Do owner-reported changes in mobility reflect measures of activity, pain and degenerative joint disease in cats?

OBJECTIVES: The aim of this blinded, nested case-control study was to compare cats with and without early owner-reported mobility changes using subjective and objective outcome measures (owner-completed questionnaires, orthopaedic examination). METHODS: A total of 57 cats with and without early owner-reported signs of impaired mobility were allocated to the case (n = 30) and control (n = 27) groups, respectively. Participating owners completed one inclusion and two pre-visit questionnaires (Feline Musculoskeletal Pain Index, VetMetrica). Cats were then visited in their own homes, where they underwent an orthopaedic examination, an assessment of their body condition score and temperament, and the placement of an accelerometer on their collar for 2 weeks. RESULTS: There was no significant difference between groups for age category, breed, sex, temperament and body condition score. Case cats scored significantly lower for the Feline Musculoskeletal Pain Index (P = 0.003) and the VetMetrica domain of Comfort (P = 0.002), but not Vitality (P = 0.009) or Emotional Wellbeing (P = 0.018). Total pain (P <0.0001), crepitus (P = 0.002) and thickening (P = 0.003) scores were higher in case cats, as was the presence of bilateral disease (P = 0.005, odds ratio 14) and the number of bilaterally affected joints (P = 0.001). CONCLUSIONS AND RELEVANCE: Both the Feline Musculoskeletal Pain Index and orthopaedic examination were able to differentiate cats with early owner-reported signs of impaired mobility from healthy cats. VetMetrica Comfort domain scores indicated a compromised quality of life for cats with early owner-reported signs of impaired mobility compared with healthy cats. Being able to recognise signs of mobility impairment earlier would allow interventions aimed at slowing disease progression, thereby improving feline health and welfare.

Post-mortem examination of fast-growing broilers with different degrees of identifiable gait defects.

BACKGROUND: The walking ability of many broilers is characterised by slight or definite defects categorised as gait scores (GS) 1 and 2. The present study aimed to examine potential relationships between GSs and indicators of body morphology, leg pathology, tibia strength and wooden breast in Ross 308 broilers assessed as GS ≤ 2. METHODS: At 38 days of age, GS and live body weight of 179 birds was recorded. Each bird was examined post-mortem for signs of wooden breast, contact dermatitis and a range of leg pathologies. Weights of different body parts and tibia strength were quantified. RESULTS: Within sex, GS increased with increasing live body weight (p = 0.020). There was a tendency for an effect of GS on prevalence of footpad dermatitis (p = 0.086) and dislocated femoral joint cartilage (p = 0.059) where both pathologies increased in frequency with increasing GS. Greater load was required to fracture tibia from GS2 than GS0 birds (p = 0.040). CONCLUSIONS: Within this relatively small data set, no strong relationships between GS ≤ 2 and indicators of body morphology, leg pathology, tibia strength and wooden breast in Ross 308 broilers were found, except for the live terminal body weight. Further studies, involving larger data sets are required for full clarification.

Are changes in behavior of fast-growing broilers with slight gait impairment (GS0-2) related to pain?

Impaired walking ability in terms of slight or definite defects is more common in broiler production than lameness that obviously hinders movement, but it has received limited scientific attention. This study aimed to compare behavior of conventional broilers with impaired walking ability (assessed as gait score (GS) 2) with those walking normally (GS0) and those with only a slight gait defect (GS1). Behavior in the home environment was registered, and an analgesic intervention to quantify changes in time budgets indicating pain relief was applied. The study included 192 Ross 308 broilers. On day 27 of age, the birds were distributed as evenly as possible into birds of GS0 and GS2 of each sex based on obtained gait score. Following this, each experimental bird was housed with 3 companion birds. On days 30 and 32 of age, the behavior in the home pens was recorded. All experimental birds were injected with the NSAID carprofen on one of the 2 d and saline on the other. The statistical analyses used the GS scored on the day of recording as explanatory factor. Compared to GS0 birds, GS2 birds tended to be more inactive (mean (CI): 4,193 (3,971-4416) vs. 4,005 (3,753-4,257) s; P = 0.074), spent more time sitting while feeding (306 (266-353) vs. 213 (180-251) s; P = 0.026), were less likely to perch (probability: 0.78 (0.69-0.85) vs. 0.91 (0.85-0.95); P = 0.012), and spent less time performing comfort behavior (749 (689-814) s vs. 875 (792-967) s; P = 0.043). Compared to GS1 birds, GS2 birds spent more time inactive (GS1: 4,022 (3,818-4225) s; P = 0.027), less time foraging (289 (253-329) vs. 347 (309-388) s; P = 0.047), and were less likely to perch (GS1: 0.90 (0.86-0.93); P = 0.001). For some of these behavioral variables, administration of carprofen led to behavioral changes across the GSs, which may suggest that the behavioral expression of the broilers was limited by pain. These findings are of relevance to animal welfare, but the underlying causes are still not fully clarified.

