Neuter Status Research Articles

Influence of preoperative septic peritonitis and anastomotic technique on the dehiscence of enterectomy sites in dogs: A retrospective review of 210 anastomoses.

To determine the influence of preoperative septic peritonitis (PSP) and stapled versus hand-sewn anastomoses on the dehiscence of intestinal resection and anastomosis (IRA). We hypothesized that the incidence of IRA dehiscence would be greater (1) when performed with PSP and (2) for hand-sewn anastomoses. Retrospective. Client-owned dogs at Michigan State University Veterinary Teaching Hospital. Records of dogs surviving 72 hours after IRAs between 2003 and 2013 were reviewed for age, gender, neuter status, weight, presence of PSP, preoperative albumin, IRA indication and location, anastomotic technique, suture type, postoperative dehiscence and timing, duration of hospitalization, last follow-up, and other complications. Univariate logistic regression and chi-square analysis were used to screen prognostic factors; factors with P < .3 were included in a multivariate analysis. Two hundred and ten IRAs in 198 dogs fulfilled the inclusion criteria. Dehiscence was diagnosed in 11.4% cases, 6.6% without PSP, and 21.1% with PSP (P = .01). Indication for IRA did not influence the risk of dehiscence. No association was detected between anastomotic technique and IRA dehiscence in dogs without PSP (stapled 4.2%, hand-sewn 8.1%); however, stapled anastomoses were less likely to dehisce in dogs with PSP (stapled 9.7%, hand-sewn 28.9%). Risk factors for dehiscence included PSP (P = .005) and hand-sewn technique (P = .02). Our results confirmed that PSP is a risk factor for dehiscence of IRA and suggest that patients with PSP may be a unique surgical population, in which stapling may be preferred over hand-sewn anastomoses after enterectomies.

Growth standard charts for monitoring bodyweight in dogs of different sizes.

Limited information is available on what constitutes optimal growth in dogs. The primary aim of this study was to develop evidence-based growth standards for dogs, using retrospective analysis of bodyweight and age data from >6 million young dogs attending a large corporate network of primary care veterinary hospitals across the USA. Electronic medical records were used to generate bodyweight data from immature client-owned dogs, that were healthy and had remained in ideal body condition throughout the first 3 years of life. Growth centile curves were constructed using Generalised Additive Models for Location, Shape and Scale. Curves were displayed graphically as centile charts covering the age range 12 weeks to 2 years. Over 100 growth charts were modelled, specific to different combinations of breed, sex and neuter status. Neutering before 37 weeks was associated with a slight upward shift in growth trajectory, whilst neutering after 37 weeks was associated with a slight downward shift in growth trajectory. However, these shifts were small in comparison to inter-individual variability amongst dogs, suggesting that separate curves for neutered dogs were not needed. Five bodyweight categories were created to cover breeds up to 40kg, using both visual assessment and hierarchical cluster analysis of breed-specific growth curves. For 20/24 of the individual breed centile curves, agreement with curves for the corresponding bodyweight categories was good. For the remaining 4 breed curves, occasional deviation across centile lines was observed, but overall agreement was acceptable. This suggested that growth could be described using size categories rather than requiring curves for specific breeds. In the current study, a series of evidence-based growth standards have been developed to facilitate charting of bodyweight in healthy dogs. Additional studies are required to validate these standards and create a clinical tool for growth monitoring in pet dogs.

