Short communication: Meta-analysis on therapy of bovine endometritis with prostaglandin F2α-An update.

The objective of the study was to update a prior meta-analysis on the efficacy of the treatment of bovine endometritis with PGF2α. Clinical endometritis in cattle is defined as the presence of a purulent or mucopurulent vaginal discharge after 20 or 26 d, respectively, postpartum. Although the prevalence and impact of this disease are well known, the questions of whether and how to treat endometritis are still controversially discussed. Hence, to ensure timeliness of scientific results, we updated an existing meta-analysis published in 2013 that showed no treatment effect of PGF2α in cases of bovine endometritis. As in the prior meta-analysis, a comprehensive literature search was conducted. After applying specific inclusion and exclusion criteria, 3 trials remained that could be added to the 6 trials in the initial meta-analysis. Data for each trial were analyzed using the meta-analysis software Review Manager (version 5.3; The Nordic Cochrane Centre, Copenhagen, Denmark). Estimated effect sizes of PGF2α were calculated on calving to first service interval (CFSI) and calving to conception interval (CCI). As revealed by the initial meta-analysis, PGF2α treatment still had no effect on both reproductive parameters. Heterogeneity remained substantial for CFSI and CCI and even increased for CCI compared with the initial meta-analysis. Subgroup analysis, however, did not reveal a source of heterogeneity. In updating the meta-analysis, publication bias for trials reporting CCI became even more pronounced, suggesting that studies with higher standard error (i.e., usually smaller studies) that reported a prolonging effect on CCI after a PGF2α treatment were less likely to be published. Finally, although the number of trials published on the chosen topic and their comparability are still limited, this update of our meta-analysis now provides results that are based on approximately twice the number of included cows. The overall outcome, however, has not substantially changed and a positive effect of a PGF2α treatment in case of clinical endometritis could not be shown. Therefore, we do not recommend a treatment of bovine endometritis with PGF2α as a means to improve reproductive performance.

Antibiotic treatment of metritis in dairy cows-A meta-analysis.

The objective of this meta-analysis was to assess the efficacy of the treatment of bovine metritis with common antibiotic and nonantibiotic treatment options. Acute puerperal metritis, a systemic and potentially painful illness with rectal temperature >39.5°C and signs of toxemia due to an infection of the uterus, occurs within 21 d after parturition. Because of the infectious nature, antibiotics are considered beneficial for the treatment of acute puerperal metritis. Each use of an antimicrobial drug, however, is associated with selective pressure for eventual emergence of resistant bacteria. The 23 trials evaluated in the course of a previously conducted systematic review were the basis for meta-analytic investigations. Selected trials were screened regarding their eligibility for the following investigations: (1) comparison of different antibiotic treatments with respect to metritis prevalence at time of re-examination, (2) efficacy of ceftiofur treatment with respect to metritis prevalence at time of re-examination, (3) comparison of efficacy of antibiotic versus nonantibiotic drugs with respect to metritis prevalence at time of re-examination, and (4) equivalence assessment of treatment effects on reproductive performance measures. Where at least 3 trials had investigated the same outcome variable and met the inclusion criteria (inclusion of a control or reference group diagnosed with metritis; reporting means and standard deviation in case of continuous data), meta-analytic investigations were carried out. Due to a shortage of comparable studies, we could not conduct investigations (1) and (3). Ceftiofur treatment of 828 metritic cows was associated with a decrease in the prevalence of metritis following treatment in comparison to 804 untreated cows. In conclusion, meta-analytic investigations uncovered a need for more high-quality studies. Furthermore, a positive effect of the most commonly used antibiotic drug, ceftiofur, for the treatment of bovine metritis could be shown. A comparison with other antibiotic or nonantibiotic treatment options could not be made.

Evaluation of prostaglandin F2α versus prostaglandin F2α plus gonadotropin-releasing hormone as Presynch methods preceding an Ovsynch in lactating dairy cows: A meta-analysis.

