Psychometric Testing and Validation of the Italian Version of the Helsinki Chronic Pain Index (I-HCPI) in Dogs with Pain Related to Osteoarthritis.

Pain assessment is of paramount importance for properly managing dogs with osteoarthritis (OA) pain. The aim of the present study was to develop and psychometrically validate the Italian version of the Helsinki Chronic Pain Index (I-HCPI). Owners of OA painful (n = 87) and healthy dogs (n = 40) were administered the I-HCPI once or twice after an eight-week meloxicam treatment. Sixty-nine owners of healthy and OA dogs also completed the Italian version of the Canine Brief Pain Inventory (I-CBPI). Pain on palpation on a 0-4 scale was assessed on all recruited dogs. Construct validity was tested both with hypothesis testing and principal component analysis, confirming the I-HCPI accurately measured chronic pain. Good convergent and criterion validity were shown through correlations with I-CBPI subscores and distribution among pain on palpation scores (p < 0.0001). The significant difference between the pre- and post-treatment I-HCPI scores (p < 0.0001) and Cohen's effect size (2.27) indicated excellent responsiveness. The I-HCPI was shown to be reliable through communalities (range 0.47-0.90) and Cronbach α (≥0.95). Discriminative ability and cut-off point, as tested through Receiver Operating Characteristic analysis, showed excellent diagnostic accuracy with a threshold value of 11 (specificity 0.98 and sensitivity 0.94). The I-HCPI was confirmed to be a valid, sensitive, reliable, and accurate tool to discriminate between dogs with and without pain.

Changes in biomarkers in equine synovial fluid two weeks after intra-articular hyaluronan treatment: a randomised double-blind clinical trial.

BACKGROUND: Inflammatory and degenerative activity inside the joint can be studied in vivo via analysis of synovial fluid (SF) biomarkers, which are molecular markers of inflammatory processes and tissue turnover. The aim of this study was to investigate the response of selected biomarkers in the SF after an intra-articular (IA) high-molecular-weight non-animal stabilized hyaluronic acid (NASHA) treatment. Our hypothesis was that prostaglandin E2 (PGE2), substance P, aggrecan chondroitin sulfate 846 epitope (CS846), and carboxypeptide of type II collagen (CPII) concentrations in SF would decrease more in the NASHA than in the placebo group. Twenty-eight clinically lame horses with positive responses to diagnostic IA anaesthesia of the metacarpophalangeal or metatarsophalangeal joints were randomized into treatment (n = 15) and control (n = 13) groups. After collection of baseline SF samples followed by IA diagnostic anaesthesia, horses in the treatment group received 3 ml of a NASHA product IA. Those in the placebo group received an equivalent volume of sterile 0.9% saline solution. The horses were re-evaluated and a second SF sample was obtained after a 2-week period. RESULTS: CS846 concentration decreased in the NASHA group only (P = 0.010). Both PGE2 and CPII concentrations decreased within the groups (PGE2, P = 0.010 for the NASHA group; P = 0.027 for the placebo group; CPII, P < 0.001 for NASHA group; P = 0.009 for placebo group). No significant treatment effect for any biomarker was found between groups. NASHA induced an increase in white blood cell count; this was significant compared with baseline (P = 0.021) and the placebo group (P = 0.045). CONCLUSIONS: Although the SF concentration of the cartilage-derived biomarker CS846 decreased in the NASHA group, no statistically significant treatment effect of any of the biomarkers were observed between treatment groups. The significant increase in SF white blood cell count after IA NASHA may indicate a mild inflammatory response. However, as no clinical adverse effects were observed, we conclude that IA NASHA was well tolerated.

Developing a testing battery for measuring dogs' stifle functionality: the Finnish Canine Stifle Index (FCSI).

