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Montout AX, Maniaki E, Burghardt T, Hezzell MJ, Blackwell E, Dowsey AW. Accelerometer-derived classifiers for early detection of degenerative joint disease in cats. Vet J 2025; 311:106352. [PMID: 40204089 DOI: 10.1016/j.tvjl.2025.106352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2024] [Revised: 04/04/2025] [Accepted: 04/05/2025] [Indexed: 04/11/2025]
Abstract
Decreased mobility is a clinical sign of degenerative joint disease (DJD) in cats, which is highly prevalent, with 61 % of cats aged six years or older showing radiographic evidence of DJD. Radiographs can reveal morphological changes and assess joint degeneration, but they cannot determine the extent of pain experienced by cats. Additionally, there is no universal objective assessment method for DJD-associated pain in cats. Developing an accurate evaluation model could enable earlier treatment, slow disease progression, and improve cats' well-being. This study aimed to predict early signs of DJD in cats using accelerometers and machine learning techniques. Cats were restricted to indoors or limited outdoor access, including being walked on a lead or allowed into enclosed areas for short periods. Fifty-six cats were fitted with collar-mounted sensors that collected accelerometry data over 14 days, with data from 51 cats included in the analysis. Cat owners assessed their cats' mobility and assigned condition scores, validated through clinical orthopaedic examinations. The study group comprised 24 healthy cats (no owner-reported mobility changes) and 27 unhealthy cats (owner-reported mobility changes, suggestive of early DJD). Data were segmented into 60-second windows centred around peaks of high activity. Using a Support Vector Machine (SVM) algorithm, the model achieved 78 % (confidence interval: 0.65, 0.88) area under the curve (AUC), with 68 % sensitivity (0.64, 0.77) at 75 % specificity (0.68, 0.79). These results demonstrate the potential of accelerometry and machine learning to aid early DJD diagnosis and improve management, offering significant advances in non-invasive diagnostic techniques for cats.
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Affiliation(s)
- A X Montout
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - E Maniaki
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - T Burghardt
- School of Computer Science, University of Bristol, Bristol, UK
| | - M J Hezzell
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - E Blackwell
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - A W Dowsey
- Bristol Veterinary School, University of Bristol, Bristol, UK.
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Lascelles BDX, Ponnala R, Kamerling SG, Williams T. Proteomic profiling of serum in cats with naturally occurring degenerative joint disease and co-morbid conditions. FRONTIERS IN PAIN RESEARCH 2025; 6:1501932. [PMID: 39968160 PMCID: PMC11832531 DOI: 10.3389/fpain.2025.1501932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Accepted: 01/16/2025] [Indexed: 02/20/2025] Open
Abstract
Introduction Degenerative joint disease (DJD) occurs very commonly in cats and can be associated with pain. Almost 70% of cats with DJD-associated pain suffer the co-morbidity of chronic kidney disease (CKD). There are currently very limited treatment or management options. A greater understanding of the systems biology of DJD, DJD-associated pain, and CKD may contribute to identifying disease specific biomarkers and relevant targets for the development of therapeutics for the control of these conditions in cats, and help inform human pain therapeutic development. Methods Using mass spectrometry-based proteomic profiling of the serum of 200 highly phenotyped cats with varying burdens of DJD, pain, and CKD, we identified significant individual proteins and pathways. Results Functional pathway analysis, based on differentially abundant proteins across individual disease states (DJD, pain, CKD), identified pathways playing a role in DJD and DJD-associated pain including acute phase response signaling, LXR/RXR and FXR/RXR activation and the complement system. With the added co-morbidity of CKD, similar pathways were identified, with the addition of IL-12 signaling and production in macrophages. Discussion We identified differentially abundant proteins associated with DJD, pain and CKD and future work should evaluate these proteins as potential biomarkers of disease (individually or as clusters). Further, these data could be leveraged to identify novel therapeutic targets to address the gap in our ability to manage DJD, pain, and CKD in cats. Given that our work was in cats with naturally occurring DJD, these results may have translational applicability to human health.
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Affiliation(s)
- B. Duncan X. Lascelles
- Translational Research in Pain, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States
- Thurston Arthritis Center, UNC School of Medicine, Chapel Hill, NC, United States
- Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, United States
| | - Rakesh Ponnala
- Veterinary Medicine Research & Development, Zoetis, Kalamazoo, MI, United States
| | - Steven G. Kamerling
- Veterinary Pharmacology Consultant, Veterinary Medicine Research & Development, Zoetis, Kalamazoo, MI, United States
| | - Tracey Williams
- Veterinary Medicine Research & Development, Zoetis, Kalamazoo, MI, United States
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Mitani K, Ito Y, Takene Y, Inaba T. Evaluation of the quality of life-enhancing effect of allogeneic feline adipose mesenchymal stem cells in cats with osteoarthritis: A pilot study. Res Vet Sci 2025; 182:105470. [PMID: 39612738 DOI: 10.1016/j.rvsc.2024.105470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 11/20/2024] [Accepted: 11/20/2024] [Indexed: 12/01/2024]
Abstract
Osteoarthritis (OA) is a progressive degenerative disease in older cats, and often leads to decreased quality of life (QOL). Mesenchymal stem cells (MSCs) have been used in novel therapies for inflammatory diseases. We aimed to evaluate quantitatively allogeneic adipose-derived MSC (ADSC) therapy in cats with naturally occurring OA, based on QOL assessment resources. To characterize the in vitro properties of ADSCs, we estimated ADSCs from four healthy cats with respect to morphology, differentiation potential, and immunomodulatory potential. Six cats with OA were administered a single intravenous injection of allogeneic ADSCs. Based on the feline musculoskeletal pain index (FMPI), the outcome measure was QOL. The cultured cells were adherent, exhibited a spindle shape without becoming flattened or large, and maintained doubling time until passage 5. After induction, the cells had osteogenic, adipogenic, and chondrogenic phenotypes. These cells expressed CD44 and CD90 and lacked expression of CD14 and CD45, had significantly suppressed the production of interferon -ɤ released from mitogen-stimulated lymphocytes (P < 0.05). The FMPI of all cats with OA significantly increased one month after ADSC therapy (P < 0.05). No adverse effects associated with ADSC administration were observed during follow-up in any of the cats. In conclusion, ADSC therapy with immunomodulatory potential could have beneficial effects on the QOL in cats with OA. Further research is necessary to carry out larger studies of the effectiveness of ADSC therapy.
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Affiliation(s)
- Kosuke Mitani
- Research and Development Department, J-ARM Co., Ltd., Osaka, Japan
| | - Yuki Ito
- Research and Development Department, J-ARM Co., Ltd., Osaka, Japan
| | - Yukio Takene
- Research and Development Department, J-ARM Co., Ltd., Osaka, Japan
| | - Toshio Inaba
- Faculty of Veterinary Medicine, Okayama University of Science, Ehime, Japan.
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Dowgray N, Comerford E, German AJ, Gardiner J, Pinchbeck G, Bates KT. Paw pressure and gait in middle-aged client-owned cats with and without naturally-occurring musculoskeletal disease. PLoS One 2024; 19:e0314629. [PMID: 39693355 DOI: 10.1371/journal.pone.0314629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Accepted: 11/13/2024] [Indexed: 12/20/2024] Open
Abstract
Musculoskeletal disease (MSD) is common in ageing cats, resulting in chronic pain and mobility impairment, but diagnosis can be challenging. We hypothesised that there would be differences between cats with and without MSD in paw pressure and spatiotemporal and kinetic gait metrics. A cohort of 53 cats, aged between 7 and 10 years from the North West of the United Kingdom, underwent an orthopaedic examination and walked on a pressure sensitive walkway. Thirty-one of the cats (58%) were determined to be apparently-healthy, based on a normal orthopaedic examination and having no history of MSD, whilst the remaining 22 cats (42%) had findings consistent with MSD; 13/22 cats (59%) had multiple limb involvement, 7/22 (32%) had forelimb involvement and 2/22 (9%) had hindlimb involvement. Bodyweight (P = 0.048) and body condition score (BCS; P = 0.015) were both greater in cats with MSD (mean bodyweight 5.4 ± 1.35 kg; median BCS 6, IQR 6-7.75) compared with apparently-healthy cats (mean bodyweight 4.7 ± 0.94 kg; median BCS 5, IQR 4.5-6.5). There was a relatively large intra-cat variation in spatiotemporal and kinetic gait variables (coefficient of variation >3.0%), whilst a linear mixed-effects model suggested no significant difference in spatiotemporal or kinetic gait variables between apparently-healthy cats and those with MSD. Palmar and plantar pressure asymmetry was assessed by pedobarographic statistical parametric mapping (pSPM) within each individual cat, with no significant difference (P = 0.353) between the apparently heathy cats and those with MSD as to the presence or absence of asymmetry. Given the marked intra-cat variation and the 'multi-limb' nature of MSD in this cohort, it was not possible to differentiate healthy cats from those with MSD based on spatiotemporal and kinetic gait metrics or paw pressure asymmetry. Future work should examine gait in cats with defined musculoskeletal disorders (e.g. hip dysplasia) and also to track longitudinal changes within individual cats to better establish age-related trends.
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Affiliation(s)
- Nathalie Dowgray
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- International Cat Care, Tisbury, Wiltshire, United Kingdom
| | - Eithne Comerford
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
- The MRC-Versus Arthritis Centre for Integrated research into Musculoskeletal Ageing (CIMA), Liverpool, United Kingdom
| | - Alexander J German
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
| | - James Gardiner
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Gina Pinchbeck
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Karl T Bates
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
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Lefort-Holguin M, Delsart A, Otis C, Moreau M, Barbeau-Grégoire M, Mellet F, Biourge V, Lussier B, Pelletier JP, Martel-Pelletier J, Troncy E. Efficacy and Safety of a Diet Enriched with EPA and DHA, Turmeric Extract and Hydrolysed Collagen in Management of Naturally Occurring Osteoarthritis in Cats: A Prospective, Randomised, Blinded, Placebo- and Time-Controlled Study. Animals (Basel) 2024; 14:3298. [PMID: 39595350 PMCID: PMC11591455 DOI: 10.3390/ani14223298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2024] [Revised: 11/11/2024] [Accepted: 11/14/2024] [Indexed: 11/28/2024] Open
Abstract
This study evaluated a therapeutic diet high in eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) of marine source (EPA:DHA ratio 0.69:1), turmeric extract, and hydrolysed collagen in cats (N = 30) with naturally occurring osteoarthritis (OA) over a 13-week (W) period, followed by a 4-W washout, using four previously validated pain/functional outcomes. Compared to the placebo diet, the therapeutic diet significantly improved peak vertical force (p = 0.017; W16, 64% responders), correlating to enhanced weight bearing; stair assay compliance (p < 0.001; W16, 87% responders), reflecting reduced fatigue related to OA pain; night-time actimetry (cohort effect; p = 0.05, 67% responders), suggesting greater spontaneous mobility and comfort; and MI-CAT(V) score (cohort effect; p < 0.001, 80% responders), indicating reduced functional impairments. The earliest therapeutic response was observed at W06, marked by an inflection point between actimetric linear regressions of both cohorts, confirmed by significant MI-CAT(V) differences (p < 0.007; W08; W12; W16). The MI-CAT(V) clinical metrology instrument was validated for inter-rater reliability, minimal placebo effect (<15% responders), and OA severity clustering. Despite baseline differences in biomechanical assessments (p < 0.05), both moderate and severe OA clusters responded equally positively to the therapeutic diet. Based on all outcomes, the therapeutic diet showed promise for the long-term management of feline OA, with no observed side effects.
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Affiliation(s)
- Manuela Lefort-Holguin
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.L.-H.); (A.D.); (C.O.); (M.M.); (M.B.-G.); (B.L.)
| | - Aliénor Delsart
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.L.-H.); (A.D.); (C.O.); (M.M.); (M.B.-G.); (B.L.)
| | - Colombe Otis
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.L.-H.); (A.D.); (C.O.); (M.M.); (M.B.-G.); (B.L.)
| | - Maxim Moreau
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.L.-H.); (A.D.); (C.O.); (M.M.); (M.B.-G.); (B.L.)
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
| | - Maude Barbeau-Grégoire
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.L.-H.); (A.D.); (C.O.); (M.M.); (M.B.-G.); (B.L.)
| | - Florence Mellet
- Royal-Canin S.A.S., F-30470 Aimargues, France; (F.M.); (V.B.)
| | - Vincent Biourge
- Royal-Canin S.A.S., F-30470 Aimargues, France; (F.M.); (V.B.)
| | - Bertrand Lussier
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.L.-H.); (A.D.); (C.O.); (M.M.); (M.B.-G.); (B.L.)
