Determination of reference intervals for nonesterified fatty acids in the blood serum of healthy dogs.

Background: Nonesterified fatty acids (NEFAs) are an important energy substrate in mammals. Measurement of the NEFA concentration in blood serum is common practice and enables reliable detection of a negative energy balance in several species. This parameter can be used to detect subclinical metabolic diseases or to optimise feeding to prevent severe negative energy balance. Since no reference values for dogs have been published, the aim of this study was to establish such values. Methods: Blood serum from 85 healthy dogs was examined with a multiparameter clinical chemistry analyser. Given that NEFA values are not usually normally distributed, reference intervals (RIs) were calculated nonparametrically using bootstrapping (5000 replicates) for the 90% confidence intervals. Results: The examined cohort had a median age of 62.16 months (2-180 months) and a median weight of 19.2 kg (3.0-55.0 kg) and comprised 27 (31.8%) males and 58 (68.2%) females, with 32 (37.6%) neutered or spayed. The fasting time was 5.9 h (range 0-23 h). The tested confounders age, sex, neuter status, bodyweight and body condition score did not significantly affect the NEFA concentrations. Conclusions: The NEFA RI for dogs in this study was 0.2-1.47 mmol/L. The results may be used to adjust food composition and amount in healthy dogs or to detect metabolic disorders. Further research on NEFA metabolism in dogs maintained in standardised conditions and in specific nutritional situations or with particular diseases is warranted.

Progesterone Concentrations during Canine Pregnancy.

Pregnancy and lactation are amongst the most challenging times of a bitch's life. Most studies focusing on the endocrinological aspect of pregnancy consider only a small number of animals. The aim of this study was to evaluate progesterone (P4) concentrations in a large number of bitches during early, mid and late pregnancy. In total, 126 bitches of various breeds were recruited following a thorough clinical and gynecological examination during estrus. Blood samples were collected three times (T1-T3) during pregnancy or from non-pregnant dogs in diestrus, and P4 was measured via chemiluminescence. At T1 (11-19 days post-ovulation (dpo)), serum P4 concentrations were 30.23 ± 6.65 ng/mL and 28.45 ± 6.26 ng/mL, at T2 (23-32 dpo) they were 22.73 ± 6.27 ng/mL and 22.59 ± 5.77 ng/mL and at T3 (52-60 dpo) they were 6.68 ± 2.18 ng/mL and 3.17 ± 2.26 ng/mL, in pregnant (n = 98) and non-pregnant (n = 23) dogs respectively. The P4 concentrations differed significantly between pregnant and non-pregnant animals at the last examination (p ≤ 0.001). In the context of hypoluteoidism, the gathered data yielded interesting results. Overall, 28 out of 98 pregnant bitches showed a greater decline (>15 ng/mL) in P4 concentrations from early to mid-pregnancy, and 56 bitches showed P4 concentrations lower than deemed adequate (>20 ng/mL at T1 and T2, >5 ng/mL at T3) according to existing recommendations. Despite not being supplemented with P4, none of those animals suffered from abortion or preterm delivery. Considering that supplementation of P4 can entail considerable risks for the bitch and the puppies, more research on P4 concentration patterns, diagnosis of hypoluteoidism and treatment indications and options is indicated.

Improving decision-making in complicated or rare cases-An approach towards Evidence-based Veterinary Medicine in small animal reproduction.

The concepts of Evidence-based Veterinary Medicine (EBVM) provide a methodological and systematic approach to include the best evidence from research into clinical decision-making. These concepts include steps as the search and assessment of relevant research findings and consideration of individual aspects. In addition, owners and other persons involved in animal health care should be included in shared decision-making. Some breeders have good basic knowledge concerning breeding management and characteristics of diseases and concerning advantages and disadvantages of different therapeutic approaches, while others are notable to understand complex medical interrelations or emergency situations. All these aspects need to be addressed when communicating and discussing different diagnostic, prophylactic and therapeutic options. In special fields, such as small animal reproduction, veterinarians often see animals with rare diseases or complex conditions so that an application of standard therapies and well-established textbook recommendations is not possible. To learn more about cases too rare for successful systematic research, the case collection tool REPROCASES (www.evssar.org/reprocases) is now available. The aim of this project is to gather information from specialists on small animal reproduction in a multicentre approach. If you see rare or not well-investigated cases such as cystic ovarian diseases, cryptorchidism or others, you are more than welcome to share your findings via the database. Even if this approach cannot completely replace standardized clinical trials, the idea is to gather more information on effects, prognosis, side effects and long-term fertility for specific conditions.

Teaching small animal reproduction via virtual patients.

Virtual patients have become an interesting alternative in medical education. Due to increasing demands regarding theoretical and clinical teaching and to improve an interdisciplinary approach, a new blended learning concept including virtual patients was developed and implemented in the veterinary curriculum of the Freie Universität Berlin. In the presented project, three virtual patients from the field of canine reproduction were developed. They focus on pregnancy diagnosis with suspected luteal insufficiency, pyometra and benign prostatic hyperplasia, respectively. The results of an evaluation by veterinary students of the 7th semester showed a high acceptance of virtual patients in a blended learning reproduction module in the interdisciplinary lectures. Students especially preferred videos, such as video lectures, hands-on videos and animations as well as a glossary for background information, to successfully and autonomously work on a virtual case. The content covered by the new modules that were developed in the context of this project is part of a spiral curriculum; they will be revised and enhanced during the clinical year.

