Clinical validity of outcome pain measures in naturally occurring canine osteoarthritis

BMC Veterinary Research

Eric Troncy¹  Jean-Pierre Pelletier¹  Johanne Martel-Pelletier¹  Dominique Gauvin¹  Bertrand Lussier²  Martin Guillot¹  Maxim Moreau¹  Sylvain Bichot³  Pascale Rialland¹ 

[1] Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Notre-Dame Hospital, Montreal (QC), H2L 4 M1, Canada;The Companion Animal Research Group; Faculty of Veterinary Medicine, Université de Montréal, St.-Hyacinthe (QC), J2S 7C6, Canada;Department of Biomedical Sciences, GREPAQ (Research Group in Animal Pharmacology of Quebec), St.-Hyacinthe (QC), J2S 7C6, Canada

关键词: Skin conductance;    Behavioral scales;    Accelerometry;    Kinetics;    Metrology;    Pain;    Dog osteoarthritis;    Psychometrics;   

Others  :  1119725
DOI  :  10.1186/1746-6148-8-162

 received in 2012-01-03, accepted in 2012-08-29,  发布年份 2012

【 摘 要 】

Background

The conceptual validity of kinetic gait analysis and disability outcome assessment methods has guided their use in the assessment of pain caused by osteoarthritis (OA). No consensus on the best clinical methods for pain evaluation in canine OA exists, particularly, when evaluating treatments where a smaller treatment effect is anticipated than with pharmacological pain killers. This study thus aimed at determining the technical validity of some clinical endpoints on OA pain in dogs using the green-lipped mussel (GLM)-enriched diet.

Twenty-three adult dogs with clinical OA completed the prospective controlled study. All the dogs were fed a balanced diet over a 30-day control period followed by a GLM-enriched diet over a 60-day period. The kinetic gait analysis parameter (PVF_BW, peak vertical force adjusted for body weight change), electrodermal activity (EDA), and a standardized multifactorial pain questionnaire (MFQ) were performed on day (D) 0 (inclusion), D30 (start) and D90 (end). The owners completed a client-specific outcome measures (CSOM) instrument twice a week. Motor activity (MA) was continuously recorded in seven dogs using telemetered accelerometric counts. We hypothesized that these methods would produce convergent results related to diet changes. A Type I error of 0.05 was adjusted to correct for the multiplicity of the primary clinical endpoints.

Results

Neither the EDA nor the MFQ were found reliable or could be validated. Changes in the PVF_BW (P_adj = 0.0004), the CSOM (P_adj = 0.006) and the MA intensity (P_adj = 0.02) from D0 to D90 suggested an effect of diet(s). Only the PVF_BW clearly increased after the GLM-diet (P_adj = 0.003). The CSOM exhibited a negative relationship with the PVF_BW (P = 0.02) and MA duration (P = 0.02).

Conclusions

The PVF_BW exhibited the best technical validity for the characterization of the beneficial effect of a GLM-enriched diet. The CSOM and MA appeared less responsive following a GLM-diet, but these measures appeared complementary to gait analysis. Apparently, the CSOM provides the capacity to rely on pain OA assessment influenced by both lameness quantification (PVF_BW) and physical functioning (MA).

