Usefulness of muscle condition score and ultrasonographic measurements for assessment of muscle mass in cats with cachexia and sarcopenia.

OBJECTIVE: To compare muscle condition scores (MCSs) and muscle ultrasonographic measurements in cats with and without muscle loss and to evaluate repeatability and reproducibility of MCS assessment. ANIMALS: 40 cats of various ages, body condition scores (BCSs), and MCSs. PROCEDURES: A prospective cross-sectional study was conducted. Body weight, BCS, MCS, epaxial muscle height (EMH), vertebral epaxial muscle score (VEMS), and forelimb epaxial muscle score (FLEMS) were assessed in each cat. The MCS for each cat was assessed 3 separate times by each of 5 raters. RESULTS: The MCS was significantly correlated with EMH (r = 0.59), VEMS (r = 0.66), and FLEMS (r = 0.41). For MCS, the overall value of the κ coefficient for interrater agreement (reproducibility) was 0.43 and the overall value of the κ coefficient for intrarater agreement (repeatability) ranged from 0.49 to 0.76. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonographic measurements of muscle may be useful for assessing muscle loss in individual cats over time. However, for the cats of this study, no advantage was observed for assessment of VEMS or FLEMS over EMH. Substantial repeatability and moderate reproducibility were shown when MCS was used for assessment of muscle mass in cats. Prospective ultrasonographic studies are warranted to evaluate the usefulness of MCS and EMH assessment for evaluation of changes in muscle mass of cats over time.

Evaluation of the use of muscle condition score and ultrasonographic measurements for assessment of muscle mass in dogs.

OBJECTIVE: To evaluate repeatability and reproducibility of muscle condition score (MCS) in dogs with various degrees of muscle loss; to compare MCS, muscle ultrasonographic measurements, and quantitative magnetic resonance (QMR) measurements; and to identify cutoff values for ultrasonographic measurements of muscle that can be used to identify dogs with cachexia and sarcopenia. ANIMALS: 40 dogs of various age, body condition score (BCS), and MCS. PROCEDURES: A prospective cross-sectional study was conducted. Body weight, BCS, QMR measurements, thoracic radiographic measurements, and muscle ultrasonographic measurements were assessed once in each dog. The MCS for each dog was assessed 3 separate times by 4 separate raters. RESULTS: For the MCS, overall κ for interrater agreement was 0.50 and overall κ for intrarater agreement ranged from 0.59 to 0.77. For both interrater and intrarater agreement, κ coefficients were higher for dogs with normal muscle mass and severe muscle loss and lower for dogs with mild and moderate muscle loss. The MCS was significantly correlated with age (r = -0.62), vertebral epaxial muscle score (VEMS; r = 0.71), forelimb epaxial muscle score (FLEMS; r = 0.58), and BCS (r = 0.73), and VEMS was significantly correlated (r = 0.84) with FLEMS. Cutoff values for identification of mild muscle loss determined by use of VEMS and FLEMS were 1.124 and 1.666, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: MCS had substantial repeatability and moderate reproducibility for assessment of muscle mass in dogs. Prospective studies of MCS, VEMS, and FLEMS for assessment of muscle mass in dogs are warranted.

Evaluation of a quantitatively derived value for assessment of muscle mass in clinically normal cats.

OBJECTIVE To evaluate use of an ultrasonographically and radiographically determined value, the vertebral epaxial muscle score (VEMS), for assessing muscle mass in cats. ANIMALS 30 healthy neutered cats of various body weights and between 1 and 6 years of age. PROCEDURES Mean epaxial muscle height was calculated from 3 transverse ultrasonographic images obtained at the level of T13. Length of T4 was measured on thoracic radiographs, and the VEMS (ratio of epaxial muscle height to T4 length) was calculated and compared with body weight. Ratios of epaxial muscle height to various anatomic measurements also were compared with body weight as potential alternatives to use of T4 length. RESULTS 1 cat was excluded because of a heart murmur. For the remaining 29 cats, mean ± SD body weight was 5.05 ± 1.40 kg. Mean epaxial muscle height was 1.27 ± 0.13 cm, which was significantly correlated (r = 0.65) with body weight. The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) were not significantly correlated (r = -0.18 and -0.06, respectively) with body weight, which is important for measures used for animals of various sizes. CONCLUSIONS AND CLINICAL RELEVANCE The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) can both be used to normalize muscle size among cats of various body weights. Studies are warranted to determine whether these values can be used to accurately assess muscle mass in cats with various adiposity and in those with muscle loss.

Quantitative assessment of muscle in dogs using a vertebral epaxial muscle score.