Associations between early neutering, obesity, outdoor access, trauma and feline degenerative joint disease.

OBJECTIVES: The aim of this case-control study was to identify early-life risk factors associated with the occurrence of owner-reported mobility changes in 6-year-old cats by examining prospective data from a longitudinal cohort study of pet cats, the Bristol Cats study. METHODS: Data on potential risk factors were obtained from seven sequential questionnaires completed between the ages of 2-4 months and 5 years. Mobility-related questions from the study questionnaire distributed at the age of 6 years were used to calculate each cat's mobility score. Cats with mobility scores of ⩾2 and 0 were allocated to the case and control groups, respectively, and the cat's status was the outcome variable. RESULTS: Of the 799 cats included for analysis, 238 (29.8%) had owner-reported mobility changes. Binomial logistic regression using backwards elimination identified four risk factors for owner-reported mobility changes at 6 years of age: entire neuter status at 6 months of age (odds ratio [OR] 1.97; 95% confidence interval [CI] 1.26-3.07), sustained trauma before 6 years of age (OR 1.85; 95% CI 1.30-2.60), outdoor access at 6 years of age (OR 1.67; 95% CI 0.96-2.90) and overweight/obese status at 6 years of age (OR 1.62; 95% CI 1.13-2.33). CONCLUSIONS AND RELEVANCE: Risk factor analysis demonstrated that obesity, outdoor access and a history of trauma may predispose cats to developing owner-reported mobility changes associated with degenerative joint disease, whereas neutering before 6 months of age appears to decrease that risk.

Pain and analgesia in pet rabbits within the veterinary environment: a review.

OBJECTIVE: To provide an overview of pain and analgesia in rabbits with the aim of developing a more accurate understanding of these topics. To illustrate and discuss the areas that have advanced in recent years and those that still require further research. DATABASES USED: Three key subject resources were used: Web of Science, Medline and CAB Abstracts. Search terms were rabbits, lagomorphs, laboratory animals, pet, pain, surgical procedures, ovariohysterectomy, orchiectomy, castration, analgesia, opioids, and non-steroidal anti-inflammatory drugs. References from books and articles relevant to the topics were also included. CONCLUSIONS: Rabbit medicine has improved over the last 20 years, but the literature suggests that pain management in this species is still inadequate and veterinary professionals believe their knowledge of pain and analgesia in this species is limited. Assessment and quantification of pain in rabbits can be challenging in a clinical environment not only because, as a prey species, rabbits tend to hide signs of pain but also because there are no validated methods to assess pain, except the Rabbit Grimace Scale, which is based on only one rabbit breed. Current consensus is that perioperative multimodal analgesia is the best practice. However, it is not widely used in rabbits. In rabbits, analgesia protocols and dosages reported in the literature are often poorly researched and do not result in complete pain amelioration with the return of normal. The present literature on rabbit pain and analgesia presents gaps either due to unexplored areas or insufficient findings. Further research should focus on these areas with the aim of improving the welfare of rabbits within a veterinary clinic.

Quantitative sensory testing in dogs with painful disease: A window to pain mechanisms?

Evaluation of the response to externally applied physical stimuli, such as pressure, heat, or cold is termed quantitative sensory testing (QST). QST may be used to identify and quantify alterations (gain or loss) in function of the sensory systems which detect and mediate these phenomena in both man and animals, and potentially discriminate peripheral and central sensitisation. It has been postulated that evaluation of QST parameters may predict response to analgesics, ultimately increasing the individualisation of treatment for pain. However, while there do appear to be correlations between QST measures and responses to analgesics in man, there is currently insufficient evidence to recommend QST to direct clinical treatments. The use of psychophysical testing, such as QST, in non-verbal subjects presents additional challenges, and requires familiarity with species and individual responses. This narrative review describes the investigations into QST in clinical populations of dogs to date, and discusses the potential benefits and limitations of such testing.

Comparison between methadone and buprenorphine within the QUAD protocol for perioperative analgesia in cats undergoing ovariohysterectomy.