This study aimed at developing a quantitative testing battery for dogs' stifle functionality, as, unlike in human medicine, currently none is available in the veterinary field. Forty-three dogs with surgically treated unilateral cranial cruciate ligament rupture and 21 dogs with no known musculoskeletal problems were included. Eight previously studied tests: compensation in sitting and lying positions, symmetry of thrust in hindlimbs when rising from lying and sitting, static weight bearing, stifle flexion and extension and muscle mass symmetry, were summed into the Finnish Canine Stifle Index (FCSI). Sensitivities and specificities of the dichotomised FCSI score were calculated against orthopaedic examination, radiological and force platform analysis and a conclusive assessment (combination of previous). One-way analysis of variance (ANOVA)was used to evaluate FCSI score differences between the groups. Cronbach's alpha for internal consistency was calculated. The range of the index score was 0-263, with a proposed cut-off value of 60 between 'adequate' and 'compromised' functional performance. In comparison to the conclusive assessment, the sensitivity and specificity of the FCSI were 90 per cent and 90.5 per cent, respectively. Cronbach's alpha for internal reliability of the FCSI score was 0.727. An estimate of the surgically treated and control dogs' FCSI scores were 105 (95 per cent CI 93 to 116) and 20 (95 per cent CI 4 to 37), respectively. The difference between the groups was significant (P<0.001).

Cross-sectional area and fat content in dachshund epaxial muscles: an MRI and CT reliability study.

MRI and CT are frequently used to diagnose spinal diseases in dogs. These modalities have detected epaxial muscle degeneration in dachshunds with intervertebral disc herniation. However, research on the reliability of epaxial muscular measurements is limited in veterinary medicine. The aims of the study were to assess the intrarater and inter-rater reliability of epaxial muscle cross-sectional area (CSA) and fat content measurements on MRI and CT images in dachshunds, and to compare the CSA measurement between the two modalities. MRI and CT images of 10 healthy dachshunds were evaluated. Two blinded observers assessed MRI CSA, MRI fat content, CT CSA and CT muscle attenuation of three thoracolumbar epaxial muscles using OsiriX. The results showed 'substantial' to 'almost perfect' intrarater reliability (intraclass correlation coefficient (ICC) 0.828-0.998) and inter-rater reliability (ICC 0.685-0.854) for all variables. When individual spinal segments were analysed, the intrarater and inter-rater reliability decreased and the confidence intervals increased. There was positive correlation (r= 0.719-0.841, P=0.001) and high agreement (0.824-0.894) for the measured CSA between MRI and CT. Epaxial muscle CSA and fat content can be reliably measured on MRI and CT, bearing in mind that measurement of certain segments requires adequate training.

The effect of intra-articular botulinum toxin A on substance P, prostaglandin E2, and tumor necrosis factor alpha in the canine osteoarthritic joint.

BACKGROUND: Recently, intra-articular botulinum toxin A (IA BoNT A) has been shown to reduce joint pain in osteoarthritic dogs. Similar results have been reported in human patients with arthritis. However, the mechanism of the antinociceptive action of IA BoNT A is currently not known. The aim of this study was to explore this mechanism of action by investigating the effect of IA BoNT A on synovial fluid (SF) and serum substance P (SP), prostaglandin E2 (PGE2), and tumor necrosis factor alpha (TNF-α) in osteoarthritic dogs. Additionally, the aim was to compare SF SP and PGE2 between osteoarthritic and non-osteoarthritic joints, and investigate associations between SP, PGE2, osteoarthritic pain, and the signalment of dogs. Thirty-five dogs with chronic naturally occurring osteoarthritis and 13 non-osteoarthritic control dogs were included in the study. Osteoarthritic dogs received either IA BoNT A (n = 19) or IA placebo (n = 16). Serum and SF samples were collected and osteoarthritic pain was evaluated before (baseline) and 2 and 8 weeks after treatment. Osteoarthritic pain was assessed with force platform, Helsinki Chronic Pain Index, and joint palpation. Synovial fluid samples were obtained from control dogs after euthanasia. The change from baseline in SP and PGE2 concentration was compared between the IA BoNT A and placebo groups. The synovial fluid SP and PGE2 concentration was compared between osteoarthritic and control joints. Associations between SP, PGE2, osteoarthritic pain, and the signalment of dogs were evaluated. RESULTS: There was no significant change from baseline in SP or PGE2 after IA BoNT A. Synovial fluid PGE2 was significantly higher in osteoarthritic compared to control joints. Synovial fluid PGE2 correlated with osteoarthritic pain. No associations were found between SP or PGE2 and the signalment of dogs. The concentration of TNF-α remained under the detection limit of the assay in all samples. CONCLUSIONS: The results suggest that the antinociceptive effect of IA BoNT A in the joint might not be related to the inhibition of SP nor PGE2. Synovial fluid PGE2, but not SP, could be a marker for chronic osteoarthritis and pain in dogs.