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
| | - Eric Troncy
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.L.-H.); (A.D.); (C.O.); (M.M.); (M.B.-G.); (B.L.)
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
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6
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Huntingford J, Looney A, Johnson J, Miller L. The use of platelet rich plasma in the treatment of degenerative joint disease in cats: an exploratory case series. Front Vet Sci 2024; 11:1394055. [PMID: 38863451 PMCID: PMC11165359 DOI: 10.3389/fvets.2024.1394055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/26/2024] [Indexed: 06/13/2024] Open
Abstract
Objective To evaluate the effectiveness of intra-articular autologous Platelet Rich Plasma (PRP) in managing Degenerative Joint Disease (DJD) in cats. Design Prospective pilot clinical trial. Methods Six domestic cats with clinically and radiographically diagnosed DJD received intra-articular injections of autologous PRP. Clinical assessments pre and post intra-articular injections were conducted using the Feline Musculoskeletal Pain Index (FMPI, owner assessed) and Visual Analog Scale (VAS, clinician assessed) at baseline, Day 14, Day 28, and Day 42-45. Results Significant improvements were noted in both FMPI and VAS scores at the end of the study period, indicating enhanced joint function and reduced pain. Conclusion and clinical relevance The study suggests the potential of PRP therapy as a safe and effective treatment for feline DJD, warranting further research with larger cohorts and longer follow-up to establish comprehensive treatment guidelines.
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Affiliation(s)
| | - Andrea Looney
- Central Hospital for Veterinary Medicine, North Haven, CT, United States
| | - James Johnson
- Companion Animal Health, New Castle, DE, United States
| | - Lisa Miller
- Companion Animal Health, New Castle, DE, United States
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Taylor S, Gruen M, KuKanich K, X Lascelles BD, Monteiro BP, Sampietro LR, Robertson S, Steagall PV. 2024 ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats. J Feline Med Surg 2024; 26:1098612X241241951. [PMID: 38587872 PMCID: PMC11103309 DOI: 10.1177/1098612x241241951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
PRACTICAL RELEVANCE Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and are effective for the management of pain in cats. These Guidelines will support veterinarians in decision-making around prescribing NSAIDs in situations of chronic pain, to minimise adverse effects and optimise pain management. Information is provided on mechanism of action, indications for use, screening prior to prescription, use in the presence of comorbidities, monitoring of efficacy, and avoidance and management of adverse effects. CLINICAL CHALLENGES The cat's unique metabolism should be considered when prescribing any medications, including NSAIDs. Chronic pain may be challenging to detect in this species and comorbidities, particularly chronic kidney disease, are common in senior cats. Management of chronic pain may be complicated by prescription of other drugs with the potential for interactions with NSAIDs. EVIDENCE BASE These Guidelines have been created by a panel of experts brought together by the International Society of Feline Medicine (ISFM) and American Association of Feline Practitioners (AAFP). Information is based on the available literature, expert opinion and the panel members' experience.
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Affiliation(s)
- Samantha Taylor
- Panel ChairInternational Society of Feline Medicine, International Cat Care, Tisbury, Wi Itshire, UK
| | - Margaret Gruen
- Comparative Pain Research Laboratory; and Behavioural Medicine Service - Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, NC, USA
| | - Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, KS, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program and Comparative Pain Research and Education Centre (CPREC), North Carolina State University, NC, USA
| | - Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, QC, Canada
| | | | - Sheilah Robertson
- Lap of Love Veterinary Hospice, Lutz, FL, USA; and Courtesy Lecturer, Shelter Medicine Program, University of Florida, FL, USA
| | - Paulo V Steagall
- Department of Veterinary Clinical Sciences and Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, SAR China; and Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, QC, Canada
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8
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Maniaki E, Murrell J, Langley-Hobbs SJ, Blackwell EJ. Do owner-reported changes in mobility reflect measures of activity, pain and degenerative joint disease in cats? J Feline Med Surg 2023; 25:1098612X231178765. [PMID: 37382593 PMCID: PMC10811984 DOI: 10.1177/1098612x231178765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
OBJECTIVES The aim of this blinded, nested case-control study was to compare cats with and without early owner-reported mobility changes using subjective and objective outcome measures (owner-completed questionnaires, orthopaedic examination). METHODS A total of 57 cats with and without early owner-reported signs of impaired mobility were allocated to the case (n = 30) and control (n = 27) groups, respectively. Participating owners completed one inclusion and two pre-visit questionnaires (Feline Musculoskeletal Pain Index, VetMetrica). Cats were then visited in their own homes, where they underwent an orthopaedic examination, an assessment of their body condition score and temperament, and the placement of an accelerometer on their collar for 2 weeks. RESULTS There was no significant difference between groups for age category, breed, sex, temperament and body condition score. Case cats scored significantly lower for the Feline Musculoskeletal Pain Index (P = 0.003) and the VetMetrica domain of Comfort (P = 0.002), but not Vitality (P = 0.009) or Emotional Wellbeing (P = 0.018). Total pain (P <0.0001), crepitus (P = 0.002) and thickening (P = 0.003) scores were higher in case cats, as was the presence of bilateral disease (P = 0.005, odds ratio 14) and the number of bilaterally affected joints (P = 0.001). CONCLUSIONS AND RELEVANCE Both the Feline Musculoskeletal Pain Index and orthopaedic examination were able to differentiate cats with early owner-reported signs of impaired mobility from healthy cats. VetMetrica Comfort domain scores indicated a compromised quality of life for cats with early owner-reported signs of impaired mobility compared with healthy cats. Being able to recognise signs of mobility impairment earlier would allow interventions aimed at slowing disease progression, thereby improving feline health and welfare.
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Affiliation(s)
| | - Jo Murrell
- Highcroft Veterinary Referrals, Bristol, UK
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Gutierre E, Crosignani N, García‐Carnelli C, di Mateo A, Recchi L. A case report of CBD and THC as analgesic therapy in a cat with chronic osteoarthritic pain. Vet Med Sci 2023; 9:1021-1025. [PMID: 37002652 DOI: 10.1002/vms3.1057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
A 10-year-old mixed breed male cat presented with clinical signs related to chronic orthopaedic pain. Upon physical examination, pain was noted, based on the feline Musculoskeletal Pain Index (FMPI). An analgesic treatment with a full spectrum cannabis oil (1.8% CBD and 0.8% THC) was proposed for 30 days (0,5 mg/kg based on CBD). The FMPI scale score decreased more than 50%. This case reported a satisfactory outcome for the patient and the owner, although this medication could increase ALT. Given the paucity of literature published to date on the treatment of veterinary species with cannabis-based medications, further clinical and pharmacokinetic studies are necessary to study the safety and efficacy of its use.
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Affiliation(s)
- E Gutierre
- Facultad de Veterinaria Departamento de Clínicas y Hospital Veterinario Universidad de la República Montevideo Uruguay
| | - N Crosignani
- Facultad de Veterinaria Departamento de Clínicas y Hospital Veterinario Universidad de la República Montevideo Uruguay
| | - C García‐Carnelli
- Facultad de Química Departamento de Química Orgánica Universidad de la República Montevideo Uruguay
| | - A di Mateo
- Facultad de Veterinaria Departamento de Clínicas y Hospital Veterinario Universidad de la República Montevideo Uruguay
| | - L Recchi
- Facultad de Veterinaria Departamento de Clínicas y Hospital Veterinario Universidad de la República Montevideo Uruguay
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Deabold K, Montalbano C, Miscioscia E. Feline Osteoarthritis Management. Vet Clin North Am Small Anim Pract 2023; 53:879-896. [PMID: 36964025 DOI: 10.1016/j.cvsm.2023.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
Feline osteoarthritis is common; despite vague clinical signs, it can result in mobility impairment and quality of life concerns. An integrative approach to management may include analgesic medications, dietary modifications, nutraceuticals, environmental modifications, physical rehabilitation, acupuncture, and regenerative medicine. Management of concurrent disease and consideration for patient tolerance and owner compliance are critical in formulating a treatment plan in cats with osteoarthritis.
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Affiliation(s)
- Kelly Deabold
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32608, USA
| | | | - Erin Miscioscia
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32608, USA.
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Rodan I, Dowgray N, Carney HC, Carozza E, Ellis SLH, Heath S, Niel L, St Denis K, Taylor S. 2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques. J Feline Med Surg 2022; 24:1093-1132. [PMID: 36259500 PMCID: PMC10845437 DOI: 10.1177/1098612x221128760] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE The '2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques' (hereafter the 'Cat Friendly Veterinary Interaction Guidelines') support veterinary professionals with feline interactions and handling to reduce the impact of fear and other protective (negative) emotions, in so doing enhancing feline welfare and In implementing these Guidelines, team satisfaction and cat caregiver confidence in the veterinary team will increase as the result of efficient examinations, better experience, more reliable diagnostic testing and improved feline wellbeing. Veterinary professionals will learn the importance of understanding and appropriately responding to the current emotional state of the cat and tailoring each visit to the individual. CLINICAL CHALLENGES Cats have evolved with emotions and behaviors that are necessary for their survival as both a predator and prey species. A clinical setting and the required examinations and procedures to meet their physical health needs can result in behavioral responses to protective emotions. Cat friendly interactions require understanding, interpreting and appropriately responding to cats' emotional states and giving them a perceived sense of control while performing the required assessment. EVIDENCE BASE These Guidelines have been created by a Task Force of experts convened by the American Association of Feline Practitioners and the International Society of Feline Medicine, based on an extensive literature review and, where evidence is lacking, the authors' experience. ENDORSEMENTS These Guidelines have been endorsed by a number of groups and organizations, as detailed on page 1127 and at catvets.com/interactions and icatcare.org/cat-friendly-guidelines.
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Affiliation(s)
- Ilona Rodan
- Cat Behavior Solutions, Cat Care Clinic, Madison, WI, USA
| | - Nathalie Dowgray
- International Society of Feline Medicine, International Cat Care, Tisbury, Wi ltshire, UK
| | | | | | | | - Sarah Heath
- Behavioural Referrals Veterinary Practice, Chester, UK
| | - Lee Niel
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Kelly St Denis
- St Denis Veterinary Professional Corporation, Powassan, Ontario, Canada
| | - Samantha Taylor
- International Society of Feline Medicine, International Cat Care, Wiltshire, Tisbury, UK
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Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022
WSAVA
guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2022. [DOI: 10.1111/jsap.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. D. X. Lascelles
- Comparative Pain Research Laboratory and Surgery Section North Carolina State University 4700 Hillsborough Street Raleigh NC USA
| | - J. Murrell
- Highcroft Veterinary Referrals 615 Wells Rd, Whitchurch Bristol BS149BE UK
| | - S. Robertson
- Senior Medical Director Lap of Love Veterinary Hospice 17804 N US Highway 41 Lutz FL 33549 USA
| | - P. V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. Wright
- Mistral Vet 4450 Thompson Pkwy Fort Collins CO 80534 USA
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Cunningham R, Gruen ME, Thomson A, Lascelles BDX. Evaluation of a nutritional supplement for the alleviation of pain associated with feline degenerative joint disease: a prospective, randomized, stratified, double-blind, placebo-controlled clinical trial. J Feline Med Surg 2022; 24:962-974. [PMID: 34719996 PMCID: PMC10812307 DOI: 10.1177/1098612x211053484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the pain-alleviating and activity-enhancing effects of glucosamine/chondroitin sulfate (Dasuquin) in cats that had degenerative joint disease (DJD) and owner-noted mobility/activity impairment. We hypothesized that the nutritional supplement would produce pain-relieving and activity-enhancing effects in cats with painful DJD. METHODS In this prospective, randomized, stratified, double-blind, placebo-controlled clinical trial, 59 cats with DJD pain were assigned to receive a placebo (n = 30) or supplement (n = 29) for 6 weeks after 2 weeks of placebo. Outcome measures (at-home accelerometry and client-specific outcome measures [feline (CSOMf); Feline Musculoskeletal Pain Index (FMPI); quality of life (QoL)]; and veterinarian examination) were collected at days 14, 28, 42 and 56. RESULTS Twenty-seven cats in the treatment group and 30 in the placebo group completed the trial. Within the first 2 weeks (placebo administration to all cats), 78% of all cats had an improvement in CSOMf scores. Both groups showed significant improvement at most time points in CSOMf, FMPI, QoL and pain scores, with the placebo group showing greater improvement than the supplement group (significant for CSOMf [P = 0.01]). Overall, no differences in activity were seen between the groups. Cumulative distribution function analysis indicated that for most levels of activity, the placebo-treated cats were more active; however, the least active cats were more active on the supplement (P = 0.013). CONCLUSIONS AND RELEVANCE This study showed a strong placebo effect. The glucosamine/chondroitin sulfate supplement did not show pain-relieving effects when compared with placebo.