【 授权许可】

   
2012 Rialland et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Johnston SA: Osteoarthritis: joint anatomy, physiology, and pathobiology. Vet Clin North Am Small Anim Pract 1997, 27:699-723.
• [2]Gordon WJ, Conzemius MG, Riedesel E, Besancon MF, Evans R, Wilke V, Ritter MJ: The relationship between limb function and radiographic osteoarthrosis in dogs with stifle osteoarthrosis. Vet Surg 2003, 32(5):451-454.
• [3]Dray A, Read S: Arthritis and pain. Future targets to control osteoarthritis pain. Arthritis Res Ther 2007, 9(3):212. BioMed Central Full Text
• [4]Brandt KD, Dieppe P, Radin EL: Etiopathogenesis of Osteoarthritis. Rheum Dis Clin North Am 2008, 34(3):531-559.
• [5]Goldring SR: The Role of Bone in Osteoarthritis Pathogenesis. Rheum Dis Clin North Am 2008, 34(3):561-571.
• [6]Pollard B, Dixon D, Dieppe P, Johnston M: Measuring the ICF components of impairment, activity limitation and participation restriction: an item analysis using classical test theory and item response theory. Health Qual Life Outcomes 2009, 7(1):41. BioMed Central Full Text
• [7]Hielm-Bjöorkman AK, Kuusela E, Liman A, Markkola A, Saarto E, Huttunen P, Leppaluoto J, Tulamo RM, Raekallio M: Evaluation of methods for assessment of pain associated with chronic osteoarthritis in dogs. J Am Vet Med Assoc 2003, 222(11):1552-1558.
• [8]Brown DC, Boston RC, Coyne JC, Farrar JT: Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis. Am J Vet Res 2007, 68(6):631-637.
• [9]Hudson JT, Slater MR, Taylor L, Scott HM, Kerwin SC: Assessing repeatability and validity of a visual analogue scale questionnaire for use in assessing pain and lameness in dogs. Am J Vet Res 2004, 65(12):1634-1643.
• [10]Wiseman-Orr ML, Scott EM, Reid J, Nolan AM: 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(11):1826-1836.
• [11]Brown DC, Boston RC, Coyne JC, Farrar JT: Ability of the Canine Brief Pain Inventory to detect response to treatment in dogs with osteoarthritis. J Am Vet Med Assoc 2008, 233(8):1278-1283.
• [12]Hielm-Björkman AK, Rita H, Tulamo R-M: 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(6):727-734.
• [13]Hielm-Björkman AK, Tulamo RM, Salonen H, Raekallio M: Evaluating Complementary Therapies for Canine Osteoarthritis Part II: A Homeopathic Combination Preparation (Zeel(R). Evid Based Complement Alternat Med 2009, 6(4):465-471.
• [14]Hielm-Björkman AK, Tulamo RM, Salonen H, Raekallio M: Evaluating Complementary Therapies for Canine Osteoarthritis Part I: Green-lipped Mussel (Perna canaliculus). Evid Based Complement Alternat Med 2009, 6(3):365-373.
• [15]Moreau M, Lussier B, Pelletier JP, Martel-Pelletier J, Bédard C, Gauvin D, Troncy E: Brachystemma calycinum D. Don effectively reduces the locomotor disability in dogs with naturally occurring osteoarthritis: A randomized placebo-controlled trial. Evid Based Complement Alternat Med 2012.
• [16]Smith GK, Mayhew PD, Kapatkin AS, McKelvie PJ, Shofer FS, Gregor TP: Evaluation of risk factors for degenerative joint disease associated with hip dysplasia in German Shepherd Dogs, Golden Retrievers, Labrador Retrievers, and Rottweilers. J Am Vet Med Assoc 2001, 219(12):1719-1724.
• [17]Clements DN, Carter SD, Innes JF, Ollier WER: Genetic basis of secondary osteoarthritis in dogs with joint dysplasia. Am J Vet Res 2006, 67(5):909-918.
• [18]Gingerich DA, Strobel JD: Use of client-specific outcome measures to assess treatment effects in geriatric, arthritic dogs: controlled clinical evaluation of a nutraceutical. Vet Ther 2003, 4(4):376-386.
• [19]Lascelles BDX, Gaynor JS, Smith ES, Roe SC, Marcellin-Little DJ, Davidson G, Boland E, Carr J: Amantadine in a Multimodal Analgesic Regimen for Alleviation of Refractory Osteoarthritis Pain in Dogs. J Vet Intern Med 2008, 22(1):53-59.
• [20]Rumph PF, Kincaid SA, Visco DM, Baird DK, Kammermann JR, West MS: Redistribution of vertical ground reaction force in dogs with experimentally induced chronic hindlimb lameness. Vet Surg 1995, 24(5):384-389.
• [21]Budsberg SC: Long-term temporal evaluation of ground reaction forces during development of experimentally induced osteoarthritis in dogs. Am J Vet Res 2001, 62(8):1207-1211.
• [22]Vasseur PB, Johnson AL, Budsberg SC, Lincoln JD, Toombs JP, Whitehair JG, Lentz EL: Randomized, controlled trial of the efficacy of carprofen, a nonsteroidal anti-inflammatory drug, in the treatment of osteoarthritis in dogs. J Am Vet Med Assoc 1995, 206(6):807-811.
• [23]Budsberg SC, Johnston SA, Schwarz PD, DeCamp CE, Claxton R: Efficacy of etodolac for the treatment of osteoarthritis of the hip joints in dogs. J Am Vet Med Assoc 1999, 214(2):206-210.
• [24]Moreau M, Dupuis J, Bonneau NH, Desnoyers M: Clinical evaluation of a nutraceutical, carprofen and meloxicam for the treatment of dogs with osteoarthritis. Vet Rec 2003, 152(11):323-329.