Prevalence of house dust mites in the homes of atopic dogs in Finland.

BACKGROUND: The house dust mites (HDM) Dermatophagoides farinae and D. pteronyssinus are important environmental allergens implicated in the pathogenesis of human and canine atopic dermatitis. Sensitization to HDM measured by allergen-specific IgE is common in Finnish atopic dogs. Studies on HDM prevalence in Finland are few but suggest that HDM are scarce. OBJECTIVE: The aim of the present study was to evaluate the prevalence of HDM in the home environments of atopic dogs in Finland. METHODS: Dust samples were obtained from the homes of 50 atopic dogs. Samples were collected by vacuuming the owners' mattresses and each dog's bed. In each case, an area of 21 × 30 cm was vacuumed for 2 min. Samples weighing 100 mg or more were considered sufficient for determination of HDM allergen concentrations (Der f 1 and Der p 1) using standardized ELISA. Samples sufficient for further analysis were also examined by direct microscopy for the presence of mites and by multiplex PCR for HDM DNA. RESULTS: Eighty one samples were sufficient for analysis by ELISA, 59 by PCR and 29 by direct microscopy. A single sample was analysed from four homes in which the dog shared the owner's bed. Der f 1 was detected in three samples (3.7%). Der p 1 was not detected in any sample. No mites were identified on microscopy. Five samples were positive for HDM on multiplex PCR (8.4%). CONCLUSION: House dust mites seem to be uncommon in the home environment of atopic dogs in Finland despite reported frequent allergen-specific IgE antibodies.

A randomised, double-blinded, placebo-controlled clinical study on intra-articular hyaluronan treatment in equine lameness originating from the metacarpophalangeal joint.

BACKGROUND: Intra-articular inflammation resulting in lameness is a common health problem in horses. Exogenous intra-articular hyaluronic acid has been shown to provide an analgesic effect and reduce pain in equine and human osteoarthritis. High molecular weight non-animal stabilized hyaluronic acid (NASHA) has gained popularity in the treatment of human arthritic conditions due to its long-acting pain-relieving effects. The aim of this study was to compare the response to treatment of lameness localized in the equine metacarpophalangeal joint injected with non-animal stabilized hyaluronic acid (NASHA) and placebo (saline). Twenty-seven clinically lame horses with a positive response to diagnostic intra-articular anaesthesia of the metacarpophalangeal joint and with no, or at most mild, radiographic changes in this joint were included in the study. Horses in the treatment group (n = 14) received 3 mL of a NASHA product intra-articularly, and those in the placebo group (n = 13) received an equivalent volume of sterile 0.9% saline solution. RESULTS: The change in the lameness score did not significantly differ between NASHA and placebo groups (P = 0.94). Scores in the flexion test improved more in the NASHA group compared with placebo (P = 0.01). The changes in effusion and pain in flexion were similar (P = 0.94 and P = 0.27, respectively) when NASHA and placebo groups were compared. A telephone interview follow-up of the owners three months post-treatment revealed that 14 of the 21 horses (67%) were able to perform at their previous level of exercise. CONCLUSIONS: In the present study, a single IA NASHA injection was not better than a single saline injection for reducing lameness in horses with synovitis or mild osteoarthritis. However, the results of this study indicate that IA NASHA may have some beneficial effects in modifying mild clinical signs but more research is needed to evaluate whether the positive effect documented ie. reduced response in the flexion test is a true treatment effect.

Long-term functional outcome after surgical repair of cranial cruciate ligament disease in dogs.

