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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: 3.6] [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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Stadig S, Lascelles BDX, Bergh A. Do cats with a cranial cruciate ligament injury and osteoarthritis demonstrate a different gait pattern and behaviour compared to sound cats? Acta Vet Scand 2016; 58:70. [PMID: 27766970 PMCID: PMC5073862 DOI: 10.1186/s13028-016-0248-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Osteoarthritis (OA) is a common cause of chronic pain and dysfunction in older cats. The majority of cats with OA do not show signs of overt lameness, yet cats with orthopaedic disease are known to redistribute their body weight from the affected limb. OA can cause changes in the cat’s behaviour, which is often misinterpreted as signs of aging. The aim of the present study was to investigate if cats with a previous cranial cruciate ligament (CCL) injury perform differently on the pressure mat and exhibit different behaviour compared to sound cats according to the owner´s subjective assessment. Ten cats with a previous CCL injury were assessed with a pressure mat system and their owners were asked to complete an assessment questionnaire. The results were compared to those of 15 sound cats, matched to have the same weight and body condition score. Results The front/hind limb index for peak vertical force (PVF) was significantly higher for CCL cats, and there was a decreased PVF and vertical impulse (VI) on the affected hindlimb compared to the unaffected one. The results indicate that cats with a previous CCL injury put less weight, on the affected hindlimb but for a longer time. There was a significantly higher owner assessment questionnaire score for the group of cats with CCL injury compared to sound cats. Conclusions Cats with a previous CCL injury have a different gait pattern compared to sound cats and a different behaviour according to owner subjective assessment. It is of great importance that further studies are performed to investigate the long term effects of CCL injury as a cause of pain and physical dysfunction, and its role in the development of OA in cats. Improved assessment tools for chronic pain caused by OA in cats are needed, both to facilitate diagnosis and to evaluate pain-relieving treatment.
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Ormandy EH, Griffin G. Attitudes toward the use of Animals in Chronic versus Acute Pain Research: Results of a Web-based Forum. Altern Lab Anim 2016; 44:323-335. [DOI: 10.1177/026119291604400410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
When asked about the use of animals in biomedical research, people often state that the research is only acceptable if pain and distress are minimised. However, pain is caused when the aim is to study pain itself, resulting in unalleviated pain for many of the animals involved. Consequently, the use of animals in pain research is often considered contentious. To date, no research has explored people's views toward different types of animal-based pain research (e.g. chronic or acute pain). This study used a web-based survey to explore people's willingness to support the use of mice in chronic versus acute pain research. The majority of the participants opposed the use of mice for either chronic (68.3%) or acute (63.1%) pain research. There was no difference in the levels of support or opposition for chronic versus acute pain research. Unsupportive participants justified their opposition by focusing on the perceived lack of scientific merit, or the existence of non-animal alternatives. Supporters emphasised the potential benefits that could arise, with some stating that the benefits outweigh the costs. The majority of the participants were opposed to pain research involving mice, regardless of the nature and duration of the pain inflicted, or the perceived benefit of the research. A better understanding of public views toward animal use in pain research may provide a stronger foundation for the development of policy governing the use of animals in research where animals are likely to experience unalleviated pain.
