Owner Quality Of Life Research Articles

Client perspectives on the support provided for the management of diabetes mellitus in dogs and cats

Background: Literature suggests that owners of pets with diabetes mellitus are not adequately supported by veterinary professionals to manage their pet's condition. Quality of life assessments for diabetic pets in practice often focus on the animal's clinical signs and overlook owner feedback. Aims: To investigate client perspectives on how having a dog or cat with diabetes mellitus affects pet and owner quality of life, the challenges faced and management options available, and how support could be improved. Methods: A questionnaire was designed using the online tool ‘NoviSurvey’ and completed by UK-based owners. Results: Out of the 99 valid responses, 26% of participants disagreed that their veterinary practice supported them with their pet's diabetes mellitus. Results showed that diabetes mellitus is perceived to have a significant effect on quality of life of not only the pet with the disease but also the owner who is managing it. Conclusions: The effects of having a pet with diabetes mellitus on quality of life are being overlooked by the veterinary profession. Online support groups are an important platform for these owners to connect but should not be their primary source of advice because of a lack of veterinary support. Registered veterinary nurses are well placed to carry out regular quality of life assessments and provide evidence-based advice during clinics.

Development and validation of a quality of life and treatment satisfaction measure in canine osteoarthritis.

Canine osteoarthritis (OA) causes pain and mobility impairment. This can reduce dog quality of life (QoL), owner QoL and owners' satisfaction with, and adherence to, treatments. No existing canine OA-specific instrument assesses all three impacts. This study aimed to develop and psychometrically evaluate an owner-completed canine OA-specific measure of dog QoL, owner QoL and owner treatment satisfaction; the "Canine OA Quality of Life and Treatment Satisfaction Questionnaire" (CaOA-QoL-TS). The CaOA-QoL-TS was developed using a conceptual model derived from a meta-synthesis of published literature followed by cognitive interviews with ten owners of dogs with OA, to evaluate content validity. Based on interview findings, ten items were reworded, four removed, and two added; resulting in 26 items that all owners understood and considered relevant. The recall period and response options were well understood and appropriate to almost all owners. To evaluate its psychometric properties, the CaOA-QoL-TS (draft 26-item version) was administered, across six timepoints in a phase 4 field study, to owners of OA treated dogs, recruited from veterinary practices (N = 93). Inter-item correlations suggested items clustered into three distinct domains: Dog QoL, Owner QoL and Treatment Satisfaction, as hypothesized. Confirmatory factor analysis supported deletion of two items and calculation of the three domain scores, with acceptable model fit. The resulting 24-item CaOA-QoL-TS instrument demonstrated strong internal consistency and good to excellent test-retest reliability. Convergent validity was supported by moderate to strong correlations with concurrent measures. Known groups validity was supported by statistically significant differences between groups categorized by owner global impression of QoL. Ability to detect change was demonstrated through statistically significant improvements over time in Owner and Dog QoL, with larger within-group effect sizes reported for the mean of 'improved' dogs compared to the mean of 'stable' dogs. Only a small sample of dogs worsened throughout the study. Anchor-based analyses supported-0.9 and-1.0-point within-group responder definitions for dog and owner QoL domains, respectively. Findings support the content validity of the CaOA-QoL-TS in canine OA. The 24-item CaOA-QoL-TS is a reliable and valid instrument to measure owner and canine QoL and TS and is sensitive to improvements following OA treatment.

Improved owner quality of life following surgical repair of canine myxomatous mitral valve disease.

To determine quality-of-life changes in owners of dogs undergoing mitral valve repair for myxomatous mitral valve disease, up to 12 months postoperatively. Owners of 26 dogs undergoing mitral valve repair at a single UK veterinary referral hospital. Dogs underwent mitral valve repair under cardiopulmonary bypass as previously described. Owner quality of life was assessed by self-completion of a previously validated questionnaire preoperatively and at 1, 3, 6, and 12 months postoperatively. There was a statistically significant improvement in quality-of-life scores from preoperatively up to 3 months postoperatively and a statistically significant improvement in individual question scores up to 6 months postoperatively. Results suggested that owner quality of life is significantly improved following surgical repair of their pet's myxomatous mitral valve disease, and this improvement continues beyond the immediate postoperative period. These results may be useful when counseling owners of surgical candidates and is another useful outcome measure.

Assessing the Quality of Life of Dogs with Inflammatory Bowel Disease and Their Owners.

