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This study aimed to evaluate the agreement and reliability of the Feline Grimace Scale (FGS) among cat owners, veterinarians, veterinary students and nurses/technicians. Raters (n = 5/group) scored 100 images using the FGS (ear position, orbital tightening, muzzle tension, whiskers position and head position). Intra-class correlation coefficients (ICC) were used to assess inter- and intra-rater reliability. Agreement between each group and the veterinarian group (gold-standard) was calculated using the Bland–Altman method. Effects of gender, age and number of cats owned on FGS scores were assessed using linear mixed models. Inter-rater reliability was good for FGS final scores (ICC > 0.8). The muzzle and whiskers yielded lower reliability (ICC = 0.39 to 0.74). Intra-rater reliability was excellent for students and veterinarians (ICC = 0.91), and good for owners and nurses (ICC = 0.87 and 0.81, respectively). A very good agreement between all groups and veterinarians (bias < 0.1 and narrow limits of agreement) was observed. Female raters assigned higher FGS scores than males ( p  = 0.006); however, male raters were underrepresented in this study. Scores were not affected by age or number of cats owned. The FGS is reliable for feline acute pain assessment when used by individuals with different experience.

Grimace scales have been used for pain assessment in different species. This study aimed to develop and validate the Feline Grimace Scale (FGS) to detect naturally-occurring acute pain. Thirty-five client-owned and twenty control cats were video-recorded undisturbed in their cages in a prospective, case-control study. Painful cats received analgesic treatment and videos were repeated one hour later. Five action units (AU) were identified: ear position, orbital tightening, muzzle tension, whiskers change and head position. Four observers independently scored (0–2 for each AU) 110 images of control and painful cats. The FGS scores were higher in painful than in control cats; a very strong correlation with another validated instrument for pain assessment in cats was observed (rho = 0.86, p < 0.001) as well as good overall inter-rater reliability [ICC = 0.89 (95% CI: 0.85–0.92)], excellent intra-rater reliability (ICC > 0.91), and excellent internal consistency (Cronbach’s alpha = 0.89). The FGS detected response to analgesic treatment (scores after analgesia were lower than before) and a cut-off score was determined (total pain score > 0.39 out of 1.0). The FGS is a valid and reliable tool for acute pain assessment in cats.

An improved understanding of behaviors reflecting acute pain in cats is a priority for feline welfare. The aim of this study was to create and validate a comprehensive ethogram of acute pain behaviors in cats that can discriminate painful versus non-painful individuals. An inventory of behaviors (ethogram) with their respective descriptors was created based on a literature review of PubMed, Web of Science and CAB Abstracts databases. The ethogram was divided into ten behavior categories that could be evaluated by duration and/or frequency: position in the cage, exploratory behaviors, activity, posture and body position, affective-emotional states, vocalization, playing (with an object), feeding, post-feeding and facial expressions/features. Thirty-six behaviors were analyzed independently by four veterinarians with postgraduate qualifications in feline medicine and/or behavior as (1) not relevant, (2) somewhat relevant, (3) quite relevant or (4) highly relevant and used for content (I-CVI) and face validity. Items with I-CVI scores > 0.67 were included. Twenty-four behaviors were included in the final ethogram. Thirteen items presented full agreement (i.e., I-CVI = 1): positioned in the back of the cage, no attention to surroundings, feigned sleep, grooming, attention to wound, crouched/hunched, abnormal gait, depressed, difficulty grasping food, head shaking, eye squinting, blepharospasm and lowered head position. Seven descriptors were reworded according to expert suggestions. The final ethogram provides a detailed description of acute pain behaviors in cats after content and face validity and can be applied to the characterization of different acute painful conditions in hospitalized cats.

This study aimed to characterize the duration and/or frequency of pain behaviors in kittens following ovariohysterectomy using video assessment. A total of 229 videos comprising 18 h of recordings were obtained during a prospective, randomized, clinical trial using an opioid-free protocol with (multimodal group, MMG) or without (control group, CG) multimodal analgesia. Videos included behaviors of 36 kittens (≤ 6 months) before and after surgery, as well as pre/post rescue analgesia. A veterinary behaviorist blinded to treatments and timepoints performed the behavioral assessment using an ethogram. Statistical analyses were performed using linear models ( P  < 0.05). Duration (%) of ‘no attention to surroundings’ (5 ± 16 and 0.0 ± 0.7, P  = 0.02), ‘lowered head position’ (4 ± 12 and 0.3 ± 2, P  = 0.009) and ‘eyes partially closed’ (15 ± 29 and 5 ± 17, P  < 0.02) was longer in kittens before than after analgesia, respectively. When compared with baseline, kittens in MMG had longer duration of playing (i.e. ‘pawing’, %) (35 ± 34) than CG (7 ± 12, P  = 0.001) at 1 h postoperatively. This study identified behavioral differences between painful and non-painful kittens following ovariohysterectomy contributing to feline acute pain assessment.