Risk factors associated with stranger-directed aggression in domestic dogs

Aggression in dogs is a safety concern both for humans and animals, and can lead to decreased animal welfare in affected dogs due to potential abuse, neglect, relinquishment or euthanasia. We examined risk factors associated with stranger-directed aggression in dogs using the previously validated, Canine Behavioural Assessment and Research Questionnaire (C-BARQ). Results are based on participant reports of dog behaviour. Data were analyzed using mixed logistic regression, with participant ID and country as random effects. Dogs (n=14,310) were more likely to demonstrate stranger-directed aggression if the participant rated them as mildly or severely fearful of strangers, or mildly, but not severely, fearful in non-social situations, when compared to dogs with no fear. There was an interaction between sex and neuter status, with neutered males being more likely to be aggressive than any other group. Furthermore, adult dogs were more likely to be aggressive compared to adolescents or seniors, and dogs were less likely to be aggressive if acquired as an adult when compared to being acquired as a puppy or adolescent. The random effects for country and participant were significant (p<0.001) with ICCs of 0.01 (CI: 0.00–0.08) and 0.40 (CI: 0.35–0.46), respectively, indicating that there was some correlation in behaviour among dogs within the same country and owned by the same person. The moderate effect of participant suggests that household effects need to be examined further. When looking only at dogs categorized as aggressive towards strangers (n=11,240), dogs were significantly more likely to be categorized as having severe aggression if they were male, and if the owner rated them as mildly or severely fearful of strangers, or mildly, but not severely, fearful in non-social situations, when compared to dogs with no fear. Breed group and where the dog was acquired also had an association with severe aggression. The random effects for country and participant were significant (p<0.001) with ICCs of 0.06 (CI: 0.02–0.15) and 0.34 (CI: 0.22–0.48), respectively, indicating once again that there was some correlation in behaviour among dogs within the same country and owned by the same person. These results suggest that variables related to the environment, owner experience and the dog’s level of fearfulness are associated with aggressive behaviour towards strangers in dogs. Therefore, it might be possible to identify dogs at risk of developing stranger-directed aggression and implement plans to prevent behavioural issues from developing.

Should I whine or should I bark? Qualitative and quantitative differences between the vocalizations of dogs with and without separation-related symptoms

Separation-related disorder (SRD) is one of the most common behavioral problems of companion dogs, causing inconvenience and stress for dog owners and others living close by, as well as being considered as a major contributor to poor animal welfare. Although excessive vocalization is considered as one of the typical symptoms of SRD, until now there were no attempts to analyze and compare the vocal output of affected and non-affected dogs in a systematic, empirical test. In a three-stage outdoor separation experiment we investigated the vocal response of 25 family dogs with, and 20 family dogs without, owner-reported SRD symptoms to the (1) departure; (2) absence; and (3) return of the owner. After the analysis of the occurrence and onset latency of barks and whines, we found that contrary to the commonly held view of excessive barking being one of the trademarks of SRD, dogs with owner-reported SRD symptoms can be reliably characterized by the early onset and high occurrence of whines during the departure and 2min long absence of the owner, while barks were affected mainly by the age of the dogs. Breed and neuter status may modify the vocal reaction to separation, we found that more purebred dogs barked sooner, while breed and neutering status affected the whines only during the departure of the owner, showing that more mixed breeds and intact dogs whined in this phase. This is the first study that targeted directly the vocal response of family dogs to separation from the owner, and according to the results, whines and barks reflect potentially different motivational/inner states of dogs during a short isolation episode. Although the effect of other factors, such as sex, neuter status and breed cannot be ignored, the owner reported SRD status of dogs showed a high coincidence with the early onset of whining, which in turn proved to be a good indicator of high stress levels of dogs in this situation.

The influence of breed and environmental factors on social and solitary play in dogs (Canis lupus familiaris).

The domestic dog is an ideal model species in which to study the genetic and environmental factors that influence play behavior. Dogs exist in a wide variety of breeds and frequently engage in multiple forms of play. In the present study, we investigated whether the levels of solitary and social play differed between dogs of three breed types with distinct predatory motor pattern sequences (herding dogs, retrievers, and livestock guarding dogs [LGDs]). Furthermore, we investigated how environmental factors (social and nonsocial contexts) influenced play in dogs of these breed types. Groups of breed-matched dyads with working experience and of equivalent age, sex, and neuter status ratios were exposed to four experimental test conditions and two control conditions in randomized orders. With respect to solitary play, environmental context did have a significant effect, with toys reliably producing the highest levels of solitary play across all breed types. Retrievers engaged in significantly higher levels of solitary play overall than LGDs, and there was a trend in comparison to herding dogs. In contrast, neither environmental context nor breed had a significant effect on social play levels; however, neuter status of the dyads did have a significant effect on social play, with mixed-status dyads engaging in significantly higher levels of social play than same-status dyads. Our findings provide experimental evidence for identifying proximate, environmental stimuli that reliably facilitate social and solitary play and discuss possible genetic (i.e., breed type) and lifetime influences on the form of play in domestic dogs.

