Variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis

Treatment variation in medicine may be driven by evidence gaps, clinician factors, and patient preferences. Although well-documented in human medicine, variation in clinical management is relatively unexplored in veterinary practice. Clinical vignette questionnaires were administered to a cross sect...

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Main Authors: White, Constance, Jones, Gareth, Baker, Sarah, Dean, Rachel, Brennan, Marnie
Format: Article
Published: MDPI 2018
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Online Access:https://eprints.nottingham.ac.uk/52470/
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author White, Constance
Jones, Gareth
Baker, Sarah
Dean, Rachel
Brennan, Marnie
author_facet White, Constance
Jones, Gareth
Baker, Sarah
Dean, Rachel
Brennan, Marnie
author_sort White, Constance
building Nottingham Research Data Repository
collection Online Access
description Treatment variation in medicine may be driven by evidence gaps, clinician factors, and patient preferences. Although well-documented in human medicine, variation in clinical management is relatively unexplored in veterinary practice. Clinical vignette questionnaires were administered to a cross section of general practitioners (GPs) and veterinarians with postgraduate training in ophthalmology (PGs) to survey recommended management of canine prolapsed nictitans gland (“cherry eye”, PNG) and feline herpesvirus (FHV-1) keratitis. The majority of veterinarians (96.2%) suggested surgical replacement of cherry eye, with a pocketing technique being the most frequently nominated procedure. GPs were more likely to suggest gland excision in the event of surgical failure, while PGs more frequently nominated techniques incorporating a periosteal anchor for salvage repair. Most respondents managed FHV-1 keratitis with topical antibiotics (76.4%), with a minority suggesting topical antivirals (32.2%). GPs favoured topical acyclovir whilst PGs more frequently recommended topical trifluorothymidine. A significantly larger proportion of PGs nominated systemic famciclovir and lysine supplement for FHV-1 keratitis. This survey revealed moderate treatment variation for these conditions, both between and within practitioner groups. Additional research is needed to assess the reasons for this variation, particularly for conditions in which high quality evidence is scant.
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spelling nottingham-524702020-05-04T19:38:58Z https://eprints.nottingham.ac.uk/52470/ Variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis White, Constance Jones, Gareth Baker, Sarah Dean, Rachel Brennan, Marnie Treatment variation in medicine may be driven by evidence gaps, clinician factors, and patient preferences. Although well-documented in human medicine, variation in clinical management is relatively unexplored in veterinary practice. Clinical vignette questionnaires were administered to a cross section of general practitioners (GPs) and veterinarians with postgraduate training in ophthalmology (PGs) to survey recommended management of canine prolapsed nictitans gland (“cherry eye”, PNG) and feline herpesvirus (FHV-1) keratitis. The majority of veterinarians (96.2%) suggested surgical replacement of cherry eye, with a pocketing technique being the most frequently nominated procedure. GPs were more likely to suggest gland excision in the event of surgical failure, while PGs more frequently nominated techniques incorporating a periosteal anchor for salvage repair. Most respondents managed FHV-1 keratitis with topical antibiotics (76.4%), with a minority suggesting topical antivirals (32.2%). GPs favoured topical acyclovir whilst PGs more frequently recommended topical trifluorothymidine. A significantly larger proportion of PGs nominated systemic famciclovir and lysine supplement for FHV-1 keratitis. This survey revealed moderate treatment variation for these conditions, both between and within practitioner groups. Additional research is needed to assess the reasons for this variation, particularly for conditions in which high quality evidence is scant. MDPI 2018-06-01 Article PeerReviewed White, Constance, Jones, Gareth, Baker, Sarah, Dean, Rachel and Brennan, Marnie (2018) Variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis. Veterinary Sciences, 5 (2). p. 54. ISSN 2306-7381 cherry eye; nictitans prolapse; third eyelid gland; feline herpes keratitis; treatment variation; clinical vignette http://www.mdpi.com/2306-7381/5/2/54 doi:10.3390/vetsci5020054 doi:10.3390/vetsci5020054
spellingShingle cherry eye; nictitans prolapse; third eyelid gland; feline herpes keratitis; treatment variation; clinical vignette
White, Constance
Jones, Gareth
Baker, Sarah
Dean, Rachel
Brennan, Marnie
Variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis
title Variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis
title_full Variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis
title_fullStr Variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis
title_full_unstemmed Variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis
title_short Variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis
title_sort variation in the reported management of canine prolapsed nictitans gland and feline herpetic keratitis
topic cherry eye; nictitans prolapse; third eyelid gland; feline herpes keratitis; treatment variation; clinical vignette
url https://eprints.nottingham.ac.uk/52470/
https://eprints.nottingham.ac.uk/52470/
https://eprints.nottingham.ac.uk/52470/