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Affiliation(s)
- Rachael Cunningham
- Comparative Behavioral Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Margaret E Gruen
- Comparative Behavioral Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Comparative Pain Research and Education Center, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Andrea Thomson
- Comparative Behavioral Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Center for Translational Pain Research, Department of Anesthesiology, Duke University, NC, USA
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Rodiño Tilve V, Allaith S, Girling S, Moores AP, Mulholland L, Morrison S, Onyett J, Maddox TW, Lascelles BDX, Langley-Hobbs S, Comerford E. Long-term follow up of 44 cats undergoing total hip replacement: Cases from a feline hip registry (2010-2020). Vet Surg 2022; 51:763-771. [PMID: 35642440 DOI: 10.1111/vsu.13822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 04/02/2022] [Accepted: 04/15/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To report indications, complications, and long-term outcomes following feline total hip replacement (THR) using a client-based clinical metrology questionnaire, the Feline Musculoskeletal Pain Index (FMPI), and owner satisfaction. STUDY DESIGN Multi-institutional retrospective cohort study. ANIMALS Cats (n = 44) that underwent THR (n = 56). METHODS Feline THRs submitted to a registry over a 10-year period were reviewed. The FMPI and owner satisfaction surveys were used to assess outcome. RESULTS Forty-four cats met the inclusion criteria. Median age was 2 years (range: 0.9-11), and median bodyweight 5 kg (range: 3.3-7.6). British Shorthair and Domestic Shorthair were the most frequent breeds. Most cats were neutered males (33/44) and slipped capital femoral epiphysis (SCFE) was the most common surgical indication (34/56). All implants were cemented micro and nano hip implants. Overall complications (11/56) included 9 major complications. The median duration of follow up was 752 days (range: 102-3089). No association was found between clinical variables and complications. The FMPI score improved from 0.111 (range: 0-1.222) to 2.111 (range: 0.888-3.666) postoperatively (P < .001). Owner satisfaction was reported as "very good" in 30/33 cases (90.9%). CONCLUSION A validated client metrology questionnaire showed clinical improvement in cats following THR. The most common indication for THR in cats was SCFE occurring in young male neutered cats. Complication rates were comparable to previous reports. CLINICAL SIGNIFICANCE Total hip replacement appears to be a successful surgical treatment for feline hip disease with very good owner satisfaction and acceptable complication rates.
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Affiliation(s)
| | - Sumaya Allaith
- Department of Musculoskeletal and Ageing Sciences, University of Liverpool, Liverpool, UK
| | | | | | - Lauren Mulholland
- School of Veterinary Science, University of Liverpool, Liverpool, UK
| | | | | | - Thomas W Maddox
- Small Animal Teaching Hospital, University of Liverpool, Wirral, UK
| | - B Duncan X Lascelles
- College of Veterinary Medicine, NC State University, Raleigh, North Carolina, USA
| | | | - Eithne Comerford
- Small Animal Teaching Hospital, University of Liverpool, Wirral, UK
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15
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Factors associated with play behavior in human-cat dyads. J Vet Behav 2022. [DOI: 10.1016/j.jveb.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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16
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Enomoto M, Lascelles BDX, Robertson JB, Gruen ME. Refinement of the Feline Musculoskeletal Pain Index (FMPI) and development of the short-form FMPI. J Feline Med Surg 2022; 24:142-151. [PMID: 34002643 PMCID: PMC10812168 DOI: 10.1177/1098612x211011984] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the reliability and responsiveness of the Feline Musculoskeletal Pain Index (FMPI) using the collective results of multiple clinical studies and iteratively refine the FMPI for future use. METHODS Data were compiled from previously conducted studies involving client-owned cats with degenerative joint disease (DJD) and which used the FMPI. The reliability of the FMPI was assessed using the data from the initial visits of those studies. For the assessment of responsiveness of the FMPI, only placebo-controlled studies that used analgesic treatments were included. Treatment groups from each study were combined and categorized as 'placebo' group and 'analgesic' group. Then, the mean change from baseline in score of each FMPI item and across all items within and between these groups were assessed. Based on the results of the reliability and responsiveness of the FMPI, stepwise elimination was used to remove the items that were least able to distinguish between the placebo and analgesic groups. Finally, after the stepwise elimination, a proposed new FMPI-short form (FMPI-sf) was constructed and its reliability was reassessed using the data sets described above. Individual and combined data sets of the studies were also used to compare the responsiveness of the original FMPI and the FMPI-sf. RESULTS The data from 180 cats from four studies were included. The original FMPI had a reasonable reliability, but low/no responsiveness. The elimination process of FMPI items refined the responsiveness of the instrument while maintaining its reliability. When the responsiveness was compared between the original FMPI (17 items) and the FMPI-sf (nine items), the treatment effect between groups was always greater when the FMPI-sf was used. CONCLUSIONS AND RELEVANCE The proposed FMPI-sf may be able to better distinguish between placebo and analgesic effects in cats with DJD.
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Affiliation(s)
- Masataka Enomoto
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Center for Translational Pain Research, Department of Anaesthesiology, Duke University, Durham, NC, USA
| | - James B Robertson
- Biostatistician, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Margaret E Gruen
- Comparative Pain Research and Education Centre, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Comparative Medicine Institute, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Behavioral Medicine, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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Yeowell G, Burns D, Fatoye F, Gebrye T, Wright A, Mwacalimba K, Odeyemi I. Indicators of Health-Related Quality of Life in Cats With Degenerative Joint Disease: Systematic Review and Proposal of a Conceptual Framework. Front Vet Sci 2021; 8:582148. [PMID: 34869707 PMCID: PMC8636455 DOI: 10.3389/fvets.2021.582148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The assessment of health-related quality of life (HRQoL) is becoming increasingly important in companion animals. This study describes a systematic review and development of a proposed conceptual framework to assess HRQoL in cats with osteoarthritis (OA). Methods: The conceptual framework was developed according to published guidelines. A comprehensive search of the CAB Direct, Scopus, PubMed, and Web of Science databases was carried out for publications in English from inception to November 12, 2019. Search words used were "cat", "feline", "chronic pain", "pain", and "quality of life". Publications were selected if they were full-text and peer-reviewed, based on primary data, and identified or measured behavioral symptoms of chronic musculoskeletal pain in cats. A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A data extraction form was developed from categories identified in the literature review and piloted on a small number of studies to ascertain the appropriateness for relevant data extraction. Categories were then finalized, and key domains were identified. The domains were then synthesized to develop a conceptual framework. Results: A total of 454 studies were identified, of which 14 met the eligibility criteria and were included in the meta-synthesis. All 14 were assessed to be of good quality. Seven domains related to HRQoL in cats with OA were thematically identified from the data: mobility, physical appearance, energy and vitality, mood, pain expression, sociability, and physical and mental wellbeing. The three main HRQoL domains were pain expression, mobility, and physical and mental wellbeing, which impacted all the others. Pain and mobility impacted all six other domains, with increased pain and decreased mobility negatively impacting physical appearance, energy and vitality, mood, sociability, and physical and mental wellbeing. Conclusions and Relevance: This is the first study to develop an evidence-based conceptual framework for the assessment of HRQoL in cats with OA. The proposed conceptual framework suggests that effective management of chronic pain in cats may improve their overall HRQoL.
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Affiliation(s)
- Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Danielle Burns
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Tadesse Gebrye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andrea Wright
- Outcomes Research, International Center of Excellence, Zoetis, Dublin, Ireland
| | | | - Isaac Odeyemi
- Outcomes Research, International Center of Excellence, Zoetis, Dublin, Ireland
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Lai YHE, Lascelles BDX, Nolan MW. Behavioral phenotyping of cancer pain in domesticated cats with naturally occurring squamous cell carcinoma of the tongue: initial validation studies provide evidence for regional and widespread algoplasticity. PeerJ 2021; 9:e11984. [PMID: 34458024 PMCID: PMC8375511 DOI: 10.7717/peerj.11984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 07/26/2021] [Indexed: 12/16/2022] Open
Abstract
Feline oral squamous cell carcinoma (FOSCC) is a common and naturally occurring condition that recapitulates many features of human head and neck cancer (HNC). In both species, there is need for improved strategies to reduce pain caused by HNC and its treatment. Research to benefit both species could be conducted using pet cats as a comparative model, but this prospect is limited by lack of validated methods for quantifying FOSCC-associated pain. A prospective non-randomized pilot study was performed for initial validation of: (1) a pet owner administered quality of life questionnaire and visual assessment scoring tool (FORQ/CLIENT); (2) a clinician assessment questionnaire (UFEPS/VET); (3) electronic von Frey testing [EVF]; and (4) Cochet-Bonnet (COBO) aesthesiometry. To assess intra-rater reliability, discriminatory ability, and responsiveness of each assay, 6 cats with sublingual SCC and 16 healthy control cats were enrolled. The intra-rater reliability was moderate-to-good for the clinical metrology instruments and EVF (intraclass correlation coefficient [ICC] ≥ 0.68), but poor for COBO (ICC = 0.21). FORQ/CLIENT scores were higher (worse quality of life) in FOSCC cats vs healthy controls. The internal reliability of FORQ/CLIENT scoring was high (Cronbach α = 0.92); sensitivity and specificity were excellent (100% when using cut-offs determined using receiver operating characteristic [ROC] curves). For the FORQ/CLIENT, there was strong and inverse correlation between scores from the questions and visual assessment (r = − 0.77, r2 = 0.6, P < 0.0001). For the UFEPS/VET, Cronbach’s α was 0.74 (high reliability). Sensitivity and specificity were 100% and 94%, respectively, when using a cut-off score (3.5) based on ROC curves (Youden index of 0.94). Total UFEPS/VET scores were positively correlated with FORQ/CLIENT scores (r2 = 0.72, P < 0.0001). Sensitivity of EVF and COBO ranged from 83 to 100% and specificity ranged from 56 to 94%. Cats with cancer were more sensitive around the face (lower response thresholds) and on the cornea (longer filament lengths) than control animals (P < 0.03). Reduced pressure response thresholds were also observed at a distant site (P = 0.0002) in cancer cats. After giving buprenorphine, EVF pressure response thresholds increased (P = 0.04) near the mandible of cats with OSCC; the length of filament required to elicit a response in the COBO assay also improved (shortened; P = 0.017). Based on these preliminary assessments, the assays described herein had reasonable inter-rater reliability, and they were able to both discriminate between cats with and without oral cancer, and respond in a predictable manner to analgesic therapy. In cats with tongue cancer, there was evidence for regional peripheral sensitization, and widespread somatosensory sensitization. These results provide a basis for multi-dimensional assessments of pain and sensitivity in cats with oral SCC.
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Affiliation(s)
- Yen-Hao Erik Lai
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States of America.,Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America
| | - B Duncan X Lascelles
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States of America.,Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America.,Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States of America
| | - Michael W Nolan
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States of America.,Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America.,Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States of America
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Ray M, Carney HC, Boynton B, Quimby J, Robertson S, St Denis K, Tuzio H, Wright B. 2021 AAFP Feline Senior Care Guidelines. J Feline Med Surg 2021; 23:613-638. [PMID: 34167339 PMCID: PMC10812122 DOI: 10.1177/1098612x211021538] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The '2021 AAFP Feline Senior Care Guidelines' are authored by a Task Force of experts in feline clinical medicine and serve as an update and extension of those published in 2009. They emphasize the individual patient evaluation and the process of aging, with references to other feline practice guidelines for a more complete discussion of specific diseases. Focusing on each cat encourages and empowers the owner to become a part of the cat's care every step of the way. A comprehensive discussion during the physical examination and history taking allows for tailoring the approach to both the cat and the family involved in the care. Videos and analysis of serial historical measurements are brought into the assessment of each patient. These Guidelines introduce the emerging concept of frailty, with a description and methods of its incorporation into the senior cat assessment. Minimum database diagnostics are discussed, along with recommendations for additional investigative considerations. For example, blood pressure assessment is included as a minimum diagnostic procedure in both apparently healthy and ill cats. Cats age at a much faster rate than humans, so practical timelines for testing frequency are included and suggest an increased frequency of diagnostics with advancing age. The importance of nutrition, as well as senior cat nutritional needs and deficiencies, is considered. Pain is highlighted as its own syndrome, with an emphasis on consideration in every senior cat. The Task Force discusses anesthesia, along with strategies to allow aging cats to be safely anesthetized well into their senior years. The medical concept of quality of life is addressed with the latest information available in veterinary medicine. This includes end of life considerations like palliative and hospice care, as well as recommendations on the establishment of 'budgets of care', which greatly influence what can be done for the individual cat. Acknowledgement is given that each cat owner will be different in this regard; and establishing what is reasonable and practical for the individual owner is important. A discussion on euthanasia offers some recommendations to help the owner make a decision that reflects the best interests of the individual cat.
