Assessment of owner perceptions of caregiver burden, veterinarian-client relationship and satisfaction with the provider in canine pruritus: An experimental vignette study.

BACKGROUND: Complicated treatments for skin disease are linked to owner-caregiver burden and poorer perception of the veterinarian-client relationship, regardless of disease severity. HYPOTHESES/OBJECTIVES: Using experimental vignettes, we explored the impact on owner perception of the interaction of treatment complexity and skin disease outcomes. We hypothesised that: (i) vignette conditions involving injection therapy would result in lower burden, better veterinary-client relationship and greater satisfaction relative to multimodal therapy conditions; (ii) the vignette condition of injection therapy with a completely effective outcome would be superior to all other conditions; (iii) ineffective vignette conditions would be inferior to all other conditions; and (iv) the vignette condition injection with a mostly effective outcome would be similar or superior to the multimodal therapy with a completely effective outcome condition. PARTICIPANTS: Three hundred and nine owners of pruritic dogs recruited from a general veterinary practice, pet-related podcast, or social media dog allergy group. MATERIALS AND METHODS: Participants were presented with six counterbalanced online vignettes representing three levels of treatment effectiveness (Completely Effective, Mostly Effective, Ineffective) and two treatment regimens (Multimodal, Injection). Measurements of participant perceptions of caregiver burden, veterinarian-client relationship and satisfaction were recorded. RESULTS: Injection with perfect outcome was superior to other conditions (p < 0.001). Conditions with poor effectiveness were inferior (p < 0.001). Comparison of Injection with a mostly effective outcome to Multimodal treatment with perfect outcome yielded small-to-medium effects of preference for the latter in veterinarian-client relationship and satisfaction (p < 0.01); no difference was observed for caregiver burden. When good effectiveness was assured, injection was preferred (p < 0.001). CONCLUSIONS AND CLINICAL RELEVANCE: Owners preferred a Completely Effective outcome and were prepared to select the Injection regimen or Multimodal therapy to achieve this; Injection was preferred when effectiveness was assured.

Perception and usage of short-term prednisone and prednisolone in dogs.

BACKGROUND: Corticosteroids are widely used with low rates of reported side effects and a broad level of comfort in the hands of most veterinarians. With a low side effect reporting level of < 5% and high level of comfort there may be complacency and underestimation of the impact side effects of corticosteroids may have on a pet and pet owner. OBJECTIVE: The objective of this clinical study was to describe the experience and perception of an owner who administered anti-inflammatory doses of oral prednisolone and prednisone to their dog for up to 14 days. We hypothesized dogs receiving anti-inflammatory doses of prednisone and prednisolone would experience much greater rates of side effects by day 14 then reported in current literature. ANIMALS: There were 45 dogs initially enrolled in the study. RESULTS: At each study point, 31 owners provided results. On day 5, 74% (23/31) reported at least 1 change in their dog's behavior including polyuria, polydipsia, polyphagia, polypnea and/or increased vocalization, with 11 individuals (35%) reporting these changes greatly increased. On day 14, 90% of owners (28/31) reported at least 1 change in their dog's behavior including polyuria, polydipsia, polyphagia, and/or polypnea as the most common changes noted. Overall, 61% (19/31) of owners reported an increase in filling of the water bowl over baseline and one-third (11/31) of pet owners reported cleaning up urinary accidents for pets who had been continent prior to the start of the study. Pet owner steroid satisfaction remained high through day 14 at 4.5/5 (1 = very unsatisfied, 5 = very satisfied). CONCLUSION: This study highlights the impact short term anti-inflammatory doses of prednisone or prednisolone have on dog behaviour and confirms our hypothesis that by day 14, 90% of dogs experienced one or more behaviour changes, with polyuria and polydipsia most commonly reported. Adverse events were noted regardless of starting dosage or regimen. Although most pet owners expressed satisfaction with steroid treatment due to its high efficacy, 70% would select a more costly treatment if that treatment had fewer side effects.

Caregiver burden in cat owners: a cross-sectional observational study.

