant benefit of vaccination was also found (RR = 0.06; 95% CI 0–0.93). Overall, the vaccine effectively prevented acute Q fever in individuals responsible for handling animals or their products and those working in the abattoir but not directly exposed to animals (RR = 0.06; 95% CI 0.02–0.18). Caution must be taken when interpreting the effect of C. burnetii vaccination as significant heterogeneity amongst publications was observed. A meta‐regression found no significant univariate associations. This may reflect the uncertainty provided by reported data in the cohort publications. Potential systematic biases were present in the publications, and evidence included may not be sufficiently robust to extrapolate the effect of vaccination on occupationally exposed groups beyond the population of abattoir employees in Australia where all included studies occurred.     

Does the taking of biopsies affect the metastatic potential of tumours? A systematic review of reports on veterinary and human cases and animal models

Clinicians and pathologists are sporadically asked by owners whether the taking of tumour biopsies may affect the behaviour of the tumour, including its potential to metastasise. Unfortunately, systematic studies on this subject are unavailable in veterinary medicine, and the aim of this study was to estimate the risk of adverse effects of biopsy taking on tumour progression in animals. A systematic review of veterinary and human case reports and clinical studies as well as experimental animal models of biopsy-induced tumour metastasis was undertaken. There were only two veterinary case reports of needle tract metastases (NTM) following the taking of needle biopsies from urogenital and pulmonary tumours. Seventeen experimental studies found a high incidence of NTM but only a rat osteosarcoma and a hamster squamous carcinoma model showed an increased incidence of distant or regional metastases after incision or excision biopsy. In human medicine, the occurrence of NTM has been reported after the taking of biopsies from mesotheliomas (15%), melanomas (11%) and gall bladder tumours (11%), liver metastases of colon carcinomas (4%) and mammary carcinomas (4%) but an incidence of only <1% for all other tumours. Circulating tumour cells increased immediately after the taking of biopsies from human squamous cell, prostate, breast and hepatocellular carcinomas. Although no increased risk of biopsy-induced distant metastasis has been reported for any type of tumour, this is inconclusive due to a lack of non-biopsied control groups in human studies. Reports of biopsy-induced metastasis in animal tumours indicate that the taking of transcutaneous biopsies from urogenital tumours may be associated with a risk of NTM. However, there is no evidence of a general increase in risk of distant metastases in any tumour type in people or animals. The overall risk therefore appears to be negligible when compared to the valuable information obtained from biopsies in veterinary practice.     

Systematic review of comparative studies examining alternatives to the harmful use of animals in biomedical education

OBJECTIVE: To systematically review the published literature for controlled studies comparing learning outcomes of traditional methods that require the terminal use of animals (eg, dissection, live-animal surgery, and live-animal laboratory demonstrations) with outcomes obtained with alternative teaching methods. DESIGN: Systematic review. STUDY POPULATION: Controlled studies published between 1996 and 2004. PROCEDURES: PubMed was searched with the following keywords, used alone and in combination: educational alternatives, nonlethal teaching methods, veterinary alternatives, medical education, and nonterminal animal use. Cited references of retrieved reports were reviewed to identify additional reports. Reports were selected for review only if a comparison group was included. RESULTS: 17 studies that were randomized controlled trials or nonrandomized trials that included a comparison group were identified. Five involved veterinary students, 3 involved medical students, 6 involved university undergraduate students, and 3 involved high school biology students. Sample size ranged from 14 to 283 students. Eleven studies appeared to be randomized, parallel-group trials, 4 involved comparative groups to which participants were not randomly assigned or for which the randomization process was not clear, 1 was a 2-period crossover study, and 1 involved a retrospective review of grades. In all 17 studies reviewed, results associated with the alternative method of instruction were not significantly different from or superior to results associated with the conventional method. CONCLUSIONS AND CLINICAL RELEVANCE: Although the number of controlled studies identified was small, the results seem to support more widespread adoption of alternative teaching methods in biomedical education.     

