In dogs with acute pancreatitis, does pre-pyloric enteral nutrition compared to total parenteral nutrition result in an improved survival rate? Treatment. One paper was critically reviewed. It was an open-label, prospective pilot study. Weak. There was no difference in outcome between the two treatments in this study. There is currently weak evidence on the effect of pre-pyloric enteral nutrition compared to total parenteral nutrition on the survival rate of dogs with acute pancreatitis.

This paper is an update to 'In Small Animal Surgery Are Alcoholic Hand Rubs Superior to Scrubbing Brushes and Antimicrobial Soap at Reducing Bacterial Counts?' by Mann (2016).Please click the link to view the original paper: https://doi.org/10.18849/ve.v1i4.51. In small animal surgery are alcoholic hand rubs superior to scrubbing brushes and antimicrobial soap at reducing bacterial counts? Prevalence. Two studies. One prospective randomised controlled trial and one clinical trial. Moderate. That alcohol hand rubs are as effective, if not more, than antimicrobial soap for presurgical hand preparation when used according to the manufacturer guidelines. Alcohol hand rubs are as effective than antimicrobial soaps at presurgical hand preparation. If human healthcare studies were included in this Knowledge Summary, the results would likely be stronger and more conclusive so this should be considered for a separate knowledges summary. There are also added benefits to using alcohol hand rubs such as saving water and quicker preparation of the surgical scrub team.

For teleost fish undergoing surgical coeliotomy, do intramuscular exogenous opioids reduce perioperative pain, compared with no analgesia? Treatment. Four studies were critically reviewed. All were randomised controlled trials, 2 with a parallel group design, and 2 with a factorial crossover group design. Moderate. The studies produced contradicting results regarding the analgesic efficacy of opioids perioperatively, with some evidence of pain alleviation when assessing behavioural parameters, but not when assessing clinical pathology or quantitative cardioventilatory data. Perioperative use of opioids for teleost fish undergoing invasive surgical procedures may reduce behavioural changes associated with pain compared with no analgesia, but there is insufficient evidence to determine if they provide adequate pain relief based on the study methodologies.

In dogs less than 18 months old with spontaneous/haematogenous bacterial septic arthritis, how effective is treatment with joint lavage and antimicrobial therapy, compared to antimicrobial therapy alone? Treatment. One case series of 5 dogs. Weak. Successful clinical outcomes were reported in patients both with and without joint lavage. No conclusions can be made regarding the impact of joint lavage on haematogenous septic arthritis in juvenile dogs as excellent outcomes were achieved in patients with and without lavage. However appropriate antibiosis continues to be pertinent with one case persistently infected when inappropriate antibiotics were selected.

In hospitalised domestic cats, does the use of hiding boxes compared to no intervention reduce fear and stress? Treatment. Five studies were critically reviewed. All five studies were defined by the researchers as randomised control trials. Moderate. Four of the five studies showed moderate evidence that hiding boxes reduce fear and stress in cats, with reduced cat stress scores (CSS) in cats given a hiding box compared to control groups. The hiding box was found more useful in aggressive cats as CSS reduced faster in these groups. Among the three studies that recorded objective physiological stress measures (e.g., temperature, salivary cortisol), two studies showed no statistically significant stress reductions between the hiding box and control groups. Only one study of these three found lower heart rates in hiding box cats, but this may have been influenced by confounding factors. There is moderate evidence suggesting that the use of hiding boxes in hospitalised cats is associated with reduced stress. The strength of the evidence is considered moderate due to varying limitations (e.g., small sample sizes) in the reviewed studies. Despite these limitations, incorporating a plastic or single-use disposable cardboard hiding box into existing feline-friendly cage environments is recommended for consideration. However, the use of a hiding box should be determined on a case-by-case basis as it may not be suitable for all patients (e.g. critical care patients requiring constant visualisation). High-standard infection control protocols should be applied to ensure the hiding box does not act as a fomite for possible infection transmission.

In dogs undergoing internal fracture fixation does the use of internal fixation and bone morphogenetic proteins (BMPs) accelerate healing compared to internal fixation alone? Treatment. Zero. Zero. There is no evidence showing that dogs undergoing fracture fixation with any internal fixation method (e.g. locking plates, dynamic compression plates) and BMPs present accelerated healing compared to internal fixation alone. In view of the absence of this evidence, it is recommended that veterinarians should base their treatment choice on their experience in internal fixation methods and BMPs usage, their available materials for the methods, the cost, the potential adverse effects, and the case-specific factors. Therefore, veterinarians should acknowledge that both methods have potential risks and complications. In dogs undergoing fracture fixation, there is no statistical evidence to support fracture fixation with internal fixation and BMPs as a method that accelerates healing compared to internal fixation alone.

