Veterinary Clinics of North America. Exotic Animal Practice

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Reporting the results of primary research is a key step in knowledge creation. Many well-conducted studies are rejected by journal editors, criticized by peers, or unsuitable for systematic reviewers because of poor reporting. This article summarizes the most important methodological items to report when writing an original research article.

Developing and conducting systematic reviews and meta-analyses is a complex process that requires many judgments and the input from a wide variety of stakeholders. This article presents an introduction on how to develop, conduct, and report these research studies. Veterinary clinicians should seek systematic reviews to address their research questions. Criteria for including meta-analyses in a systematic review are presented. However, before applying the findings of systematic reviews and meta-analyses to a particular patient, clinicians should weigh a variety of issues...

Correlation and regression assess the association between 2 or more variables. This article reviews the core knowledge needed to understand these analyses, moving from visual analysis in scatter plots through correlation, simple and multiple linear regression, and logistic regression. Correlation estimates the strength and direction of a relationship between 2 variables. Regression can be considered more general and quantifies the numerical relationships between an outcome and 1 or multiple variables in terms of a best-fit line, allowing predictions to be made...

Clinical research attempts to answer questions about patient populations by studying small samples of patients drawn from those populations. Statistics are used to describe the data collected in a study and to make inferences about the larger populations. Practitioners of evidence-based practice need a basic understanding of these principles to critically appraise the results of research studies. The main paradigm for statistical inference in medicine is called hypothesis testing, which involves generating a null hypothesis and examining the strength of evidence against it...

An essential component of evidence-based practice is finding the best available evidence to answer a clinical question. Finding evidence is difficult for veterinarians in general, and exotic animal clinicians in particular, owing to the lack of studies that provide a high level of clinically relevant evidence and limited access to resources. Knowing where and how to search for evidence can facilitate evidence-based practice.

Anesthesia and sedation of pet nondomestic species are often necessary for both invasive and noninvasive procedures. Even minimally invasive procedures can be stressful for small prey species that are not domesticated or acclimated to human contact and restraint. Recent advancements in evidence-based practice will continue to improve the field based on scientifically sound best practices and rely less on anecdotal recommendations. This article focuses on new scientific literature that has been published in the past 5 years...

The importance of appropriate recognition, assessment, and treatment of pain in all veterinary species, including exotic animals, cannot be overstated. Although the assessment of pain perception in nondomestic species is still in its infancy, this does not preclude appropriate analgesic management in these species. Although analgesic drug selection is often based on data extrapolated from similar species, as the pharmacokinetics and pharmacodynamics of many drugs can vary greatly between species, an evidence-based approach to analgesic therapy should be used whenever possible...

The provision of a good light source is important for reptiles. For instance, ultraviolet light is used in social interactions and used for vitamin D synthesis. With respect to housing, most reptilians are best kept pairwise or individually. Environmental enrichment can be effective but depends on the form and the species to which it is applied. Temperature gradients around preferred body temperatures allow accurate thermoregulation, which is essential for reptiles. Natural distributions indicate suitable ambient temperatures, but microclimatic conditions are at least as important...

Because most research on rabbit husbandry, welfare, and nutrition was performed on production animals, evidence for best practices in pet rabbits is scarce, and guidelines must be based on transfer of results, deduction, and common sense. Rabbits benefit from being kept with at least one conspecific; from large enclosures and multistory hutches; from drinking water offered ad libitum in open dish drinker systems; and from receiving hay ad libitum, with restricted amounts of fresh grass, herbs, or green leafy vegetables, and a high-fiber complete diet...

Evidence-based medicine allows veterinarians to practice high-quality medicine, because the basis for all decision making is quantitative, objective, and reproducible. Case reports and case series are limited in their scope and application. Cross-sectional studies, likewise, cannot provide answers to specific variable testing with a temporal application. It is essential for the reptile specialty to expand into case-control studies, cohort studies, and experimental/intervention studies. Unfortunately, much of the reptile literature remains limited to descriptive studies...

Fish and aquatic invertebrates deserve evidence-based medicine. Pharmacologic information is available; most pharmacokinetic studies are derived from the aquaculture industry and extrapolated to ornamental fish. Conversely, advanced diagnostics and information regarding diseases affecting only ornamental fish and invertebrates require more peer-reviewed experimental studies; the examples of carp edema virus, sea star wasting disease, seahorse nutrition, and gas bubble disease of fish under human care are discussed...

This article presents relevant advances in avian medicine and surgery over the past 5 years. New information has been published to improve clinical diagnosis in avian diseases. This article also describes new pharmacokinetic studies. Advances in the understanding and treatment of common avian disorders are presented in this article, as well. Although important progress has been made over the past years, there is still much research that needs to be done regarding the etiology, pathophysiology, diagnosis, and treatment of avian diseases and evidence-based information is still sparse in the literature...

The number of exotic companion pet rodents seen in veterinary practices is growing very rapidly. According to the American Veterinary Medical Association's surveys, more than 2,093,000 pet rodents were kept in US households in 2007 and in 2012 it was more than 2,349,000 animals. This article summarizes the most important evidence-based knowledge in exotic pet rodents (diagnostics of the hyperadrenocorticism in guinea pigs, pituitary tumors in rats, urolithiasis in guinea pigs, use of itopride as prokinetics, use of deslorelin acetate in rodents, cause of dental disease, and prevention of mammary gland tumors in rats)...

This literature review covers approximately 35 years of veterinary medicine. This article develops the current state of knowledge in pet ferret medicine regarding the most common diseases according to evidence-based data and gives insight into further axis of research. Literature review was conducted through identification of keywords (title + ferret) with Web-based database searching. To appreciate the methodological quality and the level of evidence of each article included in the review, full-text versions were reviewed and questions addressed in the articles were formulated...

Rabbit medicine has been continuously evolving over time with increasing popularity and demand. Tremendous advances have been made in rabbit medicine over the past 5 years, including the use of imaging tools for otitis and dental disease management, the development of laboratory testing for encephalitozoonosis, or determination of prognosis in rabbits. Recent pharmacokinetic studies have been published, providing additional information on commonly used antibiotics and motility-enhancer drugs, as well as benzimidazole toxicosis...

High-quality clinical practice requires veterinarians to stay abreast of new research and integrate relevant findings into patient care. Clinicians can achieve this goal using evidence-based practice (EBP), the stepwise process of integrating best research evidence into existing clinical decision-making processes. This article provides explanations and recommendations for performing key steps of the EBP process, with a focus on issues the exotic animal practitioner might encounter. Key areas of discussion include the development of focused PICO questions, types of literature and search strategies, and basic clinical epidemiology principles, including chance error, bias, confounding, and generalizability...

In the field of exotic animal medicine, there is much work to do, more than in human medicine and in companion animal medicine. The work in this field should be directed toward an evidence-based knowledge accumulation. Sound evidence supporting tests and treatments will ensure better health care for exotic animal patients.

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In the United States, desexing is performed routinely in ferrets at the age of 6 weeks, therefore reproductive tract diseases are not so common. However, in Europe most ferrets are desexed when they are several months old, or they are kept as intact animals. For this reason, diseases of the reproductive organs and a prolonged estrus are far more frequent in Europe than in the United States. This article summarizes and reviews the anatomy, reproductive physiology, management of reproduction (including surgical and hormonal contraception) and reproductive tract diseases in male and female ferrets...