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Affiliation(s)
| | - Hazel C Carney
- WestVet Emergency and Specialty Center, Garden City, ID, USA
| | - Beth Boynton
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
| | - Jessica Quimby
- The Ohio State University, Department of Veterinary Clinical Sciences, Columbus, OH, USA
| | - Sheilah Robertson
- Senior Medical Director, Lap of Love Veterinary Hospice, Lutz, FL, USA
| | | | - Helen Tuzio
- Forest Hills Cat Hospital, Middle Village, NY, USA
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Gruen ME, Myers JAE, Lascelles BDX. Efficacy and Safety of an Anti-nerve Growth Factor Antibody (Frunevetmab) for the Treatment of Degenerative Joint Disease-Associated Chronic Pain in Cats: A Multisite Pilot Field Study. Front Vet Sci 2021; 8:610028. [PMID: 34124212 PMCID: PMC8195238 DOI: 10.3389/fvets.2021.610028] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 04/06/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Pain management for cats with degenerative joint disease (DJD) remains a critical unmet need. Recent work has shown promise for a feline-specific anti-nerve growth factor monoclonal antibody (frunevetmab) to deliver safe and effective pain management. Our objectives were to evaluate the efficacy and safety of frunevetmab administered twice using two administration routes (subcutaneous and intravenous) compared to placebo. Methods: This was a randomized placebo-controlled, double-masked study. After a week-long pain and activity baseline, 126 cats were randomized to receive injections of frunevetmab (IV then SC; n = 42 or SC then SC; n = 43) or placebo (IV then SC; n = 41) on Days 0 and 28. Owners completed questionnaires on Days 14, 28, 42, and 56. Accelerometry data were collected continuously throughout. Results: Owner questionnaire results showed significant improvement in frunevetmab-treated cats [compared to placebo; (p < 0.05)] at Days 42 and 56; no difference was found between routes of administration for frunevetmab. All groups had decreased objectively measured weekly activity from baseline; frunevetmab-treated cats had a mean decrease of 0.9%, while placebo-treated cats had a mean decrease of 9.3%. Treatments were generally well-tolerated. The majority of adverse events included dermatitis/alopecia related to activity-monitor collars; these occurred in a higher percentage of frunevetmab, compared to placebo, treated cats. Conclusions and Clinical Relevance: Treatment with frunevetmab provided improvements in owner ratings of mobility over treatment with placebo; these results were supported by objectively measured accelerometry. Frunevetmab has the potential to address a critical gap in the treatment of chronic pain in cats.
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Affiliation(s)
- Margaret E. Gruen
- Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Behavioral Medicine, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States
| | - Jamie A. E. Myers
- Veterinary Medicine Research and Development, Zoetis, Inc., Kalamazoo, MI, United States
| | - B. Duncan X. Lascelles
- Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States
- Thurston Arthritis Center, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC, United States
- Department of Anesthesiology, Center for Translational Pain Research, Duke University, Durham, NC, United States
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Adrian D, King JN, Parrish RS, King SB, C Budsberg S, Gruen ME, Lascelles BDX. Robenacoxib shows efficacy for the treatment of chronic degenerative joint disease-associated pain in cats: a randomized and blinded pilot clinical trial. Sci Rep 2021; 11:7721. [PMID: 33833276 PMCID: PMC8032665 DOI: 10.1038/s41598-021-87023-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/23/2021] [Indexed: 12/29/2022] Open
Abstract
The main objective of this pilot clinical trial was to evaluate outcome measures for the assessment of the nonsteroidal anti-inflammatory drug (NSAID) robenacoxib in cats with degenerative joint disease-associated pain (DJD-pain). Otherwise healthy cats (n = 109) with DJD-pain entered a parallel group, randomized, blinded clinical trial. Cats received placebo (P) or robenacoxib (R) for two consecutive 3-week periods. Treatment groups were PP, RR, and RP. Actimetry and owner-assessment data were collected. Data were analyzed using mixed-effects and generalized mixed-effects linear models. Activity data showed high within-cat and between-cat variability, and 82.4% of the values were zero. Compared to placebo, mean total activity was higher (5.7%) in robenacoxib-treated cats (p = 0.24); for the 80th percentile of activity, more robenacoxib-treated cats had a > 10% increase in activity after 3 (p = 0.046) and 6 weeks (p = 0.026). Robenacoxib treatment significantly decreased owner-assessed disability, (p = 0.01; 49% reduction in disability; effect size ~ 0.3), and improved temperament (p = 0.0039) and happiness (p = 0.021) after 6 weeks. More robenacoxib-treated cats were successes at 6 weeks (p = 0.018; NNT: 3.8). Adverse effect frequencies were similar across groups. Results identified suitable endpoints for confirmatory studies, while also indicating efficacy of robenacoxib in cats with DJD-pain.
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Affiliation(s)
- Derek Adrian
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Elanco Animal Health, Greenfield, USA
| | - Jonathan N King
- Elanco Animal Health, Companion Animal Development, Basel, Switzerland
| | - Rudolph S Parrish
- Elanco Animal Health, Companion Animal Development, Greenfield, IN, USA
- Vista Research LLC, Bath, ME, USA
| | - Stephen B King
- Elanco Animal Health, Companion Animal Development, Greenfield, IN, USA
| | - Steven C Budsberg
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Margaret E Gruen
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Behavioral Medicine, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Comparative Pain Research and Education Centre, North Carolina State University, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
- Comparative Pain Research and Education Centre, North Carolina State University, Raleigh, NC, USA.
- Department of Anesthesiology, Center for Translational Pain Research, Duke University, Durham, NC, USA.
- Thurston Arthritis Center, UNC School of Medicine, Chapel Hill, NC, USA.
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Enomoto M, Lascelles BDX, Gruen ME. Development of a checklist for the detection of degenerative joint disease-associated pain in cats. J Feline Med Surg 2020; 22:1137-1147. [PMID: 32122226 PMCID: PMC7736399 DOI: 10.1177/1098612x20907424] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to develop an evidence-based, clinically expedient checklist to identify cats likely to have degenerative joint disease (DJD)-associated pain. METHODS Data were compiled from previously conducted studies that employed a standardized subjective outcome measure consisting of a series of questions. These studies included a prevalence study (with DJD non-informed owners) and therapeutic trials (with DJD-informed owners). For each cat, and each question, response scores were converted to 'impaired' and 'unimpaired'. Cats were categorized as 'DJD pain' and 'non-DJD' based on orthopedic pain and radiographic DJD scores. These binary data were compared between cat phenotypes (non-DJD and DJD pain) for each question. Sensitivity and specificity of each question were calculated using the binary data; based on this, potential questions for the checklist were selected. Sensitivity and specificity across this group of questions were calculated, and questions sequentially removed to optimize length, sensitivity and specificity. Finally, the proposed checklist was applied to a novel data set to evaluate its ability to identify cats with DJD pain. RESULTS In total, 249 DJD pain cats and 53 non-DJD cats from five studies were included. Nine questions with adequate sensitivity and specificity were initially identified. Following sequential removal of questions, a checklist with six binary questions was proposed. Based on the data from the cohorts of DJD-informed and DJD non-informed owners, the sensitivity and specificity of the proposed checklist were approximately 99% and 100%, and 55% and 97%, respectively. CONCLUSIONS AND RELEVANCE The proposed checklist represents a data-driven approach to construct a screening checklist for DJD pain in cats. This checklist provides a clinically expedient tool likely to increase veterinarians' ability to screen for DJD pain in cats. The identified behaviors comprising the checklist may further provide a foundation for increasing awareness of DJD pain among cat owners.
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Affiliation(s)
- Masataka Enomoto
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA
| | - Margaret E Gruen
- Comparative Pain Research and Education Centre, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Comparative Medicine Institute, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Behavioral Medicine, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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Dowgray N, Comerford E. Feline musculoskeletal ageing: How are we diagnosing and treating musculoskeletal impairment? J Feline Med Surg 2020; 22:1069-1083. [PMID: 33100170 PMCID: PMC10814220 DOI: 10.1177/1098612x20965832] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PRACTICAL RELEVANCE An understanding of the process of musculoskeletal ageing - which all senior and geriatric cats will experience - is vital to maintaining the health and welfare of our ageing cat population. CLINICAL CHALLENGES Assessment of the feline musculoskeletal system is not always straightforward. Diagnosis of impairment relies on input from owners and veterinarians in terms of visual observation, and clinical and orthopaedic examination, in addition to diagnostic imaging. AUDIENCE This review is written for the primary care veterinary team. AIMS The goals are to raise awareness and improve clinical diagnosis of musculoskeletal impairment as a result of ageing. The article also reviews therapeutic options and considers the evidence available for the prevention/deceleration of musculoskeletal ageing and impairment. EVIDENCE BASE There is good evidence of a high prevalence of osteoarthritis (OA) and degenerative joint disease (DJD) in older cats. There is also good evidence to indicate that functional impairment and chronic pain are sequelae of musculoskeletal disease. However, there is a paucity of information for what is best practice for the management and treatment of musculoskeletal impairment in a clinical situation. There is also a lack of evidence on how prevention of central stimulation of the nervous system caused by musculoskeletal impairment and, in turn the development of chronic pain, can be avoided.
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Affiliation(s)
| | - Eithne Comerford
- Institute of Life Course and Medical Sciences and School of Veterinary Science, University of Liverpool, UK
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Sharon KP, Thompson CM, Lascelles BDX, Parrish RS. Novel use of an activity monitor to model jumping behaviors in cats. Am J Vet Res 2020; 81:334-343. [PMID: 32228255 DOI: 10.2460/ajvr.81.4.334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To develop methods to identify and characterize activity monitor (AM) data signatures for jumps performed by cats. ANIMALS 13 healthy, client-owned cats without evidence of osteoarthritis or degenerative joint disease. PROCEDURES Each cat was fitted with the same AM, individually placed in an observation room, then simultaneously recorded by 3 video cameras during the observation period (5 to 8 hours). Each cat was encouraged to jump up (JU), jump down (JD), and jump across (JA) during the observation period. Output from the AM was manually annotated for jumping events, each of which was characterized by functional data analysis yielding relevant coefficients. The coefficients were then used in linear discriminant analysis to differentiate recorded jumps as JUs, JDs, or JAs. To assess the model's ability to distinguish among the 3 jump types, a leave-one-out cross-validation method was used, and the misclassification error rate of the overall categorization of the model was calculated. RESULTS Of 731 jumping events, 29 were misclassified. Overall, the mean misclassification error rate per cat was 5.4% (range, 0% to 12.5%), conversely indicating a correct classification rate per cat of 94.6%. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the model was successful in correctly identifying JUs, JDs, and JAs in healthy cats. With advancements in AM technology and data processing, there is potential for the model to be applied in clinical settings as a means to obtain objective outcome measures.
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Coleman AE, DeFrancesco TC, Griffiths EH, Lascelles BDX, Kleisch DJ, Atkins CE, Keene BW. Atenolol in cats with subclinical hypertrophic cardiomyopathy: a double-blind, placebo-controlled, randomized clinical trial of effect on quality of life, activity, and cardiac biomarkers. J Vet Cardiol 2020; 30:77-91. [PMID: 32707333 DOI: 10.1016/j.jvc.2020.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare quality of life (QOL) and activity measures between healthy control cats and cats with subclinical hypertrophic cardiomyopathy (HCM), and to evaluate the effect of oral atenolol therapy on QOL, activity, and circulating biomarkers in cats with subclinical HCM. ANIMALS Thirty-two client-owned cats with subclinical HCM and 27 healthy control cats. METHODS Owner responses to a QOL questionnaire, circulating cardiac biomarker concentrations, and accelerometer-based activity measures were compared prospectively in cats with and without HCM, and in cats with HCM before and after treatment with oral atenolol (6.25 mg/cat q 12 h) for 6 months. RESULTS Owner-assessed activity of daily living score was lower in cats with HCM than in cats in controls (p=0.0420). No differences were identified between control cats and cats with HCM for any activity variable. Compared with placebo, treatment with atenolol was associated with a lower baseline-adjusted mean ± SD heart rate (157 ± 30 vs. 195 ± 20 bpm; p=0.0001) and rate-pressure product (22,446 ± 6,237 vs. 26,615 ± 4,623 mmHg/min; p=0.0146). A treatment effect of atenolol on QOL or activity was not demonstrated. CONCLUSIONS This study failed to identify an effect of subclinical HCM on owner-assessed QOL or activity or a treatment effect of atenolol on these variables at the dosage evaluated. These findings do not support a treatment benefit of atenolol for the goal of symptom reduction in cats with subclinical HCM.
