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Blunschi F, Schofield I, Muthmann S, Bauer NB, Hazuchova K. Development and validation of a questionnaire to assess health-related quality-of-life in cats with hyperthyroidism. J Vet Intern Med 2024; 38:1384-1407. [PMID: 38647174 PMCID: PMC11099792 DOI: 10.1111/jvim.17083] [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: 11/23/2023] [Accepted: 04/05/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Health-related quality-of-life (HRQoL) assessment tools are becoming increasingly important for the assessment of diseases in veterinary medicine. OBJECTIVES To develop a tool to assess the HRQoL of hyperthyroid cats and their owners. ANIMALS Cats with hyperthyroidism (n = 229) and without hyperthyroidism (n = 322). METHODS Cross-sectional study design. A preliminary list of 28 questions relating to the HRQoL of hyperthyroid cats and the influence their cat's disease might have on owners was created. Each question consisted of 2 subquestions: (1) "how often does the item apply"; (2) "how strongly does the item affect HRQoL." The questionnaire was refined based on statistical analysis, including Mann-Whitney-U tests on each item, comparing the results from cats with and without hyperthyroidism. Internal consistency and reliability of the questions were measured by Cronbach's alpha (α). P < .05 was considered significant. RESULTS Overall, 25/28 questions were retained within the final HRQoL tool, which had an excellent internal consistency (α = .92). The tool produced a score between 0 and 382 (lower scores meaning better HRQoL). The median HRQoL score was 87.5 (range, 2-348) for cats with hyperthyroidism, and 27 (range, 0-249) for cats without (P < .001), suggesting the HRQoL was poorer in hyperthyroid cats. CONCLUSIONS AND CLINICAL IMPORTANCE This validated HRQoL tool is useful to reliably quantify the influence of hyperthyroidism on the quality-of-life of affected cats and their owners. In the future, it could be considered of assistance in the clinical assessment of cats with hyperthyroidism.
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Affiliation(s)
- Fabienne Blunschi
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | | | - Sofie Muthmann
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Natali B. Bauer
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Katarina Hazuchova
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
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Bell DJ, Vigors B, Duthie CA, Bartram DJ, Hancock A, Odeyemi I, Penny C, Haskell MJ. Developing a tool to assess the health-related quality of life in calves with respiratory disease: content validation. Animal 2023; 17:100702. [PMID: 36680850 DOI: 10.1016/j.animal.2022.100702] [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: 08/18/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Bovine respiratory disease (BRD) is a major welfare and productivity issue for calves. Despite the extensive negative impacts on calf welfare and performance, BRD remains challenging to detect and treat effectively. However, the clinical signs of disease are only one aspect of the disease that is experienced by the individual. The assessment of emotional experience in animals is not straightforward, but it is increasingly recognised that the quality of behaviour and demeanour of an individual is a reflection of their internal emotional state. The aim of the present study was to complete the content validation stage of the development process for a health-related quality of life (HRQOL) tool. This was based around indicators from an existing conceptual framework containing twenty-three indicators in two domains (clinical signs and behavioural expression). The content validation stage involves engaging with key stakeholders. For this study, this took the form of a survey and discussions with focus groups, which are standard methods in this field. A survey and stakeholder focus groups were conducted to assess the usefulness of each indicator and its relevance for inclusion within a HRQOL tool. In the survey, participants were asked to rate the usefulness of each of the indicators using a 4-point scale which were then dichotomised into 'useful' and 'less useful'. Based on the 'useful' result, each indicator within the domains was ranked. A similar approach was taken with the responses from the focus groups. Focus group participants were asked to select indicators that they felt were of use and the result of this was used to rank each of the indicators. The ranks of the indicators from both the survey and the focus groups along with the transcripts from the focus groups were used to determine the indicators from each domain to include within the HRQOL tool. Indicators within the clinical signs domain that were included were nasal discharge, cough, respiratory effort, ocular appearance (discharge and vibrancy), body and head posture and ear carriage. For the domain of behavioural expression, the indicators included were movement to feed, responsiveness, spatial proximity, volume of feed intake, motivation at feed and vigour. The next stage will be to validate the construction of the HRQOL tool through its use in practice. The inclusion of indicators that allow the experiential aspects of disease to be recorded in health assessments will likely increase the ability of farmers and others to detect respiratory disease in calves.
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Affiliation(s)
- D J Bell
- SRUC (Scotland's Rural College), West Mains, Road, Edinburgh EH9 3JG, United Kingdom.
| | - B Vigors
- SRUC (Scotland's Rural College), West Mains, Road, Edinburgh EH9 3JG, United Kingdom
| | - C-A Duthie
- SRUC (Scotland's Rural College), West Mains, Road, Edinburgh EH9 3JG, United Kingdom
| | - D J Bartram
- Outcomes Research, Zoetis, Loughlinstown, County Dublin D18 T3Y1, Ireland
| | - A Hancock
- Outcomes Research, Zoetis, Loughlinstown, County Dublin D18 T3Y1, Ireland
| | - I Odeyemi
- Outcomes Research, Zoetis, Loughlinstown, County Dublin D18 T3Y1, Ireland
| | - C Penny
- Zoetis UK Ltd., First Floor, Birchwood Building, Springfield Drive, Leatherhead KT22 7LP, United Kingdom
| | - M J Haskell
- SRUC (Scotland's Rural College), West Mains, Road, Edinburgh EH9 3JG, United Kingdom
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Rothlin‐Zachrisson N, Öhlund M, Röcklinsberg H, Ström Holst B. Survival, remission, and quality of life in diabetic cats. J Vet Intern Med 2023; 37:58-69. [PMID: 36637031 PMCID: PMC9889602 DOI: 10.1111/jvim.16625] [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: 06/23/2022] [Accepted: 12/16/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Remission is documented in a substantial proportion of cats with diabetes. The effects of diabetes mellitus (DM) on the lives of cats and their owners should be considered when evaluating treatment success. OBJECTIVES To study outcome in cats with DM and the impact DM has on the life situation of cat and owner. ANIMALS Domestic and pedigree cats with a diagnosis of DM (n = 477) insured by a Swedish insurance company during 2009 to 2013. METHODS Retrospective cross-sectional study. A questionnaire was sent to 1369 owners of cats diagnosed with DM. The questions concerned the cat, treatment, owner perceptions of the disease and treatment and disease outcome. Data were analyzed using multiple linear and logistic regression, with outcomes set as survival for more than 4 weeks after diagnosis, survival time, achieving remission, remission without relapse and quality of life (QoL) for the cat. RESULTS The response rate was 35%, leaving 477 questionnaires for analysis. The remission rate among treated cats was 29% (118/405). Feeding a commercially available wet diet was associated with both remission (OR 3.16, 95% confidence interval 1.27-8.12) and remission without relapse (OR 14.8, 95% confidence interval 2.25-153.8). Remission was associated with a better QoL for the cat. CONCLUSIONS AND CLINICAL IMPORTANCE The association between feeding a commercially available wet diet and remission is important and strengthens the role of diet in treatment of DM in cats. Linking remission and a better QoL for the cat emphasizes remission as a goal in disease management.