Epidemiologic evaluation of canine urolithiasis in Thailand from 2009 to 2015

The cross-sectional study described the epidemiology of 8560 canine urolith submissions from Thailand to the Minnesota Urolith Center between January 2009 and December 2015. The frequency of urolith types, the relationships between urolith type and breed, sex, and neutered status, and change of annual submission proportion over the study period were analyzed. Struvite was the most common canine urolith (44%), and was commonly found in intact females with a mean age of 6.3±3.1years. Calcium oxalate was the second most common (27%), more frequently found in intact males with a mean age of 8.8±3.3years. Compound, purine, cystine, calcium phosphate, and silica urolith were less common. During the study period, the proportion of struvite urolith significantly decreased from 48% in 2009 to 39% in 2015 (p<0.001). The proportion of CaOx increased from 21% in 2009 to 32% in 2015 (p<0.001). The results of this study can help veterinarians predict urolith composition to select diagnostic tests and to initiate therapy prior to urolith removal.

Association between cystine urolithiasis and neuter status of dogs within the UK

The objectives of the study were to examine the association between diagnosis of cystine urolithiasis and entire versus neutered status in male dogs and whether the strength of association varies among breeds. A previously reported canine urolithiasis database was used, documenting all urolith submissions to Hill's Pet Nutrition UK over a 10-year period. Uroliths were classified as cystine or non-cystine, and only male dogs with known neuter status were included in the analysis. Breeds of dog (and an additional crossbreed group), for which there was a minimum of 10 cystine urolith submissions, were analysed individually, with all other breeds combined together to form a reference group. Results were analysed using chi-squared and Fisher's exact tests. Logistic regression was used to assess associations between breed and neuter status and formation of cystine calculi. In multiple breeds, dogs with cystine uroliths were significantly more likely to be entire than dogs forming other types of urolith. Being an entire male, regardless of breed, was associated with an increased risk of cystine urolithiasis (odds ratio=4·5; 95% confidence interval: 3·22 to 6·37; P<0·001). Increased odds of cystine formation in entire dogs supports further investigation of castration as a method to prevent cystine urolithiasis.

Epidemiological investigation of euthanasia in an Ontario animal shelter.

Objectives The objective was to evaluate factors associated with euthanasia in an animal shelter in Kitchener-Waterloo, Ontario, Canada. Methods Data from 3737 cats admitted to the shelter between January and December 2011 were evaluated. Results Overall, 1989/3737 (53%) of admitted cats were euthanized. Male cats had greater odds of being euthanized than females (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.29-2.05; P <0.001) and surrendered cats were more likely to be euthanized than strays (OR 38.0, 95% CI 14.8-97.69; P <0.001). Black cats were more likely to be euthanized than cats of another color (OR 1.45, 95% CI 1.16-1.80; P <0.001). Cats that spent >5 days in the shelter were more likely to be euthanized than those that spent <5 days in the shelter (OR 1.57, 95% CI 1.25-1.97; P <0.001). Cats that spent >20 days in the shelter were less likely to be euthanized than those that spent <5 days in the shelter (OR 0.26, 95% CI 0.19-0.34; P <0.001). Age, an age quadratic term, neuter status and interactions among these variables were statistically significant; the odds of unneutered animals being euthanized was high and relatively stable across age groups, but in neutered animals the odds of being euthanized increased with age before plateauing in older cats. Conclusions and relevance With >50% of the cats admitted to the shelter in 2011 euthanized, it is important to understand the contributing risk factors that predispose shelter cats to euthanasia and what changes can be made to the shelter system and in owner education to lower the incidence of euthanasia.

Risk factors for underweight and overweight in cats in metropolitan Sydney, Australia