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Affiliation(s)
- Elisabeth H. Ormandy
- The University of British Columbia, Animal Welfare Program, Vancouver, British Columbia, Canada
| | - Gilly Griffin
- Canadian Council on Animal Care, Ottawa, Ontario, Canada
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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: 2.4] [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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Otis C, Gervais J, Guillot M, Gervais JA, Gauvin D, Péthel C, Authier S, Dansereau MA, Sarret P, Martel-Pelletier J, Pelletier JP, Beaudry F, Troncy E. Concurrent validity of different functional and neuroproteomic pain assessment methods in the rat osteoarthritis monosodium iodoacetate (MIA) model. Arthritis Res Ther 2016; 18:150. [PMID: 27338815 PMCID: PMC4918125 DOI: 10.1186/s13075-016-1047-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 06/09/2016] [Indexed: 11/17/2022] Open
Abstract
Background Lack of validity in osteoarthritis pain models and assessment methods is suspected. Our goal was to 1) assess the repeatability and reproducibility of measurement and the influence of environment, and acclimatization, to different pain assessment outcomes in normal rats, and 2) test the concurrent validity of the most reliable methods in relation to the expression of different spinal neuropeptides in a chemical model of osteoarthritic pain. Methods Repeatability and inter-rater reliability of reflexive nociceptive mechanical thresholds, spontaneous static weight-bearing, treadmill, rotarod, and operant place escape/avoidance paradigm (PEAP) were assessed by the intraclass correlation coefficient (ICC). The most reliable acclimatization protocol was determined by comparing coefficients of variation. In a pilot comparative study, the sensitivity and responsiveness to treatment of the most reliable methods were tested in the monosodium iodoacetate (MIA) model over 21 days. Two MIA (2 mg) groups (including one lidocaine treatment group) and one sham group (0.9 % saline) received an intra-articular (50 μL) injection. Results No effect of environment (observer, inverted circadian cycle, or exercise) was observed; all tested methods except mechanical sensitivity (ICC <0.3), offered good repeatability (ICC ≥0.7). The most reliable acclimatization protocol included five assessments over two weeks. MIA-related osteoarthritic change in pain was demonstrated with static weight-bearing, punctate tactile allodynia evaluation, treadmill exercise and operant PEAP, the latter being the most responsive to analgesic intra-articular lidocaine. Substance P and calcitonin gene-related peptide were higher in MIA groups compared to naive (adjusted P (adj-P) = 0.016) or sham-treated (adj-P = 0.029) rats. Repeated post-MIA lidocaine injection resulted in 34 times lower downregulation for spinal substance P compared to MIA alone (adj-P = 0.029), with a concomitant increase of 17 % in time spent on the PEAP dark side (indicative of increased comfort). Conclusion This study of normal rats and rats with pain established the most reliable and sensitive pain assessment methods and an optimized acclimatization protocol. Operant PEAP testing was more responsive to lidocaine analgesia than other tests used, while neuropeptide spinal concentration is an objective quantification method attractive to support and validate different centralized pain functional assessment methods.
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Affiliation(s)
- Colombe Otis
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of veterinary medicine, Université de Montréal, 1500 des Vétérinaires Street, P.O. Box 5000, St-Hyacinthe, Quebec, J2S 7C6, Canada.,Osteoarthritis Research Unit, Research Center Hospital of Montreal University (CRCHUM), Montreal, Quebec, Canada
| | - Julie Gervais
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of veterinary medicine, Université de Montréal, 1500 des Vétérinaires Street, P.O. Box 5000, St-Hyacinthe, Quebec, J2S 7C6, Canada
| | - Martin Guillot
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of veterinary medicine, Université de Montréal, 1500 des Vétérinaires Street, P.O. Box 5000, St-Hyacinthe, Quebec, J2S 7C6, Canada.,Osteoarthritis Research Unit, Research Center Hospital of Montreal University (CRCHUM), Montreal, Quebec, Canada
| | - Julie-Anne Gervais
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of veterinary medicine, Université de Montréal, 1500 des Vétérinaires Street, P.O. Box 5000, St-Hyacinthe, Quebec, J2S 7C6, Canada
| | - Dominique Gauvin
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of veterinary medicine, Université de Montréal, 1500 des Vétérinaires Street, P.O. Box 5000, St-Hyacinthe, Quebec, J2S 7C6, Canada.,Osteoarthritis Research Unit, Research Center Hospital of Montreal University (CRCHUM), Montreal, Quebec, Canada
| | - Catherine Péthel
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of veterinary medicine, Université de Montréal, 1500 des Vétérinaires Street, P.O. Box 5000, St-Hyacinthe, Quebec, J2S 7C6, Canada.,Department of Physiology and Biophysics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | - Marc-André Dansereau
- Department of Physiology and Biophysics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Philippe Sarret
- Department of Physiology and Biophysics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, Research Center Hospital of Montreal University (CRCHUM), Montreal, Quebec, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, Research Center Hospital of Montreal University (CRCHUM), Montreal, Quebec, Canada
| | - Francis Beaudry
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of veterinary medicine, Université de Montréal, 1500 des Vétérinaires Street, P.O. Box 5000, St-Hyacinthe, Quebec, J2S 7C6, Canada.,Osteoarthritis Research Unit, Research Center Hospital of Montreal University (CRCHUM), Montreal, Quebec, Canada
| | - Eric Troncy
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of veterinary medicine, Université de Montréal, 1500 des Vétérinaires Street, P.O. Box 5000, St-Hyacinthe, Quebec, J2S 7C6, Canada. .,Osteoarthritis Research Unit, Research Center Hospital of Montreal University (CRCHUM), Montreal, Quebec, Canada.