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Affiliation(s)
- A E Coleman
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
| | - T C DeFrancesco
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA.
| | - E H Griffiths
- Department of Statistics, College of Agriculture and Life Sciences, North Carolina State University, 2311 Stinson Drive, Raleigh, NC, 27695, USA
| | - B D X Lascelles
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
| | - D J Kleisch
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
| | - C E Atkins
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
| | - B W Keene
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
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Monteiro BP, Otis C, Del Castillo JRE, Nitulescu R, Brown K, Arendt-Nielsen L, Troncy E. Quantitative sensory testing in feline osteoarthritic pain - a systematic review and meta-analysis. Osteoarthritis Cartilage 2020; 28:885-896. [PMID: 32360738 DOI: 10.1016/j.joca.2020.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/31/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023]
Abstract
UNLABELLED Quantitative sensory testing (QST) is a psychophysical test used to quantify somatosensory sensation under normal or pathological conditions including osteoarthritis (OA). OBJECTIVE This study aimed to conduct a systematic review and meta-analysis of studies using QST in healthy and osteoarthritic cats, registered at Systematic Review Research Facility (#26-06-2017). DESIGN Hierarchical models with random intercepts for each individual study extracted through the systematic review were fit to subject-level data; QST measures were contrasted between healthy and osteoarthritic cats. Four bibliographic databases were searched; quality and risk of bias assessment were performed using pre-established criteria. RESULTS Six articles were included; most were of high quality and low risk of bias. Punctate tactile threshold (n = 70) and mechanical temporal summation (n = 35) were eligible for analysis. Cats with OA have lower punctate tactile threshold [mean difference (95%HDI): -44 (-60; -26) grams] and facilitated temporal summation of pain [hazard ratio (95%HDI): 5.32 (2.19; 14) times] when compared with healthy cats. The effect of sex and body weight on sensory sensitivity remained inconclusive throughout all analyses. Due to the correlation between age and OA status, it remains difficult to assess the effect of OA on sensory sensitivity, independently of age. CONCLUSIONS Clear and transparent reporting using guidelines are warranted. Similar to people, centralized sensitization is a feature of OA in cats. Future studies should try to elucidate the age effect on feline OA. Research with natural OA in cats is promising with potential to benefit feline health and welfare, and improve translatability to clinical research.
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Affiliation(s)
- B P Monteiro
- GREPAQ (Groupe de Recherche en Pharmacologie Animale Du Québec), Department of Biomedical Sciences, Faculty of Veterinary Medicine - Université de Montréal, Saint-Hyacinthe, QC, Canada.
| | - C Otis
- GREPAQ (Groupe de Recherche en Pharmacologie Animale Du Québec), Department of Biomedical Sciences, Faculty of Veterinary Medicine - Université de Montréal, Saint-Hyacinthe, QC, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.
| | - J R E Del Castillo
- GREPAQ (Groupe de Recherche en Pharmacologie Animale Du Québec), Department of Biomedical Sciences, Faculty of Veterinary Medicine - Université de Montréal, Saint-Hyacinthe, QC, Canada.
| | - R Nitulescu
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.
| | - K Brown
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.
| | - L Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Sensory-Motor Interaction (SMI®), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | - E Troncy
- GREPAQ (Groupe de Recherche en Pharmacologie Animale Du Québec), Department of Biomedical Sciences, Faculty of Veterinary Medicine - Université de Montréal, Saint-Hyacinthe, QC, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.
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27
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Williams H, Calvo I, Gaines A, Kalff S, Sajik D, Kulendra NJ, Meeson RL, Parsons K, Farrell M, Kulendra ER. Multi-centre retrospective study of the long-term outcome following suspected traumatic elbow luxation in 32 cats. J Small Anim Pract 2020; 61:354-362. [PMID: 32346883 DOI: 10.1111/jsap.13143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To describe reduction techniques and clinical outcome in a series of traumatic elbow luxations in cats. MATERIALS AND METHODS Retrospective review of unilateral elbow luxations treated at five specialist referral centres. Data included signalment, aetiology, concurrent injuries, luxation direction, time to reduction, primary reduction technique, surgical procedure and complications. Cases were excluded if reduction technique was unknown. Telephone owner questionnaire follow-up was completed using a Feline Musculoskeletal Pain Index. RESULTS Thirty-two cats were included. Lateral luxations were most common (n = 21). Time (hours) until attempted initial closed reduction was <24 (n = 12), 24-48 (n = 13), >48 (n = 3) or unrecorded (n = 4). Luxation was treated by closed reduction alone (n = 7) or by surgery (n = 25); 14 of 25 cases underwent primary surgical reduction and 11 of 25 were secondary procedures following failure of closed reduction. Transcondylar bone tunnels and circumferential suture (n = 19) was the most commonly used surgical technique. Catastrophic (n = 1), major (n = 11) and minor complications (n = 5) were recorded; reluxation occurred more frequently after closed reduction (n = 8) than after open reduction with fixation (n = 0). Feline Musculoskeletal Pain Index data were available for 12 cats; outcome was good-excellent in all 12, with a median function score of 64.5/68 (range: 55-68) and a median pain score of 0/15 (range: 0-5). Outcome was not associated with reduction technique. CLINICAL SIGNIFICANCE Elbow reluxation occurred in 61% of cats following primary closed reduction but did not occur in any open reduction cases. Reluxation rate increased with duration from injury. Most cats had good-excellent owner-assessed outcome, regardless of reduction technique.
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Affiliation(s)
- H Williams
- Queen Mother Hospital for Animals, RVC, North Mymms, Hertfordshire, AL97TA, UK
| | - I Calvo
- Queen Mother Hospital for Animals, RVC, North Mymms, Hertfordshire, AL97TA, UK.,VETSIA Hospital Veterinario, Madrid, 28914, Spain
| | - A Gaines
- Animal Trust not for Profit Veterinary Surgeons, M359AA, UK
| | - S Kalff
- Fitzpatrick Referrals, Surrey, GU72QQ, UK
| | - D Sajik
- Queen Mother Hospital for Animals, RVC, North Mymms, Hertfordshire, AL97TA, UK
| | - N J Kulendra
- North Downs Specialist Referrals, Bletchingley, Surrey, RH14QP, UK
| | - R L Meeson
- Queen Mother Hospital for Animals, RVC, North Mymms, Hertfordshire, AL97TA, UK
| | - K Parsons
- Langford Veterinary Services, University of Bristol, Langford House, Langford, Bristol, BS405DU, UK
| | - M Farrell
- Davies Veterinary Specialists, Higham Gobion, Hitchin, SG53HR, UK
| | - E R Kulendra
- North Downs Specialist Referrals, Bletchingley, Surrey, RH14QP, UK
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Abstract
This article reviews the current knowledge regarding osteoarthritis-related pain in cats as a structure in which to discuss the assessment of chronic pain in the research and clinical settings. The scientific evidence available for current and emerging drug therapies is described. The importance of environmental enrichment and positive emotions to reduce pain, stress, and anxiety as means to promote feline welfare and human-pet bond is discussed.
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Boge GS, Engdahl K, Moldal ER, Bergström A. Cranial cruciate ligament disease in cats: an epidemiological retrospective study of 50 cats (2011-2016). J Feline Med Surg 2020; 22:277-284. [PMID: 30896333 PMCID: PMC10814672 DOI: 10.1177/1098612x19837436] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to describe the characteristics and long-term outcome of surgically and conservatively treated cats with cranial cruciate ligament disease (CCLD). METHODS A retrospective cohort study of cats with CCLD, diagnosed at two university animal hospitals between January 2011 and December 2016, was performed. Signalment, history, treatment and follow-up information were retrieved. Cat owners were contacted for additional long-term follow-up information. The cases were divided into two groups: one conservatively managed and one surgically treated with the lateral fabellotibial suture technique. A quality of life questionnaire, the Feline Musculoskeletal Pain Index (FMPI), was distributed to the owners of cats alive at follow-up for assessment of chronic pain as a long-term outcome. Univariable statistical methods were used to evaluate the data. RESULTS Fifty cats were identified and were followed for a median of 41 months after diagnosis of CCLD. Seven cats (14%) developed bilateral CCLD. Twenty-eight cats (56%) were treated conservatively and 22 (44%) surgically. All surgically treated cats in which arthrotomy was performed (19/22) had total cranial cruciate ligament rupture and 9/19 (47%) had meniscal injuries. Postoperative surgical complications were recorded in 6/22 cats (27%). Owners of 24/29 (83%) cats still alive at follow-up completed the FMPI questionnaire. The conservatively treated cats had a lower FMPI score, indicating less chronic pain, than those cats treated surgically (P = 0.017). CONCLUSIONS AND RELEVANCE Conservatively treated cats with CCLD experienced less chronic pain at long-term follow-up than surgically treated cats. Bilateral disease is not uncommon in cats with CCLD.
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Affiliation(s)
- Gudrun S Boge
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, School of Veterinary Science, Oslo, Norway
| | - Karolina Engdahl
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Elena R Moldal
- Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, School of Veterinary Science, Oslo, Norway
| | - Annika Bergström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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30
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Kimura T, Kimura S, Okada J, Suzuki S, Kitanaka T. Retrospective Radiographic Study of Degenerative Joint Disease in Cats: Prevalence Based on Orthogonal Radiographs. Front Vet Sci 2020; 7:138. [PMID: 32296718 PMCID: PMC7141235 DOI: 10.3389/fvets.2020.00138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/24/2020] [Indexed: 11/30/2022] Open
Abstract
Feline degenerative joint disease (DJD) has been reported worldwide. Radiographic evidence, including that from single-plane radiographs, has been used for diagnosis in these reports, though orthogonal radiographs are generally required to diagnose DJD. However, more orthogonal radiographs are required for diagnosis. In this study, we investigated how many orthogonal radiographs are necessary to diagnose feline DJD among domestic short-haired cats. We analyzed the data from 101 cats for which the owners requested screening for arthritis. Orthogonal radiographs of appendicular and intervertebral joints were taken from the chest to the caudal side. Radiographs were then reviewed and graded by severity of DJD in each joint. Radiographic evidence of appendicular DJD was detected in 74.26% of 101 cats, of which 40.59% had intervertebral DJD (typically of the lumbosacral joint). Appendicular DJD was most common in elbow joints. Lameness was recognized by an owner of two cats and was diagnosed by a veterinarian in two cats. No obvious pain was detected on palpation in any cats with appendicular osteoarthritis, but lumbosacral DJD was associated with back pain in seven cases. Aging was associated with radiographic evidence of DJD: radiographic evidence of DJD was observed in most older domestic short-haired cats. Most cases without lumbosacral DJD had no obvious symptoms. As the lifespan of cats increases due to better lifestyles, diet, and medical treatment, lumbosacral DJD, which is more likely in older cats, may become an increasingly important clinical problem. In addition, orthogonal radiograph must be taken to make diagnosis for appendicular joint DJD especially hip and stifle joint.
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Affiliation(s)
| | | | | | | | - Taku Kitanaka
- Department of Biochemistry, Nihon University, Kanagawa Ward, Japan
- *Correspondence: Taku Kitanaka
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31
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Stadig S, Lascelles BDX, Nyman G, Bergh A. Evaluation and comparison of pain questionnaires for clinical screening of osteoarthritis in cats. Vet Rec 2019; 185:757. [PMID: 31619513 PMCID: PMC6996100 DOI: 10.1136/vr.105115] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 08/29/2019] [Accepted: 09/27/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Feline osteoarthritis (OA) is a common cause of long-standing pain and physical dysfunction. Performing a physical examination of a cat is often challenging. There is a need for disease-specific questionnaires or the so-called clinical metrology instruments (CMIs) to facilitate diagnosis and evaluation of treatment of feline OA. The CMI provides the owners an assessment of the cat's behavioural and lifestyle changes in the home environment. The purpose of the study was to evaluate readability, internal consistency, reliability and discriminatory ability of four CMIs. METHODS This is a prospective, cross-sectional study with 142 client-owned cats. Feline OA was diagnosed based on medical history, orthopaedic examination and radiography. RESULTS The results indicate that all four instruments have sound readability, internal consistency, are reliable over time and have good discriminatory ability. Preliminary cut-off values with optimal sensitivity and specificity were suggested for each instrument. The osteoarthritic cats showed significant changes in behavioural response to pain during orthopaedic examination, compared with sound cats. CONCLUSION The results indicate that all four questionnaires make an important contribution in a clinical setting, and that the cat's behavioural response to pain during physical examination should be a parameter to take into account as a possible indication of chronic pain.