Muscle loss associated with disease (cachexia) or with aging (sarcopenia) is common in dogs, but clinically relevant methods for quantifying muscle loss are needed. We previously validated an ultrasound method of quantifying muscle size in dogs in a single breed. The goal of this study was to assess the variability and reproducibility of the Vertebral Epaxial Muscle Score (VEMS) in other dog breeds. Static ultrasound images were obtained from 38 healthy, neutered dogs of 5 different breeds between 1- and 5-years-old. The maximal transverse right epaxial muscle height and area at the level of the 13th thoracic vertebra (T13) were measured. Length of the 4th thoracic vertebra (T4) was measured from thoracic radiography. Ratios of the muscle height and area to vertebral length (height/T4 and area/T4, respectively) were calculated to account for differences in body size among breeds. Reproducibility testing was performed on 2 dogs of each breed (26% of the total) to determine intra- and inter-investigator reproducibility, as well as intra-class correlation. Mean height/T4 = 1.02 ± 0.18 and mean area/T4 = 3.32 ± 1.68. There was no significant difference for height/T4 (P = 0.10) among breeds, but breeds were significantly different in area/T4 (P < 0.001). Intra-class correlation ranged from 0.80 to 0.99. Testing showed better reproducibility for height/T4 compared to area/T4. The VEMS using height/T4 was valid and reproducible for healthy dogs of different sizes and body conformations. Studies assessing this technique in dogs with congestive heart failure and other diseases associated with muscle loss are warranted.

La perte musculaire associée à la maladie (cachexie) ou à l'âge (sarcopénie) est fréquente chez les chiens, mais des méthodes appropriées pour quantifier en clinique la perte de muscle sont requises. Nous avons validé précédemment une méthode par échographie pour quantifier la taille musculaire chez des chiens d'une seule race. L'objectif de la présente étude était d'évaluer la variabilité et la reproductibilité du pointage du muscle épi-axial vertébral (PMEV) chez d'autres races de chien. Des images échographiques statiques furent obtenues de 38 chiens stérilisés en santé de cinq races différentes et âgés entre 1 et 5 ans. La hauteur transverse maximale du muscle épi-axial droit et la surface à la hauteur de la 13e vertèbre thoracique (T13) ont été mesurées. La longueur de la 4e vertèbre thoracique (T4) a été mesurée à partir de radiographies thoraciques. Les ratios de la hauteur du muscle et de la surface à la longueur de la vertèbre (hauteur/T4 et surface/T4, respectivement) ont été calculés pour tenir compte des différences de la taille entre les différentes races. Un test de reproductibilité a été effectué chez deux chiens de chaque race (26 % du total) afin de déterminer la reproductibilité intra- et inter-investigateur, ainsi que la corrélation intra-classe. La moyenne du ratio hauteur/T4 était de 1,02 ± 0,18 et la moyenne du ratio surface/T4 était de 3,32 ± 1,68. Il n'y avait pas de différence significative parmi les races pour le ratio hauteur/T4 (P = 0,10), mais les races différaient significativement pour ce qui est du ratio surface/T4 (P < 0,001). Les corrélations intra-classes variaient entre 0,80 et 0,99. Les tests ont montré une meilleure reproductibilité pour le ratio hauteur/T4 comparativement au ratio surface/T4. Le PMEV utilisant le ratio hauteur/T4 était valide et reproductible pour des chiens en santé de différentes tailles et conformations corporelles. Des études évaluant cette technique chez de chiens avec une défaillance cardiaque congestive et autres maladies associées avec de la perte musculaire sont justifiées. (Traduit par Docteur Serge Messier).

Body Condition Scores and Evaluation of Feeding Habits of Dogs and Cats at a Low Cost Veterinary Clinic and a General Practice.

This study assessed body condition scores (BCS) and feeding habits for dogs and cats. Eighty-six cats and 229 dogs (and their owners) were enrolled from 2 clinics: a low cost clinic (n = 149) and a general practice (n = 166). BCS and body weight were recorded. Owners completed a survey which included animal age, sex, and breed; owner demographics; and feeding practices (e.g., diet, rationale for feeding practices). Owners from the low cost clinic had a significantly lower income (P < 0.001) and education (P < 0.001) compared to those from the general practice. Animals from the low cost clinic were younger (P < 0.001) and dogs were less likely to be neutered (P < 0.001). Overweight prevalence was 55% overall (P = 0.083), with a significantly higher prevalence in the general practice for cats (44% versus 66%; P = 0.046), but not for dogs (58% versus 53%; P = 0.230). Multivariate analysis showed that only neuter status was significantly associated with BCS (P = 0.004). Veterinarians were the most common source of nutritional information, though lack of accurate nutrition knowledge was common among all participants. These findings support the need for enhanced communication about optimal BCS and nutrition regardless of socioeconomic status.