OBJECTIVES: Caregiver burden has been found in owners of seriously ill pets; however, research to date has been heavily represented by dog owners. Prior caregiver burden work has neither intentionally focused on cat owners nor been appropriately powered to examine differences in owners of cats relative to owners of dogs. We expected that owners of an ill cat would exhibit greater caregiver burden than owners of a healthy cat but lower burden than owners of an ill dog. METHODS: A cross-sectional online assessment of caregiver burden was completed by 1085 pet owners through a pet demographic audience platform, including 333 owners reporting on a cat with current illness, 492 owners of a healthy cat and 260 owners of dogs with a current illness. RESULTS: Owners of an ill cat, examined across all illnesses represented, had greater burden (P <0.001) than the owners of a healthy cat and somewhat lower burden (P = 0.013) than owners of an ill dog. CONCLUSIONS AND RELEVANCE: Caregiver burden is present in owners of an ill cat and may differ from that of dog owners. Future work is needed to determine the reasons underlying this difference between species. Given that restricted sample sizes precluded examination across specific conditions, it will also be important to determine whether particular diseases yield greater burden in cat owners relative to dog owners.

Use of Cytopoint in the Allergic Dog.

Allergic dermatitis is the most common type of skin disease in dogs. Of all dogs, 20 to 30% present with some type of allergic dermatitis. Pruritus is one of the most important signs of allergic dermatitis and is often the most challenging to control. Interleukin-31 (IL-31) has been found to be one of the main initiators of pruritus in dogs with allergic dermatitis. Cytopoint®, a caninized monoclonal anti-IL-31 antibody, has been shown to be effective for the treatment of dogs against allergic dermatitis and atopic dermatitis. US label indication. A recent retrospective study reported that Cytopoint achieved treatment success in 87.8% of the cases with allergic dermatitis. No prospective cohort studies have been performed investigating the effects of Cytopoint in dogs with allergic dermatitis using the dosing protocol prescribed on the product label in the United States. In this study, our objectives were to assess the efficacy of Cytopoint for treatment of canine allergic dermatitis of variable etiologies and management of the associated pruritus, and add to the body of evidence available to the veterinarian as they make treatment recommendations. Dogs included in this study had moderate to severe pruritus according to the Pruritus Visual Analog Scale (PVAS; ≥ 50 mm) and a history of likely continuation of pruritus at the time of presentation. On day 0, investigators recorded the initial body weight and every patient received one dose of Cytopoint (minimum 2 mg/kg SQ) and an isoxazoline product for parasite control. Treatment success for this study was defined as a ≥20 mm reduction in PVAS from Day 0. On Day 7, 94% of the dogs had achieved treatment success. On Day 28, 98% had achieved treatment success and cumulatively by day 56, 100% of the dogs achieved treatment success. This prospective study provides evidence that Cytopoint effectively treats dogs with allergic dermatitis of different types and the associated pruritus.

Caregiver burden, treatment complexity, and the veterinarian-client relationship in owners of dog with skin disease.

BACKGROUND: Increasing complexity of treatment plans is associated with higher levels of caregiver burden in owners of dogs with skin disease. It is possible that elevated caregiver burden resulting from treatment complexity could, in turn, affect the veterinarian-client relationship. HYPOTHESES/OBJECTIVES: We expected that treatment complexity, caregiver burden, and the client's perception of the veterinarian-client relationship would be related to each other. We also expected an indirect effect of caregiver burden on the cross-sectional association between treatment complexity and the veterinarian-client relationship, and that this effect would be robust to adjustment for the dog's skin disease course and severity. PARTICIPANTS: Participants were 349 owners of dogs with skin disease recruited through online consumer panels. MATERIALS AND METHODS: Cross-sectional online assessments were completed for caregiver burden, treatment plan complexity, veterinarian-client relationship, and skin disease course and severity. Demographic information also was collected. RESULTS: The indirect effect of caregiver burden on the relationship between treatment complexity and veterinarian-client relationship was statistically significant, accounting for 42.76% of the variance in the model. After controlling for disease severity and course, that effect remained statistically significant, accounting for 37.76% of the variance. CONCLUSIONS AND CLINICAL IMPORTANCE: Findings support the notion that greater treatment complexity is related to the owner's perception of the veterinarian-client relationship via caregiver burden. Efforts to reduce caregiver burden by using the simplest effective treatment may benefit the veterinarian-client relationship.

