Perceptions of Quality of Life and Priorities of Owners of Cats with Heart Disease
Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. Journal of Veterinary Internal Medicine
(Impact Factor: 1.88).
08/2010; 24(6):1421-6. DOI: 10.1111/j.1939-1676.2010.0583.x
Owners' perceptions and priorities regarding quality of life (QoL) are important considerations given the unknown efficacy of many commonly administered medications, stress of hospital visits, difficulties providing home care, and personal choices including euthanasia.
To describe the relative importance of quality versus quantity of life to owners of cats with heart disease.
Two hundred and thirty-nine cats with heart disease.
Prospective questionnaire-based clinical study. Cat owners completed a questionnaire to identify important parameters when assessing their cat's QoL, the relative importance of quality versus quantity of life, and willingness to trade survival time for QoL. Variables associated with these parameters were evaluated with multivariate analyses.
Appetite, owner interaction, sleep patterns, and litterbox habits were deemed important to QoL. Concern over pet suffering was significantly greater than concern over life expectancy. Ninety-three percent of owners were willing to trade survival time for good QoL; 57% of these were willing to trade up to 6 months. On multivariate analysis, the only factor significantly (P=.002) associated with willingness to trade 6 months was study site. Owner concern regarding stress of administering medications at home increased with number and frequency of medications.
These results indicated that QoL is more important to owners of cats with heart disease than longevity. The various priorities and concerns of cat owners should be taken into account in order to provide optimal care.
Figures in this publication
Available from: Jessica M Quimby
- "However, some cats refuse to eat specially formulated diets, making the maintenance of appetite and food intake for these cats a key therapeutic target. Additionally, poor appetite is perceived by owners as a significant quality of life concern and anorexia in companion animals can cause emotional distress to owners (Reynolds et al., 2010). Mirtazapine, a tetracyclic antidepressant, has utility in veterinary patients because of several beneficial side effects, namely its significant anti-nausea, anti-emetic, and appetite stimulating properties. "
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ABSTRACT: Cats with chronic kidney disease (CKD) often experience inappetence and vomiting and might benefit from the administration of mirtazapine, a medication with appetite stimulant and anti-nausea properties. The aim of this placebo-controlled, double-masked crossover clinical trial was to evaluate the effects of mirtazapine on bodyweight, appetite and vomiting in cats with CKD. Eleven cats with stable CKD were randomized to receive 1.88mg mirtazapine or placebo orally every other day for 3weeks. After a 4day washout period, each cat crossed over to the alternate treatment for 3weeks. Physical examinations and serum biochemistry profiles were performed before and after each treatment period and owners kept daily logs of appetite, activity, behavior, and vomiting episodes. Compared to placebo, mirtazapine administration resulted in a statistically significant increase in appetite (P=0.02) and activity (P=0.02) and a statistically significant decrease in vomiting (P=0.047), as determined by Wilcoxon matched pairs analysis. Cats treated with mirtazapine also gained significant bodyweight compared with placebo-treated cats (P=0.002) as determined by linear mixed model analysis. Median weight gain during mirtazapine administration was 0.18kg (range 0-0.45kg). Median weight loss during placebo administration was 0.07kg (range 0-0.34kg). Mirtazapine is an effective appetite stimulant and anti-emetic for cats with CKD and could be a useful adjunct to the nutritional management of these cases.
The Veterinary Journal 07/2013; 197(3). DOI:10.1016/j.tvjl.2013.05.048 · 1.76 Impact Factor
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ABSTRACT: PRACTICAL RELEVANCE: Feline hypertrophic cardiomyopathy (HCM) is the most common cardiac disease of cats. Treatment of HCM is usually directed at controlling signs of congestive heart failure (CHF), preventing occurrence or recurrence of systemic thromboembolism or delaying/preventing/reversing progression of subclinical disease. STUDY OBJECTIVE AND DESIGN: Despite the laudable goals of therapy, however, little objective evidence supporting therapeutic decisions has been published. We, therefore, hypothesized that cardiologists base their treatment strategies on information other than published clinically relevant science. To gain insight into therapeutic decisions that cardiologists and clinicians with an interest in cardiology (n=99) make for cats with HCM, and on what information they base these decisions, we presented participants with, and asked them to select therapy for, 12 hypothetical scenarios of HCM (± CHF). Responses and justifications for treatment choices were compiled and compared with the results of a comprehensive literature search for published information about treatment of feline HCM. FINDINGS: Evaluation of the therapeutic strategies chosen for these hypothetical cases of HCM suggests that cardiologists or clinicians with a strong interest in cardiology often prescribe treatments knowing that little documented evidence supports their decisions.
07/2011; 13(7):487-97. DOI:10.1016/j.jfms.2011.05.006
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ABSTRACT: To develop, validate, and evaluate a questionnaire (Cats' Assessment Tool for Cardiac Health [CATCH] questionnaire) for assessing health-related quality of life in cats with cardiac disease.
275 cats with cardiac disease.
The questionnaire was developed on the basis of clinical signs of cardiac disease in cats. A CATCH score was calculated by summing responses to questionnaire items; possible scores ranged from 0 to 80. For questionnaire validation, owners of 75 cats were asked to complete the questionnaire (10 owners completed the questionnaire twice). Disease severity was assessed with the International Small Animal Cardiac Health Council (ISACHC) classification for cardiac disease. Following validation, the final questionnaire was administered to owners of the remaining 200 cats.
Internal consistency of the questionnaire was good, and the CATCH score was significantly correlated with ISACHC classification. For owners that completed the questionnaire twice, scores were significantly correlated. During the second phase of the study, the CATCH score ranged from 0 to 74 (median, 7) and was significantly correlated with ISACHC classification.
Results suggested that the CATCH questionnaire is a valid and reliable method for assessing health-related quality of life in cats with cardiac disease. Further research is warranted to test the tool's sensitivity to changes in medical treatment and its potential role as a clinical and research tool.
Journal of the American Veterinary Medical Association 05/2012; 240(10):1188-93. DOI:10.2460/javma.240.10.1188 · 1.56 Impact Factor
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