OBJECTIVES: The aim of this study was to investigate the analgesic efficacy of methadone vs buprenorphine within the QUAD protocol for anaesthesia in cats undergoing ovariohysterectomy. METHODS: One hundred and twenty cats were recruited to an assessor-blinded, randomised clinical trial. Cats received either methadone (5 mg/m2) or buprenorphine (180 µg/m2) combined with ketamine, midazolam and medetomidine intramuscularly. Anaesthesia was maintained with isoflurane in oxygen. Atipamezole was administered at extubation. Pain was assessed using the feline Composite Measure Pain Scale (CMPS-F), a dynamic interactive visual analogue scale (DIVAS) and mechanical nociceptive threshold (MNT). Sedation, pain, heart rate and respiratory rate were measured prior to QUAD administration, before intubation, and 2, 4, 6 and 8 h post-QUAD administration. If indicated by the CMPS-F, rescue analgesia was provided with 0.5 mg/kg of methadone administered intramuscularly. Meloxicam was administered after the last assessment. Differences in pain scores between groups were compared using a two-way repeated-measures ANOVA and requirement for rescue analgesia was compared using a χ2 test. RESULTS: Cats administered methadone had lower CMPS-F scores over time (P = 0.04). Eighteen of 60 cats required rescue analgesia in the methadone group vs 29/60 in the buprenorphine group (P = 0.028). All cats that received rescue analgesia required it within 6 h post-QUAD administration. There were no differences between groups in MNT or pain measured using the DIVAS. CONCLUSIONS AND RELEVANCE: Methadone produced clinically superior postoperative analgesia for the first 8 h after neutering than buprenorphine when used within the QUAD protocol.

Use of midazolam in combination with medetomidine for premedication in healthy dogs.

OBJECTIVE: To assess the sedative effects, propofol sparing properties and impact on quality of induction and intubation of intravenous (IV) medetomidine and midazolam administered consecutively at different doses compared to medetomidine alone in healthy dogs for premedication. STUDY DESIGN: Prospective, randomized, blinded, clinical study. ANIMALS: A total of 40 adult healthy client owned dogs, weighing 18 ± 7 kg (mean ± standard deviation). METHODS: Dogs were assigned to four groups: medetomidine 15 µg kg-1 (positive control group), medetomidine 10 µg kg-1 and midazolam 0.2 mg kg-1, medetomidine 5 µg kg-1 and midazolam 0.3 mg kg-1, and medetomidine 5 µg kg-1 and midazolam 0.2 µg kg-1. The same clinician assessed sedation after administration at T2.5 minutes and T5 minutes using a composite simple descriptive sedation scale ranging between 0 and 15 (0 = no sedation; 15 = profound sedation). The dose of propofol for induction, quality of induction, ease of intubation and any adverse events were recorded. RESULTS: There was no significant difference in sedation scores between treatment groups at T2.5 minutes or T5 minutes (p = 0.82 and p = 0.63, respectively). Administration of midazolam in combination with medetomidine resulted in 71% of dogs displaying paradoxical behaviours (p < 0.0001) such as agitation, excitation, restlessness, aggression and vocalization, which was different from pre-sedation. Propofol requirement was not different between groups. Induction and tracheal intubation quality was smooth in all groups. CONCLUSION: In healthy dogs, at the doses studied, the combination of medetomidine-midazolam administered IV for premedication provided moderate sedation but was associated with a high incidence of paradoxical behaviours. This drug combination IV is not recommended for premedication in healthy dogs.

Chronic maladaptive pain in cats: A review of current and future drug treatment options.

Despite our increasing understanding of the pathophysiology underlying chronic or maladaptive pain, there is a significant gap in our ability to diagnose and treat the condition in domestic cats. Newer techniques being used to identify abnormalities in pain processing in the cat include validated owner questionnaires, measurement of movement and activity, and measurement of sensory thresholds and somatomotor responses. While some data are available evaluating possible therapeutics for the treatment of chronic pain in the cat, most data are limited to normal cats. This review details our current understanding of chronic or maladaptive pain, techniques for the detection and measurement of the condition and the associated central nervous changes, as well as an overview of the data evaluating potential therapeutics in cats.

Electrosurgery reduces blood loss and immediate postoperative inflammation compared to cold instruments for midline celiotomy in dogs: A randomized controlled trial.