Pain causes behavioral, autonomic, and neuroendocrine changes and is a common cause of animal welfare compromise in farm animals. Current societal and ethical concerns demand better agricultural practices and improved welfare for food animals. These guidelines focus on cattle, sheep, and pigs, and present the implications of pain in terms of animal welfare and ethical perspectives, and its challenges and misconceptions. We provide an overview of pain management including assessment and treatment applied to the most common husbandry procedures, and recommendations to improve animal welfare in these species. A cost-benefit analysis of pain mitigation is discussed for food animals as well as the use of pain scoring systems for pain assessment in these species. Several recommendations are provided related to husbandry practices that could mitigate pain and improve farm animal welfare. This includes pain assessment as one of the indicators of animal welfare, the use of artificial intelligence for automated methods and research, and the need for better/appropriate legislation, regulations, and recommendations for pain relief during routine and husbandry procedures.

This study aimed to (1) compare outcome assessments in normal and osteoarthritic cats and (2) evaluate the analgesic efficacy of tramadol in feline osteoarthritis (OA), in a prospective, randomised, blinded, placebo-controlled, crossover design. Twenty cats were included after clinical examination, blood work and full body radiographs were performed. In Phase 1, outcome assessments aimed to differentiate normal (n = 5; i.e. exempt of any radiographic and clinical sign of OA) from OA (n = 15) cats. In Phase 2, OA cats were treated twice daily with a placebo (PG: cornstarch 15 mg) or tramadol (TG: 3 mg/kg) orally for 19 days, with a 3-month washout period between treatments. Evaluations were performed in normal and OA cats at baseline and consisted of: 1) peak vertical force (PVF) after staircase exercise; 2) telemetered night-time motor activity (NMA); and 3) response to mechanical temporal summation (RMTS). After treatment, PVF, NMA and RMTS evaluations were repeated in OA cats. Data were analysed with mixed model methods with an alpha-threshold of 5%. Phase 1: 1) PVF (% of body weight; mean ± SD) was higher in normal (59 ± 10.5) than in OA cats (50.6 ± 5.7) (p = 0.005); 2) NMA (no unit) was not different between groups; 3) RMTS (number of stimuli; median (range)) was higher in normal [29.5 (23.5-30)] than in OA cats [14 (8.5-28)] (p < 0.0001). Phase 2: PVF, NMA and RMTS presented a treatment effect (p = 0.024, p = 0.008 and p = 0.018, respectively). No clinically important adverse-effects were observed. Outcome assessments such as kinetics (PVF) and evaluation of central sensitisation (RMTS) are discriminant of OA status. Mobility measured by NMA was not discriminant of OA status, however it increased in OA cats with tramadol treatment. Nociceptive hypersensitivity quantified by RMTS was evident in OA cats and was responsive to tramadol treatment.

This case series documents the occurrence of isorhythmic atrioventricular dissociation (IAVD) in three anesthetized cats. There are several proposed mechanisms for the development of this dysrhythmia. The cardinal feature of IAVD is that the atrial and junctional rates are roughly equivalent, which aids in ruling out more severe types of atrioventricular dissociation (such as complete heart block), where atrial and ventricular rates are different. Two cats were treated with anticholinergic medication when hemodynamic variables indicated that the loss of coordinated cardiac conduction had negatively affected cardiovascular function as indicated by arterial hypotension. In one cat, IAVD was not considered to negatively affect the cat's hemodynamic status and anticholinergic medication was not administered. In this cat, IAVD spontaneously resolved. Although this rhythm disturbance has been clinically recognized to manifest in domestic felids under general anesthesia, there remains a paucity of literature regarding the development, recognition and treatment of IAVD in this species. From extensive clinical experience, the authors consider this rhythm to occur frequently in clinical practice, and it behooves the feline anesthetist to be familiar and comfortable with the recognition and treatment of this dysrhythmia.