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Affiliation(s)
| | | | - Helena Röcklinsberg
- Department of Animal Environment and HealthSwedish University of Agricultural SciencesUppsalaSweden
| | - Bodil Ström Holst
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
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Long M, Dürnberger C, Jenner F, Kelemen Z, Auer U, Grimm H. Quality of Life within Horse Welfare Assessment Tools: Informing Decisions for Chronically Ill and Geriatric Horses. Animals (Basel) 2022; 12:ani12141822. [PMID: 35883370 PMCID: PMC9311870 DOI: 10.3390/ani12141822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 01/08/2023] Open
Abstract
Simple Summary Equine Quality of Life is an important concern in decision making in veterinary medicine and is especially relevant for chronically ill or aged horses when euthanasia is considered. To our knowledge, there is no assessment tool for chronically ill or aged horses that assesses equine Quality of Life defined as the horse’s evaluation of their life. However, tools exist to assess equine welfare in different contexts. Therefore, this study aimed to analyse how equine welfare, Quality of Life, well-being and happiness assessment tools define and attempt to measure these concepts. We discuss the tools’ suitability to assess equine Quality of Life in the context of end-of-life decisions for chronically ill or aged horses. Fourteen publications were found via a systematic literature search, describing ten equine welfare assessment tools and one approach to assessing equine Quality of Life in veterinary practice. Some of these welfare assessment tools have the potential to inform the development of a Quality-of-Life assessment tool supporting well-considered decision making towards the end of horses’ lives if they are adjusted to focus on the horses’ experiences, to provide an overall grade of Quality of Life and are tailored to chronically ill or geriatric horses. Abstract Equine Quality of Life (QoL) is an important concern in decision making in veterinary medicine and is especially relevant for chronically ill or geriatric horses towards the end of their lives. To our knowledge, there is no currently available QoL assessment tool for chronically ill or geriatric horses that assesses equine QoL defined as the horse’s evaluation of their life. However, tools exist to assess equine welfare in different contexts. Hence, the aims of this study were to analyse how equine welfare, QoL, well-being and happiness assessment tools label, define and operationalise the concepts and to discuss the tools’ suitability to assess equine QoL in the context of end-of-life decisions for chronically ill or geriatric horses. Fourteen articles were found through a systematic literature search, describing ten equine welfare assessment tools and one approach to integrating equine QoL in veterinary practice that suggests QoL assessment parameters. We discuss that some welfare assessment tools have the potential to support the development of a QoL assessment tool informing decisions towards the end of horses’ lives if they are adjusted to focus on the horses’ experiences, to provide an integration into an overall QoL grade and are tailored to chronically ill or geriatric horses.
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Affiliation(s)
- Mariessa Long
- Unit of Ethics and Human-Animal Studies, Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, University of Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; (C.D.); (H.G.)
- Correspondence:
| | - Christian Dürnberger
- Unit of Ethics and Human-Animal Studies, Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, University of Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; (C.D.); (H.G.)
| | - Florien Jenner
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; (F.J.); (Z.K.)
| | - Zsófia Kelemen
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; (F.J.); (Z.K.)
| | - Ulrike Auer
- Anaesthesiology and Perioperative Intensive Care Medicine Unit, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria;
| | - Herwig Grimm
- Unit of Ethics and Human-Animal Studies, Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, University of Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; (C.D.); (H.G.)
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Quality of Life Measurement in Dogs and Cats: A Scoping Review of Generic Tools. Animals (Basel) 2022; 12:ani12030400. [PMID: 35158723 PMCID: PMC8833627 DOI: 10.3390/ani12030400] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/22/2022] Open
Abstract
Simple Summary Quality of life (QoL) assessment tools play an important role in veterinary medicine by optimising companion animal welfare and directing treatment decisions. No distinct guidelines are currently available for tool design and appraisal. Nine published generic QoL assessment tools designed for use in dogs and cats were compared to each other. Each tool was uniquely individual in terms of structural design, psychometric evaluation and statistical analysis. Although each tool was unique, the majority assessed similar aspects of dog and cat QoL, namely activity level, the desire for interaction and appetite. These findings provide a reference point for future tool development by emphasizing the need for more consistency in reporting methodology and statistical validation, as well as highlighting potential valuable aspects of QoL in dogs and cats. Abstract Quality of life (QoL) assessment in companion animals is an essential aspect of veterinary medicine that helps guide treatment decisions and ensures optimal animal welfare. Veterinarians and pet owners can use disease-specific or generic QoL assessment tools to evaluate an individual animal’s QoL. The aim of this scoping review was to identify and assess published generic QoL assessment tools suitable for use in either dogs or cats. A literature search identified 82 relevant publications, nine of which contained appropriate generic QoL assessment tools in accordance with inclusion and exclusion criteria. Each tool was assessed for evidence of psychometric evaluation including statistical analysis, reliability and validity. Commonly included items were determined to highlight potential important aspects of dog or cat QoL. Five of the nine publications used a statistical method such as factor analysis to determine tool design and structure. Although at least one aspect of reliability and validity was assessed for seven of the tools, none were validated across all measures. Two of the publications contained minimal to no statistical analysis. Common items for both dogs and cats included those regarding activity level, the desire for interaction and appetite. In addition, common items for cats included those regarding mood and grooming. This scoping review identified and evaluated currently available generic QoL assessment tools, providing a reference point for future tool development and validation.
