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.
"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. "
[Show abstract][Hide abstract] 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
[Show abstract][Hide abstract] 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
[Show abstract][Hide abstract] ABSTRACT: The study sought to examine the effect of long-term meloxicam treatment on the survival of cats with and without naturally-occurring, chronic kidney disease at the initiation of therapy. The databases of two feline-only clinics were searched for cats older than 7 years that had been treated continuously with meloxicam for a period of longer than 6 months. Only cats with complete medical records available for review were recruited into the study.The median longevity in the renal group was 18.6 years [95% confidence interval (CI) 17.5-19.2] and the non-renal group was 22 years [95% CI 18.5-23.8]. The median longevity after diagnosis of CKD was 1608 days [95% confidence interval 1344-1919] which compares favourably to previously published survival times of cats with CKD. In both groups the most common cause of death was neoplasia. Long-term treatment with oral meloxicam did not appear to reduce the lifespan of cats with pre-existent stable CKD, even for cats in IRIS stages II and III. Therefore to address the need for both quality of life and longevity in cats with chronic painful conditions, meloxicam should be considered as a part of the therapeutic regimen.
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