BACKGROUND: Cranial cruciate ligament (CCL) rupture is a very common cause of pelvic limb lameness in dogs. Few studies, using objective and validated outcome evaluation methods, have been published to evaluate long-term (>1 year) outcome after CCL repair. A group of 47 dogs with CCL rupture treated with intracapsular, extracapsular, and osteotomy techniques, and 21 healthy control dogs were enrolled in this study. To evaluate long-term surgical outcome, at a minimum of 1.5 years after unilateral CCL surgery, force plate, orthopedic, radiographic, and physiotherapeutic examinations, including evaluation of active range of motion (AROM), symmetry of thrust from the ground, symmetry of muscle mass, and static weight bearing (SWB) of pelvic limbs, and goniometry of the stifle and tarsal joints, were done. RESULTS: At a mean of 2.8 ± 0.9 years after surgery, no significant differences were found in average ground reaction forces or SWB between the surgically treated and control dog limbs, when dogs with no other orthopedic findings were included (n = 21). However, in surgically treated limbs, approximately 30% of the dogs had decreased static or dynamic weight bearing when symmetry of weight bearing was evaluated, 40-50% of dogs showed limitations of AROM in sitting position, and two-thirds of dogs had weakness in thrust from the ground. The stifle joint extension angles were lower (P <0.001) and flexion angles higher (P <0.001) in surgically treated than in contralateral joints, when dogs with no contralateral stifle problems were included (n = 33). In dogs treated using the intracapsular technique, the distribution percentage per limb of peak vertical force (DPVF) in surgically treated limbs was significantly lower than in dogs treated with osteotomy techniques (P =0.044). CONCLUSIONS: The average long-term dynamic and static weight bearing of the surgically treated limbs returned to the level of healthy limbs. However, extension and flexion angles of the surgically treated stifles remained inferior to healthy joints, and impairment of AROM and weakness in thrust from the ground in the surgically treated limbs were frequently present. Ground reaction forces may be inadequate as a sole method for assessing functional outcome after cranial cruciate ligament repair.

Comparison of cross sectional area and fat infiltration of the epaxial muscles in dogs with and without spinal cord compression.

This study investigated the cross sectional area (CSA) and fat infiltration of the epaxial muscles in Dachshunds with compressive spinal cord lesions due to intervertebral disc herniation (IVDH) and in dogs with non-compressive spinal cord lesions with fibrocartilaginous embolism (FCE). The CSA and fat infiltration of the multifidi and longissimus dorsi muscles were determined from T1 weighted magnetic resonance images. Difference in CSA and fat infiltration between the lesion- and non-lesion side in the Dachshunds was assessed using mixed model analysis. Difference in CSA and fat infiltration between Dachshunds and FCE dogs was analysed with independent sample t-tests. There was no difference in CSA or fat infiltration between sides in the Dachshunds. FCE dogs had greater CSA (multifidus P = 0.036, longissimus P < 0.001) and less fat infiltration compared to Dachshunds (longissimus P = 0.017). Duration of neurological deficits, age, body size and conformation are likely to have influenced the difference between the groups.

Muscle fibre type distribution of the thoracolumbar and hindlimb regions of horses: relating fibre type and functional role.

BACKGROUND: Although the majority of equine muscles have a mixed fibre type distribution indicative of diverse functional roles, the predominance of a fibre type can indicate the primary function of a muscle. The deep epaxial musculature has an important role in core spinal stability in humans, reflected as a predominantly muscle fibre type (MFT) I or postural fibre type. The fibre type of the deep epaxial musculature has not been determined in horses. The objective of the study was to determine the MFT distribution in selected muscles of thoracolumbar and hindlimb region of horses. This included deep epaxial and hypaxial muscles that were hypothesised to have a postural stabilising role. A second objective was to examine differences in MFT distribution between horses bred for endurance (Arabian) and sprinting (Quarter horse). Muscle biopsy samples were obtained from selected thoracolumbar and hind limb muscles of 5 Quarter horses, 4 Arabians, and 2 Thoroughbreds. The myosin heavy chain distribution was determined by gel electrophoresis. Mann-Whitney rank test was used to compare the proportional MFT and differences between breeds. RESULTS: Mm. sacrocaudalis dorsalis medialis and diaphragm had the highest proportion of MFT-I. The remaining deep epaxial muscles and the hypaxial muscle m. psoas minor had approximately equal MFT I and II proportions. Mm. psoas major, iliocostalis, longissimus dorsi and the hind limb muscles contained mostly MFT-IIX. The fibre type distribution was similar between Arabians and Quarter horses, although Quarter horses had more MFT-IIX fibres in psoas major (P = 0.02) while Arabians had more MFT-I fibres in m. longissimus dorsi (P = 0.03). CONCLUSIONS: The fibre type distribution of the deep epaxial muscles, mm psoas minor and diaphragm varied from approximately equal MFT-I and II proportions to predominantly MFT-I suggesting a postural stabilising role possibly important in core spinal stability. In contrast the fibre type proportions of mm psoas major, iliocostalis, longissimus dorsi and the hind limb muscles were mainly MFT-II suggesting a locomotory role. Knowledge of fibre type distribution in such a clinically important area can direct diagnosis, prevention and treatment of muscular or neuromotor dysfunction.

