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Evidence-Based Clinical Practice in Exotic Animal Medicine, An Issue of Veterinary Clinics of North America: Exotic Animal Practice, E-Book

Evidence-Based Clinical Practice in Exotic Animal Medicine, An Issue of Veterinary Clinics of North America: Exotic Animal Practice, E-Book

Nicola Di Girolamo | Alexandra L. Winter

(2017)

Additional Information

Abstract

This issue of Veterinary Clinics of North America: Exotic Animal Practice, Edited by Drs. Nicola Di Girolamo and Alexandra Winter, focuses on Evidence-Based Clinical Practice in Exotic Animal Medicine. Topics include: Why should we direct our efforts toward evidence-based practice and knowledge creation?; Practical application of evidence-based practice; Evidence-based advances in avian medicine; Evidence-based advances in reptile medicine; Evidence-based advances in rabbit medicine; Evidence-based advances in ferret medicine; Evidence-based advances in rodent medicine; Evidence-based advances in fish and aquatic animal medicine; Evidence-based analgesia in exotic animals; Evidence-based anesthesia in exotic animals; Evidence-based reptile housing and nutrition; Evidence-based rabbit housing and nutrition; Basic statistics for the exotic animal practitioner (numerical outcomes, P values, t-test, anova); Advanced statistics for the exotic animal practitioner (categorical data, logistic regression, confidence intervals); Basics of systematic review and meta-analysis for the exotic animal practitioner; Evidence-based information resources for the exotic animal practitioner; and How to report exotic animal research.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Evidence-Based ClinicalPractice in Exotic AnimalMedicine\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITORS iii
AUTHORS iii
Contents vii
Preface vii
Why Should We Direct Our Efforts Toward Evidence-Based Knowledge Creation? vii
Practical Application of Evidence-Based Practice vii
Evidence-Based Advances in Rabbit Medicine vii
Evidence-Based Advances in Ferret Medicine vii
Evidence-Based Advances in Rodent Medicine viii
Evidence-Based Advances in Avian Medicine viii
Evidence-Based Advances in Aquatic Animal Medicine viii
Evidence-Based Advances in Reptile Medicine viii
Evidence-Based Rabbit Housing and Nutrition ix
Evidence-Based Reptile Housing and Nutrition ix
Advancements in Evidence-Based Analgesia in Exotic Animals ix
Advancements in Evidence-Based Anesthesia of Exotic Animals x
Information Resources for the Exotic Animal Practitioner x
Basic Statistics for the Exotic Animal Practitioner x
Advanced Statistics for Exotic Animal Practitioners x
An Introduction to Systematic Reviews and Meta-Analyses for Exotic Animal Practitioners x
How to Report Exotic Animal Research xi
VETERINARY CLINICS OF\rNORTH AMERICA: EXOTIC\rANIMAL PRACTICE\r xii
FORTHCOMING ISSUES xii
January 2018 xii
May 2018 xii
RECENT ISSUES xii
May 2017 xii
January 2017 xii
September 2016 xii
Preface xiii
Why Should We Direct Our Efforts Toward Evidence-Based Knowledge Creation? 733
Key points 733
REFERENCES 734
Practical Application of Evidence-Based Practice 737
Key points 737
ASKING A QUESTION 738
ACQUIRING INFORMATION 738
APPRAISING THE EVIDENCE 741
Clinical Research Basics 741
Chance 743
Bias 743
Selection bias 744
Information bias 744
Confounding 745
Generalizability 746
APPLYING THE FINDINGS TO THE PATIENT 746
SUMMARY 747
REFERENCES 747
Evidence-Based Advances in Rabbit Medicine 749