Veterinary Neurologic Rehabilitation: The Rationale for a Comprehensive Approach

The increase in client willingness to pursue surgical procedures, the heightened perceived value of veterinary patients, and the desire to provide comprehensive medical care have driven the recent demand of using an integrative treatment approach in veterinary rehabilitation. Physical therapy following neurologic injury has been the standard of care in human medicine for decades, whereas similar rehabilitation techniques have only recently been adapted and utilized in veterinary medicine. Spinal cord injury is the most common neurologic disease currently addressed by veterinary rehabilitation specialists and will be the primary focus of this review; however, research in other neurologic conditions will also be discussed. Of particular interest, to clients and veterinarians are techniques and modalities used to promote functional recovery after neurologic injury, which can mean the difference between life and death for many veterinary patients.The trend in human neurologic rehabilitation, often regardless of etiology, is a multimodal approach to therapy. Evidence supports faster and improved recoveries in people after neurologic injury using a combination of rehabilitation techniques. Although the primary neurological disorders researched tend to be spinal cord injury, peripheral neuropathies, allodynia, multiple sclerosis, and strokes—many correlations can be made to common veterinary neurological disorders. Such comprehensive protocols entail gait training activities in combination with neuromuscular electrical stimulation and directed exercises. Additionally, pain-relieving and functional benefits are bolstered when acupuncture is used in addition to rehabilitation. Studies, both laboratory and clinical, support the use of acupuncture in the management of neurologic conditions in small animals, specifically in cases of intervertebral disc disease, other myelopathies, and neuropathic pain conditions. Acupuncture’s ability to promote analgesia, stimulate trophic factors, and decrease inflammation, including neuroinflammation, make it an alluring adjunct therapy after neurologic injury.Although there is limited research in veterinary medicine on physical techniques that expedite recovery after neurologic injury, there are sparse publications on clinical veterinary research suggesting the benefits of acupuncture, rehabilitation, and LASER in dogs with intervertebral disk disease. Accordingly, due to the relative lack of evidence-based studies in veterinary neurologic rehabilitation, much of the data available is human or laboratory-animal based, however, evidence supports the utilization of an early, comprehensive treatment protocol for optimal neurologic recovery. The rationale for why an integrative approach is critical will be detailed in this review; in addition, literature on specific physical rehabilitation techniques that have evidence of improved recoveries after neurologic injury, will be addressed.     

Mathematical modeling and simulation in animal health – Part II: principles,methods, applications,and value of physiologically based pharmacokinetic modeling in veterinary medicine and food safety assessment

This review provides a tutorial for individuals interested in quantitative veterinary pharmacology and toxicology and offers a basis for establishing guidelines for physiologically based pharmacokinetic (PBPK) model development and application in veterinary medicine. This is important as the application of PBPK modeling in veterinary medicine has evolved over the past two decades. PBPK models can be used to predict drug tissue residues and withdrawal times in food‐producing animals, to estimate chemical concentrations at the site of action and target organ toxicity to aid risk assessment of environmental contaminants and/or drugs in both domestic animals and wildlife, as well as to help design therapeutic regimens for veterinary drugs. This review provides a comprehensive summary of PBPK modeling principles, model development methodology, and the current applications in veterinary medicine, with a focus on predictions of drug tissue residues and withdrawal times in food‐producing animals. The advantages and disadvantages of PBPK modeling compared to other pharmacokinetic modeling approaches (i.e., classical compartmental/noncompartmental modeling, nonlinear mixed‐effects modeling, and interspecies allometric scaling) are further presented. The review finally discusses contemporary challenges and our perspectives on model documentation, evaluation criteria, quality improvement, and offers solutions to increase model acceptance and applications in veterinary pharmacology and toxicology.     

Acupuncture: clinical trials in the horse.

A discussion of the merits of acupuncture therapy and a review of experiments that support the neurogenic mediation of acupuncture are presented. Case reports are included as examples of the therapeutic value of acupuncture in treatment of intestinal and musculoskeletal disorders in the horse. Statistical importance cannot be credited to the clinical experiences reported here because of the small number of cases. Hopefully, the clinical success reported will encourage continued investigation of the clinical efficacy and adjunctive value of acupuncture in the veterinary profession.     

Conduct,Oversight, and Ethical Considerations of Clinical Trials in Companion Animals with Cancer: Report of a Workshop on Best Practice Recommendations

Development of effective and safe treatments for companion animals with cancer requires the collaboration of numerous animal health professionals and the full engagement of animal owners. Establishing ‘Best Practice Recommendations’ for clinical trials in veterinary oncology represents an important step toward meeting the goal of rigorous clinical trial design and conduct that is required to establish valid evidence. Likewise, optimizing patient welfare and owner education and advocacy is crucial to meet the unique ethical obligations to both owners and animals enrolled in these clinical trials and to ensure trust in the team conducting the research. To date, ‘Best Practice Recommendations’ for clinical trial conduct have not been reported for veterinary oncology. This document summarizes the consensus of a workshop held in November, 2014 to identify relevant ethical principles and to ensure responsible conduct of clinical research in companion animals with cancer. It is intended as a working document that will be updated as advances in science and ethical considerations require. To the extent possible, existing guidelines for the conduct and oversight of clinical trials in humans have been adapted for veterinary trials to avoid duplicative effort and to facilitate integration of clinical trials such that translational research with benefits for both companion animals and humans are encouraged.     