Use of an owner questionnaire to evaluate long-term surgical outcome and chronic pain after cranial cruciate ligament repair in dogs: 253 cases (2004-2006).

OBJECTIVE: To evaluate, by means of an owner questionnaire, long-term outcome and prevalence of chronic pain after cranial cruciate ligament (CCL) surgery in dogs. DESIGN: Retrospective case series. ANIMALS: 253 dogs with surgically treated CCL rupture. PROCEDURES: Data from surgical records of dogs that underwent surgical repair of CCL between 2004 and 2006 were reviewed. An owner questionnaire, including the validated Helsinki chronic pain index (HCPI), served to evaluate long-term outcome and prevalence of chronic pain after surgical repair by means of intracapsular, extracapsular, or osteotomy techniques. Additional questions inquired about recovery and rehabilitation after surgery, current well-being, medications, and adjunct treatments. RESULTS: Of 507 questionnaires, 272 (53.6%) were returned; 19 were excluded because of incomplete answers. Mean ± SD follow-up time was 2.7 ± 0.8 years (range, 1.3 to 4.5 years). Owners considered surgical outcome as excellent in 122 of 226 (54.0%) dogs, good in 97 (42.9%), fair in 0 (0%), and poor in 7 (3.1%). At follow-up, the mean ± SD HCPI for 206 dogs was 8.9 ± 6.3 (range, 0 to 24). Of these 206 dogs, 64 (31.1%) had an HCPI ≥ 12, indicating chronic pain. Mean HCPI in dogs with a good outcome (11.8 ± 5.4; 95% confidence interval, 10.6 to 12.9) was significantly higher than that for dogs with an excellent outcome (6.2 ± 5.7; 95% confidence interval, 5.1 to 7.2). Owner-reported postoperative lameness was significantly shorter after osteotomy techniques, compared with lameness duration after the intracapsular technique. CONCLUSIONS AND CLINICAL RELEVANCE: On the basis of owner assessment, long-term chronic pain was found in approximately 30% of dogs after CCL repair.

Ranking of physiotherapeutic evaluation methods as outcome measures of stifle functionality in dogs.

BACKGROUND: Various physiotherapeutic evaluation methods are used to assess the functionality of dogs with stifle problems. Neither validity nor sensitivity of these methods has been investigated. This study aimed to determine the most valid and sensitive physiotherapeutic evaluation methods for assessing functional capacity in hind limbs of dogs with stifle problems and to serve as a basis for developing an indexed test for these dogs. A group of 43 dogs with unilateral surgically treated cranial cruciate ligament deficiency and osteoarthritic findings was used to test different physiotherapeutic evaluation methods. Twenty-one healthy dogs served as the control group and were used to determine normal variation in static weight bearing and range of motion.The protocol consisted of 14 different evaluation methods: visual evaluation of lameness, visual evaluation of diagonal movement, visual evaluation of functional active range of motion and difference in thrust of hind limbs via functional tests (sit-to-move and lie-to-move), movement in stairs, evaluation of hind limb muscle atrophy, manual evaluation of hind limb static weight bearing, quantitative measurement of static weight bearing of hind limbs with bathroom scales, and passive range of motion of hind limb stifle (flexion and extension) and tarsal (flexion and extension) joints using a universal goniometer. The results were compared with those from an orthopaedic examination, force plate analysis, radiographic evaluation, and a conclusive assessment. Congruity of the methods was assessed with a combination of three statistical approaches (Fisher's exact test and two differently calculated proportions of agreeing observations), and the components were ranked from best to worst. Sensitivities of all of the physiotherapeutic evaluation methods against each standard were calculated. RESULTS: Evaluation of asymmetry in a sitting and lying position, assessment of muscle atrophy, manual and measured static weight bearing, and measurement of stifle passive range of motion were the most valid and sensitive physiotherapeutic evaluation methods. CONCLUSIONS: Ranking of the various physiotherapeutic evaluation methods was accomplished. Several of these methods can be considered valid and sensitive when examining the functionality of dogs with stifle problems.

