Item generation and design testing of a questionnaire to assess degenerative joint disease–associated pain in cats

Helia ZamprognoFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Bernie D. HansenFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Howard D. BondellFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Andrea Thomson SumrellFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Wendy SimpsonFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Ian D. RobertsonFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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James BrownFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Anthony P. PeaseFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Simon C. RoeFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Elizabeth M. HardieFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Simon J. WheelerFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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B. Duncan X. LascellesFrom the Comparative Pain Research Laboratory & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, University of North Carolina, Raleigh, NC 27606.

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Abstract

Objective—To determine the items (question topics) for a subjective instrument to assess degenerative joint disease (DJD)–associated chronic pain in cats and determine the instrument design most appropriate for use by cat owners.

Animals—100 randomly selected client-owned cats from 6 months to 20 years old.

Procedures—Cats were evaluated to determine degree of radiographic DJD and signs of pain throughout the skeletal system. Two groups were identified: high DJD pain and low DJD pain. Owner-answered questions about activity and signs of pain were compared between the 2 groups to define items relating to chronic DJD pain. Interviews with 45 cat owners were performed to generate items. Fifty-three cat owners who had not been involved in any other part of the study, 19 veterinarians, and 2 statisticians assessed 6 preliminary instrument designs.

Results—22 cats were selected for each group; 19 important items were identified, resulting in 12 potential items for the instrument; and 3 additional items were identified from owner interviews. Owners and veterinarians selected a 5-point descriptive instrument design over 11-point or visual analogue scale formats.

Conclusions and Clinical Relevance—Behaviors relating to activity were substantially different between healthy cats and cats with signs of DJD-associated pain. Fifteen items were identified as being potentially useful, and the preferred instrument design was identified. This information could be used to construct an owner-based questionnaire to assess feline DJD-associated pain. Once validated, such a questionnaire would assist in evaluating potential analgesic treatments for these patients.

Abstract

Objective—To determine the items (question topics) for a subjective instrument to assess degenerative joint disease (DJD)–associated chronic pain in cats and determine the instrument design most appropriate for use by cat owners.

Animals—100 randomly selected client-owned cats from 6 months to 20 years old.

Procedures—Cats were evaluated to determine degree of radiographic DJD and signs of pain throughout the skeletal system. Two groups were identified: high DJD pain and low DJD pain. Owner-answered questions about activity and signs of pain were compared between the 2 groups to define items relating to chronic DJD pain. Interviews with 45 cat owners were performed to generate items. Fifty-three cat owners who had not been involved in any other part of the study, 19 veterinarians, and 2 statisticians assessed 6 preliminary instrument designs.

Results—22 cats were selected for each group; 19 important items were identified, resulting in 12 potential items for the instrument; and 3 additional items were identified from owner interviews. Owners and veterinarians selected a 5-point descriptive instrument design over 11-point or visual analogue scale formats.

Conclusions and Clinical Relevance—Behaviors relating to activity were substantially different between healthy cats and cats with signs of DJD-associated pain. Fifteen items were identified as being potentially useful, and the preferred instrument design was identified. This information could be used to construct an owner-based questionnaire to assess feline DJD-associated pain. Once validated, such a questionnaire would assist in evaluating potential analgesic treatments for these patients.

Contributor Notes

Supported by Fellowship Research Program of Novartis Animal Health, and the Morris Animal Foundation.

Address correspondence to Dr. Lascelles (Duncan_Lascelles@ncsu.edu).
  • 1

    Clarke S P, Mellor D, Clements DN, et al. Prevalence of radiographic signs of degenerative joint disease in a hospital population of cats. Vet Rec 2005; 157:793799.

    • Search Google Scholar
    • Export Citation
  • 2

    Godfrey DR. Osteoarthritis in cats: a retrospective radiological study. J Small Anim Pract 2005; 46:425429.

  • 3

    Hardie EM, Roe SC, Martin FR. Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994–1997). J Am Vet Med Assoc 2002; 220:628632.

    • Search Google Scholar
    • Export Citation
  • 4

    Lascelles BDX, Thomson Sumrell A, Henry JB III, et al. Cross-sectional study evaluating the prevalence of radiographic degenerative joint disease in domesticated cats. Ve t Surg 2010; 39:535544.

    • Search Google Scholar
    • Export Citation
  • 5

    Clarke S P & Bennett D. Feline osteoarthritis: a prospective study of 28 cases. J Small Anim Pract 2006; 47:439445.

