Can cat caregivers reliably assess acute pain in cats using the Feline Grimace Scale? A large bilingual global survey

Abstract

Objectives This study aimed to investigate if cat caregivers could reliably assess acute pain using the Feline Grimace Scale (FGS), and if participant demographics could affect scores. Methods An online survey in English and Spanish was advertised by International Cat Care and other platforms (March–May 2021) using convenience sampling. Eligible participants were caregivers >18 years old and non-veterinary health professionals. Participants and a group of eight veterinarians scored 10 images of cats with different levels of pain. Data were analysed using linear models and intraclass correlation coefficient (ICC; α <0.05). Interpretation of the ICC was <0.2 = poor; 0.21–0.4 = reasonable; 0.41–0.60 = moderate; 0.61–0.80 = good; and 0.81–1.0 = very good. Results A total of 3039 responses were received with 1262 completed answers from 66 countries (86%, 11.1% and 2.9% identified as female, male or other, respectively). Scores for each action unit (AU; ear position, orbital tightening, muzzle tension, whiskers change and head position) and their sum (FGS score) were not significantly different between caregivers and veterinarians, except for muzzle (caregivers 0.9 ± 0.0; veterinarians 0.7 ± 0.1; P = 0.035). The ICC single (caregivers) was 0.65, 0.69, 0.58, 0.37, 0.38 and 0.65, respectively, for AU ears, eyes, muzzle, whiskers, head and sum of scores. Demographic variables did not affect FGS scores. Conclusions and relevance Total FGS scores had good reliability when used by cat caregivers, regardless of demographic variables, showing the potential applicability of the instrument to improve feline pain management and welfare worldwide.

Construct validity, responsiveness and reliability of the Feline Grimace Scale in kittens

“…17 Finally, our classification for ICC values is more conservative than the one used by Altman (<0.2 = poor; 0.21-0.4 = reasonable; 0.41-0.60 = moderate; 0.61-0.80 = good; and 0.81-1.0 = very good), 23 which may contribute to different interpretations of our results and the use of the FGS in the clinical setting. 9 The intrarater reliability of the FGS total ratio scores in kittens was good to excellent, which was similar to previous studies with images from adult cats, when ICCs from the FGS total ratio scores from veterinarians were excellent. 5,10 Orbital tightening and ear position ranged from moderate to excellent, muzzle tension ranged from moderate to good, whiskers position was moderate and head position ranged from good to excellent.…”

“…5 The FGS has demon strated validity and reliability in various acute painful conditions, 5,8 when evaluated using realtime or image assessment, 6 and when used by individuals with differ ing levels of expertise, including cat caregivers. 9,10 Although some of these assessment tools have gone through extensive validation in adult cats, none have been uniquely validated in kittens. Nonetheless, early age neutering (⩽4 months of age) is now common prac tice in feline medicine and is supported by organizations such as the International Society of Feline Medicine for optimal health, social development and population con trol.…”

Optimising postoperative pain management in cats undergoing ovariohysterectomy

“…14 Another similar study aimed to investigate the effect of participant demographics on cat caregivers' reliability in assessing acute pain using the FGS. 15 This study also showed that FGS scores had good reliability when used by cat caregivers, regardless of demographic variables, demonstrating the potential applicability of the instrument to improve feline pain management and welfare worldwide. 15 Providing a clear explanation of how to identify signs of pain is given before hospital discharge, cat owners can reliably assess behavioural changes associated with acute pain during the postoperative period Following on from these studies, Hillen and colleagues' study 9 not only rigorously adheres to scientific methodology but also recognises the practical importance of involving cat owners in assessing their pets' pain experience.…”

Perceptions and opinions of pet caregivers in mainland and Hong Kong China about surgery, pain management, and anesthesia in dogs and cats

“…Surgery, pain management, and anesthesia are fundamental areas of small animal veterinary services that involve the collaboration between veterinarians and pet caregivers for adequate patient care. The experiences and perceptions of pet caregivers play an invaluable role in postoperative care, pain management, and evaluation of the Quality of Life (QoL) of their pets [ 1 , 2 ]. Therefore, a major responsibility of veterinary healthcare professionals is to equip the caregivers with the ability to recognize and prevent pain, and milestones related to postoperative care, making client communication and education the cornerstone of effective veterinary services.…”