A comparison of thermographic imaging, physical examination and modified questionnaire as an instrument to assess painful conditions in cats.

Pain recognition in cats is difficult and requires a multidisciplinary approach for diagnosis. A total of 103 client-owned cats were enrolled in this prospective, blinded clinical trial. Cats were invited to the clinic, or presented for annual rechecks/vaccinations, or gastrointestinal, dental or locomotor problems. The cats were of different breeds; both shorthaired and longhaired cats were included. Those cats that tolerated it were palpated and all cats were examined with the non-invasive method of thermographic imaging. Owners filled out a questionnaire about their cat's behaviour and estimated whether the cat was in any pain. The agreement between a questionnaire and thermographic imaging or palpation was low. Also, the agreement between the owner's estimation of pain and thermographic imaging or palpation was low. The agreement between palpation and thermographic imaging was moderate, suggesting that thermographic imaging is a potential tool in clinical practice for detecting and screening cats that are, potentially, in pain.

Reliability and validity of a visual analogue scale used by owners to measure chronic pain attributable to osteoarthritis in their dogs.

OBJECTIVE: To assess validity and reliability for a visual analogue scale (VAS) used by owners to measure chronic pain in their osteoarthritic dogs. SAMPLE: 68, 61, and 34 owners who completed a questionnaire. PROCEDURES: Owners answered questionnaires at 5 time points. Criterion validity of the VAS was evaluated for all dogs in the intended-to-treat population by correlating scores for the VAS with scores for the validated Helsinki Chronic Pain Index (HCPI) and a relative quality-of-life scale. Intraclass correlation was used to assess repeatability of the pain VAS at 2 baseline evaluations. To determine sensitivity to change and face validity of the VAS, 2 blinded, randomized control groups (17 dogs receiving carprofen and 17 receiving a placebo) were analyzed over time. RESULTS: Significant correlations existed between the VAS score and the quality-of-life scale and HCPI scores. Intraclass coefficient (r = 0.72; 95% confidence interval, 0.57 to 0.82) for the VAS indicated good repeatability. In the carprofen and placebo groups, there was poor correlation between the 2 pain evaluation methods (VAS and HCPI items) at the baseline evaluation, but the correlation improved in the carprofen group over time. No correlation was detected for the placebo group over time. CONCLUSIONS AND CLINICAL RELEVANCE: Although valid and reliable, the pain VAS was a poor tool for untrained owners because of poor face validity (ie, owners could not recognize their dogs' behavior as signs of pain). Only after owners had seen pain diminish and then return (after starting and discontinuing NSAID use) did the VAS have face validity.

Effect of a single acupuncture treatment on surgical wound healing in dogs: a randomized, single blinded, controlled pilot study.