Assessment of the responsiveness of the Cats' Assessment Tool for Cardiac Health (CATCH) Questionnaire.

OBJECTIVES: To evaluate the responsiveness and optimal timing of a validated health-related quality of life questionnaire, and to assess the relationship between quality of life, severity of disease, and N-terminal pro B-type natriuretic peptide (NT-proBNP) in cats with acute congestive heart failure (CHF). ANIMALS: Thirty client-owned cats with acute CHF. METHODS: Echocardiography, International Small Animal Cardiac Health Council (ISACHC) stage, and NT-proBNP were assessed in cats within 36 h of admission. The Cats' Assessment Tool for Cardiac Health (CATCH) Questionnaire (range of 0-80, with 80 being the worst possible score) was completed by cat owners and ISACHC stage was assessed at the time of hospital discharge, 3 days after discharge, and 7-14 days after discharge. NT-proBNP concentration was reassessed 7-14 days after discharge. RESULTS: The ISACHC stage at time of admission improved significantly by reevaluation 7-14 days after discharge (P < 0.001). The decrease in median NT-proBNP concentration from time of admission (655 pmol/L; range, 188 to >1500 pmol/L) to reevaluation (583 pmol/L; range, 41 to >1500 pmol/L) was not significant (P = 0.59). Median CATCH score was 26 (range, 0-70) at baseline, 19 (range, 0 to 61) at discharge, and 19 (range, 2-49) 7-14 days after discharge (P = 0.89). CATCH scores did not correlate with NT-proBNP concentrations or ISACHC stage. CONCLUSIONS: These results suggest that the CATCH questionnaire requires further refinement for uses requiring a responsive instrument in cats with acute CHF.

Assessment of methods of evaluating sarcopenia in old dogs.

OBJECTIVE: To evaluate clinically applicable methods of assessing lean body mass in dogs and compare muscle mass and inflammatory markers in healthy young and old dogs. ANIMALS: 9 healthy young (1 to 5 years old) and 10 old (> 8 years old) Labrador Retrievers with a body condition score of 5 to 6 of 9. PROCEDURES: Radiography of the thoracolumbar region was performed for measurement of epaxial muscle height at the level of T13-L1. Computed tomographic images were obtained for the measurement of the epaxial and temporal muscles. Ultrasonography also was performed for regional muscle measurements at these same sites and the quadriceps muscle. Serum C-reactive protein, insulin-like growth factor-1, and tumor necrosis factor-α concentrations also were measured, and dogs' activity for 14 days was assessed with an activity monitor. RESULTS: Mean epaxial muscle area measured by ultrasonography was significantly lower in the old group, compared with the young group, whereas epaxial muscle area measured by CT was only significantly lower in the old group after normalization for vertebral height. Neither temporal and quadriceps muscle measurements nor serum C-reactive protein or insulin-like growth factor-1 concentrations were significantly different between age groups. Tumor necrosis factor-α concentrations were undetectable in all dogs. CONCLUSIONS AND CLINICAL RELEVANCE: This study documented reduced epaxial muscle area in healthy old Labrador Retrievers, consistent with the syndrome of sarcopenia. Ultrasonography and CT were feasible methods of measuring epaxial muscle area, but much additional research is required to assess this method. A better understanding of underlying mechanisms of sarcopenia as well as methods for slowing progression is needed.

Development and evaluation of a questionnaire for assessment of health-related quality of life in cats with cardiac disease.

OBJECTIVE: To develop, validate, and evaluate a questionnaire (Cats' Assessment Tool for Cardiac Health [CATCH] questionnaire) for assessing health-related quality of life in cats with cardiac disease. DESIGN: Prospective study. ANIMALS: 275 cats with cardiac disease. PROCEDURES: The questionnaire was developed on the basis of clinical signs of cardiac disease in cats. A CATCH score was calculated by summing responses to questionnaire items; possible scores ranged from 0 to 80. For questionnaire validation, owners of 75 cats were asked to complete the questionnaire (10 owners completed the questionnaire twice). Disease severity was assessed with the International Small Animal Cardiac Health Council (ISACHC) classification for cardiac disease. Following validation, the final questionnaire was administered to owners of the remaining 200 cats. RESULTS: Internal consistency of the questionnaire was good, and the CATCH score was significantly correlated with ISACHC classification. For owners that completed the questionnaire twice, scores were significantly correlated. During the second phase of the study, the CATCH score ranged from 0 to 74 (median, 7) and was significantly correlated with ISACHC classification. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the CATCH questionnaire is a valid and reliable method for assessing health-related quality of life in cats with cardiac disease. Further research is warranted to test the tool's sensitivity to changes in medical treatment and its potential role as a clinical and research tool.