Key points 749
INTRODUCTION 749
EVIDENCE-BASED ADVANCES IN DIAGNOSIS 750
Otitis 750
Laboratory Testing 750
Blood Pressure 756
EVIDENCE-BASE ADVANCES IN THERAPEUTICS 757
Antibacterial Drugs 757
Digestive Motility 757
Toxicosis 758
EVIDENCE-BASED ADVANCES IN PROGNOSIS 759
Resuscitation 759
Glucose 759
Lactate 760
Temperature 760
EVIDENCE-BASED ADVANCES IN COMMON DISORDERS 760
Liver Lobe Torsion 760
Thymoma 761
Dental Disease 762
CURRENT CONTROVERSIES AND CLINICAL TOPICS REQUIRING ADDITIONAL EVIDENCE 764
Pain Assessment 764
Probiotics 766
NEW IDEAS 766
REFERENCES 767
Evidence-Based Advances in Ferret Medicine 773
Key points 773
INTRODUCTION 773
CLINICAL EXAMINATION 773
CLINICAL PATHOLOGY 774
Coagulation 775
Urinalysis 775
Cerebrospinal Fluid 775
Ophthalmic Data 775
DIAGNOSTIC IMAGING 775
Radiograph 775
Ultrasound 778
Abdominal ultrasound 778
Echocardiography 778
SPECIFIC DISEASES 778
Adrenal Gland Disease 778
Cause 778
Epidemiology 782
Diagnosis 784
Ultrasonography 784
Hormones 784
Treatment 784
Surgical treatment 784
Medical treatment 787
Insulinoma 788
Cause 788
Epidemiology 789
Diagnosis 789
Treatment and prognosis 789
Lymphoma 791
Cause 791
Epidemiology 791
Diagnosis 792
Treatment and prognosis 792
Influence of immunohistochemistry type and mitotic index 796
Influence of extension 796
Influence of treatment 796
SUMMARY 797
REFERENCES 797
Evidence-Based Advances in Rodent Medicine 805
Key points 805
INTRODUCTION 805
EVIDENCE-BASED ADVANCES IN DIAGNOSIS 806
Diagnosis of Hyperadrenocorticism in Guinea Pigs 806
Dental imaging 807
Pituitary tumor imaging 807
Mineral Composition of Urinary Stones 808
EVIDENCE-BASED ADVANCES IN THERAPEUTICS 809
Peristalsis 809
Use of Surgical Laser Devices 809
The use of laser devices during surgery 809
Contraceptive Medications 810
Deslorelin acetate 810
EVIDENCE-BASED ADVANCES IN COMMON DISORDERS 810
Dental Disease in Guinea Pigs and Degus 810
Mammary Gland Tumors in Rats 811
CURRENT CONTROVERSIES AND CLINICAL TOPICS REQUIRING ADDITIONAL EVIDENCE 812
REFERENCES 812
Evidence-Based Advances in Avian Medicine 817
Key points 817
INTRODUCTION 817
EVIDENCE-BASED ADVANCES IN DIAGNOSIS 818
Laboratory Testing 818
Imaging 823
Cardiology and Vascular Medicine 823
Ophthalmology 824
EVIDENCE-BASED ADVANCES IN THERAPEUTICS 824
Antimicrobial Drugs 824
Antifungal Drugs 826
Cardiovascular Drugs 828
Anticonvulsant Drugs 828
Psychotropic Drugs 830
EVIDENCE-BASED ADVANCES IN COMMON DISORDERS 830
Advances in Avian Bornavirus 830
Advances in Atherosclerosis 831
Advances in Reproductive Inhibition 832
CURRENT CONTROVERSIES AND CLINICAL TOPICS REQUIRING ADDITIONAL EVIDENCE 833
Blood Glucometer Use 833
Statistical Analysis 833
NEW IDEAS 833
REFERENCES 833
Evidence-Based Advances in Aquatic Animal Medicine 839
Key points 839
INTRODUCTION 839
Evidence-Based Advances in Diagnosis 839
HEMATOLOGY AND THE INFLUENCE OF ENVIRONMENTAL PARAMETERS 840
MICROBIOLOGY 840
HISTOPATHOLOGY 840
Evidence-Based Advances in Therapeutics 840
Evidence-Based Advances in Common Disorders 844
Carp edema virus 844
Chytrid fungi in crustaceans 845
Fish nutrition: example of advances in seahorse nutrition 845
Current Controversies and Clinical Topics Requiring Additional Evidence 846
Gas bubble disease: the example of seahorses 846
Sea star wasting disease and densovirus 847
Antinociception in fish and aquatic invertebrates 847
New Ideas 850
Oncologic treatments 850
Fish euthanasia ethics 850
SUMMARY 850
REFERENCES 850