Presynchronization of cows with 2 injections of prostaglandin administered 14 d apart (Presynch-Ovsynch) is a widely adopted procedure to increase pregnancy per artificial insemination (P/AI) at first service. Recently, a presynchronization protocol including GnRH and PGF2α (Double-Ovsynch; GnRH, 7 d, PGF2α, 3 d, GnRH) followed 7 d later by an Ovsynch protocol was introduced to overcome the limitations of PGF2α-based protocols for presynchronization of anovular cows and to precisely set up cows on d 7 of the estrous cycle when the Ovsynch is initiated. A systematic review of the literature and a meta-analytical assessment was performed with the objective to compare the reproductive performance of lactating dairy cows presynchronized with these 2 protocols for the first timed AI (TAI) considering parity-specific effects. A fixed or a random effects meta-analysis was used based on the heterogeneity among the experimental groups. Reproductive outcomes of interest were P/AI measured on d 32 (28-42) and pregnancy loss between d 32 and 60 (42-74) of gestation. A total of 25 articles with 27 experimental groups from 63 herds including 21,046 cows submitted to first TAI using either a Presynch-Ovsynch or a Double-Ovsynch protocol were reviewed. Results for P/AI were then categorized by parity if available. Information was available for P/AI for 7,400 and 10,999 primiparous and multiparous cows, respectively. Information regarding pregnancy loss was available for 7,477 cows. In the random effects model for all cows, the overall proportion of P/AI was 41.7% [95% confidence interval (CI): 39.1-44.3; n = 8,213] and 46.2% (95% CI: 41.9-50.5; n = 12,833) on d 32 after TAI for Presynch-Ovsynch and Double-Ovsynch, respectively. In the random effects model for primiparous cows, the overall proportion of P/AI was 43.4% (95% CI: 36.2-47.7; n = 2,614) and 51.4% (95% CI: 47.4-55.4; n = 4,786) on d 32 after TAI for Presynch-Ovsynch and Double-Ovsynch, respectively. In the random effects model for multiparous cows, the overall proportion of P/AI was 39.2% (95% CI: 36.2-42.3; n = 3,411) and 41.4% (95% CI: 36.4-46.4; n = 7,588) on d 32 after TAI for Presynch-Ovsynch and Double-Ovsynch, respectively. The overall proportion of pregnancy loss was 11.3% (95% CI: 7.6-15.7; n = 3,247) and 11.7% (95% CI: 9.3-14.3; n = 4,230) on d 60 after AI for Presynch-Ovsynch to and Double-Ovsynch, respectively. Substantial heterogeneity existed among the experimental groups regarding P/AI and pregnancy loss. In summary, a benefit was detected for P/AI in primiparous cows presynchronized with a Double-Ovsynch protocol for the first TAI, but this benefit was not observed in multiparous cows.

Cystic ovaries and ovarian neoplasia in the female dog - a systematic review.

Most common ovarian diseases appear to be cystic or ovarian tumours. These conditions may affect health, fertility or even the life of the animal. Literature related to ovarian cysts and neoplasia in dogs was assessed to summarize studies and case series on ovarian cysts and primary ovarian tumours in regard to epidemiologic, clinical and fertility aspects. Two research papers on histopathological examination of ovarian cysts could be identified. Seven research papers on ovarian tumours were also assessed, showing inconsistent results on the frequency of occurrence of different types of neoplasia. This might be due to different definitions of diseases and different diagnostic procedures. In conclusion, scarce research has been performed on ovarian diseases in the bitch in the last decades. Many publications are based on case reports. Most quality criteria of study methodology like blinding, randomization, sensitivity and specificity of test methods are not considered in papers on ovarian diseases. In the future, a multicentre data collection of cases could help to gather more data on the incidence, clinical relevance, treatment options and prognosis of ovarian diseases.

Effect of insemination after estrous detection on pregnancy per artificial insemination and pregnancy loss in a Presynch-Ovsynch protocol: A meta-analysis.

Presynchronization of cows with 2 injections of prostaglandin administered 14d apart (Presynch-Ovsynch) is a widely adopted procedure to increase pregnancy per artificial insemination (P/AI) for the first service. In a Presynch-Ovsynch protocol, 2 different management strategies can be observed. Either all cows receive timed artificial insemination (onlyTAI) or cows detected in estrus after the second PGF2α injection are inseminated and the remaining cows without signs of estrus will be subject to timed AI (EDAI+TAI). A systematic review of the literature was performed with the objective to evaluate the effect of insemination after estrous detection during a Presynch-Ovsynch protocol for the first service on fertility in lactating dairy cows. Two statistical approaches were conducted using either a fixed or a random effects meta-analysis based on the heterogeneity among the experimental groups. Reproductive outcomes of interest were P/AI measured on d32 (d 28 to 42) and pregnancy loss between d32 and 60 (d 42 to 74) of gestation. In approach 1, 3 randomized controlled studies including 1,689 cows with the primary objective to evaluate the effect of insemination after estrous detection in a Presynch-Ovsynch protocol were used. The incorporation of insemination after estrous detection decreased the odds of pregnancy by 35% [odds ratio=0.65; 95% confidence interval (CI)=0.53-0.80] on d32 after AI using a fixed effects model. We detected no effect on pregnancy loss on d60 of gestation (odds ratio=0.88; 95% CI=0.55-1.43). There was no heterogeneity among the 3 studies regarding P/AI and pregnancy loss. In approach 2, cows from approach 1 and cohorts from another 17 experimental groups including 8,124 cows submitted to first AI using a Presynch-Ovsynch protocol were used. Information regarding pregnancy loss was available for 5,200 cows. In the random effects model, the overall proportion of P/AI was 30.9% (95% CI=26.71-35.28; n=2,400) and 41.7% (95% CI=39.76-42.01; n=7,413) on d32 after AI for EDAI+TAI and onlyTAI, respectively. The overall proportion of pregnancy loss was 11.7% (95% CI=6.11-18.8; n=1,811) and 9.6% (95% CI=6.37-13.33; n=3,389) on d60 after AI for EDAI+TAI and onlyTAI, respectively. We observed substantial heterogeneity among the experimental groups regarding P/AI and pregnancy loss. In summary, there was a benefit on P/AI for cows with 100% TAI after completing a Presynch-Ovsynch protocol.

