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Monteiro BP, Otis C, Del Castillo JRE, Nitulescu R, Brown K, Arendt-Nielsen L, Troncy E. Quantitative sensory testing in feline osteoarthritic pain - a systematic review and meta-analysis. Osteoarthritis Cartilage 2020; 28:885-896. [PMID: 32360738 DOI: 10.1016/j.joca.2020.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/31/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023]
Abstract
UNLABELLED Quantitative sensory testing (QST) is a psychophysical test used to quantify somatosensory sensation under normal or pathological conditions including osteoarthritis (OA). OBJECTIVE This study aimed to conduct a systematic review and meta-analysis of studies using QST in healthy and osteoarthritic cats, registered at Systematic Review Research Facility (#26-06-2017). DESIGN Hierarchical models with random intercepts for each individual study extracted through the systematic review were fit to subject-level data; QST measures were contrasted between healthy and osteoarthritic cats. Four bibliographic databases were searched; quality and risk of bias assessment were performed using pre-established criteria. RESULTS Six articles were included; most were of high quality and low risk of bias. Punctate tactile threshold (n = 70) and mechanical temporal summation (n = 35) were eligible for analysis. Cats with OA have lower punctate tactile threshold [mean difference (95%HDI): -44 (-60; -26) grams] and facilitated temporal summation of pain [hazard ratio (95%HDI): 5.32 (2.19; 14) times] when compared with healthy cats. The effect of sex and body weight on sensory sensitivity remained inconclusive throughout all analyses. Due to the correlation between age and OA status, it remains difficult to assess the effect of OA on sensory sensitivity, independently of age. CONCLUSIONS Clear and transparent reporting using guidelines are warranted. Similar to people, centralized sensitization is a feature of OA in cats. Future studies should try to elucidate the age effect on feline OA. Research with natural OA in cats is promising with potential to benefit feline health and welfare, and improve translatability to clinical research.
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Affiliation(s)
- B P Monteiro
- GREPAQ (Groupe de Recherche en Pharmacologie Animale Du Québec), Department of Biomedical Sciences, Faculty of Veterinary Medicine - Université de Montréal, Saint-Hyacinthe, QC, Canada.
| | - C Otis
- GREPAQ (Groupe de Recherche en Pharmacologie Animale Du Québec), Department of Biomedical Sciences, Faculty of Veterinary Medicine - Université de Montréal, Saint-Hyacinthe, QC, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.
| | - J R E Del Castillo
- GREPAQ (Groupe de Recherche en Pharmacologie Animale Du Québec), Department of Biomedical Sciences, Faculty of Veterinary Medicine - Université de Montréal, Saint-Hyacinthe, QC, Canada.
| | - R Nitulescu
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.
| | - K Brown
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.
| | - L Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Sensory-Motor Interaction (SMI®), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | - E Troncy
- GREPAQ (Groupe de Recherche en Pharmacologie Animale Du Québec), Department of Biomedical Sciences, Faculty of Veterinary Medicine - Université de Montréal, Saint-Hyacinthe, QC, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.
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Klinck MP, Monteiro BP, Lussier B, Guillot M, Moreau M, Otis C, Steagall PVM, Frank D, Martel-Pelletier J, Pelletier JP, del Castillo JRE, Troncy E. Refinement of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians: detection of naturally occurring osteoarthritis in laboratory cats. J Feline Med Surg 2018; 20:728-740. [PMID: 28920533 PMCID: PMC11104144 DOI: 10.1177/1098612x17730172] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives Feline osteoarthritis causes pain and disability. Detection and measurement is challenging, relying heavily on owner report. This study describes refinement of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians. Methods A video analysis of osteoarthritic (n = 6) and non-osteoarthritic (n = 4) cats facilitated expansion of scale items. Three successive therapeutic trials (using gabapentin, tramadol and oral transmucosal meloxicam spray) in laboratory cats with and without natural osteoarthritis (n = 12-20) permitted construct validation (assessments of disease status sensitivity and therapeutic responsiveness) and further scale refinements based on performance. Results Scale osteoarthritic sensitivity improved from phase I to phase III; phase III scale total score ( P = 0.0001) and 4/5 subcategories - body posture ( P = 0.0006), gait ( P = 0.0031), jumping (0.0824) and global distance examination ( P = 0.0001) - detected osteoarthritic cats. Total score inter-rater (intra-class correlation coefficients [ICC] = 0.64-0.75), intra-rater (ICC = 0.90-0.91) and overall internal consistency (Cronbach's alpha = 0.85) reliability were good to excellent. von Frey anesthesiometer-induced paw withdrawal threshold increased with gabapentin in phase I, in osteoarthritic cats ( P <0.001) but not in non-osteoarthritic cats ( P = 0.075). Night-time activity increased during gabapentin treatment. Objective measures also detected tramadol and/or meloxicam treatment effects in osteoarthritic cats in phases II and III. There was some treatment responsiveness: in phase I, 3/10 subcategory scores improved ( P <0.09) in treated osteoarthritic cats; in phase II, 3/8 subcategories improved; and in phase III, 1/5 subcategories improved ( P <0.096). Conclusions and relevance The revised scale detected naturally occurring osteoarthritis, but not treatment effects, in laboratory cats, suggesting future potential for screening of at-risk cats. Further study is needed to confirm reliability, validity (disease sensitivity and treatment responsiveness) and clinical feasibility, as well as cut-off scores for osteoarthritic vs non-osteoarthritic status, in client-owned cats.
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Affiliation(s)
- Mary P Klinck
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Beatriz P Monteiro
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Bertrand Lussier
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Martin Guillot
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Maxim Moreau
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Colombe Otis
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Paulo VM Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Diane Frank
- Department of Clinical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
| | - Jérôme RE del Castillo
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
| | - Eric Troncy
- Animal Pharmacology Research Group of Quebec (GREPAQ), Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine – University of Montréal, Saint-Hyacinthe, QC, Canada
- Osteoarthritis Research Unit, Centre de Recherche du CHUM, Central Hospital of the University of Montréal, Montreal, QC, Canada
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Klinck MP, Gruen ME, del Castillo JR, Guillot M, Thomson AE, Heit M, Lascelles BDX, Troncy E. Development and preliminary validity and reliability of the montreal instrument for cat arthritis testing, for use by caretaker/owner, MI-CAT(C), via a randomised clinical trial. Appl Anim Behav Sci 2018. [DOI: 10.1016/j.applanim.2017.11.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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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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