Evaluation of calorie density and feeding directions for commercially available diets designed for weight loss in dogs and cats.

OBJECTIVE: To determine range of calorie density and feeding directions for commercially available diets designed for weight management in dogs and cats. DESIGN: Cross-sectional study. SAMPLE POPULATION: 93 diets (44 canine diets and 49 feline diets) that had a weight management claim with feeding directions for weight loss or implied weight management claims. PROCEDURES: Calorie density was collected from product labels or by contacting manufacturers. Recommended feeding directions for weight loss were compared with resting energy requirement (RER) for current body weight by use of a standard body weight (36.4 kg [80 lb] for canine diets and 5.5 kg [12 lb] for feline diets). RESULTS: Calorie density for the 44 canine diets ranged from 217 to 440 kcal/cup (median, 301 kcal/cup) and from 189 to 398 kcal/can (median, 310 kcal/can) for dry and canned diets, respectively. Calorie density for the 49 feline diets ranged from 235 to 480 kcal/cup (median, 342 kcal/cup) and from 78 to 172 kcal/can (median, 146 kcal/can) for dry and canned diets, respectively. Recommended calorie intake for weight loss in dogs ranged from 0.73 to 1.47 x RER (median, 1.00 x RER) and for weight loss in cats ranged from 0.67 to 1.55 x RER (median, 1.00 x RER). Diets ranged from $0.04 to $1.11/100 kcal of diet (median, $0.15/100 kcal of diet). CONCLUSIONS AND CLINICAL RELEVANCE: Wide variation existed in recommended calorie intake, kilocalories, and cost for diets marketed for weight loss in pets. This variability could contribute to challenges of achieving successful weight loss in pets.

Evaluation of vehicular trauma in dogs: 239 cases (January-December 2001).

OBJECTIVE: To describe a population of dogs with vehicular trauma and to determine whether age, type and severity of injury, or preexisting disease were associated with outcome. DESIGN: Retrospective case series. ANIMALS: 239 dogs evaluated at a university referral hospital after vehicular trauma over a 12-month period. PROCEDURES: Patient characteristics, including age, outcome, animal trauma triage (ATT) score, treatments performed, hospital stay, cost, and preexisting disease, were recorded from medical records of dogs that had vehicular trauma. Dogs were assigned to a young, middle-aged, or geriatric age group. Categoric and continuous variables were compared between survivors and nonsurvivors to identify possible associations. RESULTS: 239 dogs (126 males and 113 females) were evaluated following vehicular trauma during 2001: young (n = 149), middle-aged (68), and geriatric (22). The median ATT score was 3 (range, 0 to 15). Sixteen dogs had preexisting disease. Hospital stay ranged from < 1 to 28 days (median, 3 days). Cost ranged from $77 to $10,636 (median, $853). Two hundred six dogs were discharged. Twenty-six dogs were euthanatized, and 7 died. Dogs that died or were euthanatized had significantly higher ATT scores. The ATT score also was associated with a significantly higher cost of care. Dogs with multiple injuries had significantly higher ATT scores, had increased cost of care, and were significantly more likely to die or be euthanatized. CONCLUSIONS AND CLINICAL RELEVANCE: Increased injury severity in dogs was associated with increased mortality rates and higher cost of treatment.

Assessment of lipid peroxidation and serum vitamin E concentration in dogs with immune-mediated hemolytic anemia.

OBJECTIVE: To determine plasma malondialdehyde (MDA) and serum vitamin E concentrations in dogs with immune-mediated hemolytic anemia (IMHA) and healthy control dogs. SAMPLE POPULATION: Serum and plasma samples from 36 dogs with IMHA and 40 healthy control dogs. PROCEDURE: Blood samples were collected from all study dogs. Plasma MDA concentrations were measured by use of a commercial colorimetric assay, and serum vitamin E concentrations (alpha-, gamma, and delta-tocopherol concentrations) were measured via high-performance liquid chromatography. RESULTS: Plasma MDA concentrations were significantly higher in the dogs with IMHA than in the control dogs. Compared with control dogs, serum alpha-, gamma-, and &tocopherol concentrations were significantly lower in the IMHA-affected dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated a state of oxidative stress and reduced antioxidant reserve in dogs with IMHA; this finding provides support for further investigation of the potential benefits of antioxidant treatment in dogs with this disease.