Obesity is regarded as one of the most significant welfare issues in companion animals. Some risk factors affecting body condition in cats have been determined, but many remain controversial. The current study aimed to investigate the risk factors for overweight and underweight in cats in metropolitan Sydney. Electronic patient records for 11 years (2005–2015) were acquired from a feline primary practice in metropolitan Sydney. The 9-point body condition score (BCS) evaluation in each visit was classified into three groups: underweight (1–3), ideal-weight (4–6) and overweight (7–9). Multinomial logistic regression was used to identify the risk factors for underweight and overweight. The risk factors tested included: breed, hair length, sex, neuter status, age at neutering, age at visit, microchip status, lifestyle, reason for the clinic visit and the number of visits by a cat in a calendar year. The BCS examiner was included as a confounder. Over the 11-year period, 4,020 cats had made 18,349 visits to the clinic, from which BCS records were available for 15,659 visits (85.3%), with 834 cats (5.3%) being underweight, 12,362 (79.0%) being ideal-weight and 2,463 (15.7%) being overweight. Although various cat breeds showed a different tendency for body condition, British Shorthair and mixed-breed cats were more likely to be overweight. Non-illness related visits and middle age (7–11 years old) were also risk factors for overweight. The risk factors for underweight included purebred cats (apart from British Shorthair and Burmese), medium-or-long hair, being intact, increase in age, not having a microchip and illness-related visits. Sex was not a significant risk factor for either overweight or underweight. The study demonstrated that the risk factors for overweight and the protective factors for underweight were not necessarily the same, highlighting the importance of investigating the risk factors for underweight and overweight separately in future research.

Correlation of neuter status and expression of heritable disorders

BackgroundGonadectomy, or neutering, is a very common surgery for dogs having many positive effects on behavior, health, and longevity. There are also certain risks associated with neutering including the development of orthopedic conditions, cognitive decline, and a predisposition to some neoplasias. This study was designed specifically to identify if a correlation exists between neuter status and inherited conditions in a large aggregate cohort of dogs representing many different breeds.ResultsNeutered dogs were at less risk for early and congenital conditions (aortic stenosis, early onset cataracts, mitral valve disease, patent ductus arteriosus, portosystemic shunt, and ventricular septal defect) than intact dogs. Neutering was also associated with reduced risk of dilated cardiomyopathy and gastric dilatation volvulus in males. Neutering was significantly associated with an increased risk for males and females for cancers (hemangiosarcoma, hyperadrenocorticism, lymphoma, mast cell tumor, and osteosarcoma), ruptured anterior cruciate ligament and epilepsy. Intervertebral disk disease was associated with increased risk in females only. For elbow dysplasia, hip dysplasia, lens luxation, and patellar luxation neutering had no significant effect on the risk for those conditions. Neutering was associated with a reduced risk of vehicular injury, a condition chosen as a control.ConclusionsIn this retrospective study, several conditions showed an increased risk associated with neutering whereas other conditions were less likely to be expressed in neutered dogs. The complexity of the interactions between neutering and inherited conditions underscores the need for reflective consultation between the client and the clinician when considering neutering. The convenience and advantages of neutering dogs that will not be included in a breeding program must be weighed against possible risk associated with neutering.

An exploratory study into factors influencing development of acute canine polyradiculoneuritis in the UK

To investigate whether the development of acute canine polyradiculoneuritis is associated with various putative risk factors. Retrospective case-control study with conditional logistic regression analysis from a referral hospital population in the UK where controls were matched for year of presentation. Forty-three cases were identified with acute canine polyradiculoneuritis and 86 controls were selected. Jack Russell terriers and West Highland white terriers were found to have a significantly greater odds of developing acute canine polyradiculoneuritis compared to a mixed baseline group of dogs. The odds of developing acute canine polyradiculoneuritis were greater in the autumn and winter compared to spring. Vaccination, rural/urban habitation, sex, neuter status and age were not associated with development of acute canine polyradiculoneuritis in our population of dogs. Breed and season were associated with development of acute canine polyradiculoneuritis. However, this is a small sample and so this observation needs confirmation in further studies and other factors may also be involved. Nevertheless, these findings may be important in further understanding the aetiopathogenesis of this condition.

Retrospective study of more than 9000 feline cutaneous tumours in the UK: 2006-2013.

Objectives The aim of the study was to utilise a large database available from a UK-based, commercial veterinary diagnostic laboratory to ascertain the prevalence of different forms of cutaneous neoplasia within the feline population, and to detect any breed, sex or age predilections for the more common tumours. Methods Records from the laboratory were searched for feline submissions received between 31 May 2006 and 31 October 2013. For masses arising within the skin for which histopathology had been performed, the diagnosis was recorded together with the breed, age, sex and neuter status of the cat. Odds ratios for breed predisposition to skin tumours overall, to histologically malignant tumours and to the more commonly occurring tumours were calculated, with the non-pedigree cat population as the control. Results Of the 219,083 feline samples submitted, masses arising within the skin comprised 4.4% and there were 89 different diagnoses recorded for these masses. Just 6.6% of these cases were non-neoplastic in nature, and, of neoplastic masses, 52.7% were considered histologically malignant. The 10 most common skin tumour types accounted for 80.7% of cases, with the four most common being basal cell tumours, fibrosarcomas, squamous cell carcinomas and mast cell tumours. Conclusions and relevance Despite the large number of different diagnoses in this study, a relatively small number of tumour types accounts for the majority of skin masses occurring in cats, most of which are neoplastic in nature. There are a number of breed predispositions for the more common tumour types, although no pedigree breed had increased odds of developing a malignant tumour compared with the non-pedigree cat population; several breeds had significantly decreased odds. Just over half of the neoplastic masses in this study were considered histologically malignant.