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Affiliation(s)
- Sarah Stadig
- Department of Clinical Sciences, The Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - B Duncan X Lascelles
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Gorel Nyman
- Department of Clinical Sciences, The Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Anna Bergh
- Department of Clinical Sciences, The Swedish University of Agricultural Sciences, Uppsala, Sweden
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Lascelles BDX, Brown DC, Conzemius MG, Gill M, Oshinsky ML, Sharkey M. Measurement of chronic pain in companion animals: Discussions from the Pain in Animals Workshop (PAW) 2017. Vet J 2019; 250:71-78. [PMID: 31383423 DOI: 10.1016/j.tvjl.2019.07.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 12/31/2022]
Abstract
In the face of increasing recognition and interest in treating chronic pain in companion animals, we struggle with a lack of therapeutic options. A significant barrier to the development of new therapeutics, or the critical evaluation of current therapies, is our inability to accurately measure chronic pain and its impact on companion animals. Over the last 20 years, much progress has been made in developing methods to measure chronic pain via subjective and objective methods - particularly in owner assessment tools and measurements of limb use and activity. Most work has been focused on chronic joint pain conditions, but there has been relatively little work in other areas of chronic pain, such as neuropathic and cancer pain. Although progress has been made, there is a considerable interest in improving our assessment of chronic pain, as evidenced by the multiple disciplines across industry, academia, and clinical practice from the veterinary and human medical fields that participated in the Pain in Animals Workshop held at the National Institutes of Health in 2017. This review is one product of that meeting and summarizes the current state of knowledge surrounding the measurement of chronic pain (musculoskeletal, cancer, neuropathic), and its impact, in cats and dogs.
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Affiliation(s)
- B D X Lascelles
- Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA; Thurston Arthritis Center, UNC School of Medicine, Chapel Hill, NC, USA; Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA.
| | - D C Brown
- Translational and Comparative Medicine Research, Elanco Animal Health, Greenfield, IN, USA
| | - M G Conzemius
- Clinical Investigation Center, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - M Gill
- National Institute of Neurological Disorders and Stroke/National Institutes of Health, Bethesda, MD, USA
| | - M L Oshinsky
- National Institute of Neurological Disorders and Stroke/National Institutes of Health, Bethesda, MD, USA
| | - M Sharkey
- Center for Veterinary Medicine Food and Drug Administration, Rockville, MD, USA
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Abstract
PRACTICAL RELEVANCE Chronic pain is a feline health and welfare issue. It has a negative impact on quality of life and impairs the owner-cat bond. Chronic pain can exist by itself or may be associated with disease and/or injury, including osteoarthritis (OA), cancer, and oral and periodontal disease, among others. CLINICAL CHALLENGES Chronic pain assessment is a fundamental part of feline practice, but can be challenging due to differences in pain mechanisms underlying different conditions, and the cat's natural behavior. It relies mostly on owner-assessed behavioral changes and time-consuming veterinary consultations. Beyond OA - for which disease-specific clinical signs have been described - little is known regarding other feline conditions that produce chronic pain. RECENT ADVANCES Knowledge of the subject has, however, greatly improved in the past few years, informed by study of the mechanisms of pain in cats with OA and the development of pain scales that can be used by owners or veterinarians. Pain scales may facilitate the diagnosis and follow-up evaluation of chronic painful conditions, providing a basis for therapeutic decision-making. Assessment of quality of life is also recommended in cats with chronic pain, and its improvement can be used as a positive outcome in response to therapy. AIMS This article reviews recent advances and presents the challenges and some future perspectives on clinical chronic pain assessment. The most common feline chronic conditions associated with pain are also described.
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Affiliation(s)
- Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| | - Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
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Selting KA, Lattimer JC, Hause W, Megan G. Osteochondrodysplasia in a Scottish Fold Cat Treated with Radiation Therapy and Samarium-153-1,4,7,10-Tetraazacyclododecane-1,4,7,10-Tetramethylene-Phosphonic Acid. J Am Anim Hosp Assoc 2019; 55:e55304. [PMID: 30870611 DOI: 10.5326/jaaha-ms-6797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Osteochondrodysplasia is a painful, progressive clinical syndrome unique to Scottish fold cats because of a heritable missense mutation in the TRPV4 gene. An 8 yr old male neutered Scottish fold cat was presented for a mass on his hind paw. The mass caused decreased mobility in the metatarsal region and digits and resulted in significant discomfort. Because of extensive skeletal abnormalities attributed to breed-related osteochondrodysplasia, the owner was reluctant to pursue amputation. Radiation therapy was pursued for palliation of pain. After coarsely fractionated external beam radiotherapy resulted in stabilization of the mass with eventual progression after 14 mo, samarium-153-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetramethylene phosphonic acid was administered systemically, and the cat showed immediate, whole-body improvement in mobility. Concurrent intestinal and respiratory disease was evaluated and managed. Samarium-153-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetramethylene phosphonic acid administration was repeated approximately every 6 mo for three treatments until the cat succumbed to thromboembolic disease attributed to previously diagnosed cardiac disease. Radiation therapy administered using either external beam or bone-seeking radioisotopes can be effective at palliating clinical signs associated with the skeletal abnormalities that accompany this disease.
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Affiliation(s)
- Kim A Selting
- From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (K.A.S., J.C.L., G.M.); and Associated Veterinary Specialists, St. Louis, Missouri (W.H.)
| | - Jim C Lattimer
- From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (K.A.S., J.C.L., G.M.); and Associated Veterinary Specialists, St. Louis, Missouri (W.H.)
| | - Wayne Hause
- From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (K.A.S., J.C.L., G.M.); and Associated Veterinary Specialists, St. Louis, Missouri (W.H.)
| | - Grobman Megan
- From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (K.A.S., J.C.L., G.M.); and Associated Veterinary Specialists, St. Louis, Missouri (W.H.)
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35
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Klinck MP, Monteiro BP, Lussier B, Guillot M, Moreau M, Otis C, Steagall PVM, Frank D, Martel-Pelletier J, Pelletier JP, del Castillo JRE, Troncy E. Refinement of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians: detection of naturally occurring osteoarthritis in laboratory cats. J Feline Med Surg 2018; 20:728-740. [PMID: 28920533 PMCID: PMC11104144 DOI: 10.1177/1098612x17730172] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives Feline osteoarthritis causes pain and disability. Detection and measurement is challenging, relying heavily on owner report. This study describes refinement of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians. Methods A video analysis of osteoarthritic (n = 6) and non-osteoarthritic (n = 4) cats facilitated expansion of scale items. Three successive therapeutic trials (using gabapentin, tramadol and oral transmucosal meloxicam spray) in laboratory cats with and without natural osteoarthritis (n = 12-20) permitted construct validation (assessments of disease status sensitivity and therapeutic responsiveness) and further scale refinements based on performance. Results Scale osteoarthritic sensitivity improved from phase I to phase III; phase III scale total score ( P = 0.0001) and 4/5 subcategories - body posture ( P = 0.0006), gait ( P = 0.0031), jumping (0.0824) and global distance examination ( P = 0.0001) - detected osteoarthritic cats. Total score inter-rater (intra-class correlation coefficients [ICC] = 0.64-0.75), intra-rater (ICC = 0.90-0.91) and overall internal consistency (Cronbach's alpha = 0.85) reliability were good to excellent. von Frey anesthesiometer-induced paw withdrawal threshold increased with gabapentin in phase I, in osteoarthritic cats ( P <0.001) but not in non-osteoarthritic cats ( P = 0.075). Night-time activity increased during gabapentin treatment. Objective measures also detected tramadol and/or meloxicam treatment effects in osteoarthritic cats in phases II and III. There was some treatment responsiveness: in phase I, 3/10 subcategory scores improved ( P <0.09) in treated osteoarthritic cats; in phase II, 3/8 subcategories improved; and in phase III, 1/5 subcategories improved ( P <0.096). Conclusions and relevance The revised scale detected naturally occurring osteoarthritis, but not treatment effects, in laboratory cats, suggesting future potential for screening of at-risk cats. Further study is needed to confirm reliability, validity (disease sensitivity and treatment responsiveness) and clinical feasibility, as well as cut-off scores for osteoarthritic vs non-osteoarthritic status, in client-owned cats.
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Affiliation(s)
- Mary P Klinck
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Beatriz P Monteiro
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Bertrand Lussier
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Martin Guillot
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Maxim Moreau
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Colombe Otis
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Paulo VM Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Diane Frank
- Department of Clinical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Jérôme RE del Castillo
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Eric Troncy
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
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Klinck MP, Gruen ME, del Castillo JR, Guillot M, Thomson AE, Heit M, Lascelles BDX, Troncy E. Development and preliminary validity and reliability of the montreal instrument for cat arthritis testing, for use by caretaker/owner, MI-CAT(C), via a randomised clinical trial. Appl Anim Behav Sci 2018. [DOI: 10.1016/j.applanim.2017.11.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Lascelles BDX, Brown DC, Maixner W, Mogil JS. Spontaneous painful disease in companion animals can facilitate the development of chronic pain therapies for humans. Osteoarthritis Cartilage 2018; 26:175-183. [PMID: 29180098 DOI: 10.1016/j.joca.2017.11.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/17/2017] [Accepted: 11/13/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To outline the role that spontaneous osteoarthritis (OA) in companion animals can play in translational research and therapeutic pharmacological development. OUTLINE Narrative review summarizing the opportunities and limitations of naturally occurring, spontaneous OA as models of human OA pain, with a focus on companion animal pets. The background leading to considering inserting spontaneous disease models in the translational paradigm is provided. The utility of this model is discussed in terms of outcome measures that have been validated as being related to pain, and in terms of the potential for target discovery is outlined. The limitations to using companion animal pets as models of human disease are discussed. CONCLUSIONS Although many steps along the translational drug development pathway have been identified as needing improvement, spontaneous painful OA in companion animals offers translational potential. Such 'models' may better reflect the complex genetic, environmental, temporal and physiological influences present in humans and current data suggests the predictive validity of the models are good. The opportunity for target discovery exists but is, as yet, unproven.
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Affiliation(s)
- B D X Lascelles
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA; Center for Pain Research and Innovation, UNC School of Dentistry, Chapel Hill, NC, USA; Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA.
| | - D C Brown
- Translational Comparative Medicine Research, Elanco Animal Health, Greenfield, IN, USA
| | - W Maixner
- Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA
| | - J S Mogil
- Department of Psychology, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada; Department of Anesthesia, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
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Monteiro BP, Klinck MP, Moreau M, Guillot M, Steagall PVM, Pelletier JP, Martel-Pelletier J, Gauvin D, del Castillo JRE, Troncy E. Analgesic efficacy of tramadol in cats with naturally occurring osteoarthritis. PLoS One 2017; 12:e0175565. [PMID: 28403198 PMCID: PMC5389833 DOI: 10.1371/journal.pone.0175565] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 03/28/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study aimed to (1) compare outcome assessments in normal and osteoarthritic cats and (2) evaluate the analgesic efficacy of tramadol in feline osteoarthritis (OA), in a prospective, randomised, blinded, placebo-controlled, crossover design. METHODS Twenty cats were included after clinical examination, blood work and full body radiographs were performed. In Phase 1, outcome assessments aimed to differentiate normal (n = 5; i.e. exempt of any radiographic and clinical sign of OA) from OA (n = 15) cats. In Phase 2, OA cats were treated twice daily with a placebo (PG: cornstarch 15 mg) or tramadol (TG: 3 mg/kg) orally for 19 days, with a 3-month washout period between treatments. Evaluations were performed in normal and OA cats at baseline and consisted of: 1) peak vertical force (PVF) after staircase exercise; 2) telemetered night-time motor activity (NMA); and 3) response to mechanical temporal summation (RMTS). After treatment, PVF, NMA and RMTS evaluations were repeated in OA cats. Data were analysed with mixed model methods with an alpha-threshold of 5%. RESULTS Phase 1: 1) PVF (% of body weight; mean ± SD) was higher in normal (59 ± 10.5) than in OA cats (50.6 ± 5.7) (p = 0.005); 2) NMA (no unit) was not different between groups; 3) RMTS (number of stimuli; median (range)) was higher in normal [29.5 (23.5-30)] than in OA cats [14 (8.5-28)] (p < 0.0001). Phase 2: PVF, NMA and RMTS presented a treatment effect (p = 0.024, p = 0.008 and p = 0.018, respectively). No clinically important adverse-effects were observed. CONCLUSION Outcome assessments such as kinetics (PVF) and evaluation of central sensitisation (RMTS) are discriminant of OA status. Mobility measured by NMA was not discriminant of OA status, however it increased in OA cats with tramadol treatment. Nociceptive hypersensitivity quantified by RMTS was evident in OA cats and was responsive to tramadol treatment.