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The Use of Oligo Fucoidan in Cancer Bearing Dogs Undergoing Chemotherapy: A Double-Blinded Study. Top Companion Anim Med 2021; 46:100616. [PMID: 34864255 DOI: 10.1016/j.tcam.2021.100616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/01/2021] [Accepted: 11/29/2021] [Indexed: 11/21/2022]
Abstract
We evaluated the effect of oligo fucoidan (Laminina Japonica) derived from oceanic brown seaweed on the quality of life in dogs with cancer undergoing chemotherapy in a double-blinded case control study. Included in this prospective study were 100 dogs with a confirmed diagnosis of cancer that were being treated with chemotherapy. Dogs were randomly assigned to be treated with oligo fucoidan (treated group; n = 68) or placebo (placebo group; n = 32). Dogs were evaluated every 2-3 weeks for 3 months with a complete blood count (CBC) and serum biochemistry profile, and a complete history and physical examination by blinded clinicians at The Veterinary Cancer Center. The owners of the dogs enrolled in the study were required at each visit to complete a Quality-of-Life Questionnaire specifically designed for cancer-bearing veterinary patients. The owners were also blinded as to whether their dog was receiving oligo fucoidan or placebo. There were no significant differences between the CBC parameters or the serum biochemical parameters of the dogs in the treated and placebo-controlled groups. There was no significant difference in the median quality of life scores between the 2 cohorts, however, when evaluating the individual quality of life metrics, 5 out of the 23 metrics showed statistically significant improvement, and none of the quality-of-life metrics declined in the oligo fucoidan group as compared to the placebo group. All of the dogs that had a positive change in overall quality of life scores were dogs that received oligo fucoidan. There were minimal adverse side effects of giving the oligo fucoidan to dogs. Treatment with oligo fucoidan was safe and improved some of the quality-of-life metrics in dogs who were being treated with chemotherapy for cancer.
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Doit H, Dean RS, Duz M, Finch NC, Brennan ML. What outcomes should be measured in feline chronic kidney disease treatment trials? Establishing a core outcome set for research. Prev Vet Med 2021; 192:105348. [PMID: 34022713 DOI: 10.1016/j.prevetmed.2021.105348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 12/29/2022]
Abstract
Chronic Kidney Disease (CKD) is an important cause of feline morbidity and mortality. There is currently no agreement on which outcomes are most important in CKD treatment trials to assist evidence-based decision making. Core Outcome Sets (COSs) originated in human healthcare and are an agreed set of outcomes to be measured and reported as a minimum in any trial conducted relating to a particular disease. To establish a COS for feline CKD, this study used a systematic review and two consensus methodologies (an electronic Delphi (eDelphi), and an in-person consensus meeting), with an international panel of key stakeholders. The systematic review identified 104 unique published parameters, which were rated by panellists in round 1 of the eDelphi. Panellists were also asked to suggest additional parameters. In round 2 these additional parameters were rated and any parameters not understood by >10 % of panellists in round 1 were redefined and re-rated. Parameters reaching consensus in rounds 1 and 2 were removed from round 3, when all remaining parameters were re-rated by panellists who could view their own previous rating alongside the median rating of the whole panel. To reach inclusion in the COS, parameters had to be rated 8 or 9 on a Likert scale of 1-9 (where 1 was not important and 9 was very important) by more than 80 % of panellists. In the consensus meeting, panellists discussed and re-rated borderline parameters and streamlined the final COS. Borderline parameters were those that had been closest to, but not achieved, the 80 % threshold for inclusion. The eDelphi panel (n = 73) rated 24/104 parameters highly enough for inclusion and proposed an additional 20 parameters, of which 3 reached the inclusion threshold. This totalled 27 parameters for inclusion. The consensus meeting panel (n = 16) rated an additional 6/20 borderline parameters highly enough for inclusion. During the streamlining process, 4 parameters were removed as one was considered not an outcome, and three were already addressed by other parameters. The remaining COS totalled 29 parameters. These were grouped into 9 core themes: clinical examination, quality of life, serum biochemistry, complete blood count, urinalysis, total amount of food eaten, CKD progression, survival time and cause of death. This is the first COS for feline medicine. In future treatment efficacy trials the COS will strengthen the evidence-base for this condition, by facilitating easier comparison of results between studies, and reduce research waste.
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Affiliation(s)
- H Doit
- Gateway Building, School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington, LE12 5RD, United Kingdom.
| | - R S Dean
- VetPartners Ltd, Leeman House, Station Business Park, Holgate Drive, York, YO26 4GB, United Kingdom.
| | - M Duz
- Gateway Building, School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington, LE12 5RD, United Kingdom.
| | - N C Finch
- Bristol Renal, Bristol Medical School, Dorothy Hodgkin Building, University of Bristol, Bristol, BS1 3NY, United Kingdom.
| | - M L Brennan
- Gateway Building, School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington, LE12 5RD, United Kingdom.
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A systematic review of the quality of life assessment tools for cats in the published literature. Vet J 2021; 272:105658. [PMID: 33941335 DOI: 10.1016/j.tvjl.2021.105658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 11/22/2022]
Abstract
Quality of life (QoL) is an important parameter to assess in cats, as it can be pivotal to important decision-making. Research reports that owners of cats with heart disease would trade longevity for QoL, and treatment associated improvement in QoL is very important for cats with chronic kidney disease. This systematic review aimed to explore the published literature to identify the number and range of QoL assessment tools available to researchers and veterinary professionals, by discovering tools which have already been used in published studies. Medline and CAB Abstracts were searched in March 2018, using terms relevant to cats and QoL or well-being. Inclusion and exclusion criteria were applied and information on uniqueness, validation and a short description of each tool extracted. A total of 1138 manuscripts were identified, of which 96 met all criteria. Forty of 96 manuscripts contained an assessment of QoL, using one of 32 unique tools identified. Sixteen of the tools identified were structured, making detailed patient assessments. Only eight of the structured tools were validated, and of these, three could be applied to healthy cats; the remainder being specific to a disease or being hospitalised. Some validated tools appeared in more than one manuscript. Overall, 12 manuscripts used a validated tool. In the 16 unstructured tools, five tools assessed QoL by assigning a single word (e.g. 'poor'). Eight tools assessed QoL on a single Likert scale (e.g. a number between 1 and 5). This work identifies the tools that are currently available for the assessment of QoL by researchers and veterinary professionals. Additionally, it demonstrates that many are not validated or lack detailed animal assessment, highlighting that further work in this important area is needed.