Roaming behaviour of dogs in four remote Aboriginal communities in the Northern Territory, Australia: preliminary investigations.

To estimate the home range (HR) and investigate the potential predictors for roaming of 58 dogs in four Aboriginal communities in the Northern Territory. Prospective study. Global positioning system (GPS) collars were attached to the dogs for 1-4 days, recording location fixes every 1-3 min. Utilisation distributions (UDs) and extended (95% isopleth) and core (50% isopleth) HRs of dogs were determined. Potential predictors of roaming were assessed. Estimated core (median, 0.27 ha) and extended (median, 3.1 ha) HRs differed significantly (P = 0.0225 and 0.0345, respectively) between the four communities; dogs in the coastal community travelled significantly (P < 0.0001) more per day than dogs in the three inland communities studied. Significant associations were found between extended HR size and sex (P = 0.0050) and sex + neuter (P = 0.0218), and between core HR size and sex (P = 0.0010), neuter status (P = 0.0255) and sex + neuter (P = 0.0025). Entire males roamed more than neutered females. The core HR of dogs with poor/fair body condition scores (BCSs) was larger than dogs with ideal/obese BCSs (P = 0.0394). Neutered male dogs also travelled more per day than entire female dogs (P = 0.0475). Roaming information can be used to inform the management of dogs in remote communities and to design disease control programs. Widespread data collection across the Northern Territory should be undertaken to further investigate the associations found in this study, considering that data were collected during relatively short periods of time in one season.

Mineral status in canine medial coronoid process disease: a cohort study using analysis of hair by mass spectrometry

In several species, developmental skeletal diseases involving abnormal endochondral ossification have been associated with imbalanced mineral intake. Hair analysis reflects long-term mineral status. To determine the mineral content of hair...

The burden of domestication: a representative study of welfare in privately owned cats in Denmark

AbstractThe way in which domestic cats are kept and bred has changed dramatically over the last two centuries. Notably, a significant number of cats are kept indoors, most of them are neutered and many are selectively bred. This likely has consequences for their welfare. A few studies link housing, neuter status and breeding in cats to risks of welfare problems. However, the study presented here is the first to quantify the risks and document the prevalence of risk factors. It builds on results from a questionnaire sent to a representative sample of the Danish population. Using the responses from cat owners who keep cats in the home (n = 378), the paper aims to investigate how indoor confinement, neutering and selective breeding affect health, behaviour and other factors relating to cat welfare. The paper reports that confined cats had significantly more behavioural problems than free-roaming cats; that a smaller proportion of the free-roaming cats suffered from the behavioural problems investigated; and that entire cats had significantly more behavioural problems than neutered cats. Finally, significantly more purebred cats than domestic shorthair cats were found to have diseases. Being confined, being intact and being purebred are therefore significant risk factors for behavioural or health problems associated with reduced welfare in privately owned cats.

Markers of Oxidative Stress in Dogs with Myxomatous Mitral Valve Disease are Influenced by Sex, Neuter Status, and Serum Cholesterol Concentration.