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Affiliation(s)
- Beatriz P. Monteiro
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Mary P. Klinck
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Maxim Moreau
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Martin Guillot
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Paulo V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
| | - Dominique Gauvin
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Jérôme R. E. del Castillo
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Eric Troncy
- GREPAQ (Animal Pharmacology Research Group of Quebec), Faculty of Veterinary Medicine–Université de Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Research Center of the University of Montreal Hospital Centre, Montreal, QC, Canada
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Gruen ME, Dorman DC, Lascelles BDX. Caregiver placebo effect in analgesic clinical trials for cats with naturally occurring degenerative joint disease-associated pain. Vet Rec 2017; 180:473. [PMID: 28270539 DOI: 10.1136/vr.104168] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2017] [Indexed: 12/20/2022]
Abstract
A literature review identified six placebo-controlled studies of analgesics in client-owned cats with degenerative joint disease-associated pain. Five studies with 96 cats had available data. Caregiver responses on a clinical metrology instrument, Client-Specific Outcome Measure (CSOM), were compared to measured activity. Cats were categorised as 'successes' or 'failures' based on change in CSOM score and activity counts from baseline. Effect sizes based on CSOM score were calculated; factors that were associated with success/failure were analysed using logistic regression. Effect sizes ranged from 0.97 to 1.93. The caregiver placebo effect was high, with 54-74 per cent of placebo-treated cats classified as CSOM successes compared with 10-63 per cent of cats classified as successes based on objectively measured activity. 36 per cent of CSOM successes were also activity successes, while 19 per cent of CSOM failures were activity successes. No significant effects of cat age, weight, baseline activity, radiographic score, orthopaedic pain score or study type on CSOM success in the placebo groups were found. The caregiver placebo effect across these clinical trials was remarkably high, making demonstration of efficacy for an analgesic above a placebo difficult. Further work is needed to determine whether a potential placebo-by-proxy effect could benefit cats in clinical settings.
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Affiliation(s)
- M E Gruen
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA
| | - D C Dorman
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - B D X Lascelles
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA
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Gruen ME, Alfaro-Córdoba M, Thomson AE, Worth AC, Staicu AM, Lascelles BDX. The Use of Functional Data Analysis to Evaluate Activity in a Spontaneous Model of Degenerative Joint Disease Associated Pain in Cats. PLoS One 2017; 12:e0169576. [PMID: 28099449 PMCID: PMC5242440 DOI: 10.1371/journal.pone.0169576] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 12/19/2016] [Indexed: 11/22/2022] Open
Abstract
Introduction and objectives Accelerometry is used as an objective measure of physical activity in humans and veterinary species. In cats, one important use of accelerometry is in the study of therapeutics designed to treat degenerative joint disease (DJD) associated pain, where it serves as the most widely applied objective outcome measure. These analyses have commonly used summary measures, calculating the mean activity per-minute over days and comparing between treatment periods. While this technique has been effective, information about the pattern of activity in cats is lost. In this study, functional data analysis was applied to activity data from client-owned cats with (n = 83) and without (n = 15) DJD. Functional data analysis retains information about the pattern of activity over the 24-hour day, providing insight into activity over time. We hypothesized that 1) cats without DJD would have higher activity counts and intensity of activity than cats with DJD; 2) that activity counts and intensity of activity in cats with DJD would be inversely correlated with total radiographic DJD burden and total orthopedic pain score; and 3) that activity counts and intensity would have a different pattern on weekends versus weekdays. Results and conclusions Results showed marked inter-cat variability in activity. Cats exhibited a bimodal pattern of activity with a sharp peak in the morning and broader peak in the evening. Results further showed that this pattern was different on weekends than weekdays, with the morning peak being shifted to the right (later). Cats with DJD showed different patterns of activity from cats without DJD, though activity and intensity were not always lower; instead both the peaks and troughs of activity were less extreme than those of the cats without DJD. Functional data analysis provides insight into the pattern of activity in cats, and an alternative method for analyzing accelerometry data that incorporates fluctuations in activity across the day.
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Affiliation(s)
- Margaret E. Gruen
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Marcela Alfaro-Córdoba
- Department of Statistics, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Andrea E. Thomson
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Alicia C. Worth
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Ana-Maria Staicu
- Department of Statistics, North Carolina State University, Raleigh, North Carolina, United States of America
- * E-mail:
| | - B. Duncan X. Lascelles
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
- Center for Pain Research and Innovation, University of North Carolina School of Dentistry, Chapel Hill, North Carolina, United States of America
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Perry KL. Surgical management of medial humeral epicondylitis, cubital synovial osteochondromatosis and humeroradial subluxation in a cat. JFMS Open Rep 2017; 3:2055116917695053. [PMID: 28491453 PMCID: PMC5362866 DOI: 10.1177/2055116917695053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
CASE SUMMARY A 13-year-old domestic shorthair cat presented for evaluation of pain and difficulty ambulating. Orthopedic examination and CT facilitated a diagnosis of bilateral elbow synovial osteochondromatosis with medial humeral epicondylitis and concurrent osteoarthritis. Right humeroradial subluxation was evident on CT images, but no instability was evident preoperatively. Surgical treatment was elected, including external neurolysis of the ulnar nerve, removal of the areas of mineralization within the flexor carpi ulnaris muscle and medial arthrotomy to remove intra-articular mineralized bodies. Following closure, instability of the right elbow was noted with humeroradial subluxation necessitating placement of circumferential suture prostheses to provide satisfactory stability. Reassessment was performed 2, 6, 12, 24 and 40 weeks postoperatively and revealed maintenance of elbow stability and substantial improvement in mobility and comfort. RELEVANCE AND NOVEL INFORMATION While humeroradial subluxation has been reported in association with medial humeral epicondylitis on post-mortem examination, associated clinically significant instability has not been documented previously. Surgeons should be aware of the potential for this complication and check elbow stability following surgery. Despite this complication, a favorable medium-term outcome was achieved for this cat.
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Affiliation(s)
- Karen L Perry
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
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Gruen ME, Messenger KM, Thomson AE, Griffith EH, Aldrich LA, Vaden S, Lascelles BDX. Evaluation of serum cytokines in cats with and without degenerative joint disease and associated pain. Vet Immunol Immunopathol 2017; 183:49-59. [PMID: 28063477 PMCID: PMC5522727 DOI: 10.1016/j.vetimm.2016.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 12/03/2016] [Accepted: 12/15/2016] [Indexed: 11/12/2022]
Abstract
Degenerative joint disease is common in cats, with signs of pain frequently found on orthopedic examination and radiographs often showing evidence of disease. However, understanding of the pathophysiology of degenerative joint disease and associated pain remains limited. Several cytokines have been identified as having a role in pain in humans, but this has not been investigated in cats. The present study was performed to use a multiplex platform to evaluate the concentration of 19 cytokines and chemokines in serum samples obtained from cats with and without degenerative joint disease and associated pain. Samples from a total of 186 cats were analyzed, with cats representing a range of severity on radiographic and orthopedic evaluations and categorized by degenerative joint disease scores and pain scores. Results showed that cats with higher radiographic degenerative joint disease scores have higher serum concentrations of IL-4 and IL-8, while cats with higher orthopedic exam pain scores have higher concentrations of IL-8, IL-2, and TNF-α; increased concentration of IL-8 in degenerative joint disease and pain may be confounded by the association with age. Discriminant analysis was unable to identify one or more cytokines that distinguish between groups of cats classified based on degenerative joint disease score category or pain score category. Finally, cluster analysis driven by analyte concentrations shows separation of groups of cats, but features defining the groups remain unknown. Further studies are warranted to investigate any changes in cytokine concentrations in response to analgesic therapies, and further evaluate the elevations in cytokine concentrations found here, particularly focused on studies of local cytokines present in synovial fluid.
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Affiliation(s)
- Margaret E Gruen
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, 27695, USA.
| | - Kristen M Messenger
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, 27695, USA; Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
| | - Andrea E Thomson
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
| | - Emily H Griffith
- Department of Statistics, North Carolina State University, 2311 Stinson Drive, Raleigh, NC, 27695, USA.
| | - Lauren A Aldrich
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
| | - Shelly Vaden
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
| | - B Duncan X Lascelles
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, 27695, USA; Center for Pain Research and Innovation, University of North Carolina School of Dentistry, Chapel Hill, NC, 27599, USA.
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Greene LM, Royal KD, Bradley JM, Lascelles BDX, Johnson LR, Hawkins EC. Severity of Nasal Inflammatory Disease Questionnaire for Canine Idiopathic Rhinitis Control: Instrument Development and Initial Validity Evidence. J Vet Intern Med 2016; 31:134-141. [PMID: 28019044 PMCID: PMC5259640 DOI: 10.1111/jvim.14629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/04/2016] [Accepted: 11/08/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Effective treatments are needed for idiopathic chronic rhinitis in dogs, but assessment of efficacy requires a practical, quantifiable method for assessing severity of disease. OBJECTIVES To develop and perform initial validity and reliability testing of an owner-completed questionnaire for assessing clinical signs and dog and owner quality of life (QOL) in canine chronic rhinitis. ANIMALS Twenty-two dogs with histopathologically confirmed chronic rhinitis and 72 healthy dogs. METHODS In this prospective study, an online questionnaire was created based on literature review and feedback from veterinarians, veterinary internists with respiratory expertise, and owners of dogs with rhinitis. Owners of affected dogs completed the questionnaire twice, 1 week apart, to test reliability. Healthy dogs were assessed once. Data were analyzed using the Rasch Rating Scale Model, and results were interpreted using Messick's framework for evaluating construct validity evidence. RESULTS Initial item generation resulted in 5 domains: nasal signs, paranasal signs, global rhinitis severity, and dog's and owner's QOL. A 25-item questionnaire was developed using 5-point Likert-type scales. No respondent found the questionnaire difficult to complete. Strong psychometric evidence was available to support the substantive, generalizability, content, and structural aspects of construct validity. Statistical differences were found between responses for affected and control dogs for all but 2 items. These items were eliminated, resulting in the 23-item Severity of Nasal Inflammatory Disease (SNIFLD) questionnaire. CONCLUSIONS AND CLINICAL IMPORTANCE The SNIFLD questionnaire provides a mechanism for repeated assessments of disease severity in dogs with chronic rhinitis.
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Affiliation(s)
- L M Greene
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - K D Royal
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - J M Bradley
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - B D X Lascelles
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - L R Johnson
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA
| | - E C Hawkins
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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Monteiro BP, Klinck MP, Moreau M, Guillot M, Steagall PVM, Edge DK, Pelletier J, Martel‐Pelletier J, Gauvin D, del Castillo JRE, Troncy E. Analgesic efficacy of an oral transmucosal spray formulation of meloxicam alone or in combination with tramadol in cats with naturally occurring osteoarthritis. Vet Anaesth Analg 2016; 43:643-651. [DOI: 10.1111/vaa.12360] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 12/26/2015] [Indexed: 01/30/2023]
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King JN, King S, Budsberg SC, Lascelles BDX, Bienhoff SE, Roycroft LM, Roberts ES. Clinical safety of robenacoxib in feline osteoarthritis: results of a randomized, blinded, placebo-controlled clinical trial. J Feline Med Surg 2016; 18:632-42. [PMID: 26058587 PMCID: PMC10816385 DOI: 10.1177/1098612x15590870] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
OBJECTIVES The objective of this study was to evaluate the clinical safety of the non-steroidal anti-inflammatory drug (NSAID) robenacoxib in cats with osteoarthritis. Degenerative joint disease, including osteoarthritis, is highly prevalent in cats and many cases have associated pain and impaired mobility. Although NSAIDs are used routinely to control pain and inflammation in cats with osteoarthritis, there are safety concerns because of the high concurrent prevalence of chronic kidney disease (CKD) and the paucity of data on the safety of these drugs in target clinical populations. METHODS A total of 194 cats with osteoarthritis were recruited and randomly allocated to receive either robenacoxib at a dosage of 1.0-2.4 mg/kg (n = 95) or placebo (n = 99) tablets PO q24h for 28 days. Safety was assessed in 193 cats, including a subgroup of 40 animals with concurrent CKD, defined as serum creatinine concentration ⩾1.6 mg/dl and urine specific gravity <1.030. Safety endpoints included reports of adverse events, results of clinical examinations, including body weight, and clinical chemistry and hematology variables. RESULTS In all 193 cats and the subgroup of 40 animals with concurrent CKD, there were no differences between groups in frequencies of reported adverse events, body weight change or results of serum or urine chemistry or hematology variables. CONCLUSIONS AND RELEVANCE Robenacoxib was well tolerated when administered daily for 1 month in cats with osteoarthritis, including cats with evidence of concurrent CKD. There was no clinical indication of damage to the gastrointestinal tract, kidney or liver.