Evidence-Based Advances in Reptile Medicine 857
Key points 857
INTRODUCTION 857
EVIDENCE-BASED ADVANCES IN DIAGNOSTICS 858
EVIDENCE-BASED ADVANCES IN THERAPEUTICS 860
Rehydrating Reptiles 860
Novel Forms of Treatment 861
EVIDENCE-BASED ADVANCES IN COMMON DISORDERS 862
Secondary Nutritional Hyperparathyroidism/Hypovitaminosis D 862
Infectious Diseases 863
CURRENT CONTROVERSIES 865
NEW IDEAS 866
SUMMARY 867
REFERENCES 867
Evidence-Based Rabbit Housing and Nutrition 871
Key points 871
HOUSING 872
Climate 872
Space and Structure 872
Sociality 873
Enrichment 873
Other Aspects of Housing 874
WATER PROVISION 874
NUTRITION 874
Digestive Tract Physiology 874
General Recommendations 875
The Relevance of a High-Fiber Diet 875
Forage Feeding 876
Fresh Food: Green Leafy Vegetables Versus Fruits 877
Pelleted/Extruded Complete Feeds Versus “Rabbit Mixes” 877
Specific Issues Related to Rabbit Nutrition 878
Diet transitions 878
Tooth wear and overgrowth 878
Calcium metabolism and urolithiasis 879
Obesity 879
REFERENCES 879
Evidence-Based Reptile Housing and Nutrition 885
Key points 885
INTRODUCTION 885
HOUSING AND LIGHTING 885
HOUSING AND ENVIRONMENTAL ENRICHMENT 887
HOUSING AND TEMPERATURE 888
EVIDENCE-BASED INFORMATION ON DISEASES RELATED TO HOUSING CONDITIONS 889
NUTRITION 889
Evidence-Based Information on Nutrition 889
Herbivorous species 889
Insectivorous species 890
Carnivorous species 891
CURRENT CONTROVERSIES AND CLINICAL TOPICS REQUIRING ADDITIONAL EVIDENCE 891
NEW IDEAS 891
REFERENCES 892
Advancements in Evidence-Based Analgesia in Exotic Animals 899
Key points 899
INTRODUCTION 899
ANALGESIC DRUG CATEGORIES 900
Opioids 900
Nonsteroidal Anti-inflammatory Drugs 904
Local Anesthetics 904
ANALGESIC THERAPY: SPECIES-SPECIFIC ADVANCES 905
Avians 905
Small Mammals 908
Reptiles and Amphibians 909
SUMMARY 911
REFERENCES 911
Advancements in Evidence-Based Anesthesia of Exotic Animals 917
Key points 917
INTRODUCTION 917
ADVANCES IN ANESTHETIC PHARMACOLOGY 918
Avian 918
Small Mammal 921
Reptile and Amphibian 922
RECENT ADVANCES IN ANESTHETIC PHYSIOLOGY AND MONITORING 923
Temperature Monitoring 923
Lung Volume and Body Position 924
Tracheal Intubation in Birds 924
Blood Pressure 925
SUMMARY 925
REFERENCES 925
Information Resources for the Exotic Animal Practitioner 929
Key points 929
INTRODUCTION 929
What Sources Do Veterinarians Use to Find Information? 929
Do Veterinarians Feel There Is Information Available on Exotic Animals? 930
EVIDENCE-BASED INFORMATION RESOURCES 930
What Are Evidence-Based Information Resources? 930
What Are the Barriers to Finding and Using Evidence-Based Information Resources? 931
CHOOSING AN EVIDENCE-BASED INFORMATION RESOURCE 932
What Resources Do You Have Access to? 932
Where, or by Whom, Is Information About Your Question Likely to Be Published? 932
BIBLIOGRAPHIC DATABASES 934
Step 1: Develop a Focused Clinical Question 934
Step 2: Identify the Key Concepts of Your Question 939
Step 3: Generate a List of Keywords and Standardized Terms to Describe Each Concept 939
Step 4: Search Each Concept Separately, Then Combine Using AND, OR, and NOT 940
Step 5: Apply Filters to Limit Results 943
Tips for Finding Exotic Animal Literature in a Bibliographic Database 943
Include terms for related species 944
Check the controlled vocabulary terms applied to an article 944
View similar or related articles 944
View citing and cited articles 944
Restrict your search to a specific journal 944
OTHER RESOURCES 944
Google Scholar 944