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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: 16] [Impact Index Per Article: 1.8] [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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Schnabl E, Bockstahler B. Systematic review of ground reaction force measurements in cats. Vet J 2015; 206:83-90. [DOI: 10.1016/j.tvjl.2015.05.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 05/20/2015] [Accepted: 05/22/2015] [Indexed: 11/28/2022]
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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: 56] [Impact Index Per Article: 6.2] [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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Abstract
Physical orthopaedic examination in cats does not always reveal signs of lameness and no objective gait analysis method has yet been standardised for use in cats. The aims of the present study were to define appropriate parameters for pressure mat analyses during walk and jump, and to define reference values for gait parameters of healthy cats. Further, the distribution of the vertical force within the paws and the influence of a non-centred head position were investigated. The hypothesis was that cats have a symmetrical gait, a front/hindlimb asymmetry similar to dogs, and that peak vertical force (PVF) and vertical impulse (VI) have high intraclass correlation coefficients, confirming the reliability of these parameters. Data for walking (n = 46) showed gait symmetry indices of close to 1.0, besides PVF front/hind (1.3 ± 0.2). The PVF front/hind for jumping cats (n = 16) was 1.7 ± 0.6. Results from the distribution of the vertical force within the paw (n = 39) showed that the main weight during a strike is transferred from the caudal towards the craniomedial part of the paw. The findings support the hypothesis that healthy cats have similar gait symmetry to healthy dogs and that PVF and VI are reliable gait parameters. In conclusion, the present study provides a reference interval for healthy cats. Further studies are needed to investigate gait parameters in cats with orthopaedic disease.
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Affiliation(s)
- Sarah M Stadig
- SLU, Department of Animal Health and Welfare, Skara, Sweden
| | - Anna K Bergh
- SLU, Department of Anatomy, Physiology and Biochemistry, Uppsala, Sweden
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Guillot M, Chartrand G, Chav R, Rousseau J, Beaudoin JF, Martel-Pelletier J, Pelletier JP, Lecomte R, de Guise JA, Troncy E. [18F]-fluorodeoxyglucose positron emission tomography of the cat brain: A feasibility study to investigate osteoarthritis-associated pain. Vet J 2015; 204:299-303. [DOI: 10.1016/j.tvjl.2015.03.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 02/03/2015] [Accepted: 03/22/2015] [Indexed: 11/28/2022]
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Epstein M, Rodan I, Griffenhagen G, Kadrlik J, Petty M, Robertson S, Simpson W. 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats*. J Am Anim Hosp Assoc 2015; 51:67-84. [DOI: 10.5326/jaaha-ms-7331] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Epstein ME, Rodanm I, Griffenhagen G, Kadrlik J, Petty MC, Robertson SA, Simpson W. 2015 AAHA/AAFP pain management guidelines for dogs and cats. J Feline Med Surg 2015; 17:251-72. [PMID: 25701863 PMCID: PMC11148887 DOI: 10.1177/1098612x15572062] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
RATIONALE The robust advances in pain management for companion animals underlie the decision of the American Animal Hospital Association (AAHA) and American Association of Feline Practitioners (AAFP) to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines. The 2015 Guidelines summarize and offer a discriminating review of much of this new knowledge. RELEVANCE Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian-client-patient relationship. These Guidelines support veterinarians in incorporating pain management into practice, improving patient care. APPROACHES The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual patient basis. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention and treatment of pain in animals. EVIDENCE BASE The Guidelines include both pharmacologic and non-pharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. Post-surgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Chronic pain is dominated by degenerative joint disease (DJD), which is one of the most significant and under-diagnosed diseases of cats and dogs. DJD is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats.