我国循证兽医学的应用现状与发展方向

循证兽医学是循证医学的一个分支或单独的学科。对于不同患病个体,它是依据现有的证据,进行认真有效的诊断,可以认为是一种个性化诊疗。循证兽医学在国内属于一个比较新的兽医学研究领域,目前,对于循证兽医学的研究很少。在国外,循证兽医学研究较国内更为完善,并呈逐渐上升的发展趋势。循证兽医学在临床中的应用,主要依据现有临床证据、研究数据等。然而,对于兽医临床证据的缺乏是限制我国循证兽医学发展的主要因素之一。在一定程度上,目前国内兽医学研究的不足与缺陷制约了循证兽医学的发展。从今后的发展趋势来看,循证兽医学势必成为兽医学研究领域中不可或缺的一部分。     

Acupuncture and traditional Chinese veterinary medicine for treatment of a mare with rectal paralysis

An 8‐year‐old Appaloosa mare with rectal paralysis due to a cosmetic ethanol ‘tail block’ was treated with traditional Chinese veterinary medicine treatments including acupuncture and herbal medicine. Her rectal and tail tone gradually improved after the treatment. At 4 months after initial presentation, the mare was able to produce faecal piles on a regular basis, and manual evacuations were no longer needed. Significant improvement was within 30 days of beginning treatment. At 8 months, the owner indicated that the mare had normal defaecation, was able to swish the tail from side to side and lift the tail to urinate, and had no evidence of straining to defaecate or colic.     

基于文献计量分析的我国黄芪、当归、党参在畜牧与动物医学领域的研究

目的：了解国内黄芪、当归、党参等3类中草药在＂畜牧与动物医学＂领域的研究状况,为后续研究提供参考。方法：运用文献计量学与计算机统计分析的研究方法,以国内3种中草药在＂畜牧与动物医学＂领域研究的期刊文献为样本,进行文献学特征、文献主题内容的分析与研究。结果：当归是3种中草药中＂畜牧与动物医学＂领域研究最早、时间跨度最大的中药材;3种中草药的主要饲喂或治疗对象有鸡、猪、牛、鼠、犬等;主要饲喂或用药类型有单药、组方、提取物、注射液、散剂、汤剂等;主要对症有增强免疫机能、生长性能、生产性能、治疗前胃疾病等。结论：在国内,高校是3种中草药＂畜牧与动物医学＂领域研究最主要机构,3种中草药在＂畜牧与动物医学＂领域应用范围较广、应用技术日趋成熟,普遍遵循着扶正祛邪、调节阴阳平衡的中兽医治疗原则。     

Use and abuse of pyrethrins and synthetic pyrethroids in veterinary medicine

Pyrethrin and pyrethroid insecticides are widely used in veterinary medicine for agricultural and domestic purposes. Although pyrethrins and pyrethroids are generally regarded as safe to animals, there have been reports of systemic poisoning in veterinary species. This review summarises the use of pyrethrins and pyrethroids in companion and food producing animals, including their mechanism of action and toxicity. The toxicokinetics of pyrethrins and pyrethroids are described, including absorption, distribution, metabolism (including interactions with other compounds affecting drug metabolising enzymes) and excretion, leading to the application of toxicokinetic/toxicodynamic concepts. Specific cases of pyrethroid poisoning in laboratory animals (including age-related toxicity), fish, companion and large animals are considered, including the high incidence of feline pyrethroids toxicosis following the extra-label use of topical formulations.     

Thromboelastography: a tool for measuring hypercoagulability, hypocoagulability, and fibrinolysis

Objective: To describe the technique of thromboelastography (TEG) and review the applications of this coagulation test in humans and small animals. Data sources: Data sources included scientific reviews and original research publications. Human data synthesis: TEG in humans has been used for documentation of hypercoagulable and hypocoagulable states and has been shown to be beneficial in patient management. Veterinary data synthesis: Clinical evaluation of TEG in veterinary medicine is limited; however, recent reports have documented evidence of hypercoagulability in dogs with parvovirus and protein‐losing nephropathy. Additionally, many of the research models may be relevant to veterinary patients. Conclusions: TEG provides information about coagulation that is not available through routine coagulation tests. The application of TEG monitoring to veterinary patients shows promise; however, prospective clinical studies are needed.     