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Parker VJ, Rudinsky AJ, Benedict JA, Beizaei A, Chew DJ. Effects of calcifediol supplementation on markers of chronic kidney disease-mineral and bone disorder in dogs with chronic kidney disease. J Vet Intern Med 2020; 34:2497-2506. [PMID: 33128421 PMCID: PMC7694821 DOI: 10.1111/jvim.15949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 10/11/2020] [Accepted: 10/19/2020] [Indexed: 12/18/2022] Open
Abstract
Background Chronic kidney disease‐mineral and bone disorder (CKD‐MBD) in dogs is associated with hypovitaminosis D, increased parathyroid hormone (PTH), and increased fibroblast growth factor‐23 (FGF‐23) concentrations. Best practice for vitamin D metabolite supplementation in CKD‐MBD remains unknown. Objective To provide an extended‐release calcifediol supplement to dogs with CKD and to measure its effects on variables indicative of CKD‐MBD. Animals Ten dogs with International Renal Interest Society stages 2 and 3 CKD. Methods In a prospective study, dogs received a calcifediol supplement for 84 days. Serum 25‐hydroxyvitamin D (25[OH]D), 1,25‐dihydroxyvitamin D (1,25[OH]2D), 24,25‐dihydroxyvitamin D (24,25[OH]2D), creatinine, calcium, phosphorus, PTH, plasma FGF‐23 concentrations, and urine profiles were measured monthly during supplementation. Urine calcium to creatinine (UCa/Cr) ratios and fractional excretion of calcium, phosphorus, and sodium were determined. Results All serum vitamin D metabolite concentrations increased significantly by day 84 (P < .001): [25(OH)D (median 249.9 ng/mL; range, 149.7‐469.9 ng/mL) compared to baseline (median 50.2 ng/mL; range, 31.3‐66.0 ng/mL); 1,25(OH)2D (median 66.1 pg/mL; range, 56.9‐88.1 pg/mL) compared to baseline (median 37.3 pg/mL; range, 29.3‐56.7 pg/mL); 24,25(OH)2D (median 81.4 ng/mL; range, 22.1‐151.7 ng/mL) compared to baseline (median 15.4 ng/mL; range, 6.9‐40.6 ng/mL)]. There were no significant differences in calcium, phosphorus, PTH concentrations, UCa/Cr or fractional excretion of calcium. No dog developed ionized hypercalcemia. Plasma FGF‐23 concentrations increased by day 84 (median 1219 pg/mL; range, 229‐8824 pg/mL) compared to baseline (median 798 pg/mL; range, 103‐4.145 pg/mL) (P < .01). Conclusions and Clinical Importance Calcifediol supplementation for 84 days was well‐tolerated in dogs with IRIS stages 2 and 3 CKD. It remains to be determined how long‐term supplementation would affect CKD progression and QOL.
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Affiliation(s)
- Valerie J Parker
- Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
| | - Adam J Rudinsky
- Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
| | - Jason A Benedict
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Azadeh Beizaei
- EirGen Pharma LTD, R&D Center, IDA Business and Technology Park, Waterford, Ireland
| | - Dennis J Chew
- Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
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Mikhael EM, Hassali MA, Hussain SA, Shawky N. The Development and Validation of Quality of Life Scale for Iraqi Patients with Type 2 Diabetes Mellitus. J Pharm Bioallied Sci 2020; 12:262-268. [PMID: 33100785 PMCID: PMC7574754 DOI: 10.4103/jpbs.jpbs_190_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/24/2020] [Accepted: 03/08/2020] [Indexed: 11/30/2022] Open
Abstract
Background and Aim: The current trend for determining the effectiveness of new treatment or services provided for diabetes mellitus (DM) patients is based on assessing the improvement in both glycemic control and the patient quality of life. Many scales have been developed to assess quality of life among DM patients, but unfortunately, no one can be considered as gold standard. Therefore, this study aimed to develop and validate a brief and specific scale to assess quality of life among Iraqi type 2 DM patients. Methods: An extensive literature review was done using Google-Scholar and PubMed to find out scales that utilized to assess quality of life among DM patients. Four relevant scales, three diabetes specific and one general, were selected. The selected scales were carefully evaluated to find out domains that are commonly used to assess quality of life and then the items within the selected domains were reviewed to choose relevant and comprehensive items for Iraqi type 2 DM patients. Ten items were selected to formulate the quality of life scale for Iraqi DM patients (QOLSID). The content validity of QOLSID was established via an expert panel. For concurrent validity QOLSID was compared to glycosylated hemoglobin (HbA1C). For psychometric evaluation, a cross sectional study for 103 type 2 DM patients was conducted at the National Diabetes Center, Iraq. Test-retest reliability was measured by re-administering QOLSID to 20 patients 2-4 weeks later. Results: The internal consistency of the QOLSID was 0.727. All items had a corrected total-item correlation above 0.2. There was a negative significant correlation between QOLSID score and the HbA1C level (-0.518, P = 0.000). A significant positive correlation was obtained after re-testing (0.967, P = 0.000). Conclusion: The QOLSID is a reliable and valid instrument that can be used for assessing quality of life among Iraqi type 2 DM patients.
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Affiliation(s)
- Ehab M Mikhael
- Department of social and administrative Pharmacy, College of Pharmacy, Universiti Sains Malaysia, Penang, Malaysia.,Department of clinical pharmacy, College of Pharmacy, University of Baghdad, Baghdad-Iraq
| | - Mohamed A Hassali
- Department of clinical pharmacy, College of Pharmacy, University of Baghdad, Baghdad-Iraq
| | - Saad A Hussain
- Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq
| | - Nizar Shawky
- The National Diabetes Center, Al-Mustansiriyah University, Baghdad, Iraq
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Vojtkovská V, Voslářová E, Večerek V. Methods of Assessment of the Welfare of Shelter Cats: A Review. Animals (Basel) 2020; 10:ani10091527. [PMID: 32872242 PMCID: PMC7552334 DOI: 10.3390/ani10091527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022] Open
Abstract
At any moment, there are millions of cats housed in foster care facilities for abandoned and stray animals for various reasons worldwide. Care, management and regulation among these facilities differ. Moreover, shelters can never substitute the full comfort of a good home for the animal, and the welfare of cats in shelters is a subject of discussion in many respects. Cats are animals sensitive to changes; for most of them, placement in a shelter is a stressful experience because of changes in routine, environment and the presence of other animals. Stress is reflected in changes in behaviour, causes fluctuations in physiological values and disrupts the immune system, which is a predisposition to the development or reactivation of disease. Evaluation of the presence and intensity of negative impacts is possible through the use of evaluation tools based on indicators that help set the environment and management of keeping so as to disrupt the quality of life as little as possible. Although a comprehensive and valid welfare tool that would evaluate animal-based and at the same time resource-based (or management-based) indicators of cats in shelters is not currently available, it is possible to use partial evaluation of individual welfare indicators to assess welfare. This review aims to provide the readers with an insight into current options of assessment of the welfare of cats in shelters with an emphasis on behavioural, physiological and health indicators with an application in both practical and scientific contexts.