BACKGROUND: The aim of the study was to investigate the effect of acupuncture on wound healing after soft tissue or orthopaedic surgery in dogs. METHODS: 29 dogs were submitted to soft tissue and/or orthopaedic surgeries. Five dogs had two surgical wounds each, so there were totally 34 wounds in the study. All owners received instructions for post operative care as well as antibiotic and pain treatment. The dogs were randomly assigned to treatment or control groups. Treated dogs received one dry needle acupuncture treatment right after surgery and the control group received no such treatment. A veterinary surgeon that was blinded to the treatment, evaluated the wounds at three and seven days after surgery in regard to oedema (scale 0-3), scabs (yes/no), exudate (yes/no), hematoma (yes/no), dermatitis (yes/no), and aspect of the wound (dry/humid). RESULTS: There was no significant difference between the treatment and control groups in the variables evaluated three and seven days after surgery. However, oedema reduced significantly in the group treated with acupuncture at seven days compared to three days after surgery, possibly due the fact that there was more oedema in the treatment group at day three (although this difference was nor significant between groups). CONCLUSIONS: The use of a single acupuncture treatment right after surgery in dogs did not appear to have any beneficial effects in surgical wound healing.

Force platform analysis in clinically healthy Rottweilers: comparison with Labrador Retrievers.

OBJECTIVE: To (1) report ground reaction forces for healthy Rottweilers at a trot and (2) compare force platform data with values obtained for healthy Labradors. STUDY DESIGN: Prospective, clinical study. ANIMALS: Adult Rottweilers (n=9) and Labrador Retrievers (12) without orthopedic abnormalities. METHODS: Dogs were trotted over a force platform at controlled speed and acceleration. Peak vertical and craniocaudal forces, associated impulses, stance time, rising, and falling slopes were analyzed and forces, impulses, and slopes were expressed as percentages of body weight. The effects of weight and anatomic measurements on force platform values were re-evaluated with analysis of covariance (ANCOVA). RESULTS: In Rottweilers, peak vertical forces in thoracic limbs were significantly lower and vertical impulses in thoracic and pelvic limbs were significantly higher than in Labradors. Rising and falling slopes in thoracic and pelvic limbs were significantly smaller in Rottweilers. Body weight and anatomic measurements were significantly larger in Rottweilers. After removing the effect of relative velocity, functional limb length, and body weight by using ANCOVA, there were no significant differences between breeds. CONCLUSIONS: Ground reaction forces were significantly different between Rottweilers and Labradors when using standard methods of normalization. Based on ANCOVA differences were attributable to difference in conformation and body weight between breeds. CLINICAL RELEVANCE: Conformation and body weight have a significant influence on force platform values and this may cause bias when study results are compared.

Psychometric testing of the Helsinki chronic pain index by completion of a questionnaire in Finnish by owners of dogs with chronic signs of pain caused by osteoarthritis.

OBJECTIVE: To determine the validity, reliability, and sensitivity of a published chronic pain index by completion of a questionnaire in Finnish by owners of dogs with chronic signs of pain caused by osteoarthritis. ANIMALS: 61 client-owned dogs with osteoarthritis. PROCEDURES: Validity, internal consistency, and repeatability testing of the questionnaire were evaluated by completion of questions in Finnish by owners of 61 dogs; the questionnaire was named the Helsinki chronic pain index (HCPI). Sensitivity testing of the questionnaire was determined from data of 2 smaller groups of dogs treated with carprofen (n = 17) or placebo (17). Owners completed the questionnaire 5 times during a 16-week period. Psychometric properties of the HCPI were evaluated. RESULTS: Principal component analysis yielded only a single stable component, indicating that the HCPI was best explained as an 11-item single construct index of chronic pain. Changes in the HCPI correlated well with change in quality of life and with change in the mobility visual analogue scale (r = 0.72 and r = 0.67, respectively), indicating a high predictive validity. Internal consistency (Cronbach A value = 0.82) and test-retest reliability (intraclass correlation coefficient = 0.84 for items and 0.92 for the HCPI) were high. Changes in scores (from baseline to treatment and back to no treatment) between the carprofen treatment group and placebo control group were significant, indicating high sensitivity. CONCLUSIONS AND CLINICAL RELEVANCE: The Finnish version of the HCPI provided a valid, reliable, and responsive tool for assessment of response to treatment in dogs with osteoarthritis.

Custom total knee replacement in a dog with femoral condylar bone loss.