Veterinary Information Network 944
SUMMARY 945
REFERENCES 945
Basic Statistics for the Exotic Animal Practitioner 947
Key points 947
DESCRIPTIVE STATISTICS 948
Central Tendency: Numbers that Describe the Middle of the Data Set 948
Variability: Spread of the Data Around the Central Value 948
Descriptive Statistics in Study Results 950
Limitations of Descriptive Statistics 950
INFERENTIAL STATISTICS 951
Classical Hypothesis Testing 951
P Values 952
Test Procedures 952
Common Parametric Tests of Hypotheses 953
Common Nonparametric Tests of Hypotheses 954
Common Hypothesis Tests for Categorical Data 955
Inferential Statistics in Study Results 956
Limitations of Hypothesis Testing 957
CONFIDENCE INTERVALS 957
SUMMARY 958
REFERENCES 958
Advanced Statistics for Exotic Animal Practitioners 961
Key points 961
VISUALISING THE RELATIONSHIP BETWEEN 2 VARIABLES 961
CORRELATION 962
SIMPLE LINEAR REGRESSION 964
Binary and Categorical Variables 966
Assumptions of Linear Regression 967
MULTIPLE REGRESSION 968
Multicollinearity 969
Overfitting 969
LOGISTIC REGRESSION 969
Odds Ratios 970
Logistic Regression in Practice: Interpreting Model Parameters 970
Estimating a Logistic Regression Model 971
Overall Model Fit and Model Assumptions 971
SUMMARY 971
REFERENCES 971
An Introduction to Systematic Reviews and Meta-Analyses for Exotic Animal Practitioners 973
Key points 973
CHARACTERISTICS OF SYSTEMATIC REVIEWS AND META-ANALYSES 973
Introduction 973
Systematic Reviews Versus Narrative Reviews 974
Why Systematic Reviews Are Important and for Whom 974
Types of Systematic Reviews in the Health Care Sciences 976
What Are Meta-Analyses, Why They Are Important, and for Whom 976
Criteria for Conducting Meta-Analyses 976
Limitations of Systematic Reviews and Meta-Analyses 981
DEVELOPING, CONDUCTING, AND REPORTING OF SYSTEMATIC REVIEWS AND META-ANALYSES 981
Phase 1. Preparing of the Review 981
The review team 981
Prioritizing research questions 981
Formulating research questions and defining eligibility criteria 981
Assessing the need for undertaking a systematic review 982
Sponsors of systematic reviews 983
Phase 2: Developing, Registering, and Publishing the Systematic Review Protocol 983
Rationale for developing a review protocol 983
Rationale for registering and publishing a review protocol 983
Developing and reporting of a review protocol 983
The review questions and the eligibility criteria 984
Information sources 984
Search strategy 984
Study records and data items 984
Outcomes and prioritization 985
Risk of bias individual studies 985
Data synthesis 985
Meta-biases 985
Confidence in cumulative estimate 986
Phase 3. Undertaking the Systematic Review Process 989
Phase 4. Reporting of the Systematic Review 990
APPLYING THE FINDINGS OF A SYSTEMATIC REVIEW TO INDIVIDUAL PATIENTS 990
SUMMARY 991
REFERENCES 991
How to Report Exotic Animal Research 997
Key points 997
IMPROVING THE REPORTING OF RESEARCH: THE USE OF REPORTING GUIDELINES 998
TITLE 998
ABSTRACT 999
INTRODUCTION 999
METHODS 1000
Study Design 1000
Primary and Secondary Outcomes 1000
Power Calculation 1002
Randomization Procedures 1003
Allocation Concealment 1004
BLINDING 1004
Blinding of Participants/Owners 1005
Blinding of Personnel 1005
Blinding of Outcome Assessors 1005
RESULTS 1006
Participant Flow 1006
Main Results: Use of Effect Size Estimation Methods 1006
Diagnostic accuracy studies 1006
Other Results: Subgroup and Sensitivity Analyses 1008
DISCUSSION 1008
SUMMARY 1009
REFERENCES 1009