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Milevoj N, Tozon N, Licen S, Lampreht Tratar U, Sersa G, Cemazar M. Health-related quality of life in dogs treated with electrochemotherapy and/or interleukin-12 gene electrotransfer. Vet Med Sci 2020; 6:290-298. [PMID: 31910331 PMCID: PMC7397887 DOI: 10.1002/vms3.232] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/28/2019] [Accepted: 12/08/2019] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to evaluate the owners' perception of health‐related quality of life (HRQoL) of dogs after treatment with electrochemotherapy (ECT) alone or combined with interleukin‐12 gene electrotransfer (IL‐12 GET) and/or surgery. The owners of 44 dogs with histologically different tumours were offered the »Cancer Treatment Form« at least one month after treatment. The owners assessed their dogs’ quality of life (QoL) after treatment as good (mean 7.4) (from 1–very poor to 10–excellent) and the general health compared with the initial diagnosis of cancer as improving (mean 3.9) (from 1–worse to 5–better). The assessment of the current QoL was better within the group of dogs treated with non‐invasive treatment (ECT and/or IL‐12 GET only), compared with those that received invasive treatment, where, in addition to ECT and/or IL‐12 GET, surgery was performed (p < .05). The owners of dogs that achieved an objective response (OR) to the treatment assessed the QoL as significantly better compared with those whose dogs did not respond to the treatment (p < .05). The majority of the owners (86.4%) would opt for the therapy again, regardless of the financial costs. In conclusion, the results of this study demonstrate that the majority of the owners of dogs assessed their dogs’ QoL as good and felt that it improved after the treatment, especially in dogs, treated with non‐invasive treatment and in those that responded to the treatment. This supports further use of ECT and IL‐12 GET as suitable methods for the treatment of selected tumours in veterinary medicine.
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Affiliation(s)
- Nina Milevoj
- Veterinary Faculty, Small Animal Clinic, University of Ljubljana, Ljubljana, Slovenia
| | - Natasa Tozon
- Veterinary Faculty, Small Animal Clinic, University of Ljubljana, Ljubljana, Slovenia
| | - Sabina Licen
- Faculty of Health Sciences, University of Primorska, Isola, Slovenia
| | | | - Gregor Sersa
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Maja Cemazar
- Faculty of Health Sciences, University of Primorska, Isola, Slovenia.,Institute of Oncology Ljubljana, Ljubljana, Slovenia
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13
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Quimby JM, Benson KK, Summers SC, Saffire A, Herndon AK, Bai S, Gustafson DL. Assessment of compounded transdermal mirtazapine as an appetite stimulant in cats with chronic kidney disease. J Feline Med Surg 2019; 22:376-383. [PMID: 31161850 PMCID: PMC7099811 DOI: 10.1177/1098612x19851303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives The aim of this study was to assess the appetite stimulation properties of
compounded transdermal mirtazapine (CTM) in cats with chronic kidney disease
(CKD). Methods Two sequential double-blind placebo-controlled crossover prospective studies
were performed in client-owned cats with stable stage 2 or 3 CKD and a
history of decreased appetite. In the first study nine CKD cats were
randomized to receive 3.75 mg/0.1 ml CTM gel or placebo on the inner pinna
every other day for 3 weeks, then, after a 4 day washout period, the cats
were crossed over to the alternate 3 week treatment. In a second study, 10
CKD cats were randomized to receive 1.88 mg/0.1 ml CTM or placebo on the
same schedule. Physical examination and serum biochemistry were performed
before and after each treatment period, and owners kept daily logs of
appetite, activity and eating behaviors. Mirtazapine concentrations in CTM
gels and steady-state mirtazapine serum concentrations were measured using
liquid chromatography/tandem mass spectrometry. Results Administration of both 3.75 mg and 1.88 mg CTM resulted in a statistically
significant increase in weight (P = 0.002 for both),
increase in appetite (P = 0.01 and P =
0.005, respectively), and increase in rate of food consumption
(P = 0.03 and P = 0.008,
respectively). No significant difference in activity or vocalization was
seen at either dose; however, individual cats experienced excessive meowing.
Median weight increase for the 3.75 mg arm was 0.22 kg (range 0.04–0.44 kg),
while median weight increase for the 1.88 mg arm was 0.26 kg (range –0.25 to
0.5 kg). Improvement in body condition score was seen in 5/9 cats in the
3.75 mg arm (P = 0.04) and 6/10 cats in the 1.88 mg arm (P = 0.004). Conclusions and relevance CTM increased appetite and resulted in weight gain in CKD cats despite
significant inconsistencies in compounding, and may benefit cats in
countries where an approved product is not available.
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Affiliation(s)
- Jessica M Quimby
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.,Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Kellyi K Benson
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Stacie C Summers
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | - Andrea K Herndon
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Shasha Bai
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Daniel L Gustafson
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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14
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Mikhael EM, Hassali MA, Hussain SA, Shawky N. Development and validation of a comprehensive diabetes self-management scale. Diabetes Metab Syndr 2019; 13:1717-1721. [PMID: 31235083 DOI: 10.1016/j.dsx.2019.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/14/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Ehab Mudher Mikhael
- Clinical Pharmacy Department at College of Pharmacy, Baghdad University, Baghdad, Iraq; School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
| | | | | | - Nizar Shawky
- The National Diabetes Center, Al-Mustansiriyah University, Baghdad, Iraq
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15
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Conroy M, Brodbelt DC, O'Neill D, Chang YM, Elliott J. Chronic kidney disease in cats attending primary care practice in the UK: a VetCompass TM study. Vet Rec 2019; 184:526. [PMID: 31023949 DOI: 10.1136/vr.105100] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 01/25/2019] [Accepted: 02/17/2019] [Indexed: 02/03/2023]
Abstract
Chronic kidney disease (CKD) is a frequent diagnosis in cats attending primary care practice and the most frequent cause of death in cats aged over five years, yet there is limited published research for CKD in cats attending primary care practice. This study aimed to estimate the prevalence of CKD and investigate risk factors for diagnosis and survival of cats diagnosed with CKD in UK primary care practices. The study included cats attending VetCompassTM practices from January 1, 2012 to December 31, 2013. A nested case-control and cohort study were undertaken. From 353,448 cats attending 244 clinics, the prevalence of CKD was estimated as 1.2 per cent (95 per cent CI 1.1 per cent to 1.3 per cent). Most cats with CKD had clinical signs at diagnosis (66.6 per cent). Few cats underwent investigations or monitoring of serum creatinine (32.6 per cent), urine protein:creatinine ratio (14.9 per cent) or blood pressure measurement (25.6 per cent). A proprietary renal diet was the most frequently prescribed management (63.8 per cent). Median survival time following diagnosis was 388 days (IQR 88-1042 days). This study provides generalisable evidence from the wider cat population to aid veterinarians in improved diagnosis and management of CKD that can benefit the health and welfare of cats with CKD in the UK.
