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Final Copy 2020 09 29 Mania This electronic thesis or dissertation has been downloaded from Explore Bristol Research, http://research-information.bristol.ac.uk Author: Maniaki, Evangelia Title: Risk factors, activity monitoring and quality of life assessment in cats with early degenerative joint disease General rights Access to the thesis is subject to the Creative Commons Attribution - NonCommercial-No Derivatives 4.0 International Public License. A copy of this may be found at https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode This license sets out your rights and the restrictions that apply to your access to the thesis so it is important you read this before proceeding. Take down policy Some pages of this thesis may have been removed for copyright restrictions prior to having it been deposited in Explore Bristol Research. However, if you have discovered material within the thesis that you consider to be unlawful e.g. breaches of copyright (either yours or that of a third party) or any other law, including but not limited to those relating to patent, trademark, confidentiality, data protection, obscenity, defamation, libel, then please contact [email protected] and include the following information in your message: •Your contact details •Bibliographic details for the item, including a URL •An outline nature of the complaint Your claim will be investigated and, where appropriate, the item in question will be removed from public view as soon as possible. RISK FACTORS, ACTIVITY MONITORING AND QUALITY OF LIFE ASSESSMENT IN CATS WITH EARLY DEGENERATIVE JOINT DISEASE Evangelia Maniaki A dissertation submitted to the University of Bristol in accordance with the requirements for award of the degree of Master’s in Research in the Faculty of Health Sciences Bristol Veterinary School, June 2020 Twenty-nine thousand two hundred and eighteen words 1. ABSTRACT Degenerative joint disease (DJD) is one of the most common causes of chronic pain in cats. Two studies were designed to identify risk factors for DJD in 6-year-old cats by examining prospective data from a longitudinal cohort study, and compare the activity profiles and quality of life of cats with (cases) and without (controls) early owner-reported signs of impaired mobility using orthopaedic examination, accelerometry and owner-completed questionnaires (Feline Musculoskeletal Pain Index (FMPI), VetMetrica). Binomial logistic regression using backwards elimination identified four risk factors for increased owner- reported mobility impairment score in 6-year-old cats: entire neuter status at six months of age (OR=1.97, 95%CI 1.26–3.07), sustained trauma before six years of age (OR=1.85, 95%CI 1.3–2.6), outdoor access at six years of age (OR=1.67, 95%CI 0.96–2.9), and overweight/obese status at six years of age (OR=1.62, 95%CI 1.13–2.33). Case cats scored significantly lower than control cats for the FMPI (p=0.003) and the VetMetrica domain of comfort (p=0.002), but not vitality (p=0.009) or emotional wellbeing (p=0.018). Total pain (p<0.0001), crepitus (p=0.002) and thickening (p=0.003) scores were higher in case cats. Accelerometry differentiated cases from controls with a 90.9% accuracy. Risk factor analysis demonstrated that obesity, outdoor access, and a history of trauma predispose cats to developing DJD, whereas neutering appears to decrease that risk. Changes in joint health as detected by orthopaedic examination and accelerometry reflected owner-reported mobility changes, differentiating cats with early DJD-related signs from healthy cats, whilst the VetMetrica comfort domain score indicated an impaired quality of life of cats with early DJD compared to healthy cats. Being able to recognise signs of mobility impairment earlier would allow interventions aimed at slowing DJD progression, thereby improving feline health and welfare. These findings have identified that orthopaedic examination, FMPI and accelerometry are effective in identifying early DJD-related mobility changes in cats. i 2. DEDICATION AND ACKNOWLEDGEMENTS I wish to thank all the people without whom I would not have been able to complete this research project. I would like to thank to my research supervisors, Dr Emily Blackwell, Dr Jo Murrell and Professor Sorrel Langley-Hobbs for their thoughtful comments and recommendations on my research and this dissertation. I wish to express my deepest gratitude for Dr Blackwell’s guidance, support and encouragement which has been invaluable throughout this study. I am particularly indebted to Zoetis for funding this scholarship and enabling me to move one step closer to my dreams. I am thankful to Professor Séverine Tasker for believing in me and supporting me for the first months of my scholarship. I am grateful to my current scholarship supervisor, Dr Natalie Finch, who has been inspiring me to excel since we first met five years ago and supported me throughout my scholarship (I promise I will finish the calcitonin paper!). I would like to express my gratitude to the Bristol Cats team and particularly Mel W., whose support with recruitment allowed my studies to flourish (sorry for all the extra work Mel!), as well as the Animal Behaviour and Welfare group, especially Helena H. and Livia B., who supported me and had to put up with my stresses for the past two years! I would also like to thank Eli Smith for drawing some of the figures in my thesis. I would like to express my gratitude and appreciation for the owners of Bristol Cats Study cats who have been completing questionnaires year after year, as well as for the owners of all cats who allowed me into their homes to examine their cats; without them I would have no content for my thesis. I am particularly grateful for my family and for all the support they have shown me through this research, especially my partner Richard Smith; I would not have been where I am today without your unconditional support. My biggest thanks go to all the cats I have met during my veterinary career and during this study; you are truly amazing, and this research is for you. My most heartfelt thanks and love goes to Lucy who has not left ii my side since my undergraduate years and has been an inspirational part of my life; you will always hold a special place in my heart. iii 3. AUTHOR’S DECLARATION I declare that the work in this dissertation was carried out in accordance with the requirements of the University's Regulations and Code of Practice for Research Degree Programmes and that it has not been submitted for any other academic award. Except where indicated by specific reference in the text, the work is the candidate's own work. Work done in collaboration with, or with the assistance of, others, is indicated as such. Any views expressed in the dissertation are those of the author. SIGNED: .. DATE: ....................02/06/2020.......................... iv 4. TABLE OF CONTENTS 1. INTRODUCTION ....................................................................................................................................... 1 1.1 GENERAL BACKGROUND .............................................................................................................................. 1 1.2 THE FELINE JOINT ....................................................................................................................................... 3 1.2.1 Physiology ......................................................................................................................................... 3 1.2.2 Joint Disorders................................................................................................................................... 4 1.2.3 Physiology of Pain ............................................................................................................................. 4 1.3 FELINE DEGENERATIVE JOINT DISEASE ............................................................................................................ 7 1.3.1 Definition .......................................................................................................................................... 7 1.3.2 Pathophysiology of Degenerative Joint Disease ............................................................................... 7 1.3.2.1 Pathophysiology of Degenerative Joint Disease-related Pain .................................................................. 8 1.3.3 Prevalence ......................................................................................................................................... 9 1.3.4 Causes ............................................................................................................................................. 11 1.3.5 Risk Factors ..................................................................................................................................... 16 1.3.6 Clinical Signs ................................................................................................................................... 18 1.3.7 Diagnostic Methods ........................................................................................................................ 19 1.3.7.1 History Evaluation and Owner Observations ......................................................................................... 20 1.3.7.2 Physical Examination.............................................................................................................................. 20 1.3.7.3 Radiography ..........................................................................................................................................
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