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Affiliation(s)
- Mark E Epstein
- TotalBond Veterinary Hospitals PC, 3200 Union Road, Gastonia, NC 28056, USA
| | - Ilona Rodanm
- Cat Care Clinic and Feline-Friendly Consultations, 322 Junction Road, Madison, WI 53717, USA
| | - Gregg Griffenhagen
- Colorado State University School of Veterinary Medicine, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - Jamie Kadrlik
- Pet Crossing Animal Hospital and Dental Clinic, 10861 Bloomington Ferry Road, Bloomington, MN 55438, USA
| | - Michael C Petty
- Arbor Pointe Veterinary Hospital/Animal Pain Center, 42043 Ford Road, Canton, MI 48187, USA
| | - Sheilah A Robertson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Wendy Simpson
- Morrisville Cat Hospital, 100 Keybridge Drive, Suite A, Morrisville, NC 27560, USA
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Guillot M, Gravel P, Gauthier ML, Leblond H, Tremblay M, Rossignol S, Martel-Pelletier J, Pelletier JP, de Guise JA, Troncy E. Coxofemoral joint kinematics using video fluoroscopic images of treadmill-walking cats: development of a technique to assess osteoarthritis-associated disability. J Feline Med Surg 2015; 17:134-43. [PMID: 24907140 PMCID: PMC10816421 DOI: 10.1177/1098612x14537261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objectives of this pilot study were to develop a video fluoroscopy kinematics method for the assessment of the coxofemoral joint in cats with and without osteoarthritis (OA)-associated disability. Two non-OA cats and four cats affected by coxofemoral OA were evaluated by video fluoroscopy. Video fluoroscopic images of the coxofemoral joints were captured at 120 frames/s using a customized C-arm X-ray system while cats walked freely on a treadmill at 0.4 m/s. The angle patterns over time of the coxofemoral joints were extracted using a graphic user interface following four steps: (i) correction for image distortion; (ii) image denoising and contrast enhancement; (iii) frame-to-frame anatomical marker identification; and (iv) statistical gait analysis. Reliability analysis was performed. The cats with OA presented greater intra-subject stride and gait cycle variability. Three cats with OA presented a left-right asymmetry in the range of movement of the coxofemoral joint angle in the sagittal plane (two with no overlap of the 95% confidence interval, and one with only a slight overlap) consistent with their painful OA joint, and a longer gait cycle duration. Reliability analysis revealed an absolute variation in the coxofemoral joint angle of 2º-6º, indicating that the two-dimensional video fluoroscopy technique provided reliable data. Improvement of this method is recommended: variability would likely be reduced if a larger field of view could be recorded, allowing the identification and tracking of each femoral axis, rather than the trochanter landmarks. The range of movement of the coxofemoral joint has the potential to be an objective marker of OA-associated disability.
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Affiliation(s)
- Martin Guillot
- Québec Animal Pharmacology Research Group (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Montréal, QC, Canada Osteoarthritis Research Unit, CRCHUM, Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Pierre Gravel
- Department of Radiology, Faculty of Medicine, University of Montréal, Montréal, QC, Canada
| | - Marie-Lou Gauthier
- Québec Animal Pharmacology Research Group (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Montréal, QC, Canada
| | - Hugues Leblond
- Central Nervous System Research Group, Department of Physiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Maurice Tremblay
- Central Nervous System Research Group, Department of Physiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Serge Rossignol
- Central Nervous System Research Group, Department of Physiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, CRCHUM, Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, CRCHUM, Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Jacques A de Guise
- Imaging and Orthopedic Research Laboratory (LIO), Research Center of the University of Montréal Hospital Centre (CRCHUM), School of Superior Technology, Université de Québec, Québec, QC, Canada
| | - Eric Troncy
- Québec Animal Pharmacology Research Group (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Montréal, QC, Canada Osteoarthritis Research Unit, CRCHUM, Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
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66
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Tomas A, Pultorak EL, Gruen ME, Breitschwerdt EB, Lascelles BDX. Relationship between degenerative joint disease, pain, and Bartonella spp. seroreactivity in domesticated cats. J Vet Intern Med 2014; 29:21-7. [PMID: 25327962 PMCID: PMC4407694 DOI: 10.1111/jvim.12495] [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: 01/31/2014] [Revised: 08/14/2014] [Accepted: 09/30/2014] [Indexed: 11/30/2022] Open
Abstract
Background Recently, a potential association was identified between Bartonella exposure and arthritides in mammalian species other than cats. Hypothesis/Objectives We hypothesized that Bartonella exposure is associated with more severe degenerative joint disease (DJD) and a greater burden of DJD‐associated pain in client‐owned cats. Animals Ninety‐four client‐owned cats (6 months to 20 years old), ranging from clinically unaffected to severely lame because of DJD. Methods Using physical examination and radiography, pain and radiographic scores were assigned to each part of the bony skeleton. Sera were tested for Bartonella henselae, B. koehlerae, and B. vinsonii subsp. berkhoffii (genotypes I, II, and III) antibodies using immunofluorescence antibody assays. Variables were categorized and logistic regression used to explore associations. Results Seropositivity to Bartonella was identified in 33 (35.1%) cats. After multivariate analysis controlling for age, total DJD score (OR, 0.51; 95% CI, 0.26–0.97; P = .042), appendicular pain score (OR, 0.33; 95% CI, 0.17–0.65; P = .0011), and total pain score (OR, 0.35; 95% CI, 0.17–0.72; P = .0045) were significantly inversely associated with Bartonella seroreactivity status, indicating that cats with higher DJD and pain scores were less likely to be Bartonella seropositive. Conclusions and Clinical Importance Based upon this preliminary study, Bartonella spp. seropositivity was associated with decreased severity of DJD and decreased DJD‐associated pain in cats. Additional studies are needed to verify these findings, and if verified, to explore potential mechanisms.