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Affiliation(s)
- Megan Conroy
- Department of Veterinary Clinical Sciences, Royal Veterinary College-Hawkshead Campus, Hatfield, UK
| | - David C Brodbelt
- Department of Veterinary Clinical Sciences, Royal Veterinary College-Hawkshead Campus, Hatfield, UK
| | - Dan O'Neill
- Department of Veterinary Clinical Sciences, Royal Veterinary College-Hawkshead Campus, Hatfield, UK
| | - Yu-Mei Chang
- Research Support Office, Royal Veterinary College, London, UK
| | - Jonathan Elliott
- Department of Veterinary Basic Sciences, Royal Veterinary College, London, UK
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16
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Conroy M, Chang YM, Brodbelt D, Elliott J. Survival after diagnosis of hypertension in cats attending primary care practice in the United Kingdom. J Vet Intern Med 2018; 32:1846-1855. [PMID: 30315661 PMCID: PMC6271307 DOI: 10.1111/jvim.15307] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 04/28/2018] [Accepted: 07/24/2018] [Indexed: 12/01/2022] Open
Abstract
Background Hypertension is common in older cats. There is limited evidence for predictors of survival after diagnosis. Hypothesis/Objectives Investigate blood pressure assessment (BPA) and hypertension diagnosis in cats attending UK primary care practices (PCPs) and factors that influence survival. Animals Cats (347 889) attending 244 UK PCPs enrolled in the VetCompass program between January 1, 2012, and December 31, 2013. Cats identified as hypertensive (282) were included in descriptive and survival analyses. Methods All electronic patient records (EPRs) were searched to identify cats that potentially had received BPA. EPRs were read in detail to identify those that had BPA. The proportion that received BPA was evaluated using a stratified analysis and the incidence of hypertension estimated. A retrospective cohort study was used to investigate survival after diagnosis (Cox proportional hazard model). Results Estimated incidence risk was 19.5% (95% confidence interval [CI], 17.5‐21.6) from the estimated 1.34% (1.30%‐1.38%) of cats that received BPA. Few cats had BPA more than once after diagnosis (median, 1; interquartile range [IQR], 0‐3), with only 9.9% of diagnosed hypertensive cats having urine protein:creatinine ratio determined. Cats diagnosed as a result of monitoring of pre‐existing disease had improved survival (hazard ratio [HR], 0.58; 95% CI, 0.37‐0.89; P = .01) compared to cats diagnosed after clinical signs were recognized. Cats that had an amlodipine dose change had improved survival (HR, 0.56; 95% CI, 0.36‐0.87; P = .01) compared to those with no dose change. Conclusions and clinical importance These data suggest improved blood pressure monitoring in clinical practice may decrease the morbidity associated with hypertension.
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Affiliation(s)
- Megan Conroy
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, Royal Veterinary College, London, United Kingdom
| | - Dave Brodbelt
- Veterinary Epidemiology, Economics and Public Health, Royal Veterinary College, Hatfield, United Kingdom
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
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17
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Teng KTY, Devleesschauwer B, Maertens De Noordhout C, Bennett P, McGreevy PD, Chiu PY, Toribio JALML, Dhand NK. Welfare-Adjusted Life Years (WALY): A novel metric of animal welfare that combines the impacts of impaired welfare and abbreviated lifespan. PLoS One 2018; 13:e0202580. [PMID: 30208045 PMCID: PMC6135394 DOI: 10.1371/journal.pone.0202580] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 08/05/2018] [Indexed: 11/30/2022] Open
Abstract
Currently, separate measures are used to estimate the impact of animal diseases on mortality and animal welfare. This article introduces a novel metric, the Welfare-Adjusted Life Year (WALY), to estimate disease impact by combining welfare compromise and premature death components. Adapting the Disability-Adjusted Life Year approach used in human health audits, we propose WALY as the sum of a) the years lived with impaired welfare due to a particular cause and b) the years of life lost due to the premature death from the same cause. The years lived with impaired welfare are the product of the average duration of each welfare impediment, reflecting the actual condition that compromises animal welfare, the probability of an incident case developing and impaired welfare weights, representing the degree of impaired welfare. The years of life lost are calculated using the standard expected lifespan at the time of premature death. To demonstrate the concept, we estimated WALYs for 10 common canine diseases, namely mitral valve disease, dilated cardiomyopathy, chronic kidney disease, diabetes mellitus, atopic dermatitis, splenic haemangiosarcoma, appendicular osteosarcoma, cranial cruciate ligament disease, thoracolumbar intervertebral disc disease and cervical spondylomyelopathy. A survey of veterinarians (n = 61) was conducted to elicit impaired welfare weights for 35 welfare impediments. Paired comparison was the primary method to elicit weights, whereas visual analogue scale and time trade-off approaches rescaled these weights onto the desired scale, from 0 (the optimal welfare imaginable) to 1 (the worst welfare imaginable). WALYs for the 10 diseases were then estimated using the impaired welfare weights and published epidemiological data on disease impacts. Welfare impediment “amputation: one limb” and “respiratory distress” had the lowest and highest impaired welfare weights at 0.134 and 0.796, rescaled with a visual analogue scale, and 0.117 and 0.857, rescaled with time trade-off. Among the 10 diseases, thoracolumbar intervertebral disc disease and atopic dermatitis had the smallest and greatest adverse impact on dogs with WALYs at 2.83 (95% UI: 1.54–3.94) and 9.73 (95% uncertainty interval [UI]: 7.17–11.8), respectively. This study developed the WALY metric and demonstrated that it summarises welfare compromise as perceived by humans and total impact of diseases in individual animals. The WALY can potentially be used for prioritisation of disease eradication and control programs, quantification of population welfare and longitudinal surveillance of animal welfare in companion animals and may possibly be extended to production animals.