Invited review: Antibiotic treatment of metritis in dairy cows: a systematic approach.

Acute puerperal metritis (APM) is an acute systemic illness with fever ≥ 39.5 °C and signs of toxemia due to an infection of the uterus occurring within 21 d after parturition. Because of the infectious nature of APM, antibiotics are considered beneficial for its treatment. Each use of an antimicrobial drug, however, is associated with selective pressure for the emergence of resistant bacteria. Hence, there is a significant need to encourage prudent use of antibiotics and alternative therapies to antibiotics. Therefore, the objective of this study was to systematically review the current literature on treatment of APM. A comprehensive and systematic literature search was conducted utilizing the PubMed and CAB Abstracts databases to identify literature focusing on the antibiotic therapy of puerperal metritis in the cow. After application of specific exclusion criteria, 21 publications comprising 23 trials remained for final evaluation. Data extraction revealed that the majority of the studies (n = 19) were attributable to the highest evidence level. Of 21 studies controlled, 11 had an untreated group and 3 a positive control group. The majority of the studies (n = 17) applied ceftiofur for the treatment of APM. Concerning the efficacy of ceftiofur, 7 studies observed clinical improvement, whereas none found improved reproductive performance. Fewer than half of the studies (n = 10) performed a bacteriological examination and only 4 implemented an antibiotic susceptibility test. Also, 3 studies (13.0%) described a self-cure rate per se. Little attention was given to the issue of bacterial resistance (n = 3), the need for reducing the application of antibiotics (n = 2), or guidelines for prudent use of antibiotics (n = 1). Our findings demonstrate that implementation of bacteriological examinations, sensitivity testing, and determination of minimum inhibitory concentrations, as well as reporting and discussion of critical issues (e.g., self-cure rates, resistance, prudent drug use), were suboptimal. On the other hand, the quality of studies on the treatment of APM was good, as indicated by evidence level 1. Nevertheless, more high-quality research considering self-cure rates is necessary to address critical issues related to APM and crucial to the dairy industry, such as resistance, prudent use of antibiotics, animal welfare, and cost-benefit ratios.

A systematic review of studies performing the hypo-osmotic swelling test to evaluate the quality of canine spermatozoa.

The hypo-osmotic swelling test (HOS test) is a simple and inexpensive test to evaluate the functional integrity of sperm cell membranes. According to the existing literature, its simple applicability has turned it into a valuable additional parameter to standard canine semen analysis. In the recent years, much research has been conducted in this field. The aim of this systematic review was to evaluate the quality of published literature in canine reproduction concerning the HOS test. Using two distinguished databases, 38 articles were detected and analysed subsequently according to various aspects, for example study design, population, semen sampling and implementation concerning the HOS test. Although there are numerous articles available, the diagnostic value of the HOS test remains ambiguous. Until now, neither a recognized test protocol nor reliable reference values have been defined. Most of the trials evaluated show serious methodological flaws and therefore do not permit drawing reliable conclusions. According to our results, approximately half of the studies (n = 20) included a sample size of five or less animals. None of the studies examined the inter- or intraobserver agreement for the HOS test. Further research is warranted including appropriate statistical methods and a sufficient number of animals to establish a standardized test protocol as well as reliable reference values. Most importantly, it is required to clarify a correlation between the HOS test and the fertilizing capacity to determine the diagnostic value of the HOS test.

[Results of a survey regarding the publication of scientific results in German-speaking countries]. / Ergebnisse einer Umfrage zur Publikation wissenschaftlicher Studienergebnisse im deutschsprachigen Raum.