All submissions to Veterinary Evidence are handled by an Associate Editor specialising in the relevant topic area. We would like to thank these volunteer veterinary professionals for their expertise and time to support the journal. Associate Editors play a central role, assessing submitted papers, guiding the peer review process, and making decision recommendations based on peer review reports. We have welcomed six new Associate Editors to the journal in recent months, and we welcome new applications to join our editorial team. Our grateful thanks also extend to our peer reviewers, who are critical in ensuring we maintain the highest standards of excellence in our published articles. In conjunction with our Editorial Board and publishing team, we have developed a new strategy for Veterinary Evidence, aiming to increase the visibility and findability of journal content and develop ways to measure real impact. We will aim to increase the volume and breadth of what we publish and expand the journal’s editorial capacity and capability to enable that. Quality remains central and we will continue to set strong standards for published content through our policies and processes, and to ensure we make the best use of the support from RCVS Knowledge, we will continually improve editorial processes and timelines to increase editorial efficiency and reduce publication timelines. We are pleased to announce that Veterinary Evidence has recently been accepted for indexing in Scopus and has also been approved for inclusion in PubMed Central. The technical work for indexing to happen is underway, and we will continue to explore options to increase journal content visibility. Knowledge Summaries guide readers through the evidence on a clinical question. To help with understanding the context of an included study, we have expanded the evidence summary sections to include the full title of the study, a link out to the original article, and a summary of the main aims. The journal continues to grow annually in terms of users and views, and in 2024 we saw a 13% increase in users and a 5% in page views. Submission to the journal also continue at a steady rate. The process for updating published Knowledge Summaries has now been agreed. The journal runs an annual report of Knowledge Summaries that have search dates (the date that the search was carried out) that are 3 to 4 years old. For that set of papers, we review the usage metrics (views, downloads, citations) and consider whether the questions remain clinically relevant. On this basis, the Editor in Chief will select the top five papers of interest under each of the main three species categories (small animal, production animal, and equine), and we will aim to publish updates of these knowledge summaries. Finally, we would like to encourage the continued submission of clinical queries and papers for consideration for publication so that the journal can continue to thrive and go from strength to strength. Professor Peter CockcroftEditor in Chief, Veterinary Evidence

In canine patients in status epilepticus, is intranasal midazolam as effective as rectal diazepam for controlling seizures? Treatment. One study was found-a multicentre randomised open-label clinical trial comparing intranasal midazolam and rectal diazepam in canine patients. Weak. The study critically appraised in this summary indicated that intranasal midazolam is effective in achieving seizure control in canine patients, with tolerable safety margins. Mild adverse effects associated with benzodiazepine administration such as sedation and drowsiness were noted, but there were no reports of serious adverse events related to the use of intranasal midazolam. Intranasal midazolam appears to be safe and effective for achieving seizure control in canine patients, both in terms of efficacy and speed of onset, and is a suitable first-line treatment option for status epilepticus, especially when intravenous access is not rapidly available. Patients should be monitored after drug administration for development of adverse effects, including sedation, sneezing, and nasal irritation. A nasal mucosal atomisation device may be used to enhance bioavailability of the drug, improving efficacy.

In female cats undergoing routine ovariohysterectomy, is using methadone, compared to buprenorphine, in the anaesthetic protocol associated with lower postoperative pain scores? Treatment. Four assessor-blinded randomised controlled trials. Moderate. Two studies found methadone to be associated with significantly lower postoperative pain scores than buprenorphine; one showed significantly different pain scores over the entire 8-hour postoperative period and one only at 10 minutes postextubation. One study found buprenorphine to be associated with lower postoperative pain scores at some time points postsurgery. One study found no significant difference in pain scores between methadone and buprenorphine. It can be concluded that using methadone in the anaesthetic protocol may provide better analgesia for cats undergoing ovariohysterectomy compared to buprenorphine. The two papers that used validated pain scoring both concluded that methadone was associated with lower pain scores at some points postoperatively. Although one of the studies concluded that buprenorphine is associated with lower postoperative pain scores, this paper provides only very weak evidence because an unvalidated pain scoring method was used. More evidence is needed to confidently recommend using one opioid over another.