Contexte - La complexité croissante des plans de traitement est associée à des niveaux plus élevés de fardeau pour les soignants propriétaires de chiens atteints de maladies de peau. Il est possible que le fardeau élevé des soignants résultant de la complexité du traitement pourrait, à son tour, affecter la relation vétérinaire-client. Hypothèses/Objectifs - Nous nous attendions à ce que la complexité du traitement, le fardeau des soignants et la perception du client de la relation vétérinaire-client seraient liés les uns aux autres. Nous nous attendions également à un effet indirect de le fardeau du soignant sur l'association transversale entre la complexité du traitement et le vétérinaire-client relation, et que cet effet serait robuste à l'ajustement de l'évolution et de la gravité de la maladie de peau du chien. Participants - Les participants étaient 349 propriétaires de chiens atteints de maladies de la peau recrutés par le biais de consommateurs en ligne panneaux. Matériels et méthodes - Des évaluations transversales en ligne ont été réalisées pour le fardeau des soignants, le traitement la complexité du plan, la relation vétérinaire-client et l'évolution et la gravité des maladies de la peau. Informations démographiques a également été collecté. Résultats - L'effet indirect du fardeau des soignants sur la relation entre la complexité du traitement et le vétérinaire-la relation client était statistiquement significative, représentant 42,76 % de la variance du modèle. Après contrôle pour la gravité et l'évolution de la maladie, cet effet est resté statistiquement significatif, représentant 37,76 % des la variance. Conclusions et importance clinique - Les résultats appuient l'idée qu'une plus grande complexité du traitement est liée à la perception du propriétaire de la relation vétérinaire-client via le fardeau des soignants. Efforts pour réduire le soignant fardeau en utilisant le traitement efficace le plus simple peut être bénéfique pour la relation vétérinaire-client.

Contexto - O aumento da complexidade dos planos de tratamento está associado a altos níveis de sobrecarga do cuidador de cães com doenças de pele. É possível que a sobrecarga do cuidador elevada resultante da complexidade da terapia possa, desta forma, afetar a relação veterinário-cliente. Hipótese/Objetivos - Nós imaginamos que a complexidade do tratamento, a sobrecarga do cuidador, e a percepção do cliente da relação veterinário-cliente estariam relacionadas. Nós também imaginamos que poderia uma mediação da sobrecarga do cuidador na associação transversal entre a complexidade do tratamento e a relação veterinário-cliente, e que este efeito seria robusto para ajustar o curso e a gravidade da doença de pele do cão. Participantes - Os participantes foram 349 tutores de cães com doença de pele recrutados através de formulários online. Materiais e métodos - Avaliações transversais online foram preenchidas para sobrecarga do cuidador, complexidade do plano de tratamento, relação veterinário-cliente, e curso da doença de pele e gravidade. Dados demográficos também foram coletados. Resultados - O efeito indireto da sobrecarga do cuidador na relação entre a complexidade do tratamento e a relação veterinário-cliente foi significativamente significativa, sendo responsável por 42,76% da variância no modelo. Após controlar para gravidade da doença e curso, esse efeito permaneceu estatisticamente significativo, respondendo por 37,76% da variância. Conclusões e importância clínica - Os achados corroboram com a ideia de que a complexidade do tratamento está relacionada à percepção do tutor sobre a relação veterinário-cliente pela sobrecarga do cuidador. Esforços para reduzir a sobrecarga do cuidador utilizando planos terapêuticos mais simples podem beneficiar a relação veterinário-cliente.