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Affiliation(s)
- Jonathan N King
- Elanco Animal Health, Clinical Development, Basel, Switzerland
| | - Stephen King
- Elanco Animal Health, New Product Development, Greensboro, NC, USA
| | - Steven C Budsberg
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - B Duncan X Lascelles
- Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC, USA Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Stephen E Bienhoff
- Elanco Animal Health, New Product Development, Greensboro, NC, USA Current address: AlcheraBio LLC, Clinical Services, Edison, NJ, USA
| | - Linda M Roycroft
- Elanco Animal Health, New Product Development, Greensboro, NC, USA
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Bellows J, Center S, Daristotle L, Estrada AH, Flickinger EA, Horwitz DF, Lascelles BDX, Lepine A, Perea S, Scherk M, Shoveller AK. Evaluating aging in cats: How to determine what is healthy and what is disease. J Feline Med Surg 2016; 18:551-70. [PMID: 27370393 PMCID: PMC10816674 DOI: 10.1177/1098612x16649525] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PRACTICAL RELEVANCE Many of the changes that occur with aging are not considered pathologic and do not negatively affect overall wellness or quality of life. Ruling out disease is essential, however, when attempting to determine whether an aged cat can be considered 'healthy'. A clear understanding of the normal and abnormal changes that are associated with aging in cats can help practitioners make decisions regarding medical management, feeding interventions and additional testing procedures for their aged patients. CLINICAL CHALLENGES It can be difficult to determine if a cat is displaying changes that are appropriate for age. For example, healthy aged cats may have hematologic or serum biochemistry changes that differ from those of the general feline population. Assessment of behavioral health and cognitive changes, as well as auditory, olfactory and visual changes, can also be challenging in the aged patient. GOALS This is the second of two review articles in a Special Issue devoted to feline healthy aging. The goals of the project culminating in these publications included developing a working definition for healthy aging in feline patients and identifying clinical methods that can be used to accurately classify healthy aged cats. This second review proposes criteria for assessing 'healthy aged cats'. EVIDENCE BASE There is a paucity of research in feline aging. The authors draw on expert opinion and available data in both the cat and other species.
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Affiliation(s)
| | - Sharon Center
- Cornell University, College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, New York, USA
| | - Leighann Daristotle
- The Iams Company, Mars Pet Care, 6574 State Route 503 North, Lewisburg, OH, USA L Daristotle's current address is: The Blue Buffalo Co, Wilton, CT, USA
| | - Amara H Estrada
- University of Florida, College of Veterinary Medicine, Department of Small Animal Clinical Sciences, Gainesville, FL, USA
| | - Elizabeth A Flickinger
- The Iams Company, Mars Pet Care, 6574 State Route 503 North, Lewisburg, OH, USA EA Flickinger's current address is: Kent Pet Group, 2905 N Hwy 61, Muscatine, IA, USA
| | | | - B Duncan X Lascelles
- North Carolina State University, College of Veterinary Medicine, Department of Clinical Sciences, Raleigh, NC, USA
| | - Allan Lepine
- The Iams Company, Mars Pet Care, 6574 State Route 503 North, Lewisburg, OH, USA
| | - Sally Perea
- The Iams Company, Mars Pet Care, 6574 State Route 503 North, Lewisburg, OH, USA
| | | | - Anna K Shoveller
- The Iams Company, Mars Pet Care, 6574 State Route 503 North, Lewisburg, OH, USA AK Shoveller's current address is: Department of Animal BioSciences, University of Guelph, ON, Canada
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Gruen ME, Thomson AE, Griffith EH, Paradise H, Gearing DP, Lascelles BDX. A Feline-Specific Anti-Nerve Growth Factor Antibody Improves Mobility in Cats with Degenerative Joint Disease-Associated Pain: A Pilot Proof of Concept Study. J Vet Intern Med 2016; 30:1138-48. [PMID: 27334504 PMCID: PMC5153962 DOI: 10.1111/jvim.13972] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/05/2016] [Accepted: 04/28/2016] [Indexed: 12/12/2022] Open
Abstract
Background Neutralizing antibodies against nerve growth factor (NGF) are analgesic in rodent models, naturally occurring degenerative joint disease (DJD) pain in dogs, and chronic pain in humans. Objectives To evaluate the efficacy of a fully felinized anti‐NGF antibody (NV‐02) for the treatment of DJD pain and mobility impairment in cats. Animals Thirty‐four client‐owned cats with DJD‐associated pain and mobility impairment. Methods In a placebo‐controlled, pilot, masked clinical study, cats were randomized to a single treatment with NV‐02 (0.4 mg/kg SC [n = 11] or 0.8 mg/kg SC [n = 12]) or placebo (saline, SC [n = 11]). Activity was measured objectively. Additionally, owners completed clinical metrology instruments (client‐specific outcome measures [CSOM] and feline musculoskeletal pain index [FMPI]) on days 0 (screening), 14 (baseline), 35, 56, and 77. A repeated‐measures model was used to evaluate the objective activity data. Results NV‐02 significantly increased objectively measured activity overall (P = .017) and at 2 (P = .035), 3 (P = .007), 4 (P = .006), 5 (P = .007), and 6 (P = .017) weeks after treatment. CSOM scores (P = .035) and pain (P = .024) showed a significant effect of treatment 3 weeks after administration. In the treatment group, 83% of the owners correctly identified the treatment administered compared with 45% of owners in the placebo group (P = .013). No treatment‐related adverse effects were identified. Conclusions These pilot data demonstrate a 6‐week duration positive analgesic effect of this fully felinized anti‐NGF antibody in cats suffering from DJD‐associated pain.
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Affiliation(s)
- M E Gruen
- Comparative Pain Research Program, NCSU College of Veterinary Medicine, Raleigh, NC.,Comparative Medicine Institute, NCSU College of Veterinary Medicine, Raleigh, NC
| | - A E Thomson
- Comparative Pain Research Program, NCSU College of Veterinary Medicine, Raleigh, NC
| | - E H Griffith
- Department of Statistics, NC State University, Raleigh, NC
| | - H Paradise
- Comparative Pain Research Program, NCSU College of Veterinary Medicine, Raleigh, NC
| | - D P Gearing
- Nexvet Australia Pty Ltd, Melbourne, VIC, Australia
| | - B D X Lascelles
- Comparative Pain Research Program, NCSU College of Veterinary Medicine, Raleigh, NC.,Comparative Medicine Institute, NCSU College of Veterinary Medicine, Raleigh, NC.,Center for Pain Research and Innovation, UNC Dental School, Chapel Hill, NC
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Abstract
OBJECTIVES The objectives were to review systematically the range of assessment tools used in cats to detect the behavioural expression of pain and the evidence of their quality; and to examine behavioural metrics (considering both the sensory and affective domains) used to assess pain. METHODS A search of PubMed and ScienceDirect, alongside articles known to the authors, from 2000 onwards, for papers in English was performed. This was followed by a manual search of the references within the primary data sources. Only peer-reviewed publications that provided information on the assessment tool used to evaluate the behavioural expression of pain in cats, in conscious animals (not anaesthetised cats), were included. RESULTS No previous systematic reviews were identified. One hundred papers were included in the final assessment. Studies were primarily related to the assessment of pain in relation to surgical procedures, and no clear distinction was made concerning the onset of acute and chronic pain. Ten broad types of instrument to assess pain were identified, and generally the quality of evidence to support the use of the various instruments was poor. Only one specific instrument (UNESP-Botucatu scale) had published evidence of validity, reliability and sensitivity at the level of a randomised control trial, but with a positive rather than placebo control, and limited to its use in the ovariohysterectomy situation. The metrics used within the tools appeared to focus primarily on the sensory aspect of pain, with no study clearly discriminating between the sensory and affective components of pain. CONCLUSIONS AND RELEVANCE Further studies are required to provide a higher quality of evidence for methods used to assess pain in cats. Furthermore, a consistent definition for acute and chronic pain is needed. Tools need to be validated that can detect pain in a range of conditions and by different evaluators (veterinary surgeons and owners), which consider both the sensory and emotional aspects of pain.
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Affiliation(s)
| | - Daniel S Mills
- School of Life Sciences, University of Lincoln, Lincoln, UK
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Preliminary Validation and Reliability Testing of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians, in a Colony of Laboratory Cats. Animals (Basel) 2015; 5:1252-67. [PMID: 26633524 PMCID: PMC4693214 DOI: 10.3390/ani5040410] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 11/25/2015] [Accepted: 11/25/2015] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Feline osteoarthritis (OA) is challenging to diagnose. A pain scale was developed for use by veterinarians, in association with their physical examination, and tested for reliability and validity. The scale items were: Interaction with the examiner, Exploration of the room, Body Posture, Gait, Body Condition, condition of Coat and Claws, and abnormal Findings or Cat Reaction upon joint Palpation. Expert review supported the scale content. Two studies using laboratory-housed cats found the most promising results for Gait and Body Posture, in terms of distinguishing between OA and non-OA cats, repeatability of results, and correlations with objectively measured kinetics (weight-bearing). Abstract Subtle signs and conflicting physical and radiographic findings make feline osteoarthritis (OA) challenging to diagnose. A physical examination-based assessment was developed, consisting of eight items: Interaction, Exploration, Posture, Gait, Body Condition, Coat and Claws, (joint) Palpation–Findings, and Palpation–Cat Reaction. Content (experts) and face (veterinary students) validity were excellent. Construct validity, internal consistency, and intra- and inter-rater reliability were assessed via a pilot and main study, using laboratory-housed cats with and without OA. Gait distinguished OA status in the pilot (p = 0.05) study. In the main study, no scale item achieved statistically significant OA detection. Forelimb peak vertical ground reaction force (PVF) correlated inversely with Gait (Rhos = −0.38 (p = 0.03) to −0.41 (p = 0.02)). Body Posture correlated with Gait, and inversely with forelimb PVF at two of three time points (Rhos = −0.38 (p = 0.03) to −0.43 (p = 0.01)). Palpation (Findings, Cat Reaction) did not distinguish OA from non-OA cats. Palpation—Cat Reaction (Forelimbs) correlated inversely with forelimb PVF at two time points (Rhos = −0.41 (p = 0.02) to −0.41 (p = 0.01)), but scores were highly variable, and poorly reliable. Gait and Posture require improved sensitivity, and Palpation should be interpreted cautiously, in diagnosing feline OA.
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Criterion Validation Testing of Clinical Metrology Instruments for Measuring Degenerative Joint Disease Associated Mobility Impairment in Cats. PLoS One 2015; 10:e0131839. [PMID: 26162101 PMCID: PMC4498683 DOI: 10.1371/journal.pone.0131839] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 06/06/2015] [Indexed: 11/19/2022] Open
Abstract
Introduction Degenerative joint disease and associated pain are common in cats, particularly in older cats. There is a need for treatment options, however evaluation of putative therapies is limited by a lack of suitable, validated outcome measures that can be used in the target population of client owned cats. The objectives of this study were to evaluate low-dose daily meloxicam for the treatment of pain associated with degenerative joint disease in cats, and further validate two clinical metrology instruments, the Feline Musculoskeletal Pain Index (FMPI) and the Client Specific Outcome Measures (CSOM). Methods Sixty-six client owned cats with degenerative joint disease and owner-reported impairments in mobility were screened and enrolled into a double-masked, placebo-controlled, randomized clinical trial. Following a run-in baseline period, cats were given either placebo or meloxicam for 21 days, then in a masked washout, cats were all given placebo for 21 days. Subsequently, cats were given the opposite treatment, placebo or meloxicam, for 21 days. Cats wore activity monitors throughout the study, owners completed clinical metrology instruments following each period. Results Activity counts were increased in cats during treatment with daily meloxicam (p<0.0001) compared to baseline. The FMPI results and activity count data offer concurrent validation for the FMPI, though the relationship between baseline activity counts and FMPI scores at baseline was poor (R2=0.034). The CSOM did not show responsiveness for improvement in this study, and the relationship between baseline activity counts and CSOM scores at baseline was similarly poor (R2=0.042). Conclusions Refinements to the FMPI, including abbreviation of the instrument and scoring as percent of possible score are recommended. This study offered further validation of the FMPI as a clinical metrology instrument for use in detecting therapeutic efficacy in cats with degenerative joint disease.
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