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Affiliation(s)
- Kendy Tzu-Yun Teng
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
- * E-mail:
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Peter Bennett
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
| | - Paul D. McGreevy
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
| | - Po-Yu Chiu
- National Taiwan University Veterinary Hospital, Taipei, Taiwan
| | - Jenny-Ann L. M. L. Toribio
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
| | - Navneet K. Dhand
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
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18
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Reid J, Nolan AM, Scott EM. Measuring pain in dogs and cats using structured behavioural observation. Vet J 2018; 236:72-79. [PMID: 29871754 DOI: 10.1016/j.tvjl.2018.04.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 04/16/2018] [Accepted: 04/19/2018] [Indexed: 11/27/2022]
Abstract
The contemporary approach to pain measurement in people and animals seeks to measure the affective (emotional) component of the pain experience using structured questionnaires with formal scoring methodology. Chronic pain has wide-ranging impacts which affects the quality of life (QOL) of the individual, whether that is a person or an animal. Accordingly instruments to measure chronic pain are designed to measure its impact on QOL and are called health-related quality of life (HRQL) instruments. In veterinary science instruments to measure pain are based on behavioural observation by the veterinary surgeon/nurse in the case of acute pain and by the owner in the case of chronic pain. The development of HRQL instruments is an expanding field in veterinary science, not just for the measurement of pain, but for other chronic diseases, and it has a wide application in pharmaceutical research and clinical practice to improve patient care. This review highlights the challenges involved in creating such measures for dogs and cats, seeking to provide the reader with an understanding of their development process. It then provides an overview of the current status with regard to acute and chronic pain measurement.
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Affiliation(s)
- J Reid
- NewMetrica Ltd., 19 Woodside Place, Glasgow G3 7QL, UK.
| | - A M Nolan
- Edinburgh Napier University, Sighthill Campus, Sighthill Court, EH 11 4BN, UK
| | - E M Scott
- School of Mathematics and Statistics, 15 University Gardens, University of Glasgow, Gl2 8QW, UK
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19
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Noble CE, Wiseman-Orr LM, Scott ME, Nolan AM, Reid J. Development, initial validation and reliability testing of a web-based, generic feline health-related quality-of-life instrument. J Feline Med Surg 2018; 21:84-94. [DOI: 10.1177/1098612x18758176] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives The objective of this study was to develop a valid, reliable, web-based generic feline health-related quality-of-life (HRQoL) questionnaire instrument to measure the affective impact of chronic disease. Methods A large initial item pool, obtained through interviews with cat owners, was reduced using predetermined criteria, survey scores for relevance and clarity, and the ability of individual items to discriminate between healthy and sick cats when owners completed a prototype questionnaire. Using these data, factor analysis was used to derive a scoring algorithm and provide evidence for factorial validity. Validity was demonstrated further in a field trial using a ‘known groups’ approach (sick vs healthy cats will have a different HRQoL profile, and the HRQoL profile of cats will deteriorate as comorbidities increase). Test–retest reliability was assessed using intra-class correlation coefficients (ICCs). Results In total, 165 items were reduced to 20 and, on the basis of a factor analysis that explained 72.3% of the variation in scores input by 71 owners of 30 healthy and 41 sick cats using the prototype, these were allocated to three domains (vitality, comfort and emotional wellbeing [EWB]) with a scoring algorithm derived using item loadings. Subsequently, the owners of 36 healthy and 58 sick cats completed one or two (n = 48) assessments. Median scores (healthy vs sick) for all domains were significantly different ( P <0.001), 78% of cats were correctly classified as healthy or sick and for comorbidities the correlation coefficients were moderate (vitality 0.64; comfort 0.63; EWB 0.50). Test–retest reliability was good (ICC vitality 0.635; comfort 0.716; EWB 0.853). Conclusions and relevance This study provides initial evidence for the validity and reliability of a novel HRQoL instrument to aid the assessment and management of chronic diseases of cats.
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Affiliation(s)
| | | | - Marian E Scott
- School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - Andrea M Nolan
- Edinburgh Napier University, Sighthill Campus, Edinburgh, UK
| | - Jacky Reid
- NewMetrica, Glasgow, UK
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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20
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Tatlock S, Gober M, Williamson N, Arbuckle R. Development and preliminary psychometric evaluation of an owner-completed measure of feline quality of life. Vet J 2017; 228:22-32. [DOI: 10.1016/j.tvjl.2017.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 06/15/2017] [Accepted: 10/11/2017] [Indexed: 11/26/2022]
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21
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Freeman LM, Rodenberg C, Narayanan A, Olding J, Gooding MA, Koochaki PE. Development and initial validation of the Cat HEalth and Wellbeing (CHEW) Questionnaire: a generic health-related quality of life instrument for cats. J Feline Med Surg 2017; 18:689-701. [PMID: 27562979 DOI: 10.1177/1098612x16657386] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aims of the study were to define factors that owners consider relevant to the health-related quality of life (HRQoL) of cats, to develop an instrument based on this information, and to evaluate the validity and reliability of the final instrument (the Cat HEalth and Wellbeing [CHEW] Questionnaire). METHODS Psychometric research techniques and guidance from the US Food and Drug Administration on outcome measures were used to develop a valid and reliable instrument. Fifty-four cat owners and caregivers participated in the qualitative research, while 1303 cat owners were included in the quantitative validation phase (development dataset, n = 648; validation dataset, n = 655). A random subset of cat owners (n = 391) also participated in test-retest evaluation. Qualitative research was used to generate a draft instrument, which was then subjected to quantitative validation techniques. These included item reduction, domain identification, data quality assessment, and exploratory and confirmatory analysis to develop a final instrument, which underwent confirmatory reliability and validity assessment. RESULTS A draft instrument with 11 domains and 100 items based on qualitative research underwent online quantitative validation testing which refined the instrument to eight domains and 33 items. Confirmatory reliability and validity assessment showed that the final instrument had good validity, was able to discriminate between cats by age and overall health status, and demonstrated good internal and test-retest reliability. CONCLUSIONS AND RELEVANCE The CHEW Questionnaire was developed and validated. Additional research is needed to verify its ability to differentiate cats with and without disease, and to assess its potential as a screening tool.