OBJECTIVE: Veterinarians should conduct diagnostic and therapeutic procedures according to the most recent and scientifically proven methods. Therefore, a rapid and effective transfer of scientific information is crucial. An important link between science and practice are findings published in scientific journals. The productivity of scientists is often measured referring to the number of papers published in reputable journals. Because many of these journals publish in the English language, it is possible that results from German research may never reach German veterinarians or only after a delay. MATERIAL AND METHODS: Using an online questionnaire, faculty members (professors and scientific assistants) from Germany, Austria and Switzerland were asked how they had published their results during the previous 5 years. Furthermore, they were asked to identify the factors influencing their choice of journal for publication. RESULTS: A total of 118 respondents completed the questionnaire. Nearly two thirds had published ten or more papers during the previous 5 years. More than half of these were published in the English language. Most participants consider the peer review process suitable for enhancing the quality of publications. The impact factor is seen as a fair indicator for the quality of a paper while considered an important factor for the choice of a journal for publication of the respondents own results. CONCLUSION AND CLINICAL RELEVANCE: According to the data, respondents prefer to publish their results in the English language and in journals with a high impact factor. Therefore, veterinarians may never receive this information via German journals or only after a delay. One possible solution could be a regularly published practice-oriented compilation of relevant scientific findings.

[Decision making in veterinary practice]. / Entscheidungsfindung in der tierärztlichen Praxis.

OBJECTIVE: In daily practice, a veterinarian has to judge information and decide whether it can be adequately implemented for a given case. In this context, it is vital to base decisions on the most recent and reliable scientific findings. In Germany, every practitioner must take part in 20 to 40 hours annually of continuing education. To outline the current assessment and employment of evidence-based veterinary medicine (EBVM), we surveyed practitioners concerning continuing education and their skills in obtaining and evaluating scientific information. MATERIALS AND METHODS: A survey amongst veterinary practitioners was conducted throughout five continuing education courses between May 2010 and November 2011. The questionnaire contained 32 questions concerning demographic data and profession (n = 4), qualification (n = 3), continuing education (n = 5) and skills related to EBVM (n = 20). Besides evaluating the statements of all participants, veterinarians were classified based on the type of practice and their statements compared. RESULTS: In total, 293 questionnaires were returned. The majority of small animal practitioners (58.3%) and those working with food animals (54.9%) declared being capable of comprehending scientific talks or papers in English without difficulty. 10.4% of all practitioners neglected reading veterinary journals on a regular basis, while 20.8% stated they regularly read English veterinary journals. The majority of the practitioners sought advice from their employer or a colleague. They attributed a high or very high quality to both these information sources. Almost every participant (92.6%) stated that they consulted medical books, and 88.6% certified this information source as being of high or very high quality. 68.6% of the practitioners evaluated their skills in finding suitable literature as high or very high. However, only approximately half (52.1%) of all participants attributed themselves a high ability to evaluate the quality of the literature found. CONCLUSION AND CLINICAL RELEVANCE: Most practitioners are very limited in their ability to assess the evidence of scientific information. Therefore, courses that introduce EBVM should be taught in both veterinary and postgraduate education to train critical appraisal of information and to support decision-making based on valid, clinically relevant data.

Therapy of bovine endometritis with prostaglandin F2α: a meta-analysis.

The objective of the conducted meta-analysis was to assess the efficacy of the treatment of bovine endometritis with PGF(2α) by statistical means. Postpartum uterine infections have a high prevalence and a very negative effect on reproductive performance in dairy cattle. Because of a wide discordance between research results, a meta-analysis of the efficacy of the treatment of bovine endometritis with PGF(2α) was conducted. A comprehensive literature search was performed using online databases to reveal a total of 2,307 references. In addition, 5 articles were retrieved by reviewing citations. After applying specific exclusion criteria and evaluating specific evidence parameters, 5 publications, comprising 6 trials, were eligible for being analyzed by means of meta-analysis. Data for each trial were extracted and analyzed using meta-analysis software Review Manager (version 5.1; The Nordic Cochrane Centre, Copenhagen, Denmark). Estimated effect sizes of PGF(2α) were calculated on calving to first service and calving to conception interval. Prostaglandin F(2α) treatment of cows with chronic endometritis had a negative effect on both reproductive performance parameters. Heterogeneity was substantial for calving to first service and calving to conception interval [I(2) (measure of variation beyond chance)=100 and 87%, respectively]; therefore, random-effects models were used. Sensitivity analysis as well as subgroup analysis showed that the performance of randomization was influential in modifying effect size of PGF(2α) treatment. The funnel plot illustrated a publication bias toward smaller studies that reported a prolonged calving to conception interval after a PGF(2α) treatment. We conclude that the investigation of this subject by means of meta-analysis did not reveal an improvement of reproductive performance of cows with endometritis after treatment with PGF(2α). Furthermore, there is a shortage of comparable high quality studies investigating reproductive performance after PGF(2α) treatment of cows with chronic endometritis.