• [25]Moreau M, Lussier B, Doucet M, Vincent G, Martel-Pelletier J, Pelletier JP: Efficacy of licofelone in dogs with clinical osteoarthritis. Vet Rec 2007, 160(17):584-588.
• [26]Wilson AC, Palermo TM: Physical Activity and Function in Adolescents With Chronic Pain: A Controlled Study Using Actigraphy. J Pain 2012, 13(2):121-130.
• [27]Hansen BD, Lascelles BDX, Keene BW, Adams AK, Thomson AE: Evaluation of an accelerometer for at-home monitoring of spontaneous activity in dogs. Am J Vet Res 2007, 68(5):468-475.
• [28]Brown DC, Boston RC, Farrar JT: Use of an activity monitor to detect response to treatment in dogs with osteoarthritis. J Am Vet Med Assoc 2010, 237(1):66-70.
• [29]Conzemius MG, Evans RB, Besancon MF, Gordon WJ, Horstman CL, Hoefle WD, Nieves MA, Wagner SD: Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. J Am Vet Med Assoc 2005, 226(2):232-236.
• [30]Trumble TN, Billinghurst RC, Bendele AM, McIlwraith CW: Evaluation of changes in vertical ground reaction forces as indicators of meniscal damage after transection of the cranial cruciate ligament in dogs. Am J Vet Res 2005, 66(1):156-163.
• [31]Moreau M, Rialland P, Pelletier JP, Martel-Pelletier J, Lajeunesse D, Boileau C, Caron J, Frank D, Lussier B, Del Castillo JRE, et al.: Tiludronate treatment improves structural changes and symptoms of osteoarthritis in the canine anterior cruciate ligament model. Arthritis Res Ther 2011, 13(3):R98. BioMed Central Full Text
• [32]Streiner DL, Norman GR: Health measurement scales: a practical guide to their development and use. 3rd edition. New York: Oxford University Press; 2003.
• [33]Turk DC, Dworkin RH, McDermott MP, Bellamy N, Burke LB, Chandler JM, Cleeland CS, Cowan P, Dimitrova R, Farrar JT, et al.: Analyzing multiple endpoints in clinical trials of pain treatments: IMMPACT recommendations. Pain 2008, 139(3):485-493.
• [34]Lascelles BDX, Hansen BD, Simon R, Venita D, Andrea T, Courtney CP, Eric SS, Elizabeth R: Evaluation of Client-Specific Outcome Measures and Activity Monitoring to Measure Pain Relief in Cats with Osteoarthritis. J Vet Intern Med 2007, 21(3):410-416.
• [35]Hielm-Björkman AK, Kapatkin AS, Rita HJ: Reliability and validity of a visual analogue scale used by owners to measure chronic pain attributable to osteoarthritis in their dogs. Am J Vet Res 2011, 72(5):601-607.
• [36]Skene SS, Kenward MG: The analysis of very small samples of repeated measurements II: A modified Box correction. Stat Med 2010, 29(27):2838-2856.
• [37]Richardson CA, Niel L, Leach MC, Flecknell PA: Evaluation of the efficacy of a novel electronic pain assessment device, the Pain Gauge, for measuring postoperative pain in rats. Lab Anim 2007, 41(1):46-54.
• [38]Pollard B, Guilford WG, Ankenbauer-Perkins KL, Hedderley D: Clinical efficacy and tolerance of an extract of green-lipped mussel (Perna canaliculus) in dogs presumptively diagnosed with degenerative joint disease. N Z Vet J 2006, 54(3):114-118.
• [39]Roush JK, Cross AR, Renberg WC, Dodd CE, Sixby KA, Fritsch DA, Allen TA, Jewell DE, Richardson DC, Leventhal PS, et al.: Evaluation of the effects of dietary supplementation with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. J Am Vet Med Assoc 2010, 236(1):67-73.
• [40]Fritsch DA, Allen TA, Dodd CE, Jewell DE, Sixby KA, Leventhal PS, Brejda J, Hahn KA: A multicenter study of the effect of dietary supplementation with fish oil omega-3 fatty acids on carprofen dosage in dogs with osteoarthritis. J Am Vet Med Assoc 2010, 236(5):535-539.
• [41]Moreau M, Troncy E, Bichot S, Lussier B: Influence of Changes in Body Weight on Peak Vertical Force in Osteoarthritic Dogs: A Possible Bias in Study Outcome. Vet Surg 2010, 39(1):43-47.
• [42]Bui LM, Bierer TL: Influence of green lipped mussels (Perna canaliculus) in alleviating signs of arthritis in dogs. Vet Ther 2003, 4(4):397-407.
• [43]Lascelles BD, McFarland JM, Swann H: Guidelines for safe and effective use of NSAIDs in dogs. Vet Ther 2005, 6(3):237-251.
• [44]Vangsness CT Jr, Spiker W, Erickson J: A Review of Evidence-Based Medicine for Glucosamine and Chondroitin Sulfate Use in Knee Osteoarthritis. Arthroscopy 2009, 25(1):86-94.
• [45]Official Publication (Association of American Feed Control Officials). Oxford; 2003.
• [46]Littell RC, Pendergast J, Natarajan R: Modelling covariance structure in the analysis of repeated measures data. Stat Med 2000, 19(13):1793-1819.
• [47]Littell RC, Milliken GA, Stroup WW, Wolfinger RD, Schabenberber O: SAS for Mixed Models. 2nd edition. Cary: SAS Publishing; 2006.
• [48]Haukoos JS, Lewis RJ: Advanced Statistics: Bootstrapping Confidence Intervals for Statistics with “Difficult” Distributions. Acad Emerg Med 2005, 12(4):360-365.