The aim of the study was to assess the quality of life (QoL) of dogs with inflammatory bowel disease (IBD) and the impact on the life and relationship of the owner. An online questionnaire based on a Likert scale score (1-10) was designed to assess items related to dog QoL, owner QoL, and the owner-dog relationship. Responses from 110 dog owners (30 with IBD and 80 healthy dogs) were included in the study. IBD dogs had significantly lower overall QoL (p < 0.001), health (p < 0.0001), and level of activity (p = 0.049). Owners of dogs with IBD reported lower overall QoL (p < 0.001). The scores for how their dog's QoL might affect their own QoL (p = 0.028), how much their dog limited their social life, leisure time, or daily activities (p = 0.015), and how often they felt burdened by caring for their dog (p = 0.006) were significantly higher in the IBD group when compared to the healthy group. In addition, IBD dog owners were more likely to see their dogs as children (p = 0.0004). IBD has a negative impact on affected dogs and their owners regardless of the severity of the disease.

Safety and effectiveness of the sodium-glucose cotransporter inhibitor bexagliflozin in cats newly diagnosed with diabetes mellitus.

Bexagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. A pilot study has shown that bexagliflozin can decrease dependence on exogenous insulin in cats with diabetes mellitus (DM). To evaluate the safety and effectiveness of bexagliflozin as a monotherapy for DM in previously untreated cats. Eighty-four client-owned cats. Historically controlled prospective open-label clinical trial. Cats were dosed PO with 15 mg bexagliflozin once daily for 56 days, with a 124-day extension to evaluate safety and treatment effect durability. The primary endpoint was the proportion of cats experiencing a decrease in hyperglycemia and improvement in clinical signs of hyperglycemia from baseline on day 56. Of 84 enrolled cats, 81 were evaluable on day 56, and 68 (84.0%) were treatment successes. Decreases in mean serum glucose, fructosamine, and β-hydroxybutyrate (β-OHB) concentrations were observed, and investigator assessments of cat neurological status, musculature, and hair coat quality improved. Owner evaluations of both cat and owner quality of life were favorable. The fructosamine half-life in diabetic cats was found to be 6.8 days. Commonly observed adverse events included emesis, diarrhea, anorexia, lethargy, and dehydration. Eight cats experienced serious adverse events, 3 of which led to death or euthanasia. The most important adverse event was euglycemic diabetic ketoacidosis, diagnosed in 3 cats and presumed present in a fourth. Bexagliflozin decreased hyperglycemia and observed clinical signs in cats newly diagnosed with DM. As a once-daily PO medication, bexagliflozin may simplify management of DM in cats.

Effect of long-term management of hypoadrenocorticism on the quality of life of affected dogs and their owners.

The treatment of canine adrenal insufficiency consists of hormone substitution and requires high owner compliance and intense human-dog interaction. This might affect the quality of life (QoL) of owners and their pets. The aim of the study was to evaluate the impact of hypoadrenocorticism and its treatment on the QoL of dogs and their owners. Owners completed a web-based survey that contained items concerning signalment, owner QoL, dog QoL and long-term therapy. Three hundred and twenty-two owners participated. Most owners feared an adrenal crisis. Approximately half of the participants reported that the bond between them and their pet increased after diagnosis. Although many participants felt that their own QoL was not affected by their dog's disease, worries about costs and leaving their dog unsupervised were frequently reported. Half of the study participants increased their dog's glucocorticoid doses when a stressful situation was foreseeable ('boosting' of therapy). Some administered hydrocortisone, mostly switched from prednisolone, resulting in a reduction in side effects. Special attention should be given to glucocorticoid therapy and owner's QoL. The overall worry of an adrenal crisis might increase caregivers' burden, reducing their overall QoL. Hydrocortisone might be a safe alternative to prednisolone, but further research is necessary to evaluate its long-term efficacy and safety in dogs.

Associations Between Atopic Dermatitis and Anxiety, Aggression, and Fear-Based Behaviors in Dogs.

The goal of this study was to determine if anxiety, aggression, and fear-related behaviors are more common in pruritic dogs with atopic dermatitis than nonpruritic, healthy dogs. One hundred forty-one pruritic dogs >1 yr of age with a clinical diagnosis of atopic dermatitis and a >3 mo history of pruritus were recruited. Dog owners completed a behavioral survey (canine behavioral assessment and research questionnaire) and a pruritus scale (pruritus visual analog scale). Pruritic, atopic dogs showed significant increases in fear- and anxiety-related behaviors as well as aggression compared with a large control group of healthy dogs. Stranger-directed aggression, owner-directed aggression, familiar-dog aggression, dog-directed fear, nonsocial fear, touch sensitivity, excitability, and attention-seeking behaviors were all increased in the study group. Trainability was decreased in the study group. Chronically pruritic dogs experience fear and anxiety and are more likely to display aggression. This is an important welfare issue for these animals. Early recognition of the behavioral derangements that can be associated with chronic pruritic skin disease could allow early intervention with a multidisciplinary approach for these patients, thus improving patient and owner quality of life and long-term treatment outcomes.