OBJECTIVE: To report surgical planning, technique, and outcome of custom total knee replacement (TKR) performed to manage a medial femoral condylar nonunion in a dog. STUDY DESIGN: Clinical case report. ANIMAL: A 3-year-old, 20 kg Karelian Bear Hound. METHODS: Computed tomographic scan of the left pelvic limb was used to build a stereolithography model of the distal portion of the femur. The model was used to create a custom augment to replace the missing medial femoral condyle and a custom stem for intramedullary condylar cemented fixation. The augment and stem were adapted to femoral and tibial components already available. The model was used to rehearse the surgery and then the custom prosthesis was implanted. RESULTS: Weight bearing returned 8 hours after surgery and improved thereafter. Joint alignment was normal and prosthetic joint motion was 60-165 degrees postoperatively. The dog resumed moose hunting 3 months after surgery. Peak vertical force and impulse of the operated limb measured 17 months after surgery were 65% and 47% of the normal, contralateral limb. CONCLUSION: Based on short-term follow-up, cemented canine TKR was successfully achieved for management of a severely abnormal stifle joint. CLINICAL RELEVANCE: With further refinement and development of commercially available prostheses, TKR should be possible for canine patients.

Evaluation of adverse effects of long-term orally administered carprofen in dogs.

OBJECTIVE: To evaluate the adverse effects of carprofen in dogs after oral administration for 2 months. DESIGN: Prospective, randomized, blinded, placebo-controlled clinical trial. ANIMALS: 22 dogs with osteoarthritis in the hip or elbow joint. PROCEDURE: 13 dogs received orally administered carprofen daily for 2 months, and 9 dogs received a placebo for 2 months. Dogs were weighed, and serum and urine samples were collected before initiation of treatment and 4 and 8 weeks after initiation of treatment. Serum concentrations of total protein, albumin, urea, and creatinine and serum activities of alkaline phosphatase (ALP) and alanine aminotransferase (ALT) were measured. Urinary ALP-to-creatinine, gamma-glutamyltransferase (GGT)-to-creatinine, and protein-to-creatinine ratios were calculated. Dogs were observed by owners for adverse effects. RESULTS: Serum protein and albumin concentrations were lower in treated dogs than in those that received placebo at 4 weeks, but not at 8 weeks. No changes were observed in serum urea or creatinine concentrations; ALP or ALT activity; or urinary ALP-to-creatinine, GGT-to-creatinine, or protein-to-creatinine ratios. Dogs' weights did not change. Severity of vomiting, diarrhea, and skin reactions did not differ between groups, but appetite was better in dogs receiving carprofen than in dogs in the placebo group. CONCLUSIONS AND CLINICAL RELEVANCE: It is possible that the transient decreases in serum protein and albumin concentrations in dogs that received carprofen were caused by altered mucosal permeability of the gastrointestinal tract because no indications of renal or hepatic toxicity were observed. Carprofen appeared to be well tolerated by dogs after 2 months of administration.

Evaluation of methods for assessment of pain associated with chronic osteoarthritis in dogs.

OBJECTIVE: To identify variables and evaluate methods for assessing chronic pain in dogs. DESIGN: Prospective study. ANIMALS: 41 dogs with canine hip dysplasia (CHD), and 24 apparently healthy dogs with no history of pain. PROCEDURE: 2 veterinarians evaluated the dogs' locomotion and signs of pain. Owners of dogs with CHD and control dogs answered a questionnaire regarding their dogs' demeanor, behavior, and locomotion (descriptive scales) and assessed pain and locomotion (visual analog scales). Plasma concentrations of several stress-related hormones were determined, and 13 radiologic variables were assessed in affected hip joints. RESULTS: For many of the questions, answers provided by owners of dogs with CHD differed significantly from those of owners of control dogs. Stress hormone concentrations differed significantly between dogs with CHD and controls, but individual variation was too great for them to be of value in pain assessment. None of the radiologic variables examined correlated well with owner or veterinarian pain scores. CONCLUSIONS AND CLINICAL RELEVANCE: Chronic pain could be assessed in dogs with CHD through completion of the study questionnaire by a person familiar with the pet (eg, owner) after receiving appropriate education in its use. Eleven variables were identified as being potentially useful in assessment of chronic pain in dogs.