Evaluation of a CAT Database and Expert Appraisal of CATs Developed by Students.

Five steps have been recommended to provide evidence-based patient care: formulating a clinical question, searching for literature, evaluating the validity and applicability of results, implementing results into practice, and assessing if the new evidence has led to improved health care. Students can be trained in these steps by the development of knowledge summaries such as critically appraised topics (CATs). The aim of the present project was the development, use, and evaluation of a German-language CAT database and an appraisal of the quality of CATs developed by students. A total of 153 fifth-year veterinary medical students (in 21 groups) were enrolled in the project. Each group developed a CAT and most students participated in a survey. To learn more about the quality of the CATs, we asked experts to appraise the texts written by the students. The CATs were indexed with key words and assigned to specific fields corresponding to the European Colleges of Veterinary Specialisation. Currently, 57 CATs have been developed. The majority of students stated that writing CATs is a good exercise and that "it is important to teach the assessment of scientific information." In total, 13 experts completed the questionnaires, out of which 9 graded the CAT they appraised as good. In addition to English-language CAT databases, German tools should also be available for students and practitioners.

Do Veterinary Students See a Need for More In-Course Discussion? A Survey.

Rather than merely transferring information, veterinary education should stimulate and motivate students and encourage them to think. Currently in veterinary education, most curricula use the method of frontal teaching (e.g., in lectures). A student-centered critical approach to information is rarely used. Our research sought to determine if students consider in-course discussion useful and if sufficient possibilities for discussion are provided and supported by their lecturers. In December 2013, we conducted a survey of fourth-year students. Specifically, we wanted to know if students consider in-course discussion about course content useful for successful learning and if students wish to have more opportunities for discussion during class time. Finally, we wanted to identify barriers that limit the students' motivation and ability to engage in discussion of course content. In total, 105 students completed the survey. The majority of students agreed or strongly agreed that clinical topics should be discussed during class time. Frequently stated reasons were improved learning (85.7%) and the opportunity to look at topics from different perspectives (92.4%). In conclusion, we found a considerable dearth of and request for discussion within veterinary education. In light of these findings, we emphasize the need for new teaching strategies that promote independent thinking and critical questioning. We suggest the implementation of more discussion opportunities in well considered and moderated settings in veterinary teaching.

Training evidence-based veterinary medicine by collaborative development of critically appraised topics.

In current veterinary education, skills such as retrieving, critically appraising, interpreting, and applying the results of published scientific studies are rarely taught. In this study, the authors tested the concept of team-based development of critically appraised topics (CATs) in training students in evidence-based veterinary medicine (EBVM). The 116 participants were in their fifth year and attending the clinical rotation at the Clinic for Animal Reproduction. Students developed 18 CATs of varying quality on topics of their choice. Preparing the CATs in teams stimulated discussion on the topic and the quality of the retrieved papers. Evaluation of the project revealed that more than 90% of the students endorsed training in critical appraisal of information in veterinary education. In addition, more than 90% considered the development of CATs an effective exercise for assessing the quality of scientific literature. A provided literature evaluation form was perceived as a useful tool for systematically summarizing a publication's quality. In conclusion, team-based development of CATs during clinical rotations is highly valuable for training in EBVM. Learning and intrinsic motivation seem to be enhanced by creating a situation similar to veterinary practice because the task is embedded into an authentic clinical problem. This approach to clinical training helps to prepare students to integrate evidence from literature into practice.

Evidence-based medicine: quality and comparability of clinical trials investigating the efficacy of prostaglandin F(2α) for the treatment of bovine endometritis.

The objective of this study was to evaluate the quality and comparability of published literature, and to summarize the effect of prostaglandin F(2α) (PGF(2α)) for the treatment of endometritis. It has been postulated that there is a dearth of high-level evidence-based research results in veterinary medicine. Also, there is a marked variation in the quality of studies in veterinary and animal science. Post-partum uterine infections occur commonly in dairy cattle and are reported to have a negative impact on reproductive performance. A comprehensive literature search was conducted utilizing online databases revealing a total of 2723 references. After applying specific exclusion criteria, a total of 68 trials were eligible for further analysis. These articles were evaluated utilizing specific parameters listed in an evaluation form such as randomization and the involvement of control groups. The analysis revealed that more than half of the trials (51·5%) were at least 20 years old. Furthermore, we found that about one third (36·8%) of all trials were controlled and randomized, while 3 of those (4·4%) were also blinded. Of those trials which calculated a calving-to-conception interval (n=30), 50% of the authors claimed an improvement, which was statistically significant in 23·3% of the cases. We conclude that there is a wide discrepancy between research results investigating the efficacy of PGF(2α).