OBJECTIVES: To compare the use of an electrosurgical device with traditional cold instruments (scalpel and scissors) for midline celiotomy incision. STUDY DESIGN: Prospective randomized controlled clinical trial. SAMPLE POPULATION: One hundred and twenty client-owned dogs undergoing abdominal surgery. METHODS: Dogs were prospectively recruited and randomized to receive electroincision or cold instrument incision. For cold incision, surgeons used basic surgical instruments including scalpel and scissors. For electroincision, surgeons only used the electrosurgical device in cutting mode. Time for the approach, blood loss, and the incision length were recorded. A blinded observer assessed pain and incision redness, swelling, and discharge at 24 and 48 hours postoperative (graded 0-3). Owner assessment of incision healing was recorded by telephone interview. RESULTS: Blood loss during surgery was significantly lower for electroincision (mean 0.7, SD 1.7 mL) than cold incision (mean 3.0, SD 4.3 mL, P < .0001) with no significant difference in incision length or time for approach. Electroincision was associated with significantly less incision redness (cold median 1, range 0-3; electroincision median 0, range 0-2, P = .02) and less incision discharge (cold median 0.5 range 0-3; electroincision median 0, range 0-1, P = .006) at 24 hours postoperative. There was no significant difference in pain scores or incision healing in dogs receiving the two techniques. No incisional hernias were reported. A surgical site infection occurred in 1 dog (cold incision). CONCLUSIONS: Electroincision for a celiotomy approach in the dog reduces blood loss, and incision redness and discharge in the immediate postoperative period without affecting the occurrence of wound complications such as infection and dehiscence (including linea alba).

Alfaxalone Anaesthesia Facilitates Electrophysiological Recordings of Nociceptive Withdrawal Reflexes in Dogs (Canis familiaris).

Naturally occurring canine osteoarthritis represents a welfare issue for affected dogs (Canis familiaris), but is also considered very similar to human osteoarthritis and has therefore been proposed as a model of disease in humans. Central sensitisation is recognized in human osteoarthritis sufferers but identification in dogs is challenging. Electromyographic measurement of responses to nociceptive stimulation represents a potential means of investigating alterations in central nociceptive processing, and has been evaluated in conscious experimental dogs, but is likely to be aversive. Development of a suitable anaesthetic protocol in experimental dogs, which facilitated electrophysiological nociceptive withdrawal reflex assessment, may increase the acceptability of using the technique in owned dogs with naturally occurring osteoarthritis. Seven purpose bred male hound dogs underwent electromyographic recording sessions in each of three states: acepromazine sedation, alfaxalone sedation, and alfaxalone anaesthesia. Electromyographic responses to escalating mechanical and electrical, and repeated electrical, stimuli were recorded. Subsequently the integral of both early and late rectified responses was calculated. Natural logarithms of the integral values were analysed within and between the three states using multi level modeling. Alfaxalone increased nociceptive thresholds and decreased the magnitude of recorded responses, but characteristics of increasing responses with increasing stimulus magnitude were preserved. Behavioural signs of anxiety were noted in two out of seven dogs during recordings in the acepromazine sedated state. There were few significant differences in response magnitude or nociceptive threshold between the two alfaxalone states. Following acepromazine premedication, induction of anaesthesia with 1-2 mg kg-1 alfaxalone, followed by a continuous rate infusion in the range 0.075-0.1 mg kg-1 min-1 produced suitable conditions to enable assessment of spinal nociceptive processing in dogs, without subjecting them to potentially aversive experiences. This methodology may be appropriate for obtaining electrophysiological nociceptive withdrawal reflex data in client-owned dogs with naturally occurring osteoarthritis.

Does inflammation induced by ultraviolet B and heat rekindling alter pain-related behaviour in rats?

OBJECTIVE: To investigate whether induction of the ultraviolet B and heat rekindling (UVB/HR) model alters burrowing behaviour in rats. STUDY DESIGN: Randomized, blinded, prospective experimental study. ANIMALS: Sixteen adult male Wistar rats weighing 250-300 g. METHODS: In the UVB/HR group (n = 8), UV irradiation was delivered to the heel area of the right plantar pelvic limb paw at a dose of 1000 mJ cm(-2) , using a narrow-band UVB light source. Twenty-four hours later, heat rekindling was performed by placement of a feedback-controlled thermode set at a constant temperature of 45 °C over the area of UVB irradiation for 5 minutes. Both interventions were carried out under pentobarbital anaesthesia. The 'sham' group (n = 8) was anaesthetized only. In the burrowing test, rats were housed singly for 2 hours in cages furnished with a burrow filled with sand. The amount of sand remaining in the burrow after 2 hours was weighed and the amount displaced from the burrow calculated. The burrowing test was carried out for two consecutive days prior to UVB irradiation (day 0), on day 1 prior to HR, on days 2 and 3 after UVB exposure and at equivalent time points in the sham group. RESULTS: Rats in the sham group burrowed means (SD) of 2429 (73) g and 2358 (124) g of sand on days -2 and 3, respectively, while those in the UVB/HR group burrowed 2460 (26) and 2419 (58) g on days -2 and 3, respectively. There was no significant effect of treatment on the amount of sand burrowed at any time point. CONCLUSIONS AND CLINICAL RELEVANCE: Pain associated with UVB/HR model induction is below the threshold required to affect rat burrowing behaviour and therefore questions the face validity of UVB/HR as a translational model of inflammatory pain.