  • 6

    Gunew MN, Menrath VH, Marshall RD. Long-term safety, efficacy and palatability of oral meloxicam at 0.01–0.03mg/kg for treatment of osteoarthritic pain in cats. J Feline Med Surg 2008; 10:235241.

    • Search Google Scholar
    • Export Citation
  • 7

    Lascelles BD, Hansen BD, Roe S, et al. Evaluation of client-specific outcome measures and activity monitoring to measure pain relief in cats with osteoarthritis. J Vet Intern Med 2007; 21:410416.

    • Search Google Scholar
    • Export Citation
  • 8

    Lascelles BD, Henderson AJ, Hackett IJ. Evaluation of the clinical efficacy of meloxicam in cats with painful locomotor disorders. J Small Anim Pract 2001; 42:587593.

    • Search Google Scholar
    • Export Citation
  • 9

    Havig ME, Dyce J, Kowaleski M P, et al. Relationship of tibial plateau slope to limb function in dogs treated with a lateral suture technique for stabilization of cranial cruciate ligament deficient stifles. Vet Surg 2007; 36:245251.

    • Search Google Scholar
    • Export Citation
  • 10

    Miller J & Beale B. Tibiotarsal arthroscopy. Applications and long-term outcome in dogs. Vet Comp Orthop Traumatol 2008; 21:159165.

  • 11

    Moreau M, Lussier B, Doucet M, et al. Efficacy of licofelone in dogs with clinical osteoarthritis. Vet Rec 2007; 160:584588.

  • 12

    Mueller M, Bockstahler B, Skalicky M, et al. Effects of radial shockwave therapy on the limb function of dogs with hip osteoarthritis. Vet Rec 2007; 160:762765.

    • Search Google Scholar
    • Export Citation
  • 13

    Quinn MM, Keuler NS, Lu Y, et al. Evaluation of agreement between numerical rating scales, visual analogue scoring scales, and force plate gait analysis in dogs. Vet Surg 2007; 36:360367.

    • Search Google Scholar
    • Export Citation
  • 14

    Waxman AS, Robinson DA, Evans RB, et al. Relationship between objective and subjective assessment of limb function in normal dogs with an experimentally induced lameness. Vet Surg 2008; 37:241246.

    • Search Google Scholar
    • Export Citation
  • 15

    Johnston SA. Overview of pain in the lame patient. Vet Clin North Am Small Anim Pract 2001; 31:3953.

  • 16

    Worth AJ, Bruce WJ. Long-term assessment of pancarpal arthrodesis performed on working dogs in New Zealand. N Z Vet J 2008; 56:7884.

  • 17

    Brown DC, Boston RC, Coyne JC, et al. Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis. Am J Vet Res 2007; 68:631637.

    • Search Google Scholar
    • Export Citation
  • 18

    Brown DC, Boston RC, Coyne JC, et al. Ability of the canine brief pain inventory to detect response to treatment in dogs with osteoarthritis. J Am Vet Med Assoc 2008; 233:12781283.

    • Search Google Scholar
    • Export Citation
  • 19

    Hielm-Björkman AK, Kuusela E, Liman A, et al. Evaluation of methods for assessment of pain associated with chronic osteoarthritis in dogs. J Am Vet Med Assoc 2003; 222:15521558.

    • Search Google Scholar
    • Export Citation
  • 20

    Hielm-Björkman AK, Rita H, Tulamo RM. 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. Am J Vet Res 2009; 70:727734.

    • Search Google Scholar
    • Export Citation
  • 21

    Wiseman-Orr ML, Nolan AM, Reid J, et al. Development of a questionnaire to measure the effects of chronic pain on health-related quality of life in dogs. Am J Vet Res 2004; 65:10771084.

    • Search Google Scholar
    • Export Citation
  • 22

    Wiseman-Orr ML, Scott EM, Reid J, et al. Validation of a structured questionnaire as an instrument to measure chronic pain in dogs on the basis of effects on health-related quality of life. Am J Vet Res 2006; 67:18261836.

    • Search Google Scholar
    • Export Citation
  • 23

    Baltzer W. Joint disease in cats, in Proceedings. North Am Vet Conf 2009;9981000.

  • 24

    Bennett D, Clarke S P. Feline osteoarthritis, in Proceedings. 12th Eur Soc Vet Orthop Traumatol Cong 2004; 21:14.

  • 25

    Caney S. Feline arthritis. Vet Focus 2007; 17:1117.

  • 26

    Hardie EM. Management of osteoarthritis in cats. Vet Clin North Am Small Anim Pract 1997; 27:945953.

  • 27

    Leonard CA. Feline lameness. Vet Clin North Am Small Anim Pract 2001; 31:143163.