Helium‐oxygen gas‐carrier mixture (heliox): a review of physics and potential applications in veterinary medicine

Background – To review the physics of helium with regard to airway physiology, as well as known human and potential veterinary applications of administration of inhaled helium‐oxygen gas‐carrier mixture (heliox). Data Sources – Human and veterinary studies. Human Data Synthesis – Helium‐oxygen mixtures have been used in human medicine for over 70 years as an adjunct therapy in various upper and lower respiratory disorders. Helium's low density promotes laminar flow through partially obstructed airways, resulting in a decreased work of breathing. Veterinary Data Synthesis – Little to no evidence‐based medicine exists to support or oppose the use of heliox in veterinary species. However, domestic animal species and humans share several common pathophysiologic aspects of various obstructive airway disorders. Thus, veterinary patients may also ultimately and significantly benefit from this novel therapy. Conclusion – Prospective studies are needed in veterinary medicine to determine the utility of heliox in clinical scenarios.     

Comparative clinical science: The medicine of the future

This review explores the emergence of Comparative Medicine in the late 19th Century as 'the medicine of the future', its failure to realise these expectations during the 20th century as it became increasingly equated with laboratory animal models of human disease, and explains why there is now an unprecedented opportunity for this latent potential to be fully realised. Comparative medicine no longer rests on apparent similarities between disease mechanisms in different species but on the rapidly maturing ability to relate these similarities to a remarkably rich shared genetic heritage. In the United Kingdom, the creation of the new Medical Research Council Comparative Clinical Science Panel, once securely funded, will provide the infrastructure and strategic focus to foster comparative clinical research, encouraging collaboration between veterinary and human medicine and between investigators in institutes and in practice. This will generate the necessary evidence base for veterinary practice, raise the standard of veterinary research, broaden the horizons of human medicine and create real opportunities for veterinary surgeons to reconcile research with practice. The review explores the broad scope of the science which will flourish in this new environment and examines specific areas in greater depth as examples, notably multifactorial disease such as hypertension and diarrhoea, also aspects of comparative endocrinology and oncology, with emphasis on the growing power conferred by comparative molecular genetics.     

Cardiac troponins

Objective: To review the use of cardiac troponins as biomarkers for myocardial injury in human and veterinary medicine. Data sources: Data sources included scientific reviews and original research publications. Human data synthesis: Cardiac troponins have been extensively studied in human medicine. Finding an elevated cardiac troponin level carries important diagnostic and prognostic information for humans with cardiovascular disease. Troponin assays are used primarily to diagnose acute myocardial infarction in patients with ischemic symptoms such as chest pain. However, elevated blood levels may be found with any cause of myocardial injury. Veterinary data synthesis: Several studies have shown that cardiac troponins are sensitive and specific for myocardial damage in veterinary patients and may have utility in diagnosis and prognosis for certain disease states. Human assays may be used in most animals due to significant homology in the troponin proteins between species. Conclusions: Cardiac troponins are sensitive and specific markers of myocardial injury although they do not give any information regarding the mechanism of injury. They have redefined how acute myocardial infarction is diagnosed in humans. Their use in the clinical management of veterinary patients is limited at this time. Further prospective studies are warranted.     

Prospects for Plant Anthelmintics in Tropical Veterinary Medicine

Hammond, J.A., Fielding, D. and Bishop, S.C., 1997. Prospects for plant anthelmintics in tropical veterinary medicine. Veterinary Research Communications, 21 (3), 213-228The current use of anthelmintic plants in tropical veterinary medicine is reviewed and attention is drawn to the lack of scientific evidence for the effectiveness of many now in use. The case for anthelmintic plants as a means of overcoming some of the serious limitations of manufactured anthelmintics is outlined. Reasons why anthelmintic plants are not generally used in veterinary medicine, in contrast to their greater acceptance in human medicine, are considered. Strategies for their development and use are discussed, in particular the need for in vivo trials to identify those plants which are effective and suitable for general use: attention is drawn to possible candidates, including pyrethrum and papaya latex. Those helminths of most economic importance should be targeted first. Anthelmintic plants offer a traditional alternative to manufactured anthelmintics that is both sustainable and environmentally acceptable. Such plants could have a more important role in the future control of helminth infections in the tropics.