This study aimed to evaluate the analgesic efficacy of two dosage regimens using two different concentrations of buprenorphine in cats undergoing dental extractions. Twenty-three cats with oral disease (8.2 ± 2.2 years old; 4.9 ± 0.9 kg) were included in a prospective, blinded, randomized clinical trial. Cats randomly received either Simbadol (1.8 mg/mL; 0.24 mg/kg, subcutaneously, every 24h: SG, n = 11) or Vetergesic (0.3 mg/mL; 0.02 mg/kg, intramuscularly, every 8h: VG, n = 12) throughout the study. They were admitted at day 0, underwent oral examination/radiographs/treatment under general anesthesia (buprenorphine-propofol-isoflurane-meloxicam-local anesthetic blocks) at day 1 and discharged at day 4. Sedation and pain were scored using the dynamic interactive visual analog scale (day 1) and the Glasgow Composite Measure Pain Scale-Feline (CMPS-F; up to postoperative 8 hours at day 1, 8 am, 4 pm and midnight at days 2 and 3, and 8 am at day 4), respectively. Rescue analgesia was administered with hydromorphone (0.05 mg/kg intravenously on day 1 or 0.1 mg/kg intramuscularly after day 2) when CMPS-F ≥ 5. Resentment defined as any type of escape behavior associated with aversion to drug administration was recorded. Sedation and pain scores, the prevalence of rescue analgesia and resentment during drug administration were analyzed using linear mixed models and Fisher's exact test, respectively (p < 0.05). Pain and sedation scores were not significantly different between groups. Sedation scores were significantly higher up to postoperative 2 hours in both groups. Pain scores in SG and VG were significantly higher up to postoperative 8 hours and 8 am of day 2, respectively, than baseline. Prevalence of rescue analgesia and resentment were not significantly different between groups (SG: 27.3%, VG: 33.3% and SG: 0%, VG: 25%, respectively). Simbadol produced similar analgesic effects to Vetergesic without resentment during drug administration.

The performance of large language models (LLMs) during acute pain assessment in cats has not been evaluated. This study evaluated the agreement of the Feline Grimace Scale (FGS) scoring between four chatbots (ChatGPT, Gemini, Claude AI, and Perplexity) and an expert veterinarian, including bias and limits of agreement (LoA), and whether bias would be reduced when retested after two months. Fifty cat facial images were scored twice, two months apart, by each chatbot using the FGS (ear position, orbital tightening, muzzle tension, whiskers change and head position). The Bland–Altman method was used to analyze bias and limits of LoA. Chatbots showed positive bias, indicating underestimation of FGS scores. Claude AI presented an acceptable bias (< 0.1) suggesting good agreement after retesting. However, its LoA spanned the FGS threshold for analgesia (0.39). The LoA of ChatGPT did not span the threshold, but presented unacceptable bias (> 0.1). Gemini showed unacceptable bias and LoA spanned the FGS threshold. Perplexity showed unacceptable bias and its LoA spanned the threshold after retesting. Most chatbots showed poor agreement and could have compromised analgesia during testing and/or retesting; pain scoring could be overestimated or underestimated to an extent that would cause overtreatment or undertreatment of pain.

Canine neuropathic pain (NeuP) has been poorly investigated. This study aimed to evaluate the pain burden, sensory profile and inflammatory cytokines in dogs with naturally-occurring NeuP. Twenty-nine client-owned dogs with NeuP were included in a prospective, partially masked, randomized crossover clinical trial, and treated with gabapentin/placebo/gabapentin-meloxicam or gabapentin-meloxicam/placebo/gabapentin (each treatment block of 7 days; total 21 days). Pain scores, mechanical (MNT) and electrical (ENT) nociceptive thresholds and descending noxious inhibitory controls (DNIC) were assessed at baseline, days 7, 14, and 21. DNIC was evaluated using ΔMNT (after-before conditioning stimulus). Positive or negative ΔMNT corresponded to inhibitory or facilitatory pain profiles, respectively. Pain scores were recorded using the Client Specific Outcome Measures (CSOM), Canine Brief Pain Inventory (CBPI), and short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Data from baseline were compared to those of sixteen healthy controls. ΔMNT, but not MNT and ENT, was significantly larger in controls (2.3 ± 0.9 N) than in NeuP (-0.2 ± 0.7 N). The percentage of dogs with facilitatory sensory profile was similar at baseline and after placebo (61.5–63%), and between controls and after gabapentin (33.3–34.6%). The CBPI scores were significantly different between gabapentin (CBPI pain and CBPI overall impression ) and/or gabapentin-meloxicam (CBPI pain and interference ) when compared with baseline, but not placebo. The CBPI scores were not significantly different between placebo and baseline. The concentration of cytokines was not different between groups or treatments. Dogs with NeuP have deficient inhibitory pain mechanisms. Pain burden was reduced after gabapentin and/or gabapentin-meloxicam when compared with baseline using CBPI and CMPS-SF scores. However, these scores were not superior than placebo, nor placebo was superior to baseline evaluations. A caregiver placebo effect may have biased the results.