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Affiliation(s)
- A Tomas
- Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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67
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Rialland P, Otis C, Moreau M, Pelletier JP, Martel-Pelletier J, Beaudry F, del Castillo JR, Bertaim T, Gauvin D, Troncy E. Association between sensitisation and pain-related behaviours in an experimental canine model of osteoarthritis. Pain 2014; 155:2071-9. [DOI: 10.1016/j.pain.2014.07.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 06/03/2014] [Accepted: 07/21/2014] [Indexed: 12/20/2022]
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68
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Forelimb and hindlimb ground reaction forces of walking cats: Assessment and comparison with walking dogs. Vet J 2014; 202:116-27. [DOI: 10.1016/j.tvjl.2014.07.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 04/29/2014] [Accepted: 07/06/2014] [Indexed: 11/18/2022]
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69
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Marino CL, Lascelles BDX, Vaden SL, Gruen ME, Marks SL. Prevalence and classification of chronic kidney disease in cats randomly selected from four age groups and in cats recruited for degenerative joint disease studies. J Feline Med Surg 2014; 16:465-72. [PMID: 24217707 PMCID: PMC4414065 DOI: 10.1177/1098612x13511446] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic kidney disease (CKD) and degenerative joint disease are both considered common in older cats. Information on the co-prevalence of these two diseases is lacking. This retrospective study was designed to determine the prevalence of CKD in two cohorts of cats: cats randomly selected from four evenly distributed age groups (RS group) and cats recruited for degenerative joint disease studies (DJD group), and to evaluate the concurrence of CKD and DJD in these cohorts. The RS group was randomly selected from four age groups from 6 months to 20 years, and the DJD group comprised cats recruited to four previous DJD studies, with the DJD group excluding cats with a blood urea nitrogen and/or serum creatinine concentration >20% (the upper end of normal) for two studies and cats with CKD stages 3 and 4 for the other two studies. The prevalence of CKD in the RS and DJD groups was higher than expected at 50% and 68.8%, respectively. CKD was common in cats between 1 and 15 years of age, with a similar prevalence of CKD stages 1 and 2 across age groups in both the RS and DJD cats, respectively. We found significant concurrence between CKD and DJD in cats of all ages, indicating the need for increased screening for CKD when selecting DJD treatments. Additionally, this study offers the idea of a relationship and causal commonality between CKD and DJD owing to the striking concurrence across age groups and life stages.