Possible delayed respiratory depression following intrathecal injection of morphine and bupivacaine in an alpaca.

OBJECTIVE: To describe general anesthesia and successful treatment of an alpaca, which developed respiratory arrest 2 hours after intrathecal injection of morphine and bupivacaine. CASE SUMMARY: A 10-day-old female alpaca weighing 7.3 kg was presented to our hospital with a fractured right tibia. The cria was anesthetized to repair the fracture with a dynamic compression plate. Anesthesia was induced with IV propofol and maintained with sevoflurane in 100% oxygen. Prior to the start of surgery the alpaca received an unintended intrathecal injection of 0.6 mL of a solution of 0.5 mg morphine (0.068 mg/kg) and 1.5 mg bupivacaine (0.2 mg/kg), after an attempted lumbo-sacral epidural. The alpaca developed respiratory arrest 120 minutes after the intrathecal injection was administered. Adequate hemoglobin-oxygen saturation was maintained despite minimal intermittent manual ventilation, but marked hypercapnia developed (PaCO2 of 17.3 KPa [130 mm Hg]). Delayed respiratory depression resulting from cephalad migration of intrathecal morphine was suspected. Ventilation was supported until the end of surgery when sevoflurane was discontinued. The trachea remained intubated, 100% oxygen was supplied, and ventilation was supported at 2-4 breaths/min for the next 60 minutes, but no attempts to breathe spontaneously were detected. Intravenous naloxone (0.3 mg [0.04 mg/kg]) was administered slowly to effect until adequate spontaneous ventilation and full consciousness returned. The anesthetic recovery of the alpaca was rapid and uneventful after the opioid antagonist was given. NEW INFORMATION PROVIDED: Delayed respiratory depression is a potential complication after intrathecal administration of morphine. Careful dose-adjustment may reduce the risk, and close monitoring will result in early detection and treatment of this complication.

A model of corneal graft rejection in semi-inbred NIH miniature swine: significant T-cell infiltration of clinically accepted allografts.

PURPOSE: The purpose of our study is to develop a pre-clinical model of corneal graft rejection in the semi-inbred NIH minipig as a model of human rejection. METHODS: NIH minipigs received corneal allografts with MHC and minor mismatches, or minor mismatches alone. Clinical rejection was monitored, and major subsets of leukocytes and ingress of vessels were quantified post-mortem by automated digital methods. Spectratypes of recipient T-cell receptor ß-subunit variable region (TRßV) were analyzed. The capacity of pig corneal endothelial cells to proliferate in vivo was assessed. RESULTS: Autografts (n = 5) and SLA(cc) to SLA(cc) allografts (minor mismatches, n = 5) were not rejected. Median graft survival of SLA(dd) and SLA(bb) allografts in SLA(cc) strain recipients (major and minor mismatches) was 57 (n = 10) and 67 (n = 6) days, respectively. Rejected grafts did not recover clarity in vivo, and corneal endothelial cells did not proliferate in organ culture after cryo-injury. There were significantly more leukocytes in clinically rejected versus accepted grafts (P < 0.0001) and in transplanted versus contralateral eyes (P < 0.0001). Numbers of T-cells were significantly greater in clinically accepted grafts versus autografts and in rejected grafts versus accepted (P < 0.005 for most subsets). There were significant differences in TRßV spectratype between graft groups in cornea, but not in draining lymph node or blood (P < 0.05). CONCLUSIONS: The NIH minipig offers a robust model of human rejection suitable for immunological or therapeutic studies. In particular, there is limited capacity for corneal endothelial repair in vivo, and histological evidence suggests that allosensitization of the recipient may develop in the absence of clinical rejection.