BackgroundCardiovascular disease has been associated with oxidative stress, which has been suggested to contribute to myocardial remodeling in human patients. Little is known about the relationship between myxomatous mitral valve disease (MMVD) and oxidative stress in dogs.ObjectiveTo determine whether clinical stage of MMVD is associated with changes in the plasma concentrations of certain markers of oxidative stress in clinically healthy dogs and dogs with MMVD.AnimalsSeventy five privately owned dogs: 59 cavalier King Charles Spaniels (CKCS) with different severities of MMVD and 16 dogs of different breeds with clinical signs of congestive heart failure (CHF) caused by MMVD.MethodsMarkers of oxidative stress including malondialdehyde (MDA), oxidized low‐density lipoprotein (oxLDL), and vitamin E (α‐tocopherol and γ‐tocopherol) were measured in plasma and their association with clinical stage of MMVD was assessed by regression analyses.ResultsPlasma oxLDL concentration was significantly lower in female dogs compared with males (P = .01). Significantly higher plasma γ‐tocopherol concentrations were found in neutered (P = .003) dogs. Vitamin E (α‐tocopherol [P = .0004] and γ‐tocopherol [P = .003]) was associated with body condition score (BCS), but the association disappeared when cholesterol was included in the analyses. All markers of oxidative stress (MDA, oxLDL, and vitamin E) were positively associated with serum cholesterol concentration (P ≤ .04), but none were associated with clinical stage of MMVD.ConclusionsIn conclusion, markers of oxidative stress are associated with sex, BCS, neuter status, and cholesterol. The results cannot confirm a relationship between oxidative stress and clinical stage of the disease in dogs with MMVD.

Mandatory desexing of dogs: one step in the right direction to reduce the risk of dog bite? A systematic review

IntroductionPreventing dog bites is an intractable problem given the complex dog bite injury environment. Desexing of dogs has the opportunity of creating a safer injury environment, given the potential links...

Risk factors for road traffic accidents in cats up to age 12 months that were registered between 2010 and 2013 with the UK pet cat cohort (‘Bristol Cats’)

Road traffic accidents (RTAs) are a common cause of death and injury in domestic cats, and a concern to many owners. This study assessed potential risk factors for RTAs in...

A new model for evaluating maintenance energy requirements in dogs: allometric equation from 319 pet dogs.

Reports concerning maintenance energy requirements (MER) in dogs are common but most of the data cover laboratory or utility dogs. This study establishes those of healthy adult pet dogs and the factors which cause these energy requirements to vary. Within the framework of a nutrition teaching exercise, each student followed a pet from his entourage and gathered accurate records of its feeding habits. Data have been restricted to healthy adult dogs with an ideal body weight (BW) which did not vary more than 5 % during the study period. A total of 319 eligible records were analysed using multiple linear regression. Variation factors such as ownership, breed, sex and neutered status, bedding location, temperament and feeding habits were then analysed individually using a non-parametric model. Two models result from this study, one excluding age (r2 0·813) and a more accurate one which takes into consideration the age in years (r2 0·816). The second model was assessed with the main variation factors and shows that: MER (kcal) = k1 × k2 × k3 × k4 × k5 × 128 × BW0·740 × age-0·050/d (r2 0·836), with k1 the effect of the breed, k2 the effect of sex and neutered status, k3 the effect of bedding location, k4 the effect of temperament and k5 the effect of the type of feed. The resulting model is very similar to the recommendations made by the National Research Council (2006) but a greater accuracy was obtained using age raised to a negative power, as demonstrated in human nutrition.

Variation in activity levels amongst dogs of different breeds: results of a large online survey of dog owners from the UK.

Regular physical activity is an important means of promoting health, both in people and their pets. Walking is the most common method used for dogs, but there is a lack of clarity on how much daily activity different breeds of dog require. Data from an online survey of UK dog owners were collected between June and August in 2014. The University of Liverpool Ethics Committee approved the project, and owners consented to data use. The initial dataset (17028 dogs) was first cleaned to remove erroneous data, and then edited to remove mixed breed dogs, leaving a total of 12314 dogs from known pedigree breeds. Other information collected included sex, age, neuter status, breed, and amount and frequency of exercise. Exercise frequency and duration were estimated across different breeds, and compared with Kennel Club recommendations, using χ2 tests and binary logistic regression. The online survey data indicated differences amongst breeds in the amount of walking reported (P<0·001). Afghan hounds were the least exercised breed, whilst breeds reportedly exercised most included: English setter, foxhound, Irish setter and Old English sheepdog. Gundogs were most likely to be walked once per d or more (P<0·001), whilst smaller dogs were more likely to meet their UK Kennel Club guidelines for dog walking (P<0·001). The frequency of dog walking varies both within and amongst breeds, and many do not currently receive the recommended amount of exercise. This may constitute a canine welfare problem and also have an impact on the physical activity levels of their owners.