Owner quality of life, caregiver burden and anticipatory grief: How they differ, why it matters.

Understanding client perspective is important for veterinary communications, particularly during problem visits. Key client experiences of caregiver burden, anticipatory grief and quality of life (QoL) have been previously examined in this context, but never simultaneously considered. A sample of 393 owners of an elderly or seriously ill companion animal was recruited online to complete cross-sectional measures of psychosocial function, companion animal presentation and demographics. Exploratory factor analysis demonstrated that owner caregiver burden, anticipatory grief and QoL reflect distinct constructs. Cluster analysis showed these experiences occur in four separate owner profiles: 'distressed', 'resilient', 'non-distressed' and owners experiencing strain due to 'other influences'. These groups appear to be differentially influenced by various factors, such as the companion animal's QoL, nature of the illness and the owner's attachment. They also show distinct differences in consideration of euthanasia and emotional functioning, including experience of stress and depressive symptoms. Constructs of caregiver burden, anticipatory grief and QoL are not interchangeable and may differentially impact owner decisions and behaviour. The veterinarian's understanding of owner profiles relevant to these issues and distinguishing underlying features may foster effective communication.

PVM3 LINGUISTIC VALIDATION OF THE CANINE DERMATITIS QUALITY OF LIFE AND TREATMENT SATISFACTION QUESTIONNAIRE (CDQOL-TSQ) FOR USE IN THAILAND AND ITALY

The Canine Dermatitis Quality of Life and Treatment Satisfaction Questionnaire (CDQoL-TSQ) is a pet owner-completed instrument to assess canine quality of life (QoL), owner QoL, and treatment satisfaction. It is conceptually comprehensive and well-understood in English. There is a growing understanding in the animal health outcomes community of the benefits of applying best-practice clinical outcomes assessment methods to animal health outcomes measurement. In the continued development of the CDQoL-TSQ, linguistic validation was performed to facilitate use of the instrument in Thailand (Thai) and Italy (Italian). The CDQoL-TSQ was subject to two rounds of dual forward translation and reconciliation, and back translation. Following this, the forward and back translation versions were reconciled. Translators were native speakers of the target language and were fluent in English. The instrument was assessed by the original instrument developers for consistency of translation with original English in capturing intended concepts and clarity of wording. Cognitive debriefing interviews were conducted with dog owners to evaluate and improve understanding of the translated instrument. Debriefing interviews were conducted with five dog owners in each country. Revisions were made to the translated versions to simplify high-level language (e.g. original translation of ‘skin pathology’ revised to ‘skin disease’), to improve fluency, and improve clarity of the intended concept (e.g. original translation of ‘I wish’ revised to ‘I am willing to’ for consistency with intended concept), and ensure question framing was suitable for the response option. Debriefing interviews confirmed cultural appropriateness of items and owner understanding. The considerations and implications for applying best-practice methods to veterinary research and practice are discussed with a worked-example of translation and linguistic validation stages and adaptations to demonstrate that the CDQoL-TSQ is valid for use in Italy and Thailand.

Effect of prophylactic cefalexin treatment on the development of bacterial infection in acute radiation-induced dermatitis in dogs: a blinded randomized controlled prospective clinical trial.

Acute radiation-induced dermatitis (ARID) is a common sequela of radiation therapy and carries the risk of secondary bacterial skin infection. No standard of care exists for managing canine ARID and evidence-based guidelines are lacking; however, prophylactic use of antibiotics is common. To evaluate the impact of prophylactic cefalexin on the prevalence and severity of bacterial infection in canine ARID. Seventeen dogs treated with definitive-intent radiotherapy. All dogs were treated with definitive-intent radiation therapy (48-57.5 gray) targeted to the skin surface. Dogs were randomized to receive either prophylactic cefalexin (22 mg/kg twice daily) beginning halfway through the prescribed radiotherapy course (cohort A) or to serve as controls (cohort B). Aerobic skin cultures and surface cytological evaluation were performed at first onset of moist desquamation and one week following completion of radiation therapy. Skin toxicity grading and owner quality of life (QoL) questionnaires were performed weekly. The rate of infection, multidrug resistance status, toxicity severity and QoL between cohorts were compared. Staphylococcus schleiferi and S. pseudintermedius were the most frequent bacterial agents isolated in both cohorts. There was no significant difference in prevalence of bacterial infection or overall QoL between cohorts at either time point; however, multidrug-resistant infections were significantly increased in cohort A versus cohort B. Clinician- and client-perceived severity of toxicity was significantly greater and median duration of moist desquamation was significantly longer in cohort A than cohort B. Prophylactic use of cefalexin for management of canine ARID is not recommended.