  • 28

    Paul V. Feline osteoarthritis—a silent problem. Vet Nurs Times 2007; 7:89.

  • 29

    German A & Martin L. Feline obesity. In: Encyclopedia of feline clinical nutrition. Aimargues, France: Royal Canin, 2008;16.

  • 30

    Beadman R, Smith RN, King AS. Vertebral osteophytes in the cat. Vet Rec 1964; 76:10051007.

  • 31

    Keller GG, Reed AL, Lattimer JC, et al. Hip dysplasia: a feline population study. Vet Radiol Ultrasound 1999; 40:460464.

  • 32

    Langenbach A, Green P, Giger U, et al. Relationship between degenerative joint disease and hip joint laxity by use of distraction index and Norberg angle measurement in a group of cats. J Am Vet Med Assoc 1998; 213:14391443.

    • Search Google Scholar
    • Export Citation
  • 33

    McDowell I & Newell C. Pain measurements. In: Measuring health: a guide to rating scales and questionnaires. 2nd ed. New York: Oxford University Press, 1996;470519.

    • Search Google Scholar
    • Export Citation
  • 34

    Streiner DL, Norman GR. Health measurements scales: a practical guide to their development and use. 2nd ed. New York: Oxford University Press, 1995.

    • Search Google Scholar
    • Export Citation
  • 35

    Sudman S, Bradburn NM. Questionnaire from start to finish. In: Asking questions: a practical guide to questionnaire design. San Francisco: Jossey-Bass Inc, 1982;281286.

    • Search Google Scholar
    • Export Citation
  • 36

    Brown DC. Outcomes based medicine in veterinary surgery: getting hard measures of subjective outcomes. Vet Surg 2007; 36:289292.

  • 37

    McDowell I & Newell C. Measuring health: a guide to rating scales and questionnaires. 2nd ed. New York: Oxford University Press, 1996.

  • 38

    Akerblom S & Sjostrom L. Evaluation of clinical, radiographical and cytological findings compared to arthroscopic findings in shoulder joint lameness in the dog. Vet Comp Orthop Traumatol 2007; 20:136141.

    • Search Google Scholar
    • Export Citation
  • 39

    Boyd DJ, Miller C W, Etue SM, et al. Radiographic and functional evaluation of dogs at least 1 year after tibial plateau leveling osteotomy. Can Vet J 2007; 48:392396.

    • Search Google Scholar
    • Export Citation
  • 40

    Kubassova O, Boesen M, Peloschek P, et al. Quantifying disease activity and damage by imaging in rheumatoid arthritis and osteoarthritis. Ann N Y Acad Sci 2009; 1154:207238.

    • Search Google Scholar
    • Export Citation
  • 41

    Thomson MJ. The cat with lameness. In: Rand J, ed. Problem-based feline medicine. Amsterdam: Elsevier, 2006;976991.

  • 42

    Grant S, Aitchison T, Henderson E, et al. A comparison of the reproducibility and the sensitivity to change of visual analogue scales, Borg scales, and Likert scales in normal subjects during submaximal exercise. Chest 1999; 116:12081217.

    • Search Google Scholar
    • Export Citation
  • 43

    Jensen M P, Turner JA, Romano JM. What is the maximum number of levels needed in pain intensity measurement? Pain 1994; 58:387392.

  • 44

    Rosier EM, Iadarola MJ, Coghill RC. Reproducibility of pain measurement and pain perception. Pain 2002; 98:205216.

  • 45

    Maydeu-Olivares A, Kramp U, Garcia-Forero C, et al. The effect of varying the number of response alternatives in rating scales: experimental evidence from intra-individual effects. Behav Res Methods 2009; 41:295308.

    • Search Google Scholar
    • Export Citation
  • 46

    Dworkin RH, Turk DC, Farrar JT, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain 2005; 113:919.

    • Search Google Scholar
    • Export Citation
  • 47

    von Baeyer CL, Spagrud LJ. Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years. Pain 2007; 127:140150.

    • Search Google Scholar
    • Export Citation
  • 48

    Brown DC, Iadarola MJ, Perkowski SZ, et al. Physiologic and antinociceptive effects of intrathecal resiniferatoxin in a canine bone cancer model. Anesthesiology 2005; 103:10521059.

    • Search Google Scholar
    • Export Citation
  • 49

    Greig ML, Chow E, Bovett G, et al. Level of concordance between proxy and cancer patient ratings in brief pain inventory. Support Cancer Ther 2005; 3:5458.

    • Search Google Scholar
    • Export Citation

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