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PurposeTo determine the proportion of treatment-experienced eyes with exudative age-related macular degeneration successfully treated with every-4-week aflibercept that can be kept dry on fixed every-8-week aflibercept injections (maintenance).MethodsIn this retrospective chart review, we evaluated our cohort of patients treated with a treatment paradigm for CNV in AMD. Initially, patients were treated with bevacizumab or ranibizumab and switched to every-4-week aflibercept when therapeutic responses were not durable or were suboptimal. Maintenance every-8-week therapy was initiated when the retina was completely dry on every-4-week aflibercept therapy. The primary outcome measure was recurrence of exudation on optical coherence tomography (OCT) during maintenance.ResultsThirty-six eyes of 31 consecutive patients with median age of 79 years (range, 65-89) were included. Maintenance was started after a median of 34 (range, 8-88) injections. Recurrence was observed in 20 eyes (55%). Of these, 11 eyes (31%) reactivated at 8 weeks. Median time to failure of maintenance schedule was 40 weeks by Kaplan-Meier analysis. Baseline demographic and anatomic characteristics were not associated with failure of maintenance schedule.ConclusionIn treatment-experienced eyes that respond completely to every-4-week aflibercept, maintenance therapy with every-8-week injections can only temporarily maintain anatomic success with the majority of eyes developing recurring activity. This regimen fails early in one third of eyes and has a median effective duration of 40 weeks. Aflibercept appears to be inadequate to maintain control of exudation in most eyes in at least half of eyes undergoing long-term therapy.

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Background: Castration is the most common surgical procedure in domesticated equids; surgical techniques used and perioperative management vary considerably. Objectives: To identify and chart the current evidence on perioperative complications associated with different methods of surgical castration in domesticated equids. Study design: Joanna Briggs Institute systematic scoping review. Method: CAB Abstracts, Medline and Embase databases were searched using terms related to equine castration complications. Two authors independently and blindly screened publications against eligibility criteria. Data on study methods, perioperative management, surgical techniques, and perioperative complications were extracted. Surgical techniques were grouped into categories depending on technique; open, closed or half‐closed, and whether the parietal tunic was open or closed at the end of surgery. Results: The search identified 1871 publications; 71 studies met the final inclusion criteria. The data reported 76 734 castrations, most of which were open or closed, with the vaginal tunic remaining open at the end of surgery. Twenty‐five studies reported information regarding surgical techniques and perioperative management, allowing detailed charting and comparisons, of which analgesia and antimicrobial usage varied notably. Eighteen different complications were reported, with swelling or oedema being the most common. Evisceration was most commonly reported in draught breeds and Standardbreds, and the risk appeared low if the parietal tunic was closed at the end of surgery. Main limitations: Grey literature and studies not available in English were not included. Existing studies varied greatly in perioperative management, surgical techniques and reporting of outcomes, making evidence consolidation problematic. Conclusion: A lack of consensus regarding complication definitions creates uncertainty and discrepancies between complication rates associated with different surgical techniques and perioperative management. The implementation of standardised systems for describing surgical techniques and complications is recommended for future studies. A number of studies did not follow current recommendations for perioperative analgesia and use of antimicrobials. [ABSTRACT FROM AUTHOR]

Background: Effects of neutering on bitch health have been reported, and are suggested to relate to bitch age at the time of neutering for some diseases. However, variation between published studies in terms of study populations and methodologies makes comparison and consolidation of the evidence difficult. Objective: A scoping review was designed to systematically search the available literature to identify and chart the evidence on the effect of neutering timing in relation to puberty on five health outcomes: atopy, developmental orthopaedic disease (DOD), neoplasia, obesity and urogenital disease. Design: A protocol was registered, and literature searches were conducted in CAB Abstracts, Medline and Web of Science. Studies were reviewed against inclusion criteria. Data on study and population characteristics and health outcomes were charted for the final included studies. Results: A total of 1,145 publications were reviewed across all five searches; 33 were retained for inclusion and charting. Only six of the 33 studies categorised the timing of surgical neutering as prepubertal or post-pubertal; one investigating mammary neoplasia and the other five, urogenital disease, commonly urinary incontinence. No studies were identified that examined the impacts of neutering bitches before or after puberty on atopy, DOD or obesity. One study considered bitches that were pre or post-pubertal at the time of the first treatment with deslorelin acetate for oestrus suppression and 26 examined the effects on health related to age, rather than pubertal status, at neutering. Conclusion: This scoping review suggests that robust evidence to support veterinarians, those working with dogs and dog owners when discussing the timing of neutering relative to puberty does not yet exist. The impact of neutering before or after puberty on atopy, DOD, neoplasia, obesity and urogenital disease in female domesticated dogs remains unclear. [ABSTRACT FROM AUTHOR]

Background: Behavioural models are widely used within human medicine to understand beliefs and intention associated with major health interventions. Objectives: To investigate horse‐owner beliefs and practices associated with emergency colic planning. Study design: Cross‐sectional study. Methods: An online survey incorporating the Trans‐Theoretical Model of behaviour change and the Theory of Planned Behaviour was developed to assess owner intention to adopt three areas of emergency colic planning: (1) prevention/recognition, (2) involvement of others and (3) personal preparation. Participants were recruited using a snowball sampling strategy; multivariable logistic regression of data was performed. Results: There were 701 horse‐owners who completed the survey. Respondents fell into one of two categories: no intention to adopt or already implementing emergency planning recommendations. Most agreed that emergency colic plans would improve their horse's welfare (68%) and aid in decision making (78%). Most disagreed that colic was inevitable (66%) and that treatment options were not within their control (69%). Multivariable analysis showed that those who believed emergency plans were worth creating were more likely to adopt preventive (OR: 2.33, 95% CI: 1.27–4.30, p = 0.007) and personal preparation (OR: 1.61, 95% CI: 1.31–1.97, p < 0.001) recommendations. Preventive recommendations were also associated with 'REACT' campaign awareness (OR 2.36, 95% CI: 1.40–3.97, p = 0.001). Favourable behavioural beliefs, such as the acknowledgement of welfare and decision‐making benefits, were linked to the involvement of others in planning (OR: 2.93, 95% CI: 1.78–4.81, p < 0.001). Main limitations: Potential response bias and small sample size. Conclusions: The majority of owners were either unwilling to adopt suggested recommendations or believed that their approach was currently sufficient. Most owners perceived veterinary professionals as most influential on their decision to plan for a colic emergency, highlighting their importance in any educational campaign. [ABSTRACT FROM AUTHOR]