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New tool helps diagnose feline degenerative joint disease

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Nearly all cats have identifiable signs of degenerative joint disease (DJD),  yet it often goes undiagnosed.

Researchers at North Carolina State University (NCSU) came up with a screening checklist to help veterinarians and owners identify cats experiencing DJD-associated pain. They detail their research in a study published this month in the Journal of Feline Medicine and Surgery .

In the study, the authors collated data from five previous studies carried out as part of NCSU’s Translational Research in Pain Program. Using this data, the researchers compared case histories of 249 cats with DJD-associated pain to those of 53 cats without DJD-associated pain.

The results helped them develop a set of six “yes” or “no” questions—the Feline Musculoskeletal Pain Screening Checklist—that ask whether a cat can jump up and down normally, climb up and down stairs normally, run normally, and whether they chase moving objects such as toys and prey.

Then researchers compared the scoring of owners who were both aware or unaware of the link between DJD and pain in cats. Unsurprisingly, they found a gap in the responses between the groups, with a higher percentage of “DJD-informed” owners scoring their cats as impaired for every question.

The authors suggest that, given the high prevalence of feline DJD, many cats with undiagnosed DJD would nonetheless still be identified using the checklist; and, when coupled with owner education and engagement in watching for behavioral changes in their cats, the detection of DJD should improve even more.

NEWStat reached out to lead author Margaret E. Gruen, DVM, MVPH, PhD, DACVB, assistant professor of Behavioral Medicine at NCSU’s College of Veterinary Medicine, to find out more.

NEWStat: What motivated you to develop the checklist?

Margaret Gruen: We were motivated by the underdiagnosis of DJD in cats and the fact that many cat owners are not aware of what behaviors are associated with DJD. This checklist was meant to be paired with educational materials and to start a conversation about DJD between owners and veterinarians.

NEWStat: What makes feline DJD difficult to diagnose?

MG: Feline DJD is difficult to diagnose for several reasons. First, the presentation is different from dogs; cats don’t generally have a limp, and are more likely to decrease their ability to perform activities such as going up and down the stairs and jumping—changes that may be attributed to getting old rather than to a painful disease. Second, because most cats don’t perform the same behaviors in the clinic that they do at home, we rely on our observation, hands-on exam, and owner report. We know that the radiographic prevalence of DJD is remarkably high, but not all cats will have clinical signs related to DJD, and these signs are best measured through the behavior of the cat. Asking owners about those specific behaviors likely to be altered by DJD can improve our ability to identify affected cats.

NEWStat: How important is owner input in diagnosing DJD?

MG: Asking about specific activities helps to make sure that owners and veterinarians are on the same page when talking about pain. When we ask owners if their cat has any pain, I believe the interpretation may be weighted toward more severe or acute signs of pain, like vocalization. By focusing on behavioral changes, we can engage owners in watching for signs in their cat. Cat owners are really key to the diagnosis, as they’re the best observers of their cat’s behavior at home. This is important because cats will often still perform most behaviors—many cats will still jump up, will still play, etc.—but it is the way cats perform behaviors that’s altered, so it’s difficult for people to notice right away. If cats stopped doing these activities, owners would bring them in right away. But when the cat just changes the way they jump up, perhaps hesitating or not clearing the jump with their back legs, this is much harder to detect unless you’re watching for it.

NEWStat: How will your tool benefit working veterinary professionals?

MG: We hope that our tool, coupled with educational materials, will be a quick screening tool that will help engage owners and start a conversation between owners and veterinarians for at-risk cats. The checklist is meant to be a screening tool, with responses used to trigger further questioning and diagnostics as needed. As busy professionals, we hope that having a tool that’s backed up by data from cats will provide a clinically expedient way to screen cats.

Photo credit: © iStock/LukyToky