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Affiliation(s)
- Lisa M Freeman
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
| | - Cindy Rodenberg
- Global Statistics and Data Management, The Procter & Gamble Company, Mason, OH 45040, USA
| | - A Narayanan
- Global Statistics and Data Management, The Procter & Gamble Company, Mason, OH 45040, USA
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22
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Gates MC, Hinds HJ, Dale A. Preliminary description of aging cats and dogs presented to a New Zealand first-opinion veterinary clinic at end-of-life. N Z Vet J 2017; 65:313-317. [PMID: 28747096 DOI: 10.1080/00480169.2017.1360161] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS To conduct a preliminary investigation into the chronic disease conditions and clinical signs present in aging New Zealand companion animals at end-of-life and to describe the timing, circumstances, and manner of death. METHODS The medical records database of a first-opinion, companion animal, veterinary practice in Auckland, New Zealand was searched to identify all canine and feline patients ≥7 years of age that were subjected to euthanasia or cremated in the period between July 2012-June 2014. The free-text medical notes were analysed for information on the circumstances surrounding the death, previous diagnoses of chronic disease conditions, and the presence of clinical signs associated with decreased quality-of-life at the time of euthanasia. RESULTS The median age at death was 15 (max 22) years for the 130 cats and 12 (max 17) years for the 68 dogs in the study sample. Euthanasia at the clinic was carried out for 119/130 (91%) cats and 62/68 (91%) dogs, with the remainder recorded as having an unassisted death. The frequency of deaths was highest during December for both cats and dogs. Cost was mentioned as an issue in the medical records for 39/181 (21.6%) patients that were subjected to euthanasia. At the time of euthanasia, 92/119 (77.3%) cats and 43/62 (69.4%) dogs were recorded as having >1 clinical sign associated with a decreased quality-of-life. Inappetence and non-specific decline were the two most commonly recorded clinical signs for both dogs and cats. Cardiovascular disease (44/130, 34%), renal failure (40/130, 31%), and malignant neoplasia (36/130, 28%) were the most common chronic disease conditions recorded for cats. Degenerative joint disease (22/68, 32%), malignant neoplasia (14/68, 21%), and cardiovascular disease (8/68, 12%) were the most common chronic disease conditions recorded for dogs. CONCLUSIONS AND CLINICAL RELEVANCE These preliminary findings highlight that aging companion animals in New Zealand frequently have chronic disease conditions and clinical signs that may potentially be associated with decreased quality-of-life at the time of death. Further in-depth studies are required to determine whether there is a greater role for veterinarians in counselling owners about end-of-life care and euthanasia decisions.
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Affiliation(s)
- M C Gates
- a Institute of Veterinary, Animal and Biomedical Sciences , Massey University , Private Bag 11-222, Palmerston North 4442 , New Zealand
| | - H J Hinds
- b Department of Natural Science , Unitec Institute of Technology , Private Bag 92025, Victoria Street West, Auckland 1142 , New Zealand
| | - A Dale
- c RNZSPCA , PO Box 15-309, New Lynn, Auckland 0640 , New Zealand
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Knesl O, Hart BL, Fine AH, Cooper L, Patterson-Kane E, Houlihan KE, Anthony R. Veterinarians and Humane Endings: When Is It the Right Time to Euthanize a Companion Animal? Front Vet Sci 2017; 4:45. [PMID: 28470002 PMCID: PMC5395644 DOI: 10.3389/fvets.2017.00045] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 03/14/2017] [Indexed: 11/18/2022] Open
Abstract
Current advances in technologies and treatments provide pet owners and veterinarians with more options for prolonging the life of beloved pets, but can simultaneously lead to ethical dilemmas relating to what is best for both animal and owner. Key tools for improving end-of-life outcomes include (1) sufficient training to understand the valid ethical approaches to determining when euthanasia is appropriate, (2) regular training in client communication skills, and (3) a standard end-of-life protocol that includes the use of quality of life assessment tools, euthanasia consent forms, and pet owner resources for coping with the loss of a pet. Using these tools will improve outcomes for animals and their owners and reduce the heavy burden of stress and burnout currently being experienced by the veterinary profession.
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Affiliation(s)
| | - Benjamin L Hart
- Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Aubrey H Fine
- College of Education and Integrative Studies, California State Polytechnic University, Pomona, CA, USA
| | | | - Emily Patterson-Kane
- Animal Welfare Division, American Veterinary Medical Association, Schaumburg, IL, USA
| | | | - Raymond Anthony
- Department of Philosophy, University of Alaska Anchorage, Anchorage, AK, USA
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24
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Abstract
Duration of ownership strengthens the human-horse bond, affecting decision-making about the horse's welfare, quality of life (QoL), and euthanasia. Most owners consider their geriatric horses to have good or excellent QoL; however, increasing age is negatively associated with QoL. Management factors are important. The most common reasons for euthanasia include musculoskeletal disorders or lameness, colic, and nonspecific chronic diseases. The decision to euthanize is difficult, so the advice of the veterinarian and QoL are important. This article focuses on the human-horse bond, assessment of QoL, reasons for euthanasia, and owner experiences of mortality.
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25
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Quimby JM. Update on Medical Management of Clinical Manifestations of Chronic Kidney Disease. Vet Clin North Am Small Anim Pract 2016; 46:1163-81. [DOI: 10.1016/j.cvsm.2016.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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26
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Caney SM. An online survey of dietary and phosphate binder practices of owners of cats with chronic kidney disease. J Feline Med Surg 2016; 19:1040-1047. [PMID: 27754938 DOI: 10.1177/1098612x16672999] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives The objective of this study was to learn about owner experiences of chronic kidney disease (CKD), focusing on use of therapeutic renal diets (TRDs) and intestinal phosphate binders (IPBs). Methods An online survey was promoted to UK-based cat owners. Results In total, 859 owners participated. Most cats (n = 620; 72.18%) had two or more clinical signs at the time of their CKD diagnosis. Most common were polydipsia (n = 462; 53.78%) and weight loss (n = 426; 49.59%). In 94 cats (10.94%) CKD was only diagnosed as a result of wellness screening. In total, 371 participants (43.19%) reported that their cat's blood pressure had been measured; 100 of these (26.95% of those where blood pressure had been measured) subsequently received anti-hypertensive medication. In total, 90.80% of all participating owners had received a recommendation to feed a TRD. Five hundred and seventy-one owners (66.47%) reported that they were feeding a TRD as a component of their cat's diet. The most common reason for not feeding a TRD was that the cat did not like it (n = 123; 59.13%). Where a veterinary recommendation to feed a TRD had been received, 564 owners (72.31%) reported feeding a TRD as a component of their cat's diet vs seven owners (7.04%) who had not received a veterinary recommendation to feed a TRD. IPBs had been recommended to 321 owners (37.81%) and for 72 owners (8.38%) the recommendation came from a source other than a veterinary professional. Where used, IPBs were commonly added to a TRD (n = 136; 49.28%) and were generally accepted within 4 weeks (n = 178; 73.86%). Conclusions and relevance Awareness of TRDs was high but much lower for IPBs. A veterinary recommendation to feed a TRD was associated with higher compliance.
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Affiliation(s)
- Sarah Ma Caney
- Vet Professionals, Midlothian Innovation Centre, Roslin, UK
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