Veterinary evidence and comparative medicine
Veterinary treatment decisions depend on the quality and relevance of animal research. Practice records, shared datasets and comparative studies can strengthen that evidence, while communication between human and veterinary medicine needs to keep animal health and welfare in view.
Limits of the evidence
Limited funding can leave veterinary studies with small samples, insufficient power for clinical safety endpoints and susceptibility to bias, making them more suitable for generating hypotheses than establishing treatment effects.
A 2017 case illustrates the uncertainty: a veterinarian's dog developed autoimmune haemolytic anaemia and received prednisolone followed by mycophenolate, while the veterinarian had previously used dexamethasone and cyclosporine and a colleague favoured azathioprine. A literature search found small, poor-quality studies with follow-up mostly limited to 30 days, and a meta-analysis of 380 dogs that did not compare therapies, leaving treatment choice and one-year survival unanswered. The dog was euthanised eight weeks after disease onset.
A 2016 comparison found randomised controlled designs in 87% of treatment-efficacy papers in human medical journals and 52% in comparable veterinary papers. Poor question selection and study design can limit veterinary research's contribution to comparative medicine.
Proposed low-cost improvements to veterinary research include the following.
- Register research and publish and disseminate its results.
- Share data, drawing on practice in human medicine.
- Use data from veterinary practice-management software.
Practice data and shared datasets
Routinely collected veterinary data can support research using lessons from human medicine. Practice-management software can provide data-gathering and statistical tools with database controls such as access control and audit trails. Combining records from practices or universities increases sample size and can support more sophisticated analysis.
A workflow described with a practice-software provider extracts shared data in three steps, depending on the software used.
- Define the variables, such as species, breed, age, sex, disease and laboratory values.
- Obtain participating veterinarians' agreement to export anonymised data.
- Export through the software as a CSV file or another format such as XML.
Data may be incomplete and cover only the period for which the software was used. Additional questions can make practice software function like an electronic case-report form, but require manual entry. The records offer a relatively inexpensive resource for epidemiology, risk-factor analysis and disease-specific questions.
The Dog Aging Project brings together owners, researchers and volunteers to study canine ageing through questionnaires and shared veterinary records, with data sharing intended to support worldwide research and insight into human ageing. Darwin's Ark similarly involves owners in studying genetic influences on pet health and behaviour.
Clinical registries
The RECOVER initiative developed evidence-based guidelines in 2012 for preparing for and managing cardiopulmonary arrest in cats and dogs. Its registry standardises collection of cardiopulmonary-resuscitation outcomes from participating practices and hospitals. The first registry report, published in December 2022, covered more than 700 CPR events from February 2016 to November 2021: 3% of dogs and 2% of cats survived to hospital discharge. These findings indicated a need for further research into factors associated with favourable outcomes.
Comparative medicine and animal benefit
Comparative medicine examines similarities and differences between human and veterinary medicine; translational work with pet clinical data aims to advance both within a One Health framework. Pets with spontaneous disease and lifestyles resembling their owners' may bridge laboratory research and clinical practice.
A collaboration between Ohio State University and a children's hospital sought biological pathways of osteosarcoma metastasis to support screening in dogs and children. Other examples show research moving in both directions: ibrutinib, used for human B-cell malignancies and developed with evidence from spontaneous canine lymphoma, was investigated for canine mast-cell tumours; feline cognitive dysfunction has been proposed as an Alzheimer's disease model; and data from cats with hypertrophic cardiomyopathy contributed to mavacamten development. Cannabidiol has also been proposed as a possible treatment for cognitive decline in cats and people. The cardiomyopathy cats were unowned, purpose-bred colony animals undergoing experimental procedures, rather than client-owned clinical patients.
Comparative-medicine writing, particularly for veterinary audiences, should emphasise potential gains for animal patients alongside human benefits, because veterinarians prioritise animal health and welfare. Translational research should not make euthanasia more likely.
Clear terminology and collaboration
Terminology should distinguish experiments on laboratory animals of companion species from research involving client-owned pets. “Reverse translation” has been proposed for benefits flowing to veterinary species, while definitions of translational and comparative medicine need greater clarity. The European Society for Translational Medicine's definition centres on bench side, bedside and community, without mentioning animal health.
Proposals for closer human–veterinary integration include bringing faculties closer geographically and intellectually and connecting literature databases through a “One Literature” approach. Medical communicators can help develop language accessible to biomedical professionals and the public.
Keeping up with veterinary literature
VetLit is a free resource bringing together recent veterinary journal articles, organised by clinical discipline and species, with an open-access section linking directly to publications. Its selection includes the Journal of Veterinary Internal Medicine, Journal of Small Animal Practice and Veterinary Surgery; selection from clinical-specialty reading lists gives it a clinical emphasis.