Severity of Nasal Inflammatory Disease Questionnaire for Canine Idiopathic Rhinitis Control: Instrument Development and Initial Validity Evidence.

BackgroundEffective treatments are needed for idiopathic chronic rhinitis in dogs, but assessment of efficacy requires a practical, quantifiable method for assessing severity of disease.ObjectivesTo develop and perform initial validity and reliability testing of an owner‐completed questionnaire for assessing clinical signs and dog and owner quality of life (QOL) in canine chronic rhinitis.AnimalsTwenty‐two dogs with histopathologically confirmed chronic rhinitis and 72 healthy dogs.MethodsIn this prospective study, an online questionnaire was created based on literature review and feedback from veterinarians, veterinary internists with respiratory expertise, and owners of dogs with rhinitis. Owners of affected dogs completed the questionnaire twice, 1 week apart, to test reliability. Healthy dogs were assessed once. Data were analyzed using the Rasch Rating Scale Model, and results were interpreted using Messick's framework for evaluating construct validity evidence.ResultsInitial item generation resulted in 5 domains: nasal signs, paranasal signs, global rhinitis severity, and dog's and owner's QOL. A 25‐item questionnaire was developed using 5‐point Likert‐type scales. No respondent found the questionnaire difficult to complete. Strong psychometric evidence was available to support the substantive, generalizability, content, and structural aspects of construct validity. Statistical differences were found between responses for affected and control dogs for all but 2 items. These items were eliminated, resulting in the 23‐item Severity of Nasal Inflammatory Disease (SNIFLD) questionnaire.Conclusions and Clinical ImportanceThe SNIFLD questionnaire provides a mechanism for repeated assessments of disease severity in dogs with chronic rhinitis.

Development and validation of a questionnaire to evaluate the Quality of Life of cats with skin disease and their owners, and its use in 185 cats with skin disease

Skin disease can negatively affect the Quality of Life (QoL) of cats and of their owners. To develop and evaluate a questionnaire on QoL of cats with skin disease and their owners. Following interviews with owners of cats with severe skin disease and elaboration of a preliminary 19 item questionnaire, a final 15 item (score 0-3) questionnaire was developed. This was administered to owners of 45 cats with allergic dermatitis and 39 healthy cats, to assess its ability to differentiate between diseased and healthy subjects. In allergic cats, owners evaluated overall disease severity (S) and pruritus with a Visual Analog Scale (VAS); veterinarians evaluated skin lesions [SCORing Feline Allergic Dermatitis (SCORFAD) and Feline Dermatitis Extent and Severity Index (FeDESI)]. The correlation with QoL was analysed by Spearman's rank test. In 31 allergic cats, SCORFAD, FeDESI, pruritus VAS, S and QoL scores were obtained before and after therapy, and their improvement evaluated statistically. QoL scores in allergic cats were significantly higher than in healthy cats (P=<0.0001). Severity correlated well and significantly with both cat's and owner's QoL (r = 0.51 and 0.64, P = 0.0003 and <0.0001, respectively). Correlation of QoL with pruritus VAS was moderate and significant (r = 0.3, P = 0.03), whereas with SCORFAD and FeDESI it was low and not significant. With therapy all scores decreased significantly (P < 0.0001); however, QoL was not influenced by improvement of clinical scores. Questions related to the burden of therapy showed the smallest improvements. This QoL questionnaire could be a useful tool in evaluating cats with skin disease.

Development of a survey instrument to assess health-related quality of life in small animal cancer patients treated with chemotherapy

To develop a quality of life (QOL) survey for use in a canine cancer chemotherapy setting, validate the instrument's utility, identify key questions that facilitate client and clinician communication regarding decisions in patient care, and use human and veterinary QOL literature to develop a comprehensive yet simple proxy survey instrument. Survey. 29 canine chemotherapy patients. Patients were evaluated by both owners and veterinarians at the time of initial visit to the clinic and at 3 and 6 weeks after the initiation of chemotherapy. This survey consisted of a longitudinal evaluation of QOL with 6 components addressing the animal's QOL retrospectively, before onset of cancer; changes in the animal's QOL since manifestation of disease; changes in the animal's QOL with regard to treatment response; owner's QOL and its impact on priorities in decision making; clinician's impression of the owner's priorities and QOL; and clinician's impression of the dog's QOL. Multiple regression analysis indicated 3 significant predictors of canine cancer patient QOL to be play behaviors, signs of illness, and canine happiness as perceived by owners. The QOL instrument was easy to use and enhanced client perception of patient care and clinician concern. Owners enjoyed the opportunity to complete the survey. Since questions regarding play behaviors, clinical signs of disease, and canine happiness were significant indicators of changes in QOL, these should be included in future studies. Quality of life assessment may facilitate treatment decisions and assessment of canine patients undergoing chemotherapy.