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Affiliation(s)
- Christina L Marino
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Comparative Pain Research Laboratory, Surgery Section, Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC, USA
| | - Shelly L Vaden
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC, USA
| | - Margaret E Gruen
- Comparative Pain Research Laboratory, Surgery Section, Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA Comparative Biomedical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA
| | - Steven L Marks
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC, USA
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Guillot M, Taylor PM, Rialland P, Klinck MP, Martel-Pelletier J, Pelletier JP, Troncy E. Evoked temporal summation in cats to highlight central sensitization related to osteoarthritis-associated chronic pain: a preliminary study. PLoS One 2014; 9:e97347. [PMID: 24859251 PMCID: PMC4032234 DOI: 10.1371/journal.pone.0097347] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 04/17/2014] [Indexed: 12/26/2022] Open
Abstract
In cats, osteoarthritis causes significant chronic pain. Chronicity of pain is associated with changes in the central nervous system related to central sensitization, which have to be quantified. Our objectives were 1) to develop a quantitative sensory testing device in cats for applying repetitive mechanical stimuli that would evoke temporal summation; 2) to determine the sensitivity of this test to osteoarthritis-associated pain, and 3) to examine the possible correlation between the quantitative sensory testing and assessment using other pain evaluation methods. We hypothesized that mechanical sub-threshold repetitive stimuli would evoke temporal summation, and that cats with osteoarthritis would show a faster response. A blinded longitudinal study was performed in 4 non-osteoarthritis cats and 10 cats with naturally occurring osteoarthritis. Quantification of chronic osteoarthritis pain-related disability was performed over a two week period using peak vertical force kinetic measurement, motor activity intensity assessment and von Frey anesthesiometer-induced paw withdrawal threshold testing. The cats afflicted with osteoarthritis demonstrated characteristic findings consistent with osteoarthritis-associated chronic pain. After a 14-day acclimation period, repetitive mechanical sub-threshold stimuli were applied using a purpose-developed device. Four stimulation profiles of predetermined intensity, duration and time interval were applied randomly four times during a four-day period. The stimulation profiles were different (P<0.001): the higher the intensity of the stimulus, the sooner it produced a consistent painful response. The cats afflicted with osteoarthritis responded more rapidly than cats osteoarthritis free (P = 0.019). There was a positive correlation between the von Frey anesthesiometer-induced paw withdrawal threshold and the response to stimulation profiles #2 (2N/0.4 Hz) and #4 (2N/0.4 Hz): Rhos = 0.64 (P = 0.01) and 0.63 (P = 0.02) respectively. This study is the first report of mechanical temporal summation in awake cats. Our results suggest that central sensitization develops in cats with naturally occurring osteoarthritis, providing an opportunity to improve translational research in osteoarthritis-associated chronic pain.
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Affiliation(s)
- Martin Guillot
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine – Université de Montréal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, Université de Montréal Hospital Centre, Notre-Dame Hospital, Montreal, Quebec, Canada
| | - Polly M. Taylor
- Topcat Metrology, Gravel Head Farm, Downham Common, Little Downham, Nr Ely, Cambridgeshire, United Kingdom
| | - Pascale Rialland
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine – Université de Montréal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, Université de Montréal Hospital Centre, Notre-Dame Hospital, Montreal, Quebec, Canada
| | - Mary P. Klinck
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine – Université de Montréal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, Université de Montréal Hospital Centre, Notre-Dame Hospital, Montreal, Quebec, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, Université de Montréal Hospital Centre, Notre-Dame Hospital, Montreal, Quebec, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, Université de Montréal Hospital Centre, Notre-Dame Hospital, Montreal, Quebec, Canada
| | - Eric Troncy
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine – Université de Montréal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, Université de Montréal Hospital Centre, Notre-Dame Hospital, Montreal, Quebec, Canada
- * E-mail:
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Moreau M, Lussier B, Pelletier JP, Troncy E. Does a placebo effect really occur in dogs afflicted by hip osteoarthritis as measured by force platform gait analysis? BMC Vet Res 2013; 9:260. [PMID: 24359688 PMCID: PMC3878098 DOI: 10.1186/1746-6148-9-260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 12/13/2013] [Indexed: 01/24/2023] Open
Abstract
A recent study investigated the therapeutic response of dogs afflicted by hip osteoarthritis when evaluating therapeutic modalities compared to a negative (placebo) control group. Authors suggested a placebo effect based on peak vertical force measurement. In addition, small effect size for each of the tested therapeutics as well as the extremely large sample size needed (>450) to discern therapeutic efficacy using force platform gait analysis were reported. We wish to express our concerns regarding the eligibility criteria used to select the studied cohort, the small effect size, and the placebo effect reported in force platform gait analysis.
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Affiliation(s)
| | | | | | - Eric Troncy
- Osteoarthritis Research Unit, Université de Montréal Hospital Centre, Tour Viger, 900 rue St-Denis, Montreal, Quebec H2X 0A9, Canada.
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Pelligand L, Lees P. Monitoring and treating chronic pain in cats: bring on the challenge! Vet J 2013; 196:275-6. [PMID: 23683856 DOI: 10.1016/j.tvjl.2013.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 04/09/2013] [Indexed: 11/17/2022]
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