Introducción- el aumento de la complejidad de los planes de tratamiento se asocia a mayores niveles de responsabilidad de los propietarios de perros con enfermedades de la piel. Es posible que esta mayor carga para el propietario resultante de la complejidad del tratamiento pueda, a su vez, afectar a la relación veterinario-cliente. Hipótesis/Objetivos- esperábamos que la complejidad del tratamiento, la mayor responsabilidad para cuidadores y la percepción de los propietarios de la relación veterinario-cliente estuvieran relacionadas entre sí. También esperábamos un efecto de mediación de la mayor carga del cuidador en la asociación transversal entre la complejidad del tratamiento y la relación veterinario-cliente, y que este efecto sería sólido para el ajuste del curso y la gravedad de la enfermedad de la piel del perro. Participantes- los participantes fueron 349 propietarios de perros con enfermedades de la piel reclutados a través de paneles de consumidores vía telemática. Materiales y métodos- se completaron evaluaciones transversales en línea sobre la carga del cuidador, la complejidad del plan de tratamiento, la relación veterinario-cliente y el curso y la gravedad de la enfermedad de la piel. También se recopiló información demográfica. Resultados - El efecto indirecto de la carga del cuidador sobre la relación entre la complejidad del tratamiento y la relación veterinario-cliente fue estadísticamente significativo, explicando el 42,76% de la varianza del modelo. Después de controlar la gravedad y el curso de la enfermedad, ese efecto siguió siendo estadísticamente significativo y representó el 37,76 % de la varianza. Conclusiones e importancia clínica- los hallazgos respaldan la noción de que una mayor complejidad del tratamiento está relacionada con la percepción del propietario de la relación veterinario-cliente mediante una mayor carga del cuidador. Esfuerzos para reducir la carga del cuidador mediante el uso de tratamientos efectivos más simples pueden beneficiar a la relación veterinario-cliente.

Treatment complexity and caregiver burden are linked in owners of dogs with allergic/atopic dermatitis.

BACKGROUND: Skin disease severity and treatment plan complexity are both related to owner experience of caregiver burden; however, to date they have not been examined simultaneously in owners of dogs with atopic or other chronic allergic dermatitis. HYPOTHESES/OBJECTIVES: We expected to replicate and extend previous work by showing that caregiver burden is linked to treatment complexity and disease severity in this population. Moreover, we hypothesized that a relationship between burden and treatment complexity would be present in both subjective (owner report of experience) and objective (number of weekly treatments) measures, and that these relationships would exist independent of skin disease severity. PARTICIPANTS: Eighty-six owners of dogs with atopic or other chronic allergic dermatitis recruited through social media dog allergy groups. METHODS AND MATERIALS: Cross-sectional online assessments were completed for caregiver burden, treatment plan complexity and skin disease severity. RESULTS: Caregiver burden was correlated with skin disease severity (r = 0.40) and both subjective (r = 0.37) and objective (r =0.30) measures of treatment complexity (P < 0.01 for all). Relationships between caregiver burden and treatment complexity remained significant after accounting for skin disease severity. CONCLUSIONS AND CLINICAL IMPORTANCE: Greater treatment plan complexity is associated with higher caregiver burden in owners of dogs with atopic or other chronic allergic dermatitis. The independence of this relationship highlights the importance of simplicity in effective treatment planning.

Development and preliminary psychometric evaluation of an owner-completed measure of feline quality of life.

Due to improved healthcare and pet longevity, measurement of health-related quality of life (HRQoL) is increasingly important in companion animal medicine. The aim of this study was to develop and evaluate the content and psychometric properties of an owner-completed assessment of health and quality of life (QoL) in cats for use in general veterinary clinical practice. A 23-item feline QoL measure, drafted based on findings from an online survey completed by 45 pet owners, was revised following qualitative interviews with 10 pet owners of healthy cats to assess content validity. The resulting 22-item measure was completed twice by 199 owners of healthy cats to assess the reliability and validity of the measure via psychometric evaluation, including assessment of missing data, item response distributions, item correlations, factor analysis, internal consistency, test-retest reliability, multi-trait analysis, known groups analyses and estimation of minimally important differences. There were no missing data. Responses for all items were heavily skewed due to the sample being healthy. Analysis of items and factor analysis supported deletion of six items and calculation of two domain scores and a total score. Internal consistency and test-retest reliability were strong for all domains (0.70-0.80), indicating good reliability. All but three items demonstrated strong item convergent validity (item-scale correlation>0.40) and correlated highest with their respective domain (item discriminant validity). Significant between-group differences in scores differing according to a global impression of feline health item provided evidence of discriminative validity. Findings provide evidence that the final 16-item